MEDGATE Philippines is integrating artificial intelligence (AI) into its telemedicine platform. Called AIDA, the chatbot-like system allows patients to self-triage and accounts for risk factors such as allergies and age.

“This helps determine whether a patient should have a teleconsultation, or go to a clinic, or an emergency room,” said Ronald T. Estrella, Medgate Philippines country manager, at a recent event.

Open Web Technology, which developed Medgate’s Android and iOS apps, summarized how AIDA works on its website: it takes as input the patient’s symptoms; then, it goes through a question-and-answer phase to gather more data; ultimately, a recommendation is provided.

Open Web Technology collaborated with technology firm IBM to leverage Medgate’s 11 million historical medical cases collected over two decades to build AIDA. The machine learning–powered symptom checker has already been integrated in Switzerland, where Medgate was founded. It will be rolled out in stages in the Philippines this year.

“Patients suffering from conditions treatable remotely (e.g., the flu) are suggested telemedical cares, those requiring physical attention (e.g., a broken foot) are directed to a family doctor, and those in need of immediate help (e.g., heart attack) are urged to call an emergency line,” according to Open Web Technology.

The local platform saw its number of consultations jump to at least 500 calls per day in 2021 year from 100 calls per day in 2019, leading to a total patient base of 1.5 million.

“You can view Medgate as a virtual hospital,” said Mr. Estrella, who added that Medgate has a resolution rate of 80% — 4/5 of the cases that come through the portal are successfully treated by telemedicine — the rest of the cases are referred to clinics (16%) and emergency rooms (4%).

In these consultations, Medgate employs a medical co-management approach where doctors with multiple specializations consult on a single case. An internist, for example, may also treat a pediatric case to get a better background of and solution for a patient’s condition, contributing to high treatment rate for the provider. Doctors undergo a minimum of 80 hours of training on the platform’s tools and methodology. There is also refresher course every quarter.  

In Switzerland, the platform handles 10,000 daily calls. “We could deliver that number of daily consultations in the Philippines too. We could mirror the Swiss volume with appropriate partnerships,” said Stavros Athanasiou, president of Medgate Philippines.

To achieve this scale, the Philippines has to address infrastructure gaps and increase the number of healthcare professionals in the country, said Mr. Estrella.

“If our government can graduate more doctors and nurses, this will help the healthcare industry in general,” he said. “The government will have to look at telemedicine as a key component of universal health coverage. There are not enough doctors. You have to leverage technology to deliver medicine.”

As of 2019, the doctor-to-patient ratio in the Philippines was 1:33,000 — significantly worse than the global average of 1:6,600.

“If you look at the whole landscape, there are discrepancies,” added Mario M. Silos, chairman and president of Intellicare, a health maintenance organization that has partnered with Medgate. “In the cities, [the ratio might be] one doctor to every 5,000 patients. In the boondocks, that ratio could actually be 1:100,000.”

While advances in 5G and wearables could lead to “immersive high-resolution video experiences” informed by data captured by smartwatches, telemedicine, at its core, is about connecting doctors with patients using whatever technology is available, including basic mobile phones.

Said Medgate’s Mr. Estrella: “We actually don’t need the Internet to use telemedicine. With Medgate, all you need is a phone. You don’t even need to have load. Send us a message and we’ll call you back and bear the cost of that call.”

And if people don’t have phones? Intellicare’s Mr. Silos suggested that barangay centers in rural areas be equipped so that people can call telemedicine providers. “If they don’t have phones, they can access telemedicine through these barangay centers,” he said. “We can begin giving people [remote healthcare] access at the primary level … Telemedicine will probably be the great equalizer.”  P. B. Mirasol