Telehealth provider 19Labs, which has experienced success in partnering with the Government of Guyana in delivering medical services in some of the most remote sections of that country, is now exploring opportunities for expanding its service offerings in Jamaica.

Founded in 2014 by Ram Fish, 19Labs uses Internet connectivity to power his telehealth platform GALE, which the company describes as “an affordable, accessible, easy-to-use point-of-care platform that brings a full clinic experience to schools, rural communities, and pharmacies worldwide”.

According to Fish, the company has been in dialogue with government officials about the dissemination of the technology in communities where access to health care is limited due to resources or challenges with travelling.

“So our involvement in Jamaica started about a year and a half ago through the leadership of the prime minister and minister of health, who are acutely aware that they need to provide health care not just to the main cities but also rural communities. And they know how critical it is for the Government to provide health care equity throughout the nation,” he told Jamaica Observer in an interview.

The GALE platform is used in cases where local health-care professional such as a general practitioner is unable to either diagnose or treat a medical condition. Upon reaching this point, the general practitioner can activate the platform to have a second-level consultation with a specialist.

Once that specialist receives a notification on the GALE platform, he or she can accept the invitation to begin consultation session with the patient and the general practitioner. If the specialist believes that the medical condition cannot be treated remotely, then he or she sends the patient to a major hospital, scheduling an appointment through GALE.

“In those communities we really help local members avoid the need to drive or fly or take a boat to see a specialist,” Fish said, pointing out that in one community in Guyana women can get ultrasound procedures while remotely consulting with an obstetrician-gynaecologist.

“There is a significant impact reducing a natal morbidity for both the mothers and babies, and it’s something that both the community members and the health ministry is seeing a significant improvement in health-care quality within those communities,” he added.

Some of the communities in Guyana in which 19Labs has rolled out its platforms consists of between 300 and 600 people and can only be accessed by boat or aeroplane, or both. But the 19Labs founder is convinced that the implementation process in Jamaica can be smoother since Internet connectivity is better here.

“In Jamaica we are seeing multiple opportunities, some of it being in the faraway communities in mountainside in the centre of the country,” Fish told Caribbean Business Report.

One such opportunity is for remote patient monitoring (RPM) which requires that health-care workers assigned to a health centre visit patients at home to administer blood pressure and blood sugar tests, among others, to monitor the health of those living with non-communicable diseases. Additionally, the GALE telemedicine platform can enable information sharing between health-care providers, as requested by the patient.

“You can get, at the end of the visit, a full report and you can even forward this report to any other clinician or physician so that they can leverage what has been done before,” Fish outlined.

Aside from the technological implementation, Fish, who previously led Samsung’s digital health division, said his company is involved in the operationalising the telehealth platform from a human capital standpoint as well. Emphasising that 19Labs is engaged in a collaborative effort with Government, he added that the company takes a hands-on approach in the implementation of its services.

“We are very sensitive to the operation side not just technology. And if we view it really as what we call public-private partnership, then really we work on providing the operation know-how and the technology as the Government provide the doctors and provide the funding,” he shared.

“We help with analysing problems and monitoring what are the issues, and you know problems can be connectivity problems [or they can be] you haven’t trained one of the community members well…What we have learned in Guyana about what it takes to be successful in deployment, the main point is you need amazing technology but amazing technology is never sufficient. What you really need to succeed is good operations and you need to build a feedback mechanism. You need to have dashboards, you need to focus on community workers and really be able to tie in the community worker because they are the key,” Fish continued.

The 19Labs began its operations in Brazil then expanded its reach into Guatemala. Alongside Guyana, the company is also working in Costa Rica.

When asked if there are any other Caricom markets that the company is looking at, Fish informed Caribbean Business Report that he has prospected Trinidad and Tobago with hopes of beginning ground work in 2024.

“The thing is not all the countries have the budget for it. And geographies have different needs. So it is very different like Trinidad and Tobago have relatively well off and reasonably good vaulting system today. It’s dependent on what the country has in place today and what are the needs,” he said.

In 2018, Minister of Health and Wellness Dr Christopher Tufton launched a telemedicine project in Kitson Town to allow patients who need to see specialist doctors to access one, using telemedicine technology.

The aim of the initiative was to reduce the time to deliver patient care by linking them via teleconferencing/videoconferencing with specialist physicians and clinicians from health centres and certain hospitals, through mobile devices.

“What it meant was that, patients could get consultations without travelling to Kingston, because the service would allow them to be treated via a video link or teleconference,” Dr Carl Bruce, medical chief of staff at The University Hospital of the West Indies (UHWI), told JIS then.