By Ashlee Starratt

With transcribed files from Abdullah Amir.

Thomene Dilley’s brow furrows as she recalls the night her four-year-old son Faolan’s temperature sky-rocketed past 40 degrees Celsius. After weeks of battling a chest infection and courses of antibiotics that failed to knock it back, Dilley was frantic as Faolan would show signs of improvement and then quickly regress back into illness. By this time, they’d visited several different private clinics around Doha, and made two trips to Hamad Medical Corporation’s Pediatric Emergency Center in Al Sadd in search of a concrete diagnosis and treatment for Faolan’s illness.

When his fever continued to climb at midnight, Dilley posted a distraught call on social media for advice and help. “I put something out on Facebook, and five minutes later I got a call from Dr. Ahmed Yehai. At this point I was in tears and he could hear I was frantic – I was getting ready to take Faolan to the hospital again,” she says. “He just seemed right from the beginning over the phone – he asked me about [Faolan’s] symptoms and what I was giving him, and there and then he said ‘It sounds like an infection’. He said to me ‘Go to the pharmacy, I want you to get this [medication], it’s by the counter’, and I went in and got it. Dr. Ahmed was ready to come from his home in Al Sadd, all the way to Umm Salal where I live – at midnight.” After starting a new course of medication prescribed by Dr. Ahmed, and with regular follow-ups from him, Faolan began to improve and eventually made a full recovery.

(Photo: Hesham Elfeshawy)

It’s experiences like these that keep Egyptian twin brothers and At Home Doc co-founders Hesham and Hatem Elfeshawy going. An engineer by trade, Hesham oversees the business development of the company and its upcoming app, set for release mid-April. While Dr. Hatem Elfieshawy is co-founder and Chief Medical Officer of MediHealth Solutions Pty Ltd. in Australia, and MediHealth Solutions Doha.

Hatem has accumulated 16 years of experience in different medical fields; he spent nine years finishing his specialist qualifications in cardiothoracic and general surgery in Egypt, before deciding to change his scope of practice and move to Australia after successfully acquiring his AMC credentials, and obtaining a general registration with the Australian Health Practitioners Regulation Agency (AHPRA). In addition to running his home doctor business, Hatem is currently finishing the final stage of his cosmetic surgery fellowship in Australia.

The idea of bringing back the practice of traditional medical home-visits and implementing it in Qatar was born after a particularly nasty viral infection left Hesham bed-ridden and questioning whether or not to exhaust hospital emergency room resources for a common virus when there were much more critically ill patients needing emergency care.

So, two years ago, the brothers founded MediHealth Solutions Doha in Qatar – from which the At Home Doc service and app sprung –as a sister company of MediHealth Solutions Pty Ltd. in Australia which was already in operation in the field of home healthcare visits Down Under. While the concept of a visiting home doctor isn’t new, after Hatem’s field experience in the Australian system, the brothers identified gaps where it could be strengthened and made more comprehensive. This included bringing services such as medication delivery, lab tests, and specialist referrals, plus oversight and management for chronic disease as added value to patients in Qatar.

Starting off with a humble Facebook page where patients could reach out to request a doctor’s visit, At Home Doc began offering service to its first clients in February and has already generated a following of customers who would rather put their trust in the level of quality and continuity of care that comes with a home visit. And with the upcoming launch of their website and mobile app, it’s their hope that residents in Qatar will see this as a new platform from which to take ownership of their healthcare options.

(Photo: Hatem Elfieshawy)

How it works

At Home Doc is a primary health-care provider that offers the convenience of having a physician on-call to come to a patient’s home when needed to examine, treat, refer, or organize transfer to hospital if necessary. They also provide on-going continuity of medical care through follow-up visits.

“We have two very important pillars – the quality of the medical practice is number one, and then the quality of the essential technology that’s the core of every business,” explains Elfeshawy. “This digital focus supports the efficiency of our healthcare eco-system, and maybe eventually regulations might change so that anyone who is practicing medicine can participate in this [digital] platform so that physicians can reach people in need as fast as possible.”

Attracting qualified, talented doctors to join a new start-up venture was a challenge the Elfeshawy brothers faced head-on. Receiving full registration and accreditation for MediHealth Solutions Qatar and At Home Doc through Qatar’s Ministry of Public Health helped legitimize the company – and helped with the process of recruitment. Currently, At Home Doc prioritizes those physicians for employment who are certified with the Australian Medical Council, along with those who have undergone Advance Medical Certification training.

Until their website goes live in April, patients can presently access At Home Doc’s services through the telephone number provided through the company’s Facebook page. When a new patient downloads the At Home Doc app, they’ll be asked to register and provide some basic medical details before being linked with a healthcare practitioner who is then dispatched to their home.

“We’re not an emergency provider, so if a person needs an ambulance we can call 999 on their behalf,” Elfeshawy states. “Within the app, if you’ve requested an emergency it actually connects you to the ambulance dispatch through our call centre. Once you initially register with the app, your details are then on-file – your address, any medical conditions and medical history. To make the app user-friendly, we don’t ask people to type in their entire medical history in the app – just the basics. This then triggers a notification to our back-end support, and a trained nurse practitioner will call you back to fill in the rest of the information on your behalf.

Presently, At Home Doc is charging QR 350 for a home-visit consultation – a fee Elfeshawy states is very competitive among the range charged by private clinics in Doha, and can be paid directly through the app. Specimen collections and laboratory fees are also charged to the patient at cost, with no additional mark-up on behalf of the service provider. They also provide full access to medical insurance claim forms for processing – and which can be brought to the patient’s home by the responding physician.

“We wanted to do this the right way,” expresses Elfeshawy. “Not just going into business simply to make money – that’s not the case. We want to offer a holistic experience for our patients – we don’t want people to see this as a big opportunity for cash and that we’re driven by money, forgetting the whole concept behind our company – which is actually to provide the best medical practice as we can.”

Healthcare at the touch of a button

The convenience of at-home treatment is a practice that can not only benefit the patient, but also alleviate extra strain on over-burdened hospital resources. Too often patients with minor illnesses that could be assessed and treated by a primary care physician end up going to the hospital emergency room. Elfeshawy explains that in a country such as Qatar, with a high expat population, many people struggle to find a consistent primary healthcare provider. It is his belief that alternative providers such as At Home Doc will help reduce both wait times and the costs associated with patient intake at hospital emergency rooms for non-critical cases.

The company’s roster of attending practitioners can conduct in-home assessments and examinations, carry out sample and specimen collections for lab-work, issue and retrieve pharmacy prescriptions for delivery, assist with hospital transfers, and act as a liaison between the patient and referred specialists or hospital staff – keeping track of their medical records and ensuring continuity of care is adhered to.

“We recently did a specimen collection for a patient who was suspected of contracting the mumps, as he missed his vaccination, so we decided to do a blood test to confirm,” says Elfeshawy. “We’ve established a partnership with labs where we can go to a home and conduct a collection which we then send back to them for analysis. These are Joint Commission-accredited labs and diagnostic imaging providers which we’ve sub-contracted. We have an agreement where they send their staff to a patient’s home to collect a sample, and they provide the results the same day. You receive a phone call with your results and then our doctors return to your home for a follow-up.”

“We’re coming to the next level where the app is going to act as a platform where, if you need to see a specialist, the referral from your At Home Doc physician can be made in our system. Prior to referral, within the app there’s a ratings system. So our doctors might refer you to a specialist and we can show you the ratings this doctor has, so you can choose which one is best for you according to patient feedback. For example, our practitioners may refer you to a pediatrician and you’ll be shown the options. Once your selection is in the system, you get to choose that same doctor again – ensuring greater consistency of care.”

When asked if At Home Doc has plans to be truly round-the-clock, Elfeshawy tells ILQ that they are setting up a time-frame for accessibility that will allow them to be as responsive as possible – even if that means 24/7. And for parents like Thomene Dilley, that level of accessibility is priceless when it comes to quality of care and peace of mind.

“Being a parent is especially frightening when your child is sick,” she expresses. “I had such a bad experience at hospital with this massive doctor holding [Faolan] down just so they could put a stick in his mouth [to examine his throat]. I found that extremely upsetting – but you get that so often sometimes…a lack of sensitivity.”

“As a person living in a foreign country, it’s not that I say doctors are bad – it’s just that you’re used to the systems you have back home, where you might have the same family doctor for decades. So when you’re living abroad it’s sometimes isolating, and it can be really frightening as a mother. So to be able to reach out and have someone come to you and your child – I think the platform is amazing. And in my case with At Home Doc, I suppose the power of social media is amazing as well.”

Here’s how to contact and learn more about MediHealth Solutions Doha and At Home Doc:

Website:www.at-home-doc.com

Telephone: (+974) 7772-0807

Facebook: @CraftingTheFutureOfHealthcare

@athomedoc

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Ashlee

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