Vladimir Gurdus: A doctor may well be artificial intelligence

27 March 2019

Just like in the rest of the world, telemedicine in Russia can be a driver for the digital health market, which is expected to grow to RUR 90 bln ($1.4 bln), or 2.8% of the entire health care market, by 2030. At the same time, doubts are often voiced about the new industry. Frost & Sullivan analysts note that its development can be hindered by medics’ reluctance to cooperate, the unfriendly regulatory environment and a tangled system of payment for the services. This last obstacle was probably the reason why major mobile operator Megafon’s telemedicine project, Megafon.Health, was suspended. Prior to that, the Erkapharm group abandoned its planned chain of telemedicine booths – a project it developed in partnership with the Doc+ service. Invest Foresight asked Vladimir Gurdus, partner of Team Drive asset management company and co-founder of Doctor Ryadom, a chain of private clinics, about the prospects for investing in the healthcare market.

– Mr. Gurdus, which segments of the digital medicine market are the most appealing to investors?

– First of all, it is worth investing in artificial intelligence-based solutions. Their range is quite wide. It is also promising to invest in the development of medical information systems (MIS), such as electronic document flow, support for clinical decision-making, and systems that read and process data from remote health monitoring devices, etc. Solutions using the P4 medicine approach to make medicine more Predictive, Preventive, Personalized and Participatory are also should be considered. Another area is everything that relates to remote health monitoring, self-diagnostic kits and simplified diagnostic procedures. I think that a certification boom will happen in this area. Many companies will offer solutions allowing people to deal with various medical problems at home. ‘Doctor Google’ is a good thing, but equipment is still needed. A boom will happen when such companies as Apple or Samsung begin to make built-in medical services. By the way, Apple’s first device which is capable of conducting an electrocardiogram using a phone has already been approved by FDA. It will be a breakthrough! In your pocket you will have your own medical kit and you will be able to avoid visiting doctors in many cases. And, of course, storage of medical data is also a very promising and interesting segment.

– What digital medicine investment would Team Drive consider?

– Our project Doctor Ryadom is to a large extent an integrating project related to interaction with the end user. It is not a specialized company engaged in the development of a new cardio device, for instance. It is an ecosystem project. If we see an interesting idea or a project that can benefit the ecosystem, we will consider investing in it. However, there are not too many things in Russia you would want to invest in yet.

– Do you consider entering the global market?

– Yes, we do. But we would prefer to purchase more or less ready-to-use products and not invest in the development. It is just time is of the essence. We are not an incubator or market maker, we are ready to take the end product and introduce it to the market, including testing and piloting. So therefore we do not invest in new developments but in end products and people who are always on the cutting edge and who bring innovations to the market.

– Still, what segments of the industry do you prefer?

– Our priority is primary care, general practitioners. Instead of focusing on specialized medicine, we opted for the primary level, the first stop for a patient’s symptoms and concerns. This is what constitutes about 95% of the average patient’s needs. Thank God, people rarely need a heart transplant. Asthma, hypertension, coronary heart disease, and diabetes are the most frequent complaints. So that is the area we are looking to now.

– That is, if you are looking to solutions, then those are primary care solutions?

– If you are talking about the specific project we are working on, we are currently focused on customer convenience. Without going too deeply into medical ideology, we are trying to improve efficiency to save patients’ time and effort, and also to facilitate decision making. So, for example, instead of Googling “headache what to do” and trudging through tons of garbage on the Web, you could click a button in an application and talk to a doctor. That would be really quick, easy and convenient. The next stage would be to connect you with your selected primary care provider. By the way, your PCP may well be artificial intelligence, which would analyze your complaints and previous recommendations, and would later remind you that you had high sugar level in your test three months ago, and suggest that you do another test. This is what we want to invest in – this is our medical and service concept.

– Do you believe in telemedicine?

– This is not about believing in telemedicine or not. It is about the level of confidence in the current model. You could serve borsch for breakfast and, if your family refused to eat it, conclude that breakfast has exhausted itself as a format. There are certain development phases the industry has to go through, where relevant culture should emerge. Now we are helping the existing doctors with digital technology. So far, people do not yet have the habit of entering a booth and sticking a finger into an unknown device to diagnose themselves. They are not accustomed to this yet. They have to overcome their fears to press a button and talk to the doctor. And if they have to enter a booth and let some unknown device to take their blood… this is a bit unusual and can only work as part of a system. For instance, a patient talked to a doctor who suggested visiting the nearest pharmacy with a self-diagnostic booth and taking a blood test. In 20 minutes, the patient receives the results and the doctor’s recommendations. So a just a booth without a doctor’s consultation is not going to work.

– How does your project differ then?

– We try to look at the healthcare system through the eyes of a patient. It is not an accident that we started as an insurance company: I personally took part in the establishment of private medicine insurance in Russia. And private medicine insurance is all about providing medical care for reasonable money in a comfortable way. We are following the same principle. We are adapting the healthcare system to the needs of patients. Unfortunately, the Russian healthcare system has always been neglecting patients: everything in it centers around doctors. We are trying to make patients the center of attention. The Russian Healthcare Ministry knows about this trend too. We are striving to meet individual needs of our clients, therefore we have so many of them.

– Will there be a boost to the development of telemedicine if it is included in the obligatory medical insurance?

– It doesn’t matter. It will happen when people will use telemedicine more actively. Even if only 10% of the 3.8 mln people with an access to our telemedicine use Doktor Ryadom, it would be a great breakthrough. And if they like it, they will use it again. I am sure that telemedicine is very convenient. We offer an affordable product at just RUR 4K-5K per year for the digital assistant.

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