How Jivo Connect Clinic Turns One Masterclass Into an Ongoing Referral Pathway

What today would be a 10,000-dollar problem, tomorrow might become a requirement for an LVAD or RVAD and turn into a quarter-million-dollar problem. It is only this afternoon that I wrote such an email for a 14-year-old girl from North Africa, asking for a quarter of a million dollars even to begin treating her. She is in complete heart-lung failure. She is the fourth sibling to have hereditary congenital pulmonary hypertension. Three of them have died.

Going to Africa to do camps is not the answer. That has been tried over the last 30 years by half a dozen people I know. It does not work. It is a financially profitable proposition to go and operate 30 to 40 cases and come back with a reasonable amount of money. But 30 or 40 lives saved is not an answer where 30 to 40 million lives are at stake. The answer is training, treating, and timing.

I would be happy to dedicate a little of my time for weekly or fortnightly consultations. I am happy to travel economy, live a very normal life for 10 to 15 days, and train a bunch of doctors in one specialty clinic on the ABCDs of seeing a valvular heart disease patient, the ABCDs of reporting it, how to follow them up in the community, and what the relevant paperwork looks like.

Africans are not genetically or racially predisposed to have valvular heart disease. It is primarily the socioeconomic factor which makes rheumatic heart disease such a huge problem, almost 20 times the global burden. The lowest rates of calcific and degenerative valvular disease are also found in Africa, which confirms this is not a biological phenomenon.

For stenotic lesions, whether mitral or aortic stenosis, we ought to be talking about orifice area, orifice area indexed to body surface area, pressure half time, and pressure gradients. For regurgitant lesions, it has to talk about jet surface area, vena contracta, pressure half times, and flow dynamics. You ought to be talking about valvular heart disease in terms of the AHA classification of A, B, C: at risk, progressive, and progressed.

The doctor shares patient case details through their dedicated Jivo WhatsApp group. The Jivo team collects and documents the medical information, shares it with the relevant specialist for review, and then schedules a consultation on Google Meet, Zoom or WhatsApp once the doctor, specialist and patient are all available.

It runs on pre-agreed monthly slots, for example the 23rd to 28th of a given month, so doctors can plan patient cases around a known window rather than waiting for an ad hoc opening, across specialties including cardiology, orthopaedics, sickle cell disease, oncology, liver disease and urology.

Photographs of a scan taken on a phone, sometimes with a bedsheet or a child visible in the background, give a specialist almost nothing to work with, while uploading the original DICOM files to a shared Google Drive folder takes minutes and makes proper remote assessment possible.

Yes. St. John's Hospital in Zambia now runs a Connect Clinic telemedicine schedule directly with Artemis, Fortis and Max, giving its doctors a standing line to established Indian hospital brands rather than relying on a single specialist's goodwill.