You don’t need statistics to tell you there are severe inefficiencies in the South African healthcare system. You just need to look at the long queues at clinics and hospitals. Or if you’re fortunate enough to afford private healthcare, try and make an appointment with specialists (months’ long waiting lists aren’t uncommon).

It is worth noting, however, that the waiting list at one Eastern Cape Hospital for knee and hip replacements is over a decade long. Across the Gauteng public healthcare system, meanwhile, wait times for the same operations can be up to five years long.

That’s to say nothing of the long clinic queues that can cost wage workers whole days of income. While things are undoubtedly better in the private sector, you probably know the frustration of taking time off to see a GP only to be prescribed something you could have gotten over the counter at the pharmacy anyway.

While there are a number of underlying causes behind those inefficiencies, one of the biggest is simply people either going to the wrong place for treatment or not knowing that a pharmacist or nurse could often help them at a fraction of the cost of visiting a doctor. One company trying to overcome these inefficiencies is South African startup HealthDart.

Headquartered in Johannesburg, Healthdart is backed by early-stage investor Founders Factory Africa and was recently selected for the Google For Startups Black Founders Fund 2023 cohort. Its inclusion in the cohort comes with up to US$150 000 in non-dilutive cash awards, US$200 000 in Google Cloud credits, Google Ads support, and one-on-one mentoring from Googlers and industry experts.

HealthDart works by bringing together an array of technologies, including Artificial Intelligence (AI), to make it easier for South Africans to get the healthcare they need at an affordable price.

From healthcare to the business of healthcare

For HealthDart co-founder and CEO Njabulo Skhosana, getting the company to this point is a significant milestone in a journey that’s seen him go from a healthcare scientist to someone who’s passionate about changing the business of healthcare.

“I’m a pharmacologist by way of background but then kind of got into the business side of healthcare,” says Skhosana, explaining that several of his family members are also doctors and nurses.

“I think it’s a core passion that’s been instilled in me from a young age,” he adds. “I’ve always understood that it’s important to be interested in the space and contribute however I can.”

After a few years of working in a laboratory, Skhosana realised that he wanted to be at the intersection of healthcare and business. That led to a spell in the UK working for Bupa, a multinational health insurance company, before a 2013 return to South Africa to work in Deloitte Consulting’s Life Sciences and Healthcare division.

When asked why he chose to return to South Africa, Skhosana says it was about being where he could make the most impact.

“There’s a lot of room to actually make an impact and improve things and innovate and I think when you look across the African continent, that’s what it’s really ripe for,” he says.

The HealthDart CEO adds that he also has a burning desire to help Africa realise the downstream benefits that come from improved healthcare systems. Some of the benefits are obvious. The faster people can be treated correctly, for example, the less time they need to spend in the healthcare system, freeing up space for other patients to be treated. But they’re also going to spend less time and money seeking out treatment. That, in turn, means that they can return to work faster and will have more income at their disposal.

The patient interface is vital

While Skhosana stresses that a lot of important work is being done to address inefficiencies in both the public and private healthcare sectors, one key component that’s been missing to date is how patients’ interface with those systems.

“There you’ve got a lot of inefficiency and fragmentation and that leads to high costs,” he says. “By inefficiency, I mean patients often don’t know where it is that they should begin. As a result, they seek care in the wrong places. They might go to the hospital and they just need to go to a clinic or they might start off at a pharmacy instead of going to the doctor when they really need a script.”

That’s where HealthDart comes in. With its virtual triage system, it can help ensure that people seek out the right healthcare providers for their needs. The company launched an AI triage chatbot in 2022 and is now working with Google to take the chatbot to the next level. But its services don’t stop at triage, it also allows people to digitally consult with pharmacists, doctors, and nurses, bringing further efficiencies. It additionally allows patients to book consultations, upload scripts, buy medications for delivery to home or work, and make in-app payments.

Business benefits

The benefits of these added efficiencies don’t just extend to patients either. Healthcare facilities, for instance, can provide a better overall experience. Lower spending by patients, meanwhile, means fewer payouts by medical aid schemes and health insurance companies, allowing them to keep annual increases to a minimum.

“With the state of where technology is now, especially with the efficiencies that you can get from AI,” he says, “you’ve really got the opportunity to fix a lot of issues not just clinically, but also non-clinically.”

It’s for that reason that HealthDart hopes to work with medical aid schemes and insurers in the future.

“If we can get the experience to be a lot more cost-effective, not just for medication, but also visiting the right healthcare professional,” he says, “that is a very valuable IP. We can lend that IP to the medical scheme environment and can utilise the learnings and the technology that we’ve built to benefit medical schemes and primary health insurers to help them run more efficiently.”

The start of digital healthcare

While Skhosana is bullish about the future of digital healthcare in South Africa, and the continent as a whole, he’s quick to caution that South Africa is still at the beginning of its journey on this front.

“We’re still literally right at the beginning of the digital transformation process within healthcare,” he says. “We’ve got 60-million people in the country and I would honestly be shocked if more than a hundred thousand have actively used virtual healthcare services on a regular basis.”