INTERVIEW! Accuread brings many firsts in the Nigerian healthcare systems
In 2020, a largely uncharted and coveted field in Nigerian healthcare saw a shift with the establishment of the first indigenous subspecialty radiology reporting company. Dr Chindemu Anosike and Dr Hammed Nainoo, both astute medical doctors, came together to make this a reality.
Employing over 25 radiologists of Nigerian descent practising internationally, their vision was to empower Nigerians with access to accurate radiology reports interpreted by homegrown experts who understand their specific needs. In this interview with Temitayo Ayetoto-Oladehinde, BusinessDay’s senior health journalist, they elaborate on their vision and expansion plans.
What did Accuread set out to achieve?
Anosike:
Accuread Radiology was established four years ago to be a tele-radiology company providing specialist and subspecialist radiology reporting services to hospitals and diagnostic centres in Nigeria. At the time we established it, subspecialty radiology was not available in Nigeria. There was general radiology to clarify. We are talking about subspecialty radiology, which is specific to different aspects of medicine. So just like you don’t have a general surgeon, you have surgeons that specialise in other different aspects of surgery. The same thing has happened in radiology as well.
We were the first company in Nigeria to be set up to be able to provide services to diagnostic centres and hospitals. Before we started Accuread in Nigeria, these services were being provided by Indian and Egyptian companies. We were the first indigenous company to provide the service, and we have managed to displace a lot of those foreign companies, making it a great addition to the Nigerian healthcare space.
Another positive about our community ideology is that we make use of radiologists of Nigerian descent practising in the West and Middle East to reverse brain drain. We are getting Nigerians who have left the country to be able to contribute.
Most of your partners are health facilities specialising in cancer care. Do you major in cancer reporting or analysis of cancer cases?
Anosike:
Cancer hospitals are clients of our group due to their expertise in subspecialist medicine. We provide comprehensive care for these hospitals, including cancer care, cardiology, orthopaedic patients, and neurosurgeons. Our group has specialists who can interpret heart and chest scans, as well as interpret studies for orthopaedic surgeons. We also have subspecialists with therapeutic interests, ensuring that our services are tailored to meet the needs of these patients. Our team also works with neurosurgeons who perform brain operations, requiring specialists in reading scans to interpret and offer their services.
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What enables you to deliver this service?
Anosike:
Teleradiology is a core business that uses technology to bring healthcare closer to people in remote areas. It involves integrating specialists from around the world using IT solutions. Telemedicine allows patients to consult, stay up all night, and talk to them anywhere in the world. The company is bringing radiology to sub-Saharan Africa by uploading images to the cloud, allowing doctors to access, interpret, and send reports via the internet to various centres.
Apart from the reports, we also provide the technological support to enable them to transfer those images to us and also get their readings in a timely manner.
Is this initiative a product of private capital, venture capital, or private equity?
Ninalowo:
Dr Anderson and his team founded a company in 2019 using private capital and a lean system to grow organically without external funds. They are now looking to expand outside Nigeria, with the first expansion going to Ghana. Teleradiology is common globally, but in Africa, there is a lack of human capital to read scans, especially in hospitals. Nigeria currently has only about 500 radiologists for a population of over 200 million people. Aggregating scans from multiple centres to have radiologists working from home or an office could solve the problem of each hospital not having a radiologist.
Teleradiology is currently the only indigenous company in sub-Saharan Africa or Western Africa. The company aims to grow the market with proper investment and continued support. It has been profitable since its second year, making it valuable to the continent. The company is committed to growing its market and believes it is valuable for the continent as a whole.
How do you ensure that your interpretations meet international standards, especially considering the potential risks associated with misinterpretations in the diagnostic segment of Nigeria’s healthcare sector?
Ninalowo:
We are already at international standards. If you look at doctors who adopted our service very early, they are doctors who have worked in the diaspora and understand what it means to get a subspecialty report. Those are the doctors who were employed in our services very early and helped us grow by spreading the word that there is something better than just a radiology report. There’s a subspecialty report where you get feedback from a radiologist. The other thing that is very specific for us is that we are reading for Nigerian patients.
Most of the radiologists that read for us—over 90 percent of our radiologists—are Nigerians. We have a few non-Nigerians read for us based on the subspecialty, but mostly Nigerians. We ensure that every radiologist who reads for us can be contacted by a hospital through our administrators if they have specific questions.
Given the persistent shortage of radiologists and radiotherapy machines in Nigeria, how do you assess the impact of this deficiency on the healthcare system, particularly in terms of unaddressed damages that may be overlooked but require urgent attention and government intervention for resolution?
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Ninalowo:
The government acknowledges that people are leaving Nigeria due to better lifestyles and livelihoods. However, many registrars in Nigeria’s radiology training programs don’t finish residency and go abroad, with 60 percent of students leaving before completing residency. This results in fewer radiologists, with only 500 available for over 200 million people. This issue is particularly concerning in private hospitals, where there is an endemic problem of fewer radiologists than in public centres.
How do we ensure we can continue to serve Nigerian patients even though we can’t stop people from leaving? The only way is through technology. And we have shown that we can do that with technology. Most of our clients—about 90 percent of our clients—do not have a radiologist that sits in their hospital. But they have 25 different radiologists that work for them at all times. And what if you think about the finances of most hospitals? You cannot hire a subspecialty radiologist in every specialty.
How would you describe the Nigerian market’s growth potential, and where do you see Accuread with additional investments injected?
Anosike:
Healthcare is now seen as a commodity tied to the economy, with many people paying for services out of pocket. The lack of a robust health insurance scheme means many people are paying for services out of pocket. New scanners and new hospitals are being built, but there is a shortage of specialists. Opportunities for growth are abundant as new hospitals and diagnostic centres attract more people to use healthcare services.
What do you consider your biggest challenges?
Anosike:
We are not immune from economic challenges. We have talked about technology, which is a major part of how we do our work. A lot of that cost is dollarized. Some of the technologies we use are hosted in the West, meaning that they need to be paid for as a dollar cost.
Most of our specialists are Nigerian, so they get paid in naira even though they are abroad. But we do have certain specialties like cardiac MRI where the specialist we use is non-Nigerian for the simple reason that there are less than 100 people who do that type of reporting in Nigeria.
We are competing for services with the international market because, as my partner said earlier, healthcare is an international business. We have managed to secure somebody who does that service for us among the 100 in the world, and he needs to be paid for it. So all of that is a dollar cost. Those are challenges to our business because, ultimately, we have to keep the costs down to keep it affordable for the centres to be able to make a profit from what they are doing.
But at the same time, we need to keep the service afloat. So we are practising in Nigeria, where there are economic challenges at the moment, but we think that there is a brighter future on the horizon. We think that as more healthcare investment comes in, there will be more people requiring our services, and as the economy turns around, people will be more comfortable embracing our services.
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So in terms of your expansion, you talked about Ghana, going to Ghana, and all that. Are you looking for, or are you already bidding for, some level of investment to come out happy with your expansion?
Ninalowo:
We are expanding into Ghana now. However, we are looking to have a major expansion in sub-Saharan Africa and also look at French-speaking countries in sub-Saharan Africa shortly. We have had investors look at us recently and look at our business model, and we are considering taking up some investments to make sure that we could have the workforce that could do the work and the marketing machine that could get our business out there, because we believe that we can be doing 10 times the work we are doing right now if it is properly scaled.
