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SharingintheGlobalEconomyLessonsfromDigitalHealthInnovators
18th AnnualGlobalDevelopmentNetworkConferenceScience,Technology&InnovationforDevelopment
NewDelhi,India
March22,2018JohnCampbell,Jr.ErinSwearing
TheCenterforHealthMarketInnovationsisaglobalpublicgood.
Weenableknowledgesharingbyprovidingaplatformtohostinformation,analysis,andconnectionstosupportinnovativehealthprogramsInlow- andmiddle-incomecountries.
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Identify Analyze Connect
TheSharingEconomy
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SeveralLMICshavehighpercentagesofcellulartechnologycoverage.
ManyLMICshave morethan90%2Gcoverage.1
ManyLMICshavenearly80%3Gnetwork coverage.1
70%oftheworld’spopulationwillhaveaccesstomobiletechnologyin2020– 100,000,000morethosewithaccesstoelectricity.2
Sources: 1. GSMA, (2017) 2. Cisco, (2016)
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Accesstoamobiledeviceconnectsustotheglobalmarketplace.
Wearetrustingothersthatwehavenevermetperson.
Wearegrowingoursocialcapitalandintroducingmorepeopleintothemarket.
Wehavemoreopportunitiestoobtaincapital.
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Weareexperiencinganeweconomicreality.Marketshiftsfosteredbythedigitalrevolutionwillchangehowhealthcareisdeliveredandexperienced.
KeyIssuesinemergingmarkethealthcarelandscapes:Poorcoverage,quality,andlowdigitization
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1 Healthcaredemandinemergingmarketsisgrowing,drivenbyanumberoffactorssuchasagrowingandageingpopulation.
2 Withthegrowingmiddleclassandrisingincomes,peoplearespendingmoreonhealthcare
3 Chronicdiseasessuchasdiabetesarenolonger‘richcountry’diseases,andtheirprevalenceisincreasinginemergingmarkets
4 InLMICs,mostofthehealthcareinfrastructureisconcentratedinurbanareas,whilemorethan50%ofthepopulationlivesinruralareas
Digitalhealthinnovationsdisrupthealthcareatalllevels
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LEVEL 1:SYSTEMS
•Supply-chainmanagement•Integrateddigital platformforbookingand payment
LEVEL 2:CENTERS
•Remotepatient monitoring•Remote diagnostics
LEVEL 3:PROFESSIONALS
•Educationand training•Datacollectionand reporting
LEVEL 4:PATIENTS
•Healthand wellnessinformation
•Medical advicePatients demand affordable, personalized health care in a shared economy Source: United Nations University Press, (2012)
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Improved
health
outcomes
Time
Paperbasedhealth
solutions
Allpaperrecords
Traditionaldigitalhealthmodel
Digitalversionofpatient
informationCoded
Data-centeredSiloed
NewdigitalhealthmodelCloud-basedOpensourceIntegratedSocialMobile
TheshiftfromtraditionaltonewdigitalhealthsolutionsinLMICs
Source:PWCReport,TheDigitalHealthcareLeap,2017
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Digitalhealthinnovationsuniquelyaddressthreepersistentchallengesinemergingmarkets
Access
Quality
• Greaterreachofhealthcaredeliveryviatechnology-basedsolutions
• Greaterandfasterpatientaccesstohealthandwellnessinformationdeliveredviamobilephones
• Enablesfasterandsecurecommunicationanddatasharingbetweenhealthcarecenters,professionals,andpatients
• Resourceoptimization:digitalhealthcanensurethatavailablehealthresourcesareusedmosteffectivelyandwhere/whenneeded
Cost
ResearchQuestions
Inwhatwaysaredigitalhealthtechnologiesadministeredinemerginghealthmarketsthathavemadethemsuccessful?
Howcanhealthmodelsthatutilizedigitalhealthtechnologiesbe integratedintohealthmarkets?
1
2
ResearchApproach
ConductsearchofCHMIprograms
database
1
§ Reviewed366innovativedigitalhealthprogramsinCHMIdatabase
§ 52digitalhealthprogramshadimpactevaluations
Identifydigitalhealth
technologyInnovatorinterviews
2 3
ToidentifypromisingdigitalhealthinnovationsthatareachievingscaleinLMICs
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Identifythedigitaltechnologysolution§ Whatarethecorecomponentsorattributesofthedigitaltechnologythatis centraltoachievingtheprogram’soutcomes?
ResearchApproach
ConductsearchofCHMIprograms
database
1Identifydigital
healthtechnology
Innovatorinterviews
2 3
ToidentifypromisingdigitalhealthinnovationsthatareachievingscaleinLMICs
Digitalhealthtechnologyinnovations
EnablingMarketEnvironment
Synthesisoffindings
4
ConductsearchofCHMIprograms
database
1Identifydigital
healthtechnology
Innovatorinterviews
2 3
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Healthcaredeliveryinnovationthroughdigitalhealth
Twofactorsthatleadtothescaleofdigitalhealthinnovations
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EnablingMarketEnvironment
Digitalhealthtechnologyinnovations
Telemedicinetoextendaccesstocare
mHealth technologiestoimprovethecarecontinuum
Cloud-basedandopensourcetechnologytoenhancetheeffectivenessandefficiencyofhealthworkers
Integrateddatacollectionplatformstosupportdecision-makingandpatientcaremanagement
Fourdigitaltechnologytypeswereidentifiedinouranalysis.
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Telemedicinetoextendaccesstocare
TechnologyType#1:
doctHERs
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• DigitalhealthcareplatformconnectingremotelylocatedfemaledoctorsinPakistantounderservedhealthconsumersvianurse-assistedvideo-consultation
AsherHasan,MDFounder&ChiefExecutiveOfficer
doctHERs leveragesdigitaltechnologytocorrecttwomarketfailures:
1. Accesstoqualityhealthcareforunderservedcommunities2. Inclusiveemploymentforwomen
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WorldHealthPartners:
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Gopi GopalakrishnanPresident
• India-basednon-profitidentifyinginformalhealthprovidersbylivestreamingtoconnectthemtoqualifiedspecialistdoctorsbasedinurbancenters
• SkyHealth telemedicinecentersalsoofferpoint-of-caretele-diagnosisusingaRemediTM kitthattransmitdiagnosisresultsdirectlytothespecialistphysicians
WHP’sutilizestelemedicinetoestablishcomprehensive,large-scale,andcost-effectiveservicedeliveryplatform
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Need to restructure this. Why are the elements in this formation?
Source: World Health Partners, (2013)
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mHealth technologiestoimprovethecarecontinuum
TechnologyType#2:
iKure Techsoft
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• Point-of-caretechnologiesenablecommunity-basedhealthworkers(CHWs)toprovidehealthcaremonitoringanddiagnosticsupport
• MeetsIndianruralhealthcareandpreventionneedsthroughhealthoutreachinitiative,skillsdevelopment,andtechnologyintervention
Sujay SantraFounderandChiefExecutiveOfficer
WirelessHealthIncidentMonitoringSystem(WHIMS)byiKureTechsoft de-fragmentshealthcaredeliveryinIndia
Providestechnology-enabledinfrastructurefordoctors-CHWsinrural
areas
Mobiledatacollection&real-timesharingof
patientdata
Remoteincidencetracking
Accessiblethroughtables&smartphones
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Cloud-basedandopensourcetechnologytoenhancetheeffectivenessandefficiencyofhealthworkers
TechnologyType#3:
MicroClinic Technologies
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• Kenya-basedcorporationdevelopingpoint-of-caretechnologiesforbottomofthehealthpyramid
• ZiDi™isaninnovativeenterprisehealthmanagementapplicationdesignedtoimproveefficienciesandrevenuesforclinics
Moka Lantum,MD,PhD,MSFounder&ManagingPartner
MicroClinic Technologies’mHealth innovationofferspatient-centeredsolutionsthatoptimizeaccessibilityandqualitycare
ZiDi™istheintegrated,onestopsourceenterprisesolutionthatfacilitatesdata-drivendecisions,regardlessofgeographiclocation
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Integrateddatacollectionplatformstosupportdecision-makingandpatientcaremanagement
TechnologyType#4:
access.mobile International,Inc.
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• InternationaldigitalhealthcompanyfocusedonmobilepatientengagementinEastAfrica
• Deploysmobileandcloud-basedtechnologytoproactivelyconnectwithpatientsanddrivehealthybehaviors
• AdvancedanalyticsandAfricanhealthmarketexpertisecreateauniquesolutionforengagement
Kaakpema“KP”Yelpaala,
MPHFounderand
CEO
SaraYelpaala,MPHDirectorofMarketing
&Strategy
access.mobile providesend-to-endengagementsolutionsthatpatients’ownershipoftheirhealthcare
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amHealthisanaffordable,secure,andeasy-to-usetechnologythatsimplifies practicemanagementandimprovespatient engagement
•Groupandindividual messaging•Appointment calendar•Patientrecord management•Practice administration
Provider-sideengagementthroughamHealth
Patient-sideengagementthroughGozee
Gozee isafreewebappthatconnectsuserswithhealthfacilitiesandpharmaciesinthe area
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Keypoints:usingdigitalhealthtechnologiestoscaleimpact
§ Integratedigitalhealthtechnologiesintoexistinghealthprogramsinsteadofcreatingstandalonesolutions
§ Viewdigitalhealthtechnologiesasenablers,notsubstitutesforpeopleandprocesses
§ Designdigitaltechnologiesforandwithend-usersinmind
Telemedicine
mHealth
Cloud-based &opensource
Integrateddatacollectionplatforms
EnablingMarketEnvironment
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NavigatingtheMarket
EnablingMarketEnvironment
Demand
Relationships
Consumer Insights
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Demand
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Youworkinpost-conflictPakistan.HowdidthosefactorsplayintothefoundingofdoctHERs?
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Therewasanopportunitytoreintegratethesewomen,andtherewasanopportunitytoleveragethisunderutilizedcapacitytoempowerwomenbothathomeaswellasintheoffice,onthefrontlines.
- AsherHasan,CEOandFounderofdoctHERs
HowdidtheverticalmarketplayintothecreationofWorldHealthPartners?
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Toreachunderservedmarketsthroughthemarketplace, ifyougovertical,youarenotabletothengettheinterestoftheproviders,,especiallywhenyouaretryingtosellsubsidizedproductsandservices.
- Gopi Gopalakrishnan,PresidentofWorldHealthPartners
Demand
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Opportunitiesfornewengagementsforpopulations
thatthemarkethasatendencytoexclude
ConsumerInsights
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Inanemergingmarket,whatchallengesdoyoufacedrivingdemand?
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Weknowweareaddingvalue.Weknowthattheprovidersandthepatientswantit,butvalueinthismarketis- similartoemergingmarkets– valueisn’tenough.Peoplearen’tpayingbasedonvalue.Ittakesawhiletogetpeopletopayforthevaluethatthey’reseeing.
- SaraYelpaala DirectorofMarketingandStrategyforaccess.mobile
International,Inc.
Howdoestheconsumerinformtheprioritiesinyourmodel?
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[…]thesimpleinterfaces[and]swipeofthescreensinasmartphone[…]wasnotsosimpleforthevillagewomanworkingascommunityhealthworkers.So,weliterallyhadtospendourtimeingivingthemenoughconfidencetousethesystems,andwehadtoreallyensurethatthesymbolswereverysimpleandintuitiveinnature.Therewereseveralotherfactors,forexample,theproblemsofheat,sweat,dust,andinthosesettingshowthewholehardwaresoftwarebehaves.
- Sujay Santra,FounderandCEOofiKureTechsoft
Whatcharacteristicsofanopenmarketshouldasocialenterpriseconsider?
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Whenyougointotheopenmarket,theyarenotlookingforefficiency.Theyarelookingforpremiumexperience.
- Moka Lantum,FounderandManagingpartnerofMicroClinic Technologies
Limited
Whatiskeywhensellingyourvaluetovariousentities?
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Offeringafreeversionofourcloudbasedsolution.Thatthenallowsnon-profitorganizationsothersocialorganizationsevengovernmentstothinkabouttakingthisonandtryingthesystemandseeingthebenefitsandloweringthecosttoenter.
- Kaakpema “KP”Yelpaala FounderandCEOofaccess.mobile International,Inc.
ConsumerInsights
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Offervariedexperiencesofyourmodeltoallowdifferententitiestoexperiencethe
valueofyourservices.
Considerhowvaluecanbeleveragedwhenwillingnesstopayisnotpresent.
KeyPartnerships
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Whatalternativesexistformodelsthatarenoteconomicallyviable?
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Eitherwemakeiteconomicallyviable,whichoftencannothappen,ortheonlyotherchoiceistolockinwiththegovernment. Somehowintegrateorsomehowforgearelationshipwiththepublicsector.
- Gopi Gopalakrishnan,PresidentofWorldHealthPartners
Whatiskeywhensellingyourvaluetovariousentities?
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Interoperabilitywithothersystems.Totheextentthatwecanpartnerwithothercomplementarysystems,thenthatisgoingtomultiplyimpactforeverybody.Withoutinteroperabilityandsharingofdata,andconnectingsystems,it’smakesithardonorganizationsandultimatelyitdoesn’tbenefitpatients.
- Kaakpema “KP”Yelpaala FounderandCEOofaccess.mobile International,Inc.
Asasocialenterprise,howwereyouabletosurviveuntilyouintegratedintothepublicsector?
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Weareanenterprise,whilethatworkisgoingon,attheendoftheday,youhaveabusinesstorun,andthat’sreallywheretheprivatesectorcomesin.Weneedtofigureouthowwecantailorourservicestotheprivatesector.
- Moka Lantum,FounderandManagingpartnerofMicroClinic Technologies
Limited
Whatpartnershipsarekeytomaintainasyourimpactgrows?
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Aswegrowandasweimpactpopulationhealthindifferentways,wewanttomakesurethatwe’realignedwithnationalgoalsandalsothatpublicsectorseesopportunityinthethingswearedoing.
- Kaakpema “KP”Yelpaala FounderandCEOofaccess.mobile International,Inc.
Howimportantareimpactinvestorswhenoperatinginafrontiermarket?
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Pakistanisconsideredafrontiermarketwithfairlyhighriskperception.Alotofdonorsandimpactinvestorsshyawayfromthecountry.Withoutthatsupport,it’sgoingtobeverychallengingforustocontinuetoattractthekindofhumantalent,humancapitalthatweneedtoenableustocontinuetogrow. Alotofthattalentgetsvacuumedupbythemultinationalcorporatesector.
- AsherHasan,CEOandFounderofdoctHERs
Keypartnerships
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Publicsectorofficialsshouldbekeypartnersinthiseffort,butintegration
takestime.
Businessescanbesustainedwithsideprojectsthataremore“market-
ready”inthemeantime.
Interoperabilitycannotbeoverlookedinemergingmarkets.
Criticisms
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Whatwouldyousaytothoseskepticalofusingdigitalhealthtoenhancepatientexperience?
- access.mobile International,Inc.
We see health technology as an enabler, a way to ease painpoints and improve quality and access issues. As an enabler,technology can expedite the process, help shortcut extraneoussteps and facilitate informed decisions. Technology does notreplace the decision making process, it helps simplify andinform it.
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Whatwouldyousaytothoseskepticalofusingdigitalhealthtoenhancepatientexperience?
- WorldHealthPartners
Werealizeourwayisnotthebestwaytoprovidehealthcare.Atanideologicallevel,wewouldlikeeventhepoortogethealthservicesthatcomparewiththe[servicesthe]waybetter-offurbanclassesget--wherethedoctorandthepatientareunderthesameroof,wherethereiseyecontactandbodylanguagenecessaryforempathyandbettermedicaljudgment,andwherethereisacomfortingreassuranceofpersonalconnect.
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DigitalHealthTechnologiesintheFuture
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DigitalHealthTechintheFuture
§ Howdowekeepdigitalhealthtechnologiescosteffective?§ HowdoWEensuredigitalhealthtechnologiesremain
unbiasedtowardscertainend-users?§ Howdowepreventdigitalhealthtechnologiesfrom
disadvantagingserviceprovidersinthefuture?§ Onceadigitalhealthsolutionisintegratedintothemarket,
whatneedstobeestablishedinordertoenablesustainability?
QuestionstoConsider
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ScalingDigitalHealthintheSharingEconomy
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Integratingtechnologiesintothemarket
Opportunitiestoobtaincapital
Increasedsocialcapital
TrustTelemedicine
mHealth technologies
Cloud-basedandopensourcetechnology
Integrateddatacollectionplatforms
References
Cisco,(2016).VNIGlobalFixedandMobileInternetTrafficForecasts.Availableat:https://www.cisco.com/c/en/us/solutions/service-provider/visual-networking-index-vni/index.html?CAMPAIGN=MobileVNI2015&COUNTRY_SITE=us&POSITION=PR&REFERRING_SITE=SocialMedia&CREATIVE=PR+to+VNI+page&_ga=2.16005744.737117080.1521459007-764718862.1521459007
GSMA,(2017).Scalingdigitalhealthindevelopingmarkets:Opportunitiesandrecommendationsformobileoperatorsandotherstakeholders.Availableat:https://www.gsmaintelligence.com/research/?file=c581aa43bdb7b7d236bb937698c2d6fd&download
PwC,(2017).TheDigitalHealthcareLeap.Availableat:https://www.pwc.com/gx/en/issues/high-growth-markets/assets/the-digital-healthcare-leap.pdf
UnitedNationsUniversityPress,(2012).Freeandopensourcesoftwareandtechnologyforsustainabledevelopment.Availableat:https://collections.unu.edu/eserv/UNU:2517/ebrary9789280812176.pdf
WorldHealthPartners,(2013).TheRoleofTelecentresine-HealthSolutions.Availableat:https://www.slideshare.net/tistalks/the-role-of-telecentres-in-ehealth-solutions
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