BundaBaby Obstetrics Emergencies App

BundaBaby is committed to solving adverse events caused by delays in managing obstetrics emergencies and complications. I committed in creating this app upon encountering many obstetrics patients, especially from rural Indonesia, presenting with obstetrics emergencies that could have been preventable with better knowledge. For example, a patient lost her baby because despite her water having broken a few days prior, local beliefs consider it to be normal and not at all harmful. 

My solution is a step-by-step guidance for patients on emergency situations, where patients can enter their symptom of concern and proceed down a query path to learn the correct management on their part. The app also connects patients with the nearest (and correct) healthcare provider, (eg, midwives or the nearest ER), to prevent delays in treatment.

Scaled globally, by directing patients to the correct action and saving precious time, countless lives could even be saved.

Maternal death in Indonesia currently stands at 177/100.000 births (World Bank, 2017)- on a downward trend, but still comparably high. Newborn deaths stand at 23/1000 births. There are 5.3 pregnant mothers in Indonesia each year, but only less than 6000 OBGYN specialists- and 60% of them are concentrated in the island of Java. (Indonesian Health Profiles, 2017). Although cosmopolitan Indonesian cities provide top-notch obstetrics care, major discrepancies exist in rural areas, with the triple threat of lack of education, lack of resources, and lack of access to healthcare. Many obstetrics emergencies face delays in management due to this, endangering both mother and child.

Lack of education can cause further delays of treatment, especially with the myriad community or traditional superstitions/beliefs regarding pregnancy. Rupture of amniotic membrane, an emergency situation, is prevalently believed to be harmless and only the "water twin" of the baby breaking out. There is no wide knowledge about the harms of post-mature pregnancy, or the management of vaginal bleeding. OBGYN specialists, doctors, and midwives stand at the front line of providing obstetrics education, but their numbers are limited and unevenly distributed, and the method isn't easily scalable. 

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Doctors and healthcare professionals often rely on pragmatic, evidence-based step-by-step guidelines on managing emergencies.The same concept can be applied to patients. With the prevalent lack of knowledge often causing harmful delays in treatment, a simplified step-by-step guide proceeding on the patients' query path can act as a type of preliminary anamnesis, substituting for healthcare providers in the meantime and instructing the patient on the urgency of the situation and what to do next.

BundaBaby is designed to be a simple app, just concentrating on the emergency obstetrics queries. Water breaking, bleeding, unmoving fetus, are among the major first signs of an obstetrics emergency.By choosing one of those signs and entering the required information, the patient then proceeds down a query path that can "diagnose" the patient preliminarily, explain the most likely situation, and give instructions on what to do. 

The app will also connect the patient with the nearest midwife according to the patients' location, or instruct the patient to go to the nearest hospital ER in cases that most likely has surgical implications.This bypasses the complex Indonesian healthcare referral system and provides precious time for early treatment.

The target population is rural to semi-rural patients lacking knowledge about obstetrics management, especially those dealing with emergencies. While antenatal care in Indonesia now has been majorly improved and disseminated, information for emergencies specifically are still lacking and this app hopes to bridge that gap and reduce deaths due to untimely emergency treatment.

I'm currently also working as a general practitioner in such areas, and each development phase of the app will hopefully involve testing and feedbacks from obstetrics patients. 

Diagnosing many obstetrics emergencies, on the fundamental level, do not need complicated data beyond several very characteristic symptoms. This is something that can be easily bridged, especially for rural patients or those with limited access to healthcare, who deserve emergency management and knowledge dissemination just as much as women who live in developed areas. This app is intended to be free, and usable by absolutely everyone. It's heartbreaking to think that many Indonesian fetal deaths were caused by something that an app could have warned, and it should never happen again.

There have been a few HealthTech startups in Indonesia. Alodokter, Halodoc, etc are several well-established startups that rely on the consultation / telemedicine model. They aren't specific for OBGYN and the model isn't exactly suited for emergency situations where we need immediate care.

Sehati is an established OBGYN-related startup that integrates especially with midwives. It has pregnancy tracking features, ANC examination logs, and tele-cardiotocography for midwives. While we think this is a brilliant startup, our app focuses on the emergency side specifically and simply instructions on what the patient must do in cases of emergency. What sets our app apart is its simplicity (that's also suited for more rural users), its patient-oriented feature (that's oriented towards the first point of care, patients), its accessibiity (as the app is meant to be free or extremely affordable, with minimal operational costs due to its simple framework and little need to involve medical professionals as paid consultants)

BundaBaby is a simple mobile app. It is designed to be functional even when offline. We hope to be able to use AI to synchronize the symptoms further with existing databases, increasing its reliability, and it is intended to be constantly improved for ease of use, patient experience, and simplicity.

The Diagnosis App (https://play.google.com/store/...) is highly similar to what we wish to achieve, although we intend our app to be much simpler and tailored to emergency situations- however, it also utilizes AI to synchronize symptoms. We also hope to add a feature to connect the patient with nearby healthcare providers that is correct for the situation- something that could automatically be done by integrating the phone number database and syncing the app with the Phone app.

Our solution has not yet launched. We expect to serve upwards of 1000 patients in the first year, and 10.000 annually by the 5th year.

We hope to launch this app officially in December 2020 / Early 2021.

In 2021, we hope to:

• raise funding
• liaise with the Health Ministry of Indonesia
• advertise and achieve 1000 initial users
• develop iterations of the app according to user feedback

In 2025, we hope to:

• be able to become a prominent initial management app for obstetrics emergencies in Indonesia
• achieve widespread use among patients with upwards of 10.000 annual users, and widespread knowledge/endorsement among midwives and healthcare professionals
• be able to raise funding / develop a business model that allows the app to be completely free

My main limitation is a technical limitation in developing the app, as I am a physician by profession with only rudimentary app developing skills and I am still looking for a partner that can help me develop the technical aspect of the app.

Financial limitations may arise in the app development phase and dissemination phase, although early in the process I do not expect it to be significant.

Legal barriers may arise in my goal to connect the app to healthcare providers directly upon diagnosis, although technically the "referral" should not be considered a telemedicine consultation and therefore any related laws should not be applicable.

Dissemination to the target population is also another aspect facing cultural and market challenges, as the rural population is widespread and often lack access to other population centres.

I hope my technical app-developing limitations can be helped by Solve community or other partners with expertise on this front. 

Dissemination to the target population is also another aspect facing cultural and market challenges. However, smartphone penetration (especially Android) in Indonesia is high, including in rural areas. There should not be major educational, resource, or literacy limitations in the usage of the app per se. However, dissemination would most likely need frontline workers such as midwives or local doctors to introduce the app and advise the app into use. 

I currently have advantages being my profession practicing medicine in resource-limited areas, with direct access and experience with my target population, which will help refine the idea and the app. 

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1 Part time staff

I am a physician with a few years of experience working with rural Indonesian population, including experience providing obstetrics care in a rural healthcare center, which provides me with a clear perspective and experience on the problem that needs to be addressed and the likely solution towards the problem. 

I plan to make the BundaBaby Emergency Obstetricsapp as I previously described, free to download and ad-free for my customers- that is, all pregnant women who wishes to download it. There is an estimated 5.3 million pregnant women in Indonesia every year. Indonesia also has a large market for smartphone app, with the fourth largest user base in the world and an estimated 80 million people using smartphones in 2020. With the constantly increasing affordability of smartphones, it can provide both links to healthcare-limited areas, as well as a large market potential.

After the main (emergency) app has been launched, I plan to expand the app with a pregnancy-tracking, telemedicine, and symptoms-tracking section that is affordable. I believe the expanded section should be able to succeed as it also fulfills a need among pregnant Indonesian mothers- albeit a less "urgent" need- for a sophisticated Indonesian pregnancy-tracking app they could use. 

During the first phase, I plan to fund the app through donations, grants, and funds, potentially through the SOLVE award or other awards as applicable. Once the paid section of the app has launched, the revenues will partially offset the cost, although we expect to continue raising funds and charity donations to fulfill our operational cost. 

We also expect to liaise and gain funding from the Ministry of Health, Obstetrics & Gynaecology Association or other both governmental/NGO bodies that also work towards the same cause.

I am applying to Solve as I feel I lack talented personnel, initial funds, as well tech / business / distribution / scaling expertise. By applying to Solve, I hope to raise initial funds to develop the product up to the final version and launch it into circulation. I hope to gain networks, potential collaborators, assistance in the tech / business / distribution side, and most importantly mentorship in social startup and enterpreneurship to truly develop and refine my product.

I hope to be able to join forces with other talented collaborators that can contribute towards the AI / machine learning and refine the backbone decision-making technology of this solution.

I hope to gain feedback and evaluation on my planned business model, my tech backbone and my revenue model, to assess for its effectiveness and refine it to form the healthiest revenue model possible.

I hope to gain mentorship on marketing/media, product distribution, and stakeholder liaison once I reach the phase of discussion / involvement with the public sector.

• MIT faculty, for mentoring and tech expertise
• CareMother, a Solver Team advancing AI-powered antenatal care in India, which works on a similar theme and can advise on tech, business model and scaling
• Association of Indonesian Obstetricians and Gynaecologists, who can help with endorsement and product distribution

My solution introduces a new method of emergency diagnosis and early treatment, as well as providing a direct hotline in emergency situations to the nearest healthcare worker. Through my solution, pregnant women in resource-limited situations can still have correct management in obstetrics emergencies, by replacing the need for urgent first assessment by insufficient healthcare workers by AI. This solution is also highly scalable and can quickly expand the healthcare capabilities of the region.

My solution replaces the insufficient healthcare workers and resources using AI to perform first diagnosis in obstetrics emergencies. This solution can expand obstetric healthcare to anywhere a smartphone is used and available, and can potentially give great impact towards the lives of pregnant mothers everywhere.

My solution introduces a new method of emergency diagnosis and early treatment, as well as providing a direct hotline in emergency situations to the nearest healthcare worker. We plan to work closely with the government in the implementation of this solution, synchronizing the decision making process to official medical guidelines and to relevant localities. Most importantly, we would sync the part of consultation with healthcare worker with the offical government database for hospitals, midwives and health professionals, and matching the process with the Indonesian medical referral process. We also plan to sync the app with the national health insurance (BPJS) and its app, to further increase seamless medical treatment for the patient. Through my solution, pregnant women in resource-limited situations can have adequate initial response to emergencies and have clear directions to the next point of care and save precious time.