Self Risk Assesment and Contact Tracing

The current limitations on the movement of people has caused a decline in economic activities putting 50% of global workforce at risk of job loss. Poor healthcare system has left many Sub Saharans dissatisfied with their health.Teleafya is a self managed symptom-based surveillance app that  allows people to return to school and work while controlling the spread  of COVID-19 and maintain a social distance through contact tracing and location based mapping. 24/7 nurse triage centers get patients to the right care faster. If scaled globally, a boost of confidence in infection mitigation by tracking of symptoms will lessen the impact  on the social and economic status of the workforce and protect jobs.  Dispatch centers will create new job opportunities that did not previously exist. Doctors expand reach of care and knowledge sharing. Longterm, a decline in the number  people estimated to be in working poverty worldwide post the pandemic. 

 The international labour organization estimates  almost  25 million jobs could be lost worldwide as result of COVID-19.  It further estimates between 8.8 and 35 million additional people will  be in working poverty worldwide, compared original 2020 estimates.On the low end  we could see global unemployment of between 5.3 million and on the  high end 24.7 million. Health workers are most vulnerable to COVID-19  infection as they are on the frontline in providing care. This causes  anxiety and fear in bringing the disease home to their families. Due to across the board lockdowns, much  needed childcare and schools are closed causing not only a disruption  in the education system but affecting the ability of people to go back to  work.  Manual contact tracing cannot identify  an asymptomatic person that may be infected or who they could have  come in contact with, which increases the likelihood of the spread of the  infection before the symptoms begin to show. 

Teleafya is a digital self assessment symptoms based tracker that disseminates severity alerts and information to end users, healthcare providers and government entities to fight  the pandemic, other risk health symptoms and reduce uncertainty in the populations served. Geolocation is integrated into  the application for users to find the closest hospital, pharmacy, COVID-19 testing and  laboratory center to get immediate care. It also allows users to track areas where there is an infected person to make an informed decision to self-isolate. When in distress, our artificial intelligence uses behavioral and voice analysis to route calls appropriately even if a user doesn't have the strength to determine the next level of care in an emergency. Embedded with GPS Live tracking, the app allows users to track requested medicine delivery to mitigate  the spread of the infection by reducing the number of people an infected person comes in contact with thus mitigating the spread. Patients can converse virtually with providers via video calls and text messaging without ever leaving their home.

Our solution seeks to serve the low-income areas that are usually densely populated and prone to infections, those in rural and remote location who lack adequate access to healthcare and specialty facilities. Interviews with refugee and slum dwellers has given insight into the healthcare problems facing the communities. First year was spent doing research in East Africa region understanding the healthcare problems by interviewing providers, population and transporters. We also researched economic opportunities of providers and the barriers to them in expanding their reach delivering efficient care. 

We also have users from undeserved locations test the application and provide feedback. Most of the residents in these communities indicate they may forgo good care due to lack of transportation, high costs to travel long distances,fear of infection and lack of reliable income to access specialty care. 

Our solution ensures remote patient monitoring (RPM), timely transmission of medical information between patient, provider and community healthcare facility and provides access to mobile health communication (mHealth).

Teleafya slows and tracks the possible spread of an infection through symptom based self assessments that are matched against a database of reference symptoms for early detection of diseases reducing threats to the economy and healthcare ecosystem. Healthcare  workers can rapidly identify if they have been exposed  to a disease by tracking their symptoms and seek the necessary resources to help  protect them, their jobs and their families.  Analyzing the location based data, users make a more informed decision to self isolate rather than government isolating an entire population. Virtual provider support strengthens the access to emergency care.

Government officials and healthcare workers cannot go door to door to reach over 400 million that may or may not be infected to perform risk based symptoms assessments. Crowd sourcing the symptoms  is a cost benefit solution that gathers the data from self assessments, analyzes the symptoms to provide information on regions that may have a breakout. With this data mining capabilities institutions are able to use the  data points to make a more informed decision in isolating specific regions,workers or populations. Detection and isolating regions is done based on crowd sourcing vs the current systems that are manual or  door to door.

Most TeleHealth applications require downloading or logging to various applications to get other healthcare related services.Our solution is one application that supports every healthcare need end to end with every patient in mind. It connects to transport providers, Health Care Providers, Test Centers,Emergency call centers and patients do not have to download or log in to multiple applications to get the support they need for their healthcare. 

There are currently no emergency medical call centers in Kenya or Tanzania nor Eastern Africa that are  focused on the end to end health and wellness of a patient.Our solution seeks to retrofit existing clinics with smart technology that connects to our platform and reduce the time lapse in times of urgency. With one application , we provide the single source for patients to communicate with all their providers and lessen the distance to receive continued care.

Cloud computing infrastructure that allows growth and scale regardless of number of people that sign up to the application.

Video technology adaptive codec selection and WebRTC Api that gives quality video and audio that does not have static signals thus reducing interruptions from background noises.

The programming language used allows for concurrent users without affecting the performance.

Artificial Intelligence to behavioral analysis and call routing to triage center.

Geolocation technology tracks providers within a user's proximity to provide rapid response from providers who are able to quickly pinpoint users location using GPS technology.

The ability to remotely diagnose and evaluate patients in addition to detecting risk symptoms is a widely adopted model that is picking pace in healthcare settings.

According to consultQD a site for primary care physicians and healthcare professionals from Cleveland Clinic, Telemedicine has been used successfully to improve patient access to medical care while reducing healthcare costs. In 2016, an estimated 61 percent of U.S. healthcare institutions and 40 to 50 percent of U.S. hospitals used telemedicine. 

From 2012 to 2013, the telemedicine market grew by 60 percent.

Doctor Ondemand  is an example that is using similar technology but limited to patient - doctor relationship.

According to a primary healthcare journal, A study that  examined whether nurse-led triage assists with managing demand for general practitioner (GP) appointments in primary care,a total of 13,113 GP appointments were saved over the study period reducing demand on general practitioners’ time.

Activities:

• Video call a doctor for emergency care.
• Answer questions about symptoms. 
• Do a search for test center based on location 
• Search for medical records.
• View reported cases in the region based on suspected, active, recovered and death
• Call Dispatch center with interconnected devices

Outputs

• Rapid response to receiving the needed care in time.
• Patients self manage their health and well being.
• Informed decision making in caring for a patient and government ability to enforce social distance without impacting entire population. 
• Health providers and facilities can scale their level of care regardless of location. Reduced distance of travel to seek care.
• Care can transition to a nurse triage center to improve patient engagement and outcomes.

Outcomes 

• More informed population reducing the health security threats because of infectious disease.
• Public gains awareness on areas to avoid thus mitigating the contact and spread.
• Reduced job losses and increased community confidence in government and healthcare response to emergencies.
• Improved Treatment. No missed doctor calls for continuity of care post discharge with regular updates to providers for faster diagnosis.

350,000 of the Nairobi and Tanzania population that currently live in low income settlements are our direct impact patients. We are currently onboarding healthcare workers that are first line responders and providers. Retrofitted smart centers for nurse triaging will see an addition 1000+ jobs created. We estimate this number at 1.5 million to be directly impacted based on our response rate.

Within one year of number we will be serving include additional patients,and other indirect healthcare service providers. We estimate this number at 3.5 million to be directly impacted. 

In five years our target is to increase our reach to the other tertiary healthcare service providers,other countries and rural communities to serve over 10 million people.

By Next Year:

• Fully operational in Kenya and Tanzania with estimated 200k+ downloads.
• Partnered with atleast 30+ micro-clinics per county in Kenya and Tanzania
• Partnered with Government ministry of Health to use the data and distribute information to the community.
• Partner with government test centers.
• Have atleast 3 Dispatch centers that are fully staffed with triage nurses.
• Over 25% increase rate in patient satisfaction with the healthcare system

Five Year Goal:

• Replicate the model in East Africa specifically targeting: Uganda, Ethiopia 
• Replicate model in atleast 5 USA rural states.
• 80% increase in patient engagement and trust in the healthcare ecosystem

Our barrier is a lack of funding to scale,establish the dispatch centers and poor access to reliable  internet for our target locations and population. 

Social stigmas related to infectious diseases may deter people from doing self checks. 

The high cost of technology ownership deters those from rural communities with low income from embracing the technology changes.

Lack of enough end user awareness on our existence and the capabilities of our solution.

We lack access to strategic partners that specialize in infectious diseaseas, business and revenue model framework, Telehealth implementation, Training and equipment supplies allowing our solution to scale and be accessible to rural and remote area residents globally.

Lack of Funding

• Self funding, Government support, Grant fund seeking and other applications 

Social Stigmas 

• Peer to peer mentoring support groups, education, grassroots workshops.

High Cost of Technology ownership

• Partner with  mobile device providers, internet providers, Network equipment suppliers, and healthcare organizations that can donate supplies.

Lack of Solution Awareness

• Advertising on local News channels, branding micro clinics, distributing branded gear,Social media ads

Lack of Access to  strategic partners

• Media outreach and global challenge participation to increase visibility. Partner with CDC, RedCross, Doctors without borders and other healthcare organizations, school institutions,  Community leaders, community based organizations to market products and services.

N/A

Fulltime team Members - 4

Local micro clinicians and nurses part time -10

Our team is made up of diversified talent and  strategic skills that drives the value we intend to deliver both globally and reginal . We are passionate about healthcare and incorporating technology to bridge the gap.  Our micro clinicians  are trained local nurses and doctors.

Our core team is made up of Software Engineer with over 8 years experience in enterprise software architecture and development.Business Systems Analyst and Certified Project manager with over 10 years experience in business process modelling and implementing decision support systems. Registered Nurse Practitioner in Kenya and is region based to better understand and disseminate problems facing the Kenya community in healthcare. Registered Nurse Practitioner in USA with experience in Emergency care coordination.

Kenya:

• Partnered with 2 regional clinics for branding , marketing and raising awareness about the solution in Kenya.
• Partnered with Clinical officers in Bomet County, Mombasa County, Kisii County and Kericho County to educate on Telehealth and Digital Medical delivery
• Partnered with transport providers in Mombasa County and Kericho County.
• Currently seeking an office space for our first  nurse triage smart center.

Key Resources: Technology Experts, Healthcare Practitioners, Infectious disease researchers and experts, Healthcare educators, Customer Service Agents, Internet Network Providers,Donor Network,Teleafya Platform

Key Activities: 

• Infection spread risk Alerts
• 24/7 Answering Service
• Minor urgent care services
• Transportation access
• Care Transitions through information sharing
• Self Risk Assessments monitoring
• Appointment scheduling
• One stop Healthcare Marketplace

Type of Intervention: Remote patient monitoring, Care Transitions, mobile health.

Segments: Providers and Patients and Job seekers

Channels: Online, Mobile App, Micro clinics,Dispatch centers

According to a report, the health of people in sub-saharan Africa is a major global concern. Sub-saharan Africans are relatively unhappy with their health care: Only 42.4 percent are satisfied with the availability of quality health care in the city or area in which they live. This being the lowest level of satisfaction in the world.

We plan to seek sustained donations and grants, earn fees from the healthcare marketplace, provide health IT and Telehealth job skills trainings,raise investment capital and charge for membership fees.

Solve provides us with the platform to connect with potential partners, receive product feedback and mentorship.

It is a learning experience from experts to enhance our product and refine our business framework.

Solve partners gives us the visibility to reach untapped market, healthcare investors and donor network providing opportunity to scale faster.

Partnerships will help us scale our operations to have an interconnected healthcare system increasing patient engagement and satisfaction.

Infectious Disease Experts: Provide knowledge sharing to local doctors.

Nurse Triage Operators: Provide framework, training and mentorship

Strategic Partners: Provide business revenue model expertise 

Technology Providers: Provide equipment and supplies

CDC,WHO,Doctors without Borders, RedCross provide talent.

Donor Network: Provide funding 

The main beneficiaries of our solution doctors and nurses that are risking their lives daily as front line responders in doing assessments for patients that may be infected by COVID-19. They are most vulnerable to being infected by a person a person that is asymptomatic but later tests positive. 

We will use the funding to equip the capacity of the workforce in telemedicine delivery. Through our provided smart care devices, nurses will screen the patient calls, assess symptoms and virtually direct patients to a telehealth physician appointment. This provides an opportunity to expand their operation to initiated dedicated nurse triage centers and employ other nurses scaling income opportunities.

The fear of healthcare workers bringing the disease home to their families adds additional stress to an already tough situation. We strive to keep our first line responders that have to see patients in person well informed through self assessments and tracking the risk of the people they come in contact with by crowd sourcing symptoms and balancing them them against our reference database. With this funding our workforce will continue to deliver care at the comfort of their homes, scale our product to keep them informed on making decisions to return to work. 

Flow of Care 

Addition of artificial intelligence and machine learning to our application helps the system predict and diagnose infectious diseases. A patient inputs their symptoms then the system guides them to the correct level of care based on the risk assessment. This helps diagnose and contact trace faster.

We seek to advance the participation and representation of women through education opportunities and job skills training.This funding will help us scale application to disseminate information on reproductive health, well baby care and other information on issues hindering women from receiving good care.

Data from center for medicare and medicaid services show that between 2004 and 2014, 179 rural counties lost or closed their hospital obstetric services. There is a shortage of maternal health care providers in rural and urban areas. By 2020, it is estimated that the US will have a shortage of 6,000-8,800 obstetricians and gynecologists (OB-GYNs) with a projected increase in that shortage to 22,000 by 2050. The shortage is more severe in rural areas, where many counties do not have a practicing OB-GYN.

Our solution allows pregnant women and mothers in rural areas to remotely connect to providers and community health facilities to  raise concerns and obtain critical information needed to have a healthy pregnancy and baby through integrated video conference, phone calls or texting. Teleafya maps real-time patient data and analytics to a remote provider so as to identify and track high-risk pregnancy symptoms improving mother and baby monitoring. This in turn increases the quality of care for undeserved expectant women. Remote provider monitoring during pregnancy, childbirth and the postpartum reduces cultural, economic, or geographic maternal barriers in care coordination and management for new and expecting mothers.

According to the UN refugee agency, almost half of the refugees in Kenya (44%) reside in Dadaab, 40% in Kakuma and 16% in urban areas (mainly Nairobi), alongside 18,500 stateless persons. These regions usually have poor access to healthcare.

Our solution targets the remote and rural populations including refugee camps that have limited access to specialty care.Through video calls, texts and our 24/7 nurse triage centers, refugees are able to connect to providers remotely to receive care that would otherwise not be able to reach them.

We will use funding to set up devices, triage hubs and train locals on how to utilize our application. 

Winning the people prize will allow us to reach a bigger market through promotion, create more job opportunities for the people of Kenya and Tanzania by adding dedicated dispatch Nurse triage centers in each county, providing telehealth training and onboarding more providers.