The Dijitali Health Application

An application that combines real time clinical decision support with asynchronous teleconsultations to empower frontline health workers. 

A nurse in rural Kenya is the sole medical provider for her community.  She bears the burden of care for pregnant women, the elderly, and newborn babies, along with children and adults with a host of individual medical complications. She alone carries the knowledge to provide community-based care to an entire population of unique, complex, and chronic health conditions. She provides the best care she can despite these extensive limitations.

Thousands of miles away, there is a well-staffed hospital in which hundreds of physicians trained in dozens of medical specialties care for their community. A patient with a common diagnosis such as Type 2 Diabetes has a team of 4 specialists to ensure he receives optimal care. Knowledge and skills are in abundance and these clinicians, too, provide the best care they can to their patients, yet with the support and collaboration of their medical colleagues.

So how do we send a hospital of experts to support each frontline health worker while also leaving the responsibility of patients in the hands of their local clinicians, ensuring the most culturally competent care?

At The Addis Clinic, we have revolutionized the use of simple technology to connect compassionate, volunteer physicians all over the world with health workers in need of medical decision support and specialty consultations. With an app designed for use in connectivity limited settings, we have brought a hospital of specialized care to the most remote communities on the planet for over 6 years. And we want to do it better.

With the new Dijitali Health app, frontline health workers will have access to 3 important aspects of support:

1) Training Modules- Built into the app, these provide education on topics such as technology skills, telemedicine integration, and case submissions and can be catered to the knowledge gaps identified through the teleconsultations

2) Real-Time Clinical Decision Support- Pre-downloaded on the app, this first line guidance will be available offline as the app is designed for use in limited connectivity

3) Individual Asynchronous Teleconsultations- Using templates within the app, health workers are able to input patient information along with pictures and medical documents and submit cases for a virtual referral. Each case is triaged and assigned to a volunteer physician in our growing network of 100 specialists. The consulting physician receives a notification and responds within 24 hours, all within the platform. The specialist and frontline health worker continue to communicate until a diagnosis, treatment plan, or decision is made to close the case. These teleconsultations bring a hospital of expertise directly to the pocket of health workers.

We believe the transfer of knowledge is the most important use of telemedicine on the international scale. An open source application, the Dijitali app does not require high dollar technology, additional hardware, or 4G support. It embraces a user-centered design meant to empower health workers around the world through something all clinicians rely on- teamwork. 

While The Addis Clinic has provided teleconsultations to frontline health workers for over 6 years, Dijitali Health will be a newly designed application made specifically to meet the needs of frontline health workers operating in the most limited resource environments.

The human connection is the most important element of our teleconsultations, however, appropriate technology allows for the transfer of knowledge that bridges the gap in specialty medical care. Health workers all over the world utilize communication tools to connect with other clinicians (such as email, WhatsApp, and SMS), but most are not well suited for this purpose given their design and limited privacy capabilities.  

Over the next 6 months we will work with developers to design the features and functionality necessary to accomplish the goal of producing the Dijitali Health app. It will be available in 6 months and by 12 months will be in use in over 8 countries. Additionally, we will continue to grow our network of trained, volunteer physicians to ensure we keep up with the demand for teleconsultations. 

At no cost to local organizations, Dijitali Health will bring expert level care to communities across the globe by supporting the local health workforce. We build partnerships with local organizations which increases use by local health workers.

We partner with existing organizations and give access to the Dijitali Health application to them health at no cost. Once a partnership is established, the courses loaded within the application will provide the training and knowledge required for health workers to implement telemedicine at a local level. We continue to support each organization through teleconsultations provided by our network of volunteer physicians.

Through existing technology, The Addis Clinic has facilitated over 1,300 physician connections with frontline health workers caring for patients in remote and underserved settings. This includes life-saving recommendations from specialists in the areas of Internal Medicine, Dermatology, Pediatrics, Infectious Disease, and many others. Our recent survey results show that 94% of health workers believe they have increased their medical knowledge and abilities through using our telemedicine consultations.  

We have an exceptionally experience board of directors led by our founder, and board president, Dr. Stephen Chan. Dr. Chan is clinician-scientist and ABIM-certified physician in Cardiovascular Disease and Internal Medicine. He completed a MD-PhD at the University of California, San Francisco and then completed training in Internal Medicine at the Brigham and Women’s Hospital and in Cardiology at the Massachusetts General Hospital. 

The resources through the Solve community would allow us to bring this new technology to fruition and expand our ability to support frontline health workers in their local communities, increasing the quality and availability of care around the world. Specifically, the technological guidance and experience available through Solve would enable us to produce an application that meets the needs of health workers right where they are and will have a monumental impact on rural and remote patient and their caregivers. 

Technology Assistance- Having a broad network to understand what technology has been developed and what is lacking. We want to learn from others and continue to collaborate in this project, just like we do for any other endeavor. 

Funding- A project of this magnitude would require a more diverse funding stream than we currently have available. 

Marketing- Educating local health systems and organizations on the benefits of bringing clinical education and guidance to their health workers through teleconsultations will require targeted marketing and education to these partners.