WHIMS enabled frontline health workers for integrated care

iKure's WHIMS enabled front line health workers for integrated primary care at the last mile rural population. 

Rural India with high burden of diseases confronts critical shortage of health workforce that poses significant challenge in rural healthcare delivery. Various studies reveal the consistent deficit of health workers across the rural terrains, where one doctor serves a community averaging 19,000 people. This gap in services is attributed to lack of training, placement, and retention strategy where solutions are often implemented in silos rather than community responsive. Realizing the unmet demands of health workforce in last mile community, iKure has developed a cloud based platform called Wireless Health Incident Monitoring System(WHIMS) which is designed with an intuitive graphics user interface that even a rural health worker, with basic education can effectively use. Accompanied with WHIMS and Medic Bags, these CHWs are strategically placed by iKure across different care delivery modes to perform household visits, community level health camps, and facility based hub clinics. 

Household visits: The CHWs visit households of the rural patients with integrated Point-of-Care devices (POC) supported by WHIMS to screen, monitor and capture basic vitals, without manual error. In fringe areas, WHIMS offer the capability to capture data in offline mode, and update in the cloud server in online mode. This data stored on the cloud is available to remote doctors for diagnosis, monitoring and assisting tertiary referral. An internal trigger in the app alert CHWs of the potential high risk health conditions, through which they are able to counsel, forewarn and prepare the patient for appropriate medical intervention. Information and awareness on regular antenatal checkup, nutritional counselling, and screening for high risk pregnancy and development delays in children (0-2 years) are also made available through these CHWs at household levels.

Health camps: The CHWs with medical staff are made available at pre-arranged sites (spokes) to provide general doctor consultation with basic medicines and offer referral of patients/subjects to Obstetrician & Gynaecologist(s) and Paediatrician(s) as a part of Maternal and Child Health Services.These camps offer counselling and conduct awareness building programe through certified doctors to sensitize patients on health and nutrition practices, water, sanitation and hygiene issues. it promotes care-seeking behavior among community, bring down cost of care and distance travelled for seeking care and save wage day’s loss. 

Hub Clinic: iKure’s CHWs also offer diagnostic services at hub clinics assist telemedicine services and act as the referral point to assist tertiary linkages. Critical patients are seamlessly escalated to tertiary care utilizing iKure’s strong hospital partnerships. iKure’s CHWs disseminate IEC/BCC messages through mobile phones of its beneficiaries. WHIMS platform can send automated nudges to inform and educate patients. The CHWs collects revenue against different set of services which includes services obtained through diagnostic facility,  pathology tests, nutritional supplements, issuing of digital health cards, medicines and tertiary linkages. The model leverages technology to multiple.  The availability of doctors in rural India, achieved through community health workers that communicate electronically with urban doctors, enables awareness, advocacy and actions for health, and brings sustained impact in socio-economic outcomes at the village level.     

The solution brings technology innovations, scalable model and ecosystem partnership of multiple-stakeholders from community members in the grassroots up to the highest level of the Government to build an integrated care delivery model that is both inclusive and community responsive. 

The solution serves three sections of the community; youth population to develop capacity and skills to earn livelihood locally, women community to earn income and respect, and village community members to benefit from improved primary healthcare delivery model.

iKure has developed cloud based platform called Wireless Health Incident Monitoring System(WHIMS) designed with an intuitive graphics user interface that rural health workers, with basic education can use. WHIMS is accompanied with instruments to measure vital statistics of patients, and for it to be a more reliable diagnostic tool, iKure created Medic Bags with low-cost POC instruments to measure basic statistics. WHIMS is loaded and employed to diagnose patients in remotest areas. The diagnostics are shared in real-time with doctors in these hospitals, who suggest treatments and prescribe medication through WHIMS to CHWs, who relay this information to the patients.

iKure will select 240 village women and 60 male members from districts of West Midnapore, Bankura and Purulia, in West Bengal, India and train them for a duration of 576 hours over 3 months period (8hours/day) to become CHWs. It will build the capacity of these CHWs through integrated technology training where each health activist will serve 5000 populations, impacting 1.5 million rural populations within 2 years of deployment.

We aim to scale up the inclusive model leveraging the captive customer base of iKure and other partners in the network across 20 districts in 5 different states in India and empower 2000 CHWs within 5 years of deployment of the initiative.  

To expand the reach of the care delivery model, the initiative through CHWs will work through different delivery modes. At an household level, CHWs will provide antenatal checkup, nutritional counseling, and screening for high risk pregnancy and development delays in children (0-2 years), through health camps, the village community will get access to information and awareness on health, sanitation and awareness and through hub clinics, the community through CHWs will get access to tertiary referral care. Through different touch points, established by these CHWs, the rural and remotest community will get access to integrated care at reduced cost and distance   

iKure has pioneered the healthcare service delivery  model in India’s resource constraints rural villages  since 2010. Through 400 trained CHWs, it has successfully catered to 8 million rural population, in six states in India across 2300 villages through services such as curative, diagnostic and prevention of diseases, maternal and child health and nutrition intervention, computerised eye care facilities, telemedicine services, and low-cost pathology services.  It directly impacts the village community by building local resources through skills development & capacity building, strengthening the overall livelihoods of the community and conferring sustainability through its healthcare delivery model.

The initiative will focus on replication & adaptation of the approach in three districts of West Bengal with focus on providing CHW training, logistics and marketing support, procure loans for medic bags and enabling CHWs attain sustainable income. The programe will employ additional workforce and collaborate with Govt. level skill development initiatives to expand the outreach in other geographic terrains. We aim to scale up the inclusive model leveraging the captive customer base of iKure  in 20 districts across different states in India and empower 2000VLEs within 5 years of deployment of the initiative to impact 5 million rural population.  

Sujay Santra: Founder & CEO, with an MCA degree from IETE, Hyderabad and strong technical knowledge in Siebel CRM, Analytic, Business Intelligence and R&D, has worked for  12 years in IT firms like IBM and Oracle and formulated iKure in 2010. Dr Lalmohan Banerjee: Senior Medical Advisor & Medical Directorwith more than 35 years of experience has served in the Govt. and Pvt Sector(s) in India, Malaysia, Libya,Maldives, Seychelles, and extensively in the Middle-East.Apart from this, iKure is led by technology expertise, research expertise and competent and motivated ground force to make sustained impact in healthcare delivery. 

The healthcare delivery model offers various revenue streams to make it self-sustainable in the long run which includes:

• Doctor’s consultation fees
• Issuing of Digital health cards
• Services obtained through diagnostic facility
• Services obtained through Pathology lab
• Telemedicine Services
• Services obtained by CHWs for door step healthcare delivery
• Power testing, selling of eye glasses, medicines and nutritional supplements
• Services obtained through tertiary linkages

The initiative will develop a strong product supply chain system to scale up the inclusive solution to meet the wide diversity of needs (both health and lifestyle products) of the rural populations and help CHWs to break even.  Leveraging the methodical livelihood generation schemes offered by iKure(through the above listed revenue streams), these CHWs will promote various products and services through mobile based supply chain application and make them accessible to all even in hard-to-reach communities. Furthermore through strategic partnership with key supporting organizations, across sectors such as businesses, NGOs, philanthropists, and academia, the existing ecosystem partnership of iKure will play a pioneering role in business development, customer acquisitions and building on a robust network in respective community.

We are applying for mentoring, technical expertise, investment opportunities, media and conference exposure from the Solve Partners. We want to leverage the technical expertise of Solve team to make technology more robust, profound and adaptable in global rural health context.   

Key barriers to succeed includes investment, motivated workforce to serve resource constrains settings, technical expertise to scale up and expand our solution. We are looking for technical assistance from solve, mentoring and media exposure to take our solutions in different geographic locations, connect with investors and peer networking.