HealDec

Empowering decision makers and connecting communities to care through a comprehensive referral platform

Access to comprehensive infrastructure and manpower is a critical component of a strong healthcare ecosystem. In India, the healthcare system is suffering from low doctor to patient ratios and a lack of well-distributed basic infrastructure. While secondary and tertiary medical care resources are more readily available in major urban areas, semi-urban and rural areas have a deficiency in these services. Unfortunately, the availability of healthcare resources will not change drastically overnight. What can change, however, is how health workers tap into existing resources.

There is currently no formal healthcare referral process being followed across India. The lack of a comprehensive referral system leads to uneven distribution of the patient load across limited healthcare facilities. Uneven utilization of existing resources leads to long wait times, delays in treatment, poor health outcomes, and overall lower quality of patient care. Community health workers, as well as primary care providers, including doctors, nurses and technicians, are charged with making decisions on where to send patients with limited information at their disposal. In a setting with limited healthcare resources, access to real-time information on the capacity and capability of medical care facilities is of critical importance.

Our solution is a comprehensive electronic referral platform that is easily accessible for health workers. The platform contains a robust database of medical care facilities within a region, including all private and public primary, secondary and tertiary care facilities, as well as diagnostic centers and pharmacies. The database includes verified geotags, contact information, services provided and manpower availability of these healthcare establishments. The platform incorporates an algorithm taking into account geographical distance from a patient’s residence, the type of specialty care needed, and other critical factors in order to determine which facility best suits the patient’s needs. Through this platform, medical care providers can refer patients electronically to facilities that can provide them with necessary care. A doctor or a community health worker can use the portal to inform medical care providers at other facilities that a patient is coming and in need of treatment.

This electronic referral system would ensure a close relationship between all levels of the health system, while facilitating citizens receiving the best possible care as swiftly as possible. By providing healthcare workers with the ability to make informed decisions about patient referral, there will be a more balance distribution of utilization of healthcare resources. By tapping into existing assets to a greater extent, patients will be provided with shorter waiting times, the ability to access more targeted care, and overall improved quality of health service delivery.

The challenge of limited medical-care resources is a problem that permeates throughout India and many other countries facing the same constrictions. Not only is the platform conducive to geographic scaling, but there is also strong potential to increase the services provided within the platform in the future. From incorporating pharmacy data, to providing a patient interface, there are several directions in which the technology could grow.

The strength of our proposed solution stems from the fact that it facilitates enhanced utilization of existing resources by promoting connectivity and knowledge enhancement. Rather than expanding upon existing infrastructure, our platform provides a service that connects health workers and communities to medical care providers and facilities that are already available to them. This platform is currently being designed and built. While e-referral technology is used in several western countries, our platform is designed with a very different application in mind, aiming to aid frontline health workers and connect vulnerable communities with healthcare.

The proposed solution aims to collect and integrate the data from all the medical service providers on one single platform to aid in decision making for patient referral. The data collection will initially focus on digitally capturing basic information of medical facilities along with geotagging the data. Once listed, the medical providers will use the platform to update their data (such as availability of a specialist doctor, number of beds, etc.) on a regular basis. As the request for referral is made, the platform algorithm will identify the most suitable medical facility available for quick, affordable and quality treatment.

Over the next 12 months, the focus lies on digital cataloguing the basic information about the medical service providers of Karnataka along with increasing the effectiveness of decision making algorithm through the inclusion of various indicators. We want to upload geotagged verified data such that our backend database is structured and reliable. In the last 2 months, we want to commence the pilot in a Karnataka district to test the efficacy of the solution and improve the backend capability and user experience. Finally, we want to gauge the immediate outcomes of the solution and incorporate user feedback.

The solution is aimed at overcoming the uneven distribution of medical resources by promoting efficient utilization of existing physical infrastructure and human resources. We want to develop and implement the full-fledged solution throughout the state of Karnataka with a population of 65 million citizens. The solution will drastically help medical providers and citizens make better decisions for availing affordable quality healthcare. Furthermore, once the technology has been implemented and established in Karnataka, we want to scale up the solution across India as there are similar prevailing conditions leading to inefficient resource utilization and degraded health outcomes throughout the country.

There are several mechanisms that we will use to recruit health workers to use our platform. Accredited Social Health Activists (ASHA workers) provide primary care services in remote locations. Through discussions with leadership in the ASHA network, we plan to market our platform to the wider community of ASHA workers. We will provide financial incentives for ASHA workers and primary care providers to adopt use of the platform so as to promote its adoption and continued use. By marketing directly to larger medical care facilities, we will obtain their business by showing how platform usage will provide additional patients.

The platform has yet to be deployed.

Upon successfully updating of our database to include the roughly 10,000 medical facilities across the state of Karnataka, we intend to choose Gulbarga, one of the districts in Northern Karnataka region, to launch our product. Our team will onboard the 600 odd medical facilities in Gulbarga to adopt our electronic referral system. Upon implementation, platform usage is likely to impact 0.6 million people in the district. Upon successful implementation of the model in one district, we intend to expand our platform’s reach to the 30 state districts with 10,000 hospitals and 65 million people.

Through the background experience of our multinational team, we possess an extremely diverse skill set required to develop and implement our solution. Our skill set is spread across a wide spectrum covering human centered design, product development, data collection and analysis, managing multiple stakeholder partnerships, developing execution frameworks, conducting qualitative study and implementing high level projects in fixed timelines. Our skill set is further complemented by our knowledge of healthcare systems and their operations at a grass-root level, which makes our team capable of designing and implementing a solution which is effective, realistic and easy to operate.

There are two prospective avenues of garnering revenues for the electronic referral system:

1. Per-case payment from the hospitals: Under the referral system, the initiating facility will guide the patient to the receiving facility for efficient redressal of their health concerns. A per-patient-transfer cost will be levied upon the receiving hospitals if a referred patient has availed the services from that hospital. A percentage of that cost will be given to the initiating facility in order to incentivize them to continue utilizing the referral system.

2. Subscription model for the existing Health Management Information Systems companies: In larger hospitals wherein HMIS systems are present, our electronic referral system will act as an add-on to make the MIS system more robust. We hope to tap into the MIS company market in order to integrate our solution on a subscription basis.

Solve presents a unique opportunity to gain insights from a diverse group of peers and mentors. While our team is comprised of engineers and consultants with experience working within the health ecosystem, we hope to be able to gain additional insights into how to effectively brand and implement the technology. We would forward to receiving assessments of how our platform could be improved, as well as guidance to identify the gaps within our own knowledge that need to be accounted for. Solve also provides a fantastic platform for collaboration with innovators with a range of expertise working in healthcare.

The major challenges in deploying an electronic referral platform in Karnataka and in India as a whole would be: 1) Achieving buy-in on the scale necessary for successful implementation and 2) Conducting successful monitoring of solution implementation in order to assess necessary technology developments. In order successfully achieve this end, we need to develop a structured outreach plan and develop a system of oversight beginning with the launch of pilot. Solve would provide us with the opportunity to learn more about how to conduct outreach, and how to integrate effective monitoring and evaluation mechanisms into our technology.