Ithaka - Supporting Patient Journeys

Ithaka is a digital health steward that empowers patients to effectively manage chronic disease onboarding health journeys.

Fragmented coordination of services by healthcare providers is a global problem and a major driver of inflated healthcare costs and poor outcomes. Although there are multiple digital interventions targeting parts of the continuum of care for chronic conditions (prevention, screening, education, monitoring), there is no solution that ties them together and guides the patient through their health seeking journey.  This poor coordination makes the management of chronic illnesses more expensive and less sustainable, despite the existence of tools and processes proven to be successful in managing these conditions.

For patients, the early stages of being diagnosed with a chronic illness can be particularly challenging and cause significant financial and/or emotional distress. People often have great difficulty in understanding the instructions given to them as they are overwhelmed by vast amounts of new and intimidating information. As a result they tend to drop out of the system and are not seen again until the symptoms of their illness have progressed, negatively impacting their long-term prospects.

Well-designed mobile-phone-based customer service tools have proven to be remarkably efficient in the delivery of services and are often preferred by customers for common tasks.  This is because they empower the customer/patient to choose how and when they engage with the healthcare system. Further, patients are able to select the questions that they consider most relevant as well as their preferred learning methods.

Ithaka is a mobile-based tool developed by Aviro Health to empower patients with engaging guidance, support and learning that can improve the journey of being newly diagnosed with a chronic condition like diabetes or HIV. It is a patient-centered solution that features bespoke user profiles tailored to increase the likelihood of successful journeys. The platform is designed to actively involve users and was built using human-centered design and three empirically proven pillars for effectively shaping patient journeys: 1) Engagement via gamification 2) behavior change via reimbursements and 3) customised patient management via feedback loops.

Healthcare Providers are supported by our experts in mapping their patients’ journeys and setting up the appropriate content and features to best serve their clients, maximising the impact of their existing resources.  The tool can be easily integrated into existing systems and features dashboards and analytics in order to provide access to real-time information. This enables healthcare professionals to make informed decisions and provide care that is not only efficient but also evidence-based.

Health providers use Ithaka to:

• increase uptake of critical disease management tools and services;

• reduce costs of patient coordination and avoidable complications;

• improve the provision of services;  

• improve visibility into patient experience and challenges to the continuum of care (stock-outs, service problems, etc).

By using the platform, healthcare providers can measure the impact of their patient programs across all modes of engagement (both in-person and digital) and refine program effectiveness for each patient segment.  Ithaka is a powerful tool for patient empowerment and task-shifting of the routine drudgery of coordination of care to technology, critical components for better management of the early phase of chronic care management globally.

Ithaka combines several existing technologies into a new application and process that meets pressing and unmet health needs, all with a focus on having an inclusive and patient-centered approach. Ithaka includes a progressive web app, chat messaging, gamification and continuous optimization/customization in order to create a convenient and accessible experience for most patients. The platform is carefully designed to meet patient needs by using innovative tools such as interactive video and unique patient paths to engage and monitor patients. This reduces the burden on health workers so that they can concentrate on higher-touch health services.

Ithaka is a mobile-phone based platform that benefits from the smartphones' anonymity, convenience, and empowerment.  The platform is currently built on proven, robust and well-understood technologies. In time, we foresee expansion to include newer technologies such as chatbots, AI/machine learning, and voice-based solutions however, as we believe that patient engagement must use mobile technology/apps which enable an “always on” multichannel experience that meets patients where they are and with solutions that truly help them.

In the coming 12 months, we intend to:

1. Onboard, support and track one million patients, primarily in HIV and  with a significant portion in diabetes.

2. Publish 3 research papers detailing the positive benefits of using such a system for patients and clients

In South Africa, scaling requires integration into the Department of Health, who have expressed a strong interest in supporting both independent initiatives and novel approaches to chronic disease. This allows us to penetrate the local market and drive change quickly while substantiating our ability to drive results, economies and satisfaction at the interface of health. We will partner with global technology and health firms to support the tool and data internationally. We can reach 50M newly diagnosed patients in five years by targeting geographies with overburdened frontline workers.

Ithaka will be distributed and supported by insurers, pharmacies, pharma/device manufacturers and departments of health.  They will provide Ithaka to patients at either the point of testing or of diagnosis to help the patient more successfully navigate their condition and the health system. Providing Ithaka to patients/customers will improve the management and adherence to programs and enhance visibility of patient behaviour.  This will allow health payers such as insurers and MoH funders to drive down costs and improve outcomes; and will create loyalty and adherence with those brands providing services or products.

We are building and testing prototypes of Ithaka with 100+ people and are currently piloting the solution for HIV self-test kits in downtown Johannesburg with Wits University. During the trial phase, we will serve ±6,000 clients over a three month period and then scale to 10,000 users/month post pilot with this partner only.

In the coming year, we will reach ±10% (100,000 people) of the South Africans who are self-testing for HIV. In three years, this will rise to 5 million for South Africa and HIV alone.  We will not only empower patients so that they can show that they are more confident and knowledgeable about how to seek care; but we will also support and encourage them to seek care. If, using Ithaka and self-testing to better serve clients, we can increase linkage to care rates by 20%, 50,000 lives would be prolonged.

Musaed is a South African doctor with 20 years of expertise and networks who is well-placed to refine Ithaka for impact and to secure partnerships and funders locally.

Luke is an MBA with 20 years experience in managing and scaling health and technology organizations, often in a business development role.  He will ensure company stability and viability during rapid growth and has the international experience to drive expansion beyond South Africa.

Lebohang has 10 years experience building mobile tools and serving health clients.  She will ensure that the work we do is well-executed and serving our clients and end users.

Our revenue will come from providing clients with a customization of a white labelled version of the platform (amount dependant on the level of customization required), and then charging per user licences.  Our clients will be insurers who want to improve patient chronic disease onboarding; pharma and device manufacturers who want to improve the experience, usage and adherence to their products; major employers who wish to better assist their employees in health-seeking behaviours; and global health donors who want to trackably improve access to care for patients in emerging economies.  

Being based in South Africa gives us a competitive cost base to compete globally as well as a small market with highly skilled medical and technical experts who can help us to quickly refine and test our tool.  By looking at chronic diseases more generally, we allow ourselves to secure funding to tackle a very real ongoing problem in South Africa (HIV) and, by also working on diabetes, we are positioning ourselves as leaders in a global issue.

Aviro recognizes the unique opportunity offered by Solve to facilitate the connections and partnerships required to make Ithaka available globally. As the platform expands to cater to other conditions and to other countries, access to global leaders in the industry will help us learn and grow.  We would specifically benefit greatly in the short term from academia partnerships to develop strategies for measuring/showing proof of impact; and from technology partners to help us ensure that our technical and data architecture is scalable and future-proofed.

We have confidence in our product and business model, and we have a good roadmap for short term scaling. Our key challenges are currently related to data analytics and technology. At present, we do not have a strong enough view into the necessary architecture, or the funds required to support a sufficiently robust build and analytics set-up.  With the competition funds and Solve’s support, we would like to bring on a CTO/CIO. We would provide them with the resources and networks to set up of a robust system and future roadmap to ensure proof of impact, system stability and security.