PreMedicus®

The Covid-19 pandemic has cruelly laid bare the deficiencies of healthcare systems worldwide. We have been horrified and then numbed by unimaginable scenes of desperation as millions suffer and die in the clutches of an invisible enemy that is literally going viral. We at PreMedicus will not stand by helplessly; we are committed to solving the global problem of health system disarray in mass health security events by tapping the vast potential of digital health and AI.

As the 2020 pandemic raged, we built a digital platform by linking patient- and provider-facing mobile applications (apps) to private, secure cloud-based analytics tools that predict disease outbreaks, inform at-risk individuals and communities early, and organize health resources optimally.

Scaling our platform globally would affordably deliver the power of Digital Medicine to vulnerable people, especially in severely under-resourced nations, resulting in efficient healthcare utilization during this and future mass health security events.

COVID-19 disrupted the global health landscape forever, exposing gross deficiencies in even the most advanced healthcare systems, with pandemonium reigning as emergency departments and intensive care units were overrun. The result has been a remarkably rapid digital transformation made possible by congruence in positive patient and provider sentiment regarding digital health and telemedicine.  The paradigm has quickly shifted to favor digitally-enabled, patient-centered, inter-connected platforms that consistently deliver personalized, high quality, cost-effective and efficient population based care.  This is beyond the reach of most of the world’s population if we depend on current health information technology.

PreMedicus® PH is a precision population health cloud platform designed to democratize specialized medical knowledge and overcome the deficiencies of legacy electronic health record systems.  We liberate the patient-provider interaction by unobtrusively embedding technology that provides value to all stakeholders.  We have been in R&D since 2015, steadily building an integrated suite of mobile apps and sensors that work together to digitally streamline critically important medical and business functions in a highly secure cloud environment. These tools engage patients, expedite virtual or in-person evaluation, increase workplace safety, optimize staff workflow, provide clinical decision support, and provide strategic data insights to population managers.  

PreMedicus® PH is a proprietary cloud-based software platform that collects and processes data from our mobile apps and the built-in sensors on mobile devices and wearables to deliver:

1. reliable digital monitoring for signs of early illness;
2. hyper-personalized health status determination for at-risk populations;
3. accurate acuity-based digital triage and demand-based patient-facility matching for symptomatic patients;
4. world-class patient education and healthcare provider decision support;
5. robust population data insights in real time.

 Patients and frontline healthcare workers access PreMedicus® PH from our user-friendly apps on Apple or Android smart phones or tablets.  Using clinical and AI algorithms, our PreMedicus® ER app analyzes patient-entered and local community data to pre-diagnose and accurately triage over 100 medical conditions, then provides real-time specific triage advice with an in-app link to telemedicine, emergency call capability, and GPS guidance to the most appropriate care site. If in-person care is required, our PreMedicus® ASV app for healthcare facilities automates all aspects of the patient-provider interaction.  PreMedicus® ASV is a lean and smart electronic health record tool that intuitively documents the encounter using voice analytics, reformats clinical and billing data in real time to reduce staff work burdens and exposure risks, and improves both patient and health worker experience.  

There is a wide gap between the quality of Medicine practiced in developed and resource constrained nations. Millions of patients die every year around the world without the benefit of life-saving medical management strategies widely available to those in wealthy countries. Even if it was possible, it would take decades to train enough Emergency Medicine, Hospital Medicine and Critical Care physicians to meet global needs when these physicians are already in short supply in developed regions. 

The pandemic has accelerated research in advanced patient monitoring technology, making it realistic to imagine computer-based disease diagnosis at least on par with human physicians coming of age in the near future.  With the worldwide diffusion of smart mobile devices and wearables, rapid advances in computer and sensor technology, and the birth of digital medicine, we will soon offer frontline healthcare workers carefully designed evidence-based software tools so that they can provide world-class healthcare anywhere on the globe.  We now have a tremendous humanitarian opportunity to develop a digital health infrastructure that could dramatically bolster equitable delivery of high quality care at a remarkably reduced cost. The benefits of success to local communities in low- and medium-income nations are almost incalculable.  Spending the same or less for a healthier population would positively affect life expectancy, individual productivity, economic growth, and many other development parameters.

PreMedicus® PH, our precision population management platform, is useful in supporting medical care rendered during “peace time” by transitioning healthcare systems from paper or basic electronic health records to an analytical system designed to foster the patient-provider relationship and benefit populations at scale. In a healthcare “war” like the current global pandemic, our platform rises to its full potential, enabling health and economic systems to deal with the unexpected shocks of a mass health emergency.

PreMedicus® PH has the digital infrastructure and built-in knowledge base to support delivery of individualized, low cost, high quality medical care to millions of people around the world. Our solution will create value for commercial enterprises, faith-based organizations, charities, non-profits and government entities whose mission is population wellness and the mitigation of disease burden in the people they serve. These population managers will see vastly improved care rendered at lower cost by an unfettered and better informed work force. The people using our virtual assistant apps will become so engaged in their own care and empowered with information that they will finally take a seat at the head of the table of their own health management.

We have prioritized customer discovery and market validation with key high level opinion leaders in target markets, understanding their digital health transformation needs over the last 5 years. While in Merck KgaA’s 2016 Digital Health Accelerator cohort we spent 3 months in Kenya evaluating the ecosystem, testing our mobile app and holding focus groups with patients, physicians, pharmacists and telecom leaders.  In 2017 we traveled to England to attend an NHS Digital conference on their urgent and emergency care initiatives. We receive regular information on the U.K’s digital health needs as registered software vendors with NHS Wales, NHS Scotland and Crown Commercial Service. We have received feedback from top 10 U.S. health insurers in 2018 and 2019, interviewed global health leaders in Miami at the 2019 international IFC Global Private Healthcare Conference, and met with life insurance, private equity and venture capital firms since 2019.  All these interactions have deeply influenced our software development strategy, value propositions and business model.

Underserved and medically vulnerable individuals have always been our special focus. We have performed primary research in both developed and emerging nations, carefully evaluating how people ranging from urban African-Americans to tech-savvy Kenyans perceive and interact with our software. We used their input in developing our enterprise solutions. These precious people will have the full power of computer technology working on their behalf to quantify their risks, enhance their well-being, forewarn of predictable diseases, and pre-diagnose illness early allowing for timely intervention.

This confidence stems from our successful integration of powerful synergistic existing computer technologies and sensor technologies to create exponential value. Our pilot study may be the first to document parity of machines and humans in the complex medical task of real world diagnosis and triage decision making. We combine these proprietary algorithms with the power of natural language processing, AI/ML, micro-sensor remote monitoring, world-class medical knowledge databases and global GPS to create a unique platform that delivers on the promises of digital medicine.

PreMedicus® PH helps communities prepare for, detect and respond to health security threats by:

1. identifying and notifying vulnerable individuals;
2. providing concerned, vulnerable and affected individuals guidance and trustworthy information;
3. helping last-mile providers pre-diagnose and triage patients to receive the right care at the right time in the right place using world class clinical decision support and documentation tools;
4. securely storing health system data;
5. recognizing hot spots earlier so that public health and economic systems understand the magnitude and progression of the health emergency in real time and adjust their countermeasures and policies accordingly.

We are in the Pilot stage, having already built and successfully tested a proof of concept mobile application in the real world setting of WellStar Atlanta Medical Center’s level 1 Emergency Department that serves a vulnerable U.S. urban population. We have developed and beta tested the Android and iOS virtual assistant mobile apps, and built the secure and private cloud infrastructure with initial population health functionalities. The pandemic delayed comprehensive testing of our mature platform planned for 2020. We are actively engaging hospital systems, seeking to perform a definitive evaluation of our platform in about 1,000 people.

IBM Watson failed in making accurate diagnoses because human disease manifestations vary and overlap in a wide variety of conditions with vastly different consequences, making purely AI based approaches extremely challenging.  To our knowledge, PreMedicus® PH is the only full service real-time precision population health platform, and is a unique pre-diagnosis, triage and interventional solution.   PreMedicus® PH interacts directly with the patient in real time, providing personalized guidance in the dynamic and fluid environment that precedes the decision to seek or defer medical care. Our Machine Learning Engine develops models from both clinical and AI algorithms to render reliable results.  We risk stratify people before they are symptomatic, directing focused attention on vulnerable populations to prevent illness or buffer its impact.  For example, in patients with chronic lung conditions, we can prevent dangerous and expensive acute flares leading to ER visits or hospital admissions by reporting poor air quality in their specific geographic location, and alerting them by text to limit outdoor physical activity. This level of hyper-personalized population health management is only possible in a platform turns that insights into specific actions delivered directly to the right patients, and to providers within existing workflows.

Our solution is catalytic in that our pioneering work spans computerized medical decision-making and digital remote patient monitoring. Our successful integration of automated medical evaluation and management will accelerate progress in this ecosystem (such as medical grade sensor development for mobile devices and computerized care models), revolutionizing healthcare globally. 

PreMedicus® PH is in the advanced stages of development, and we are preparing for our definitive clinical trial. We are not serving any people yet, so that number is zero. We expect to be serving 100,000 people in one year, and 20 million in five years.

The key success indicators that we monitor against our impact goals are:

1. Achieving high user engagement.

• Metrics: Number of downloads, new users, active users, retention, digital surveys.
• Pilot results: Digital surveys showed an average 4/5 user satisfaction rating.

2. Matching expert physician diagnostic acumen with our digital pre-diagnosis algorithms.

• Metrics: Correlation with top 3 expert physician diagnostic considerations.
• Pilot results: Cardiac (100%), urinary tract (100%), gastro-intestinal (88%), musculoskeletal (87%), neurological (80%), respiratory (75%).

3. Matching expert physician triage accuracy with our digital triage algorithms.

• Metrics: Sensitivity, specificity, positive and negative predictive values.
• Pilot results: 86%, 88%, 93%, 76% respectively.

4. Maintaining >99% system availability.

• Metrics: AWS cloud service up time reports.
• Pilot results: 100% system availability.

5. Quantifying value delivered to population managers.

• Metrics: Population manager supplied cost and quality indices.
• Pilot results: Not applicable to pilot study.

Our plan is to monitor and report these metrics quarterly.

Full time staff: 1

Part-Time staff: 1

Contractors: 12

Dr. Anthony Kimani is a Kenyan physician with 25 years of experience in Pulmonary, Sleep and Critical Care Medicine, and holds an MBA in Management of Technology from Georgia Institute of Technology.  He trained in the U.S. and has lectured and practiced internationally; he recently stepped away from the COVID-19 frontlines as medical director of a busy ICU to advance the digital tools that are essential for effective global healthcare.  He has designed our proprietary pre-diagnosis, triage and risk factor analysis software with a strong focus on patient and provider usability.  He is a co-inventor of complementary patented remote patient sensor technology that we will add to our suite of capabilities.  Our CIO Bill Mennenoh brings technology, strategic planning and complex project leadership from startups to global healthcare companies.  Destiny Kimani, our Chief People Officer is an ordained minister, educator and world traveler in faith-based and non-profit roles.  Our software developers work in India.  

This team brings multi-cultural perspectives on the social, educational, medical, business and health IT needs of our stakeholders.  Seven years of experience in cost effectively developing and testing our high quality advanced capability apps has given our team proficiency in agile and lean software design, scrum process and user-friendly interfaces based on direct input from patients, providers and potential enterprise customers. 

Our primary approach to building a diverse, equitable and diverse leadership team is to find the very best people we can. This means that we see all people as equally unique individuals bestowed with special combinations of gifts and talents. We endeavor to discover and develop the attributes that are critical to our success, regardless of the person in whom they are packaged.  

Our founder is an academically trained black sub-specialist physician, a demographic comprising less than 4% of his field. He has learned first-hand about the tremendous strength of diverse teams from working with and training the brightest minds in Medicine from around the world.

Our global mission mandates a strong and diverse team; we are deeply committed to this and envision having representatives from every continent in our cadre of leaders. Our founding leadership team of 3 already embodies diversity in terms of gender, race, age, nationality and ethnicity.  

We are applying to this Solve Challenge because it dovetails extremely well with our mission, vision and strategic goals, and is a catalyst to the work we have been doing for the last seven years. There is no pivoting involved in carrying out the mandates of the Challenge.

Winning the Challenge would be game-changing by providing remarkable opportunities and helping us overcome multiple high barriers. First and foremost, it would authenticate our vision of a world where any person on the planet with access to a smart mobile device can receive world-class personalized health management, and meaningfully participate in their own healthcare. 

We would have access to the world’s most admired technology companies and health organizations, making it much easier to complete our value proposition validating clinical trial, recruit highly talented staff, and attract high quality capital partners. This synergy would help us solve our business model and price optimization dilemma and open doors to where and when we grow to achieve global reach.

Many minority entrepreneurs, especially those from emerging nations, would be inspired and invigorated by our success. It would be an honor for our team to mentor some of them.

Human capital trained to apply ML/AI and data analytics to solving population health problems is difficult for startups to recruit due to intense competition for talent from far wealthier and highly attractive global technology firms that are increasingly venturing into healthcare.

Digital health is a relatively young field, and business models are still evolving; it would be helpful to work with accomplished business consultants to determine the best way to enter and scale PreMedicus® PH globally.

We are looking for partners that are highly proficient in the ML/AI and data lake capabilities of AWS Cloud to help develop and test our models.

We would be delighted to partner with large healthcare and IT partners that have mentoring and innovation integrated into their very DNA. We will benefit immensely from their experience in developing and globally scaling services and products, their business relationships and their guidance in solving the inevitable problems that will arise.

Our wish list for partners seeking to raise quality and reduce costs in urgent and emergency care is made up of health insurers, large self-insured employers, telehealth companies and in-person healthcare providers. Enterprises that we expect to be highly motivated to collaborate with us are United Healthcare, Amazon Care, Providence St. Joseph Health, University of Pittsburgh Medical Center, and Kaiser Permanente in the USA; and NHS Digital in the UK.  

Amazing IT partnerships would be with Amazon (Sagemaker AI/ML, health data lakes), Google (NLP and GPS analytics) and Apple (health data integration).

R&D assistance in remote patient sensor prototype development from relevant MIT faculty would of great help.

PreMedicus® qualifies for and would like to be considered for the Robert Wood Johnson Foundation Prize. Our precision population health platform can easily and equitably distribute the digital knowledge tools required for health and wellness.  Our software platform offers every American with a mobile device the same individualized medical attention and high quality care, and engages them in their own health maintenance journey. Urgent and emergency care resources are allocated based purely on clinical need and personal vulnerability to disease complications. 

PreMedicus® qualifies for and would like to be considered for The Andan Prize. Refugees are an especially vulnerable population, particularly when housed in crowded and unsanitary living conditions. Early identification of disease outbreaks could save many lives.  Our precision population health platform can easily and equitably distribute the digital knowledge tools required for health and wellness, direct refugees to the most appropriate local health resources by GPS, and forewarn of spreading disease allowing early intervention.  We will offer our software platform at cost to any refugee agency. 

PreMedicus® qualifies for and would like to be considered for The AI for Humanity Prize. Efforts to use AI/ML for more accurate clinical diagnosis have proven to be very difficult because human disease manifestations vary from person to person and often overlap in a wide variety of conditions with vastly different consequences, making purely AI based approaches extremely challenging.  Our Machine Learning Engine develops models from both clinical and AI algorithms to render more reliable results than using either method alone.  Our team would use The AI for Humanity Prize to advance the integration of clinical and machine learning models to give frontline healthcare workers truly augmented clinical intelligence for more accurate diagnosis and better management of acute medical conditions.