Digital Health AI Powered Clinics System for LMIC Countries

• 3.5 BILLION PEOPLE: Half of the world population has no access to essential healthcare services due to a lack of facilities, and/or treatments both in urban and rural locations according to the World Bank and WHO. As a result, patients are often advised to go to public crowded hospitals, far from home in other cities, waiting days to weeks, delaying emergency and safe treatments.

• DOCTORS & HEALTH WORKERS: according to the WHO, there is an estimated shortage of health professionals and 4.3 Million physicians worldwide. In the LMIC countries, it is nearly impossible to provide accurate diagnosis and treatment for sickness and injuries with insufficiently trained health workers, unavailable physicians, costly labs and/or radiology for the ethnic minorities, refugees and underserved communities as factory workers. 

• PHARMACIES / MEDICINES: Treatments, medicines are either expensive, unavailable, and/ or the ones on the market kept in poor safety condition, often with passed expiration dates.

• POVERTY: Around the globe, 800M people allocate more than 10% of their household budget to healthcare, and each year 100 Million falls into extreme poverty. In developing countries, 96% of the healthcare expenses are out-of-pocket which often results in people having to make a difficult choice between healthcare and nutrition, a discriminating biais for women and children.

• COVID 19  PANDEMIC: The global humanitarian crisis has exacerbated the problem and emphasized the need for facilities, physicians and treatments among the population in LMIC countries  (Asia, LATAM and Africa). The vulnerable population was even more at risk such as the one living in slums, camps as poorest communities and refugees, who could not maintain social distances and had little to no sanitation facilities. Additionally the immunization program (COVAX) and the deployment of vaccines demonstrated high inequalities among countries and populations, with insufficient quantities of vaccines to be distributed to all nations for all their population, and LMIC nations' population received little and  delayed distribution in comparison with western and developed nations. Many LMIC have no vaccines factories, cold chains and lack of immunization centers and public health data for full transparency.

• PILOT: In Bangladesh, NBHTS pilot country, the government has deployed 18 thousand clinics to serve 165 Million people, mostly in rural areas. The health workers in those clinics have received only 8 weeks of training. There are no dostor supervision onsite and no technology, radiology or labs. The government offers a basket of 30 types of medicine for free. The alternative is private primary care doctor visit which costs 7.2% of the monthly salary ($13USD / $180 USD).

• FUNDING & GENDER GAP IN HEALTHCARE SENIOR MANAGEMENT: Finally I should mention some discriminations I have encountered since I started my company NBHTS that have tremendously slowed down the deployment of a practical solution to address the lack of  essential healthcare services for the underserved communities, refugees and women around the globe. Firstly as a woman entrepreneur, founder and CEO, in the field of life science, health technology and social impact, we women represent a minority of 4% CEO compared to male with equal qualifications, which reflects on a lack of trust and Gender parity in this industry regardless of the fact that most healthcare services and hospitals relies on women, mostly nurse to ensure the quality of their care.  Secondly, the funding for impact and social changes, especially for projects whose mission is to transform the lives of hard working people in emerging countries and vulnerable communities are not as appealing to investors as tech IP projects for in the developed countries customers, users. It is today a major challenge to raise funds to address these immense inequalities and a change of mindset is needed among enablers and investors.

• SUSTAINABILITY, TECHNOLOGY & SYSTEM: NBHTS is a Healthcare Technology System that develops an IT platform to integrate the most advanced digital health, medical equipment, devices, Artificial Intelligence and Machine Learning to leverage technologies benefit in providing accurate diagnosis and treatment for primary care, Point-Of Care, occupational health, women and child healthcare services within clinics infrastructure in developing and emerging countries.

• EMPATHY, EFFICIENCY & RELIABILITY: For more empathy our healthcare services are provided by company trained Health Workers and for reliability they are supervised by doctors. Health workers are trained by the company to use the equipment, medical devices and technologies to input correct data, and offer a quality service to patients. Clients, patients, are provided with a quality experience, affordable, while technologies enable them to receive faster and more accurate diagnostic, care and treatments. As part of our service delivery, we believe based on our research and observation that it is easier for patients to discuss their conditions when meeting a professional assisted by health IT, devices, and Artificial Intelligence than inputting information in a BOT or app as some health tech device developer consider the future of health, especially when considering the population in LMIC. We understand that regardless of the smartphone penetration among the population worldwide (24% to 95% in 2019), many among our target population have limited resources, sometimes no smartphone, and limited “reading-writing” proficiency. Therefore the best care will come through our supportive and specially trained professionals.   

• DIGITAL HEALTH, AI & DELIVERY: We have sourced / scouted a dozen of digital health solutions from companies interested in collaborating with us. Their solutions include: Electronic Medical Record, AI on primary care triage, heart rate ECG, temperature, throat exam, lungs, skin,  ear pain, asthma, diabetes, drug Subscription, pill box, chronic illness medication (ex tuberculosis), Infection and Communicable diseases diagnosis, Blood & urine Tests (Labs), CBC Blood exam (Labs), fetal - pregnancy monitoring and cervical cancer (women health) and more. Those are some of the most innovative technologies (softwares and devices) solutions existing today,  FDA / CE approved , are usually available only for the richer upper middle class population in developed countries, yet those companies we have reached out to, are interested to work with us to achieve our mission to reduce healthcare inequalities around the globe. We will also consider using telemedicine services with existing patients for ongoing management and/or in the case of epidemics as Covid-19, as remote areas in a secondary stage of development.

• AGILE INCLUSIVE PROCESS: Once the diagnosis and treatment are determined, patients have access to onsite medicines at our pharmacies. This enables us to deliver safe drugs, kept in the best conditions, as an opportunity for pharmaceutical companies to partner with us. Patients / Clients are free to chose if they prefer to use our system or other pharmacies but the accessibility, proximity and quality would make it a best choice.

• PUBLIC HEALTH SYSTEM STRENGTHENING: In times of pandemic and humanitarian crisis, those clinics can support the local health system with treatments and immunizations, while offering data and KPI measurements.

• REDUCE INEQUALITIES & POVERTY: Our system-solution addresses many discrimination and offers equal opportunities for women to work in our clinics, get proper education and training for them to gain financial freedom and contribute to their communities. Moreover, we believe that leveraging technologies will enable us to lower costs while creating more job opportunities and addressing the shortage of healthcare professional, a win-win for every stakeholders.

• NBHTS healthcare system is designed to address the Low Middle Income population, often the poorest social class as refugees in Developing and Emerging Countries population.

• Our pilot market country is Bangladesh, a country of 165 Million people, recognised as an example among nations for alleviating poverty and offering micro-funding to women (World Economic Forum). Bangladesh is thought to be the fastest growing economy in South and SouthEast Asia (Asian Development Bank), yet a country that deals with some essential challenges such as healthcare, climate change (flooding) and food safety among others as the one hosting 1 Million Rohingyas refugees from Myanmar in the 8th most populated nation on earth. Bangladesh is an industrialized country, the second largest producer of ready made garments worldwide working mostly with and for European and North Americans brands. It is also independent on the pharmaceutical production, with a capacity and capability to produce generic medicines. 

• Our pilot target populations are factory workers, mostly women and their families. Many of those workers earn a minimal salary, work for long hours and have no medical insurance to cover them. This means that they can not afford to become sick else they won’t be able to feed their families. We also target all the other workers and employees working in the supply chain and logistics in this and ready other industry sectors in Bangladesh.

• Women in Bangladesh already have access to family planning through several NGOs located in the country and governmental programs. The continuous work of the government to improve primary care had a positive impact on reducing mother and child mortality, as an impact to reduce poverty, enable children a better future and education within smaller families.

• Our initial pilot will be in Urban Bangladesh, Dhaka City. Dhaka is the capital of the country with an estimated population of 22 Million people. Through meetings with the WHO and USAID in Bangladesh, as with our local partners, we were able to identify locations where our healthcare services and clinics infrastructure were most needed. Bangladesh has been undergoing a process of rapid urbanization over the past two decades, with increasing numbers of rural residents moving to urban areas due to poverty and a changing rural environment marked by river erosion and frequent natural disasters. Much of this formerly pastoral population migrated to informal settlements in urban areas, which often lack access to proper hygiene, healthcare, and social services. This caused a balloon in the burden of urban residents without reliable access to primary healthcare services, especially because the government’s capacity to provide services did not scale at the same pace as the changing population dynamics within Bangladesh’s cities.

• While the government has been active in developing the primary care, there are still great gaps and an immense population in need and we believe that our services can be both complementary to the governments, local NGOs as a future partner for growth.

• Workers work for 8 to 15 hours a day, often 6 days a week, mostly for the most lucrative brands while they live in poor conditions, as slums with no sanitation and hygiene. They are often denied the basic and essential preventive primary health care and occupational health and we aim to address this inequality, exploitation, and provide a fair service that will be endorsed by most sustainable brands. With our healthcare system and partnership with factories we can both offer them preventive health, yearly check up and ongoing affordable health services, at a minimal cost to help them maintain good health through our local workers with the best services and equipment. Our facilities, clinic infrastructure will be open early morning to late at night to offer flexibility in accessibility of our health services. Our pricing model is based on the minimal salary to make sure our services are affordable to reduce out-of-pocket spending that contributes to poverty. Moreover our infrastructure and technology company aims to help establish sustainable cities and safer consumption, use renewable solar energy and other systems that are environment friendly.

• Following our successful pilot, with measurable KPIs and data, we will be able to scale in other geographies where health services are as needed. We have already established contacts with potential partners in the Philippines, India, Africa and Latin America. In Africa, we met with the President of  The African Center for Global Health based in Kenya, an expert Women Health. We also met with the people in the ministry of healthcare in Rwanda interested to hear more about our pilot and see collaboration.

While our initial service is a private service, we consider a collaboration with governments for deployment, operation and scaling our service to ensure that more vulnerable people, ethnic minorities, and underserved communities will be able to benefit from quality services that will reduce the existing inequalities.

• NBHTS stands on firm collaboration and partnerships to achieve our mission to reduce inequalities, and our values are shaping our daily activities. NBHTS has defined 13 core values, that are the backbone of the collaboration between all stakeholders from partners, to advisors, team to interns. We are mirroring the need of a new generation that seeks companies that deliver on their promises, where the utmost advantage of  digitalization is to enable global transformation, reduce cost, provide affordability, reliability, efficiency and transparency to serve mankind for good.

• NBHTS was initiated and founded on a collaboration of Bangladeshi entrepreneurs (men) that want the unprivileged communities and people of their country to get quality healthcare and an international woman, social activist and entrepreneur devoted to create better healthcare service (as mental health) to reduce the suffering of every human being, an example of diversity from top down to create a meaningful impact.   

• Galite Valerie Rabi, NBHTS founder and CEO, is highly familiar with the ready made garment industry, factories and workers conditions. A knowledge she gained over a decade of work experience as a senior executive position in an international retail and fashion brands prior to embracing a new career path to the field of healthcare technology, innovation management and social impact, with the determination to create value for people.

• Between the partners, the story started from an international business collaboration in the field of fashion to a close family like friendship. The shared values and common mission helped them align their goals in creating an opportunity for a Joint- Venture. The needs of such a solution was identified through grassroot development, a collaboration between the partners as with market and healthcare research (World Bank, WHO, BRAC), consultation with experts (doctors, pharmacists), WHO, USAID, SID and onsite meetings and observations. Our local partners are connected to the local communities and factory owners to facilitate the integration, communication, and operations all essential for a successful implementation.

• NBHTS tool charge of designing of the solution both from a medical, organizational and technology aspects. NBHTS has attracted an international, diverse and multi-disciplinary team of experts with IT, Tech, digital health, International health, UN humanitarian social impact workers, primary care doctors, women and child health, and talents now ready to join our team for implementation and operation. NBHTS advisory team combines expertise in international healthcare deployment, IP Technology licensing, Diplomacy, Technology R&D and Digital Transformation, Expert in Market Growth that are all engaged in advancing NBHTS has worked to design a feasible solution through a skilled team, and resources available to make a valuable contribution in our world.

• MIT Solve offers a unique opportunity to present our startup solution and equitable health system to stakeholders interested to take part in addressing the inequalities, biases and discrimination and to collaborate on a positive and much needed impact.

• The MIT Challenge offers an opportunity to reflect on the various aspects of the prototype prior to launch the pilot, and review the technical, cultural, measurements, technological, financial and human capital needed to achieve our goals in a lean, agile, thorough, professional execution within a short time, as to test many of the strategy key points in the pilot deployment.

• MIT Solve can help us connect with strategic partners and investors ready to join us onboard.

• Finally, MIT and its judging panel of experts offer the indisputable advantage of recognition and validation of our solution.

• NBHTS was developed based on thorough understanding and knowledge  of the market and the digital health technologies, medical devices, softwares (AI/ML).

• Our solution was developed as a disruptive model of care, the one that understands that we can not transfer the developed countries healthcare systems to the developing countries. Our newly developed model considers the many existing challenges: poverty, population location, population number, lack of doctors, lack of facilities, lack of treatments, medical errors, lack of transparent and reliable data in healthcare services, benchmark with existing services in pilot and global healthcare services, WHO Universal healthcare coverage goals by 2030, experts inputs, technology facilities and scalability requirement.

• NBHTS healthcare system relies on 4 pillars as in person healthcare treatment with company trained health workers supervised by doctors, equipment and technology (diagnosis, treatment, triage, process, health management, data measurement, patient monitoring and patient safety), Labs and radiology for diagnosis and immunization, onsite pharmacies for safe treatment. Moreover, the objective was to reduce the out-of-pocket spending and find several sources of revenues to make this system sustainable and at minimal costs for patients.

• NBHTS pilot is of 5 Clinics in Dhaka Bangladesh and we expect 700K Medical Visits in Year one, based on a 60% occupancy of our clinics. We expect to grow from 50 to 100 more clinics in the same country, both in urban and rural areas within the 5 years following our pilot. We have traction with countries in ASIA, Africa and LATAM and expect to partner with them following our successful pilot, while making local adaptation to local settings and cultural needs.

• Health:
  Primary Care, Women and Child Healthcare services are our first priority and we aim to diagnose early illness and conditions, to treat them with quality care at affordable costs, reduce both mortalities and the development of chronic, infectious, communicable diseases that are either curable (cervical cancer) or manageable (diabetes) to enhance the quality of life of this population. This also has an impact on family planning and the decision to have less children as their risk of reaching maturity is reduced and they can offer them better living conditions.

• Infrastructure:
  Clinics equipped with smart renewable energy systems. Infrastructure designed to serve the population with care and with water / sanitation facilities often missing in those countries yet highly important to achieve an impact.

• Technology:
  As a platform and integrator, enable more tech companies to partner with us in the delivery, enabling their growth as ours.

• Education:
  Full training program for our workers with certificates, to reduce the immense shortage of medical professionals in the world, in partnership with Academia.

• Gender Parity: Equal chances for women and men to work and develop a local / international career, paying close attention to gender blindness and discriminating factors. Facilitating works for mothers with young children and education programs that will enable them to bridge the gap.

• Poverty: Reduce out of pocket spending in household medical costs

• Food Hunger: As poverty, and in direct correlation. People healthy are more likely to work and feed their families. Our health data will be able to identify patients in need of Food support and set a partnership with NGOs in the field as WFP.

•  Financial:
  A Sustainable business model to enable scalability and growth.

• Industry:
  A potential to extend our core services to other field and in partnership (ex food distribution, philanthropy, other)
  
  NBHTS system offers a pivotal and transformational impact both in the vertical and the horizontal healthcare delivery model, placing a great emphasis on collaboration and partnerships.

• HEALTH & WELLBEING:
  Through our health IT platform we will gather data that will enable us to provide accurate measurements and KPIs of improvement (Number of visits, returning visits, age group, gender, medical conditions, potential epidemic, treatment adherence - ex tuberculosis, survey on patients service satisfaction, medical trends, pathologies and more). 

• SDGs:
  As explained in previous points about impact, and as we are aligned with 13 SDGs, we aim to include every SDG measurements and KPIs in our quarterly check and monitoring of our service to consistently improve in an agile loop our services, process, and impact.

• Today's Health System in Developed Countries can not be transferred to LMIC, therefore one needs to define a completely different system.

• While we understand that the healthcare system in Developed Countries has mostly relied on doctors and healthcare professionals, we realize that with the immense shortage as mentioned by the WHO (4.3 Million physicians), radiologists, labs, nurse, etc, it becomes increasingly more challenging for LMIC countries where a majority of the population is not sufficiently educated and fewer access the academia for university degree, not to mention Doctor of Medicine. Finally in some countries, the population is so large that it is simply impossible to have sufficient healthcare experts (India, Pakistan, Bangladesh) and the use of technology is the only way to enable them to scale and attend to each and everyone. It is already the case in the USA, where AI / ML assists radiologists, a task made nearly impossible today without it.

•  For this reason and in order to fix the problem with a reliable, scalable and affordable solution, NBHTS has placed technology in the center of its process delivery, believing that our prototype model is by far the best for high impact and low cost. It is not a product but an integrative system that considers every step of the delivery process, leverages technologies where it can, while keeping human capital to think, input, empathize and communicate. A New PROCESS CHAIN to transform and provide equitable health system.

• Our IT platform that is also the EMR is at the core of our service, business and process. It uses softwares, medical devices, robots, blockchain, telemedicine, sms technology.

• As mentioned previously, we have an IT platform, a EHR with a provider interface and a system where existing solutions (digital health, AI, ML, Medical devices, other as mentioned above) plug in their software to enlarge our capacities to provide various services, and a wide range of medical solutions for diagnosis and ongoing treatments.

• Based on the medical conditions and needs of our pilot market we have sourced technologies and devices that answer those specific needs.

• The equipment is light, usually log in a laptop computer or tablet that can be easily placed in each medical cabin.

• Our data is collected, processed and saved on cloud.

NBHTS is founded by a woman that serves as the CEO.

Women fill nearly half of our management team and executive positions in all aspects of our system: Medical, Medical equipment, Social Impact Measurement, Marketing, HR, and other highly important roles in the company.

We believe in providing equal chances and are aware of the gender blindness criteria. We make our work flexible for our employees as the ones that have young children, a responsibility that often falls on women duties at home.

Our team is not only diverse as far as gender, but international, multi-racial, multi-disciplinary to reflect on our ambition to feel home for our stakeholders, being tolerant of each other believes.

NBHTS is a for profit private, social impact healthcare venture. 

Our initial "business model" is based on B2C revenues. We aim to offer a medical visit at a $3 USD in our pilot market based on the average income of factory workers $180 USD -$250 USD

We also aim to create a B2B financial model with factories at a cost of $30 - $50 USD for factories per worker that will cover the occupational health services and offer their workers with a reduce out-of-pocket cost.

 As we start our pilot, we will generate revenue from serving patients - families, the working class, low-middle income population in Developed and Developing Countries. The pricing is based on the market average monthly salary of a full time worker to cover operative costs, mostly.

In the medium term, we will seek to B2G revenues to cover costs for services provided and covered by National Healthcare Baskets, if/when we serve as a local partner. 

Once New Beginning’ Clinics will demonstrate its system efficiency, we will be able to partner with NGOs and Foundations, to receive donations from philanthropes that want to directly impact the inequalities and improve the healthcare challenges of the vulnerable populations. 

Our long term business model comprises several streams of revenues for healthcare services, pharmacies, technology, and b2b services.

Our medical visit cost $3 USD.

$1 USD for technology and $2 USD to cover operation.

This price does not include labs, radiology, medicine.

We aim to partner with the state to be able to distribute the medicine in the health basket for free.

We also consider a B2B model for factories that will help them ensure their workers are in good health and safety. This will guarantee a minimum income to cover our operating costs through yearly medical visits.

We are applying for grants from partners in various field that look to participate in such an impactful project.

Our Business model is based on a JV where local partners are invested to reduce costs in the early implementation years to enable to grow and deploy safely, such as real estate properties that are usually highly expensive in the Dhaka City.

We have a seed funding that enabled us to do all the prototyping of the clinic at low costs and make the validation, build team, scout technologies, make research, marketing, build financial plan, roadmap, meet with investors and sign contracts.

Those projects could cost Millions of USD and we managed to keep low cost at this stage. 

We will continue to progress, leveraging our network, resources to make sure we will remain financially viable, yet transparent with our investors and grants donors.