PHC-Data

• Poor service quality in PHC 
• Scarcity of data for performance assessment and decision making in PHC
• Shortage of skilled frontline health workers in early disease detection and prompt treatment in PHC

PHC-Data is a mobile based software that guides healthcare workers in managing patient process while collecting crucial data. The solution was designed using human centered approach by understanding the process behind patient management in a health care center and at which point technology can improve the process for the healthcare workers and the PHC health system in general. As the healthcare workers use the software, data will be collected on daily basis The software is designed to run in low and middle income settings with limited resources. PHC-Data employs a data driven architecture powered by analytical engine, the solution has three folds

1. It is designed to capture end to end process of primary health care centers while collecting crucial data for performance measurements and decision making

2. Train healthcare workers in early disease detection, classification and prompt treatment

3. Collect data to be used for development of data science and AI solutions for the health sector, mainly for disease detection and classification.

General population (Patients) - Improved care and treatment in the PHC as the center will be using a software that will guide the healthcare workers using WHO guidelines and AI. The solution will: 

• reduce waiting time for patients in the healthcare center
• improve efficiency in early disease detection and classification
• improve on drug management (availability)  

Frontline health workers - Frontline health workers will be working with an innovative tool that will provide step by step guidance on early detection and disease classification according to WHO guidelines and machine learning algorithms. This process will improve their clinical decision making skills and it will also allow them to receive continuous feedback on the assessment of their performance during their routine activities.

Ministry of Health - The solution will improve the quality of services provided to patients at PHC, as data is collected throughout the cycle of patient care. The data will enable the service provider to identify where the pain points are from a service provision perspective and what is the root cause. Moreover, the public health agencies will be able to use the solution to conduct supervision of the primary health care service which is crucial to monitor performance and quality.

Public health agencies - The public health agencies or ministry of health will benefit from a solution that will provide statistics on disease incidence and prevalence in communities. The data that will be collected by the solution will improve the process of decision making in relation to PHC and public health concerns, the solution can also be used as an added tool for health surveillance in communities.  

The team is composed of 4 individuals with diverse backgrounds and skill sets. The team members have long years of experience working with communities in low and middle income settings, mostly in Mozammbique.

Jovito Nunes. He is an epidemiologist with a background in computer science, a PhD student (Translational medicine) researching environmental epidemiology in rural areas of Mozambique, with over 20 years of collective work experience in technology, research and health. For the past 5 years Jovito has been working with sexual and reproductive health at PHC in rural areas of Mozambique. Jovito assisted the United Nations and the MoH collecting data for PHC during 5 emergencies (4 cyclones and COVID-19) in Mozambique. Jovito understands what tools and technology needs to be in place to collect and analyze data for measurements, research and decision making. Jovito has an entrepreneurial mind and skills that will be instrumental for putting the final product in the market and selling.    

Dr. Elsa Nehemia. She is a renowned medical doctor (gynecologist)  with a PhD in public health, and a maternal & child health specialist with over 35 years of working with primary, secondary and tertiary health care settings, ministry of health and public health. Dr. Elsa is a senior member of the National Maternal Death Monitoring Committee. Dr. Elsa is the right person to advise on how to measure performance in PHC and what are the appropriate tools and methods to train frontline health workers. 

Jeecy Cachopas. She is a law student with over 10 years of experience working as an activist for access to primary healthcare services in hard to reach communities, a social entrepreneur that fights for equal rights of health services for hard core poor and a marketing campaign professional. She has a strong understanding of what the poor and hard to reach communities go through to get basic health care service. Jeecy is well positioned to create partnerships, search for fundings and sell the solution to NGOs, World Bank, UN agencies and embassy AIDS, which will be our main customers that will pay for the products.  

Carlos Villamizar, MD. He is a Pediatrician from Colombia with seven years of experience attending children in the emergency room. He is currently located in Barcelona completing his Master's Degree studies in International Health and Cooperation in the Universitat Autónoma of Barcelona. He completed his internship of the Master´s Degree in the Pediatric emergency room of the PCMH Hospital of Pujehun, Sierra Leone. He is interested in developing innovative solutions for improving education, training and clinical skills of the health care staff attending in low and middle and income countries.  

We are applying for this challenge because we are looking for funding to pilot our solution in 10 healthcare centers in one of the poorest district in Mozambique, through the result of the pilot, we will have sufficient data to approach clients and donors. At this moment the only barrier we have is financial and we hope to overcome this barrier through this challenge.

The solution is innovative because it combines education and data science to improve patient care processes in PHC while collecting data for decision making and research. The solution  can also be tailored for community health workers, in this sense, primary health care services can be taken to the community thus reaching more people with PHC services.  

PHC-Data will use WHO guidelines and the Ministry of Health algorithm to guide and education frontline healthcare workers while harnessing the power of data science for process improvement, decision making and prediction.

During the first year we aim to improve the PHC services in one district in Maputo, the capital of Mozambique. During the pilot phase we will select 10 health care centers in the district that will benefit from the following:

• Capacity building - healthcare workers including community healthcare workers will be trained by our team on best practice regarding clinical management of patients using WHO guidelines and Ministry of Health algorithm, the training will involve learning how to use the software and interpreting the results (reports) generated by the software

• Data collection and analysis - during the pilot phase the team will assist with data collection and analysis for performance measurement and improvement. We will use the data to train the machine learning models (predictive and decision tree) for a better outcome of the solution.

A baseline study will be conducted in the 10 health care centers to assess how the health care centers are performing:

• Number of patients that visit the center per month vs number of patient get to see the clinician

• Number of patients that get to see the clinician vs number of patients that get treatment

• Availability of drugs in the center

• Ratio of number of patients per healthcare worker

• Number of patients treated in the center per month vs number of patient referred to another hospital

• Average waiting time for a patient to see a clinician

• The current patient management process cycle

• How supervision is conducted and how often it is conducted

At the end of the 1st year we will compare the performance (results) during the year compared to the baseline.  

For the next five years we aim to deploy the solution in every PHC centers (approximately 2100 health care centers) in Mozambique and provide capacity building to over 20,000 health workers (an average of 10 healthcare worker per healthcare center), this will be achieved by establishing a partnership with the government and sell the solution to NGOs, World Bank, African Development Bank, UN agencies and embassies that support the Ministry of Health.

Measuring progress against target will be done by implementing well defined KPIs and employing a result framework with clear milestones to measure the outcome and impact of the project and capture lessons learned and indicate if we are succeeding or not. The following KPIs will be used:

• Number of patients visiting the center per month 

• Number of patients treated

• Number of cases that are correctly diagnosed

• Treatments success rate

• Monthly average waiting time

• Number of patients satisfied with PHC service

• Number of healthcare workers satisfied with the solution

• Number of healthcare workers trained in early disease detection and classification 

People living in rural areas of low- and middle-income countries face economical and geographical access barriers to receive proper medical care. In addition, the degree of training of the healthcare staff and the infrastructure of the health system is not very reliable as well. For example, in sub-Saharan Africa, one of the regions with the highest overall mortality rates in the world is just 0.2 physicians per 1000 people, with the greatest proportion of trained doctors working around the big cities or migrating to high income countries to continue their educational processes or improving their quality of life. This association of factors leads to primary health care services being attended by community health workers, nurses, and clinical health officers.

Considering these facts, we conducted an initial validation market survey for our solution in 3 health centers in the Manhiça research center in Mozambique.  We interviewed Doctors, Nurses, Clinical health officers and Community health workers about their perception of their level of training regarding their challenges in their daily practice. More than 90 percent concluded that their level of training was not sufficient to meet the demands of patients, especially newborns, children under 5 years of age and pregnant women.

Moreover, we asked them about the perception of including new technologies in their daily practice. All the interviewed agreed on the need to include technologies in their practices, especially if these solutions are focused on complementing their training and helping them to improve their skills in clinical decision making.  These findings are in line with the recent trends in e-learning and digital health application, where clinicians around the world are looking for alternative ways to access to health training (From 2016 to 2021, the WHO Open courses platform has increased from 49 thousand to 6,7 million users) and where healthcare workers are willing to include digital tools in their practice, as evidenced during the response to the Covid-19 Pandemics. These suggest that a window of opportunity might be opening for the inclusion of new technologies in primary care services in remote areas.

Our theory of change is that we can improve the performance of the primary health care services of remote areas through the inclusion of new technologies in healthcare. We will design a solution that will assist healthcare workers in the processes of: a) patient registration; b) patient assessment and disease classification; and c) patient discharge and drug distribution, while collecting data on the performance of the health centers and the frontline healthcare workers during their routine activities. These data will contribute to authorities and health agencies in their effort to strengthen primary health care services. We might find barriers related to internet connectivity, data protection and the staff. Hence, we are working to develop a software that works in online/offline modalities that secures patient confidentiality. We are also working on our solution with a bottom to top approach, taking into consideration the working environment of the healthcare staff and the needs of the local governments and health agencies. 

The core technology that powers our solution is a data driven software that harness the power of data science to combine mathematics, statistics, epidemiology and informatics to learn from historical data and make accurate predictions of clinical results. A software that works on offline and online mode, on mobile and desktop.

Healthcare Workers at the local health centers:

• Service assistant or person in charge of patient registration.

• Clinician (Clinical Health Officer; Community health workers; Nurses)

• Pharmacist or person in charge of drug distribution.

Searching for a solution that aims to tackle inequalities and barriers we have composed a gender balanced  team with different profiles, perspectives and nationalities with the possibility of addressing needs at different levels of the social determinants of health. 

We have included the profiles of clinicians experts in the field of child and maternal health, researchers in epidemiology and environmental health, and a social leader/activist that will give representation to the community in our project. Our team is connected with academic leaders, research centers and NGOs of the region, at the same time that we receive support from the ecosystem of Startups of the University of Barcelona - EIT Health partnership at the StarUB program.

Our business model is "Fee for service", we will sell our products and services to third party organizations such as UN Agencies, World Bank, Embassies and NGOs that operate in the health sector while focusing on providing better healthcare services to the general population.

Our company will focus on strategic partnerships with the Ministry of Health. The MoH will be the main consumer of our solution to serve the general population, but our main clients will be organizations that support the health sector. The solution will be provided to the MoH based on annual license, the license will be per user and the license will be sold to organizations such as World Bank, UN Agencies, NGOs in the health sector and private companies that support the health sector as part of their corporate social responsibility. The company will continue to innovate and create new solutions for the health sector and expand to new markets

We have not generated any revenue or received any grants so far.