mPowered Health

Approximately 3.2 billion people, 40% of the world’s population, cannot reach a healthcare facility in one hour by foot. Yet, living nearby to a healthcare facility does not guarantee high quality service as many facilities, particularly in rural communities, low- and middle-income countries (LMICs), and other low-resource settings are overburdened, understaffed, and lack the specialists and clinical capacity to adequately treat patients. As a result, even patients with routine or common diseases may receive low quality care and face exorbitant wait times. At the same time, the COVID-19 pandemic demonstrated that health misinformation is widespread and many people lack access to consistent, verified health information.

In LMICs, long-standing health systems challenges and information deserts is exacerbated among those with rare diseases. Treatments and medicines considered “standard-of-care” for rare diseases in high-income countries are often altogether unavailable in LMICs and often require international travel to obtain proper care, a major barrier to access. A 2020 analysis found that only 2 of 45 included LMICs in Africa and the Middle East had essential medicines lists that addressed rare diseases. At the same time, the lack of clinical specialists and proper diagnostic equipment and genetic testing and limited surveillance capacity, means that the burden of rare diseases in LMICs is not well characterized. Despite a lack of data, we hypothesize that patients with rare diseases in LMICs face significant barriers to high-quality healthcare. 

mPowered Health is a multi-lingual, SMS- and mobile phone application providing education and mobile and telehealth services to traditionally hard-to-reach individuals and communities in the U.S. and around the world. mPowered Health leverages mobile phone technology to fill information deserts, overcome health systems challenges, improve health access and quality, alleviate poverty, and reduce global health inequity. At mPowered Health, we recognize the power of the rapidly growing mobile phone technology sector. In Kenya, for example, there are only 0.16 physicians per 1,000 people and 3 total rare disease specialists, yet 99.9% of Kenyans own a mobile phone. Our SMS and mobile phone application is developed for low-cost feature phones and smart phones and includes the following features:

• A learning hub with fun, accessible and localized educational modules;
• An easy-to-use platform to manage health records;
• Clinician-developed health assessment surveys to help users assess their health status and identify health risks;
• A secure telehealth platform where users can consult with qualified healthcare providers via SMS, phone, or video calling; and
• A directory of community healthcare workers, pharmacies, and laboratories that facilitate home-based clinical diagnostic testing and deliver medicines and medical supplies to users’ doorsteps. 

We will leverage our app to reach patients with rare diseases to:

• Estimate the regional and national prevalence rates of various rare diseases;
• Launch a rare diseases education module to provide education and expert-verified information (including on signs and symptoms, treatment, and daily care management) to patients with rare diseases, their families, and other community members to reduce misinformation and stigma; and
• Connect patients with rare diseases to healthcare specialists around the world.

In the future we aim to:

• Leverage our existing collaborations with Ministries of Health, national private and public sector health facilities, laboratories, and pharmacies to deliver standard-of-care diagnostics and treatments to patients with rare diseases.

The number of people with rare diseases who cannot access high-quality specialized care globally is unknown. However, it is estimated that 4% of the global population has a rare disease while approximately 3.2 billion people, 40% of the world’s population, cannot reach a healthcare facility in one hour by foot. Our target population includes those with rare diseases who cannot access specialize care due to geographic, socioeconomic, cultural, or health systems challenges. While our services will be made available globally, our target population will include those living in rural communities, low- and middle-income countries (LMICs), and other low-resource settings who currently cannot access speciality care or for whom the access barriers to care are insurmountable.

For the past year, the mPowered Health team has conducted market survey and user research in our 10 first-round priority countries to co-develop an SMS and mobile phone platform that will fill existing gaps in health literacy and health systems. We have pilot tested the app format and functionalities and health educational materials and modules, and engaged with government and non-government stakeholders to develop a user-driven application. Although access to mobile phone technology is rapidly growing globally, feature phones and low-cost smartphones are the most common among our target populations; therefore, our SMS platform and mobile phone app has been adapted for easy use on these phones and to ensure that traditionally hard-to-reach individuals and communities can utilize our app. Our development and expansion process centers around an iterative focus group process in which we identify and test assumptions and develop, pilot-test, and redevelop materials and functionalities. Our app allows users to opt in to our demographic and epidemiological data collection activities which fills evidence gaps and informs our next steps in subject matter and clinical capacity expansion. 

We are looking for financial and technical support. Financial support will allow us to hire rare disease specialists to consult on the development of educational modules and provide telehealth services on our app. We are also looking for technical support to allow us to expand our clinical, diagnostic, and pharmaceutical offerings to include standard-of-care diagnostics and treatments for rare diseases.

Our solution leverages mobile phone technology to increase access to health education and affordable health services. We aim to bridge the gap between the private mobile phone technology sector with the public health sector to overcome decades-long health systems challenges and change the way healthcare is delivered around the world. Our solution also leverages the latest science of learning research to develop health educational materials that are powerful tools for long-term learning and behavior change. Our solution will contribute to achieving all 13 targets of the UN sustainable development goal on health and well-being (goal number 3). Our solution will also contribute to reducing inequalities by improving healthcare access and health status of lower income and hard-to-reach communities and vulnerable populations including women, migrants, stateless persons, and internally displaced persons and refugees. Importantly, our solution is flexible and can be rapidly scaled to cover additional geographic areas or to target specific patient populations with specific diseases.

Over the next year, we aim to bring education and telehealth to at least 1 million users across the US, Africa, and the Middle East, expand our network of telehealth providers to 1,000 individuals across specialties; and provide mobile health, laboratory, and pharmacy services to 100,000 people in priority (lowest access considering geographic location, racial minority status, and gender identity/sexual orientation) communities. Our five-year targets include reaching at least 10 million people with application, expanding our network of telehealth providers to 5,000 people, and providing mobile health, laboratory, and pharmacy services to 500,000 people.

Our short-term indicators include the following which are assessed quarterly:

Number of users accessing health education modules

Number of users who improve their knowledge, attitudes, and self-reported practices regarding their health following an interaction with our health education modules (as measured through quizzes placed before, during, and after the educational modules)

Number of users (patients) connecting with healthcare providers via telehealth services

Number of users (patients) who connect with telehealth providers in specialties that their local regional or country does not offer

Cost of telehealth and mobile health services compared to local regional or national costs of similar healthcare services

Time spent accessing/seeking healthcare services through our platform compared to local regional or national estimates of time spent seeking health services

Number of users (patients) receiving standard-of-care treatment interventions enabled through our telehealth services or mobile health offerings 

Number of users (patients and their caregivers) receiving emotional or psychosocial support

Our long-term indicators include the following and will be assessed every 3 years:

Change in disease incidence among our target communities

Change in mortality rate among patients with each target disease or illness

Change in suicide mortality rate among patients and their caregivers

Change in community-level awareness for diseases and health conditions and reduction in stigma or social alienation of patients

Change in the number of people incurring impoverishing out-of-pocket health costs 

Our app provides a holistic step-wise solution to several pressing health systems challenges. First, engagement with our educational modules (activity) results in our users having increased awareness and knowledge of health (output) which increases their demand for health services and interest in seeking out health services (output). As a result, users seek out health services via traditional (brick-and-mortar) health facilities or through our telehealth and mobile health services (short-term outcome); in specific cases, our platform will provide more affordable, more accessible, or more specialized care than traditional health systems. As users seek out health services, our app will help them manage their health records and treatment regimens (short-term outcome). As our user base expands, community-level awareness about health and illness increases (short-term outcome) and social stigma around disease is reduced (long-term outcome). As users continue to engage with health education and health services, they become empowered and in-charge of their health (long-term outcome) while improved access to healthcare results in improved health status, reduced inequalities, increases in economic opportunities and freedoms and decline in health-associated poverty (long-term outcome). 

Mobile phone technology including SMS and applications

We are an equal opportunity employer; however, we recognize that many of the same barriers mPowered Health is working to overcome in the health sector apply to job seekers. Therefore, we have included three diversity, equity, and inclusion programs in our company's operational and human resources strategies. First, we have pledged to maintain a gender balance (across all current and future gender types) among our employees and to ensure that 75% of our employees are nationals of low- and middle-income countries. Second, in recognizing that talent and knowledge can be cultivated outside of the traditional classroom setting, we have removed minimum education requirements from all our current and future job openings. Third, we are preparing to launch a community champion program in which we collaborate with local NGOs, aid groups, and community health workers to identify individuals in our target communities to serve as community champions; these liaisons will serve as a critical communication node to ensure that there is an avenue for mPowered Health staff to receive feedback and input from our users and that concerns or questions can be brought to our attention and addressed promptly. 

Key resources: mPowered Health brand, SMS platform, mobile phone application platform, network of telehealth providers, network of pharmacies and laboratories in country, network of community healthcare workers delivering home-based care, user base

Partners and key stakeholders: users, telehealth providers, clinical consultants, Ministries of Health and other national or regional public and private sector health and public health organizations, telecommunications companies, mobile money services, international health organizations such as the World Health Organization, local pharmacies and laboratories

Key Activities: developing, validating, pilot-testing, and disseminating educational modules; expanding user base; expanding telehealth provider base and screening telehealth providers; expanding network of in-country laboratories and pharmacies; developing; validating, pilot-testing, and disseminating health assessments; connecting users and telehealth providers; ensuring telehealth providers provide high-quality and timely care across various specialties; covering cost of telehealth and mobile health services for our lowest income user/beneficiary segment

Type of intervention: Education, telehealth and mobile health services, health records management services

Channels: SMS and mobile health application advertised through social media, local media and advertising such as via radio, billboards, and ads in health facilities

Segments: Our segments are defined by access to traditional health services and income. Our lowest income segment are those who have no expenditure capacity for healthcare including costs to travel to a health facility, consult with a healthcare provider, or to purchase medicine or medical supplies. Our middle-income segment can afford health services in the range of 1-5 USD per hour of medical consultation or travel to healthcare facilities and can expend up to 10 USD per month on medicines or medical supplies. Our high-income segment can spend more than 5 USD per hour to travel to health services or for healthcare consultations and can spend more than 10 USD per month on medicines or medical supplies. Our lowest access segment are users whose closest health facility requires greater than one day's transportation to access. Our middle access segment are users whose closest health facility requires 3-5 hours of transportation to access or whose closest health facility is overburdened and requires an entire day's wait time. Our highest access segment are those living in urban settings and in close proximity to health facilities but who may still lack access to specialized health services. 

Value proposition: We offer verified and engaging health education for adults and children, verified health assessments and screening services, access to affordable and specialized telehealth services, mobile and home-based clinical diagnostic and treatment options, and healthcare records management.

Cost structure: Staff, educational modules development and testing, app development and maintenance, costs for lowest income segment to receive healthcare

Surplus: Profits are reinvested into expanding our geographic and subject matter reach and acquiring and disseminating specialty medicines and medical supplies. We also plan to invest profits into research and development for improved point-of-care diagnostics and treatment products to enhance our telehealth and mobile health offerings.

Revenue: Initially, we will be supported 100% by investors and grants. Within 5 years, we aim to be supported 100% by capital raised through our app. Income streams will include selling advertisements, selling premium ad-free subscriptions, selling memberships to telehealth providers, and receiving a 1% commission paid by our highest income user segments on payments for telehealth services

Initially, we will be supported 100% by investors and grants. Within 5 years, we aim to develop a sustainable business model in which costs to support the business are generated from the app and our services. Income streams will include selling advertisements, selling premium ad-free subscriptions, selling memberships to telehealth providers, and receiving a 1% commission paid by our highest income user segments on payments for telehealth services.

We have raised 50,000 from private investors, including both individuals and organizations.