Assisted Telemedicine for un(der)-served communities

The field of rare diseases is complex and heterogeneous. The landscape of rare diseases is constantly changing, as there are new rare diseases and conditions being identified and reported regularly in the medical literature. Apart from a few rare diseases, where significant progress has been made, the field is still at a nascent stage. Even if we do identify the rare diseases in a Rural setup it is very unlikely to get the medical attention from the senior doctors who understand these diseases. The possible solution for addressing this issue can be using telemedicine. As the senior Doctors cannot travel to every village they can offer support through telemedicine to address the rare diseases.

People have used telemedicine and services more than ever since the COVID-19 outbreak began. A new study from the University of Maryland School of Public Health discovered that people in rural regions encountered higher challenges in adopting these telehealth techniques than those in urban areas. I've personally encountered a problem with ongoing telemedicine, where I've seen a disconnect in the Rural communities when I visited my hometown. Shortage of Medical professionals, Distance and Transportation, Social Stigma, and Privacy Issues are some of the key problems in Rural areas which can be addressed using telemedicine. Unfortunately, due to poor literacy rates, people do not get the opportunity to utilize the telemedicine model of consultation.

To use the existing Telemedicine platforms the rural community needs to take the support of individuals who has the knowledge to understand and access such platforms using a mobile phone. This becomes the biggest barrier for the rural community to even explore this alternative.

We at Caare will empower the Health workers in the village so that they can become a bridge between the Rural Patient and the Senior remote Doctor in the city.

A support system in the form of local health workers can make a true difference in adopting telemedicine in Rural communities. The most crucial necessity of vital checks for the Doctor is not addressed in the current telemedicine platforms so the Health worker again will become an enabler who can connect the Remote Doctor with the Local Rural patient and ensure the quality of care is enhanced.

A Community Health Worker, Nurse, Caregiver, or any Private Practitioner, at the patient will simplify the procedure for the patient and doctor, allowing them to give a better treatment plan. With our methodology, we will ensure that the prescriptions to patients are provided by the Senior Doctor who is accessible online with our Mobile App. For every consultation that happens on our platform, we record the details of all the participants involved in the consultation including the Health worker. A separate interface is also developed for Patients, Doctors, and Health workers in the process.

How does CAARE Rural assisted telemedicine model work?

1. Meet the Health worker in your village
Meet the Health worker (Rural Practitioners) and he or she will schedule a video consultation with the Senior Doctor based on the need.
2. Consult Senior Doctor
Health workers, who are experienced healthcare professionals, will ask questions and take vitals to share with Senior doctors in real-time.
3. Get treatment like Hospital
Together, the Patient will video chat with the Health worker and the Senior doctor who will provide care, offer a treatment plan, and prescribe medication.

Most of the common problems in the Rural communities are the Shortage of Medical professionals, Distance and Transportation, Social Stigma and Privacy Issues, and Poor Health Literacy.

Shortage of Medical professionals: Only 18.8% of rural doctors have a medical qualification. India needs more senior doctors and trained nurses for the system, particularly in Primary and Community based Healthcare centers.

Distance and Transportation: Geographic access is another rural healthcare access barrier. The travel burden is amplified by the road conditions, the terrain, and the weather.

Social Stigma and Privacy Issues: The problem intensifies when rural residents are seeking care for conditions associated with social stigma such as mental health, substance abuse, sexual health, etc One of the biggest reasons for Farmer suicides in India is also Mental Health.

Poor Health Literacy: Rural residents have a higher risk for low health literacy because on average, they have lower education levels, are living in poverty, or do not have language proficiency.

Even though the above-stated problems can be addressed using Telemedicine to some extent, unfortunately, the people in Rural communities cannot utilize this model due to poor literacy and lack of understanding.

Also, if we compare the huge health understanding barrier between rural and urban areas. We can highlight some of the below aspects       

• low-quality treatment in villages
• Restricted access to specialists
• Hours of nonstop waiting at Primary healthcare centers
• Language barrier.

Considering the above challenges within the target population of Rural communities. Below are some of the benefits which we bring through our platform to Rural communities.

• Personalized Care by Health worker
• Reduced Costs as the patient does not require to move from their village for treatment.
• Saves time from the travel.
• Virus-free as the patient does not travel to Hospital.
• Access to renowned Doctors through the platform.
• Patient wellness centralized track-record

We have a great mixture of Doctors, Academicians, Health workers, Sales and Technology team who are capable to address this solution. As we are currently serving the Rural communities the approach we took is through the NGOs and Hospital networks. Most of the NGOs with whom we are collaborating are either working on specific health conditions or addressing the needs of Primary healthcare.

We started our first dedicated Rural telemedicine clinic in the rural areas of Uttar Pradesh in India. With the support of an NGO, we were able to identify a local health worker who is currently serving their rural population using our assisted telemedicine software. We also provide our solution to NGOs who wish to carry out their own projects, where we provide them a dedicated dashboard and analytics on the outcomes of the project.

Additionally, we are working with different hospital networks to support them to establish dedicated Rural clinics using our software.

We are aiming to build 6 clinics by end of June 2022 with the support of
NGOs and hospital networks we are targeting 500 clinics by end of the
the year 2022.

The acceptance of telemedicine in rural communities, as well as the training of local health professionals to use the technology to connect rural patients with remote doctors, are the issues we address. We will be able to raise awareness in rural areas with the help of this challenge by running particular programs at the same time to train new health workers and onboard them into the platform so that they can personally serve their own village. Another big problem may be gaining access to senior doctors; however, with this financing, we will be able to enroll numerous doctors who will fully support the endeavor.

Everyone has witnessed the impact of telemedicine during covid and agrees that telemedicine will play a significant role in the future of healthcare. Despite this, telemedicine penetration in rural regions is quite low. To make telemedicine more acceptable, we need to find a blended strategy that allows the influence that telemedicine has in urban regions to be felt in rural populations as well. As a result, our solution is ideally positioned, has a very simple design, and can onboard a health worker in less than an hour to begin serving his or her community.

We have a dedicated telemedicine clinic currently running with the support of an NGO in Uttar Pradesh, India.

We have more than 6 aspiring health workers who are willing to start telemedicine clinics in their rural segment by end of June 2022.

We aim to set up at least 500 telemedicine clinics in Rural areas by end of the year 2022.

We are also in the final stages of our discussion with several NGOs who are looking to run their own Rural healthcare programs using our platforms. A few of the NGOs we are talking to are listed below. We aim to reach a wider population with their support. Also, described the solution we are offering through different NGOs.

http://searchforhealth.ngo/
https://www.rvinstitutions.com
https://mamta-himc.in/
https://catalysts.global/

Current Projects: 

• SEARCH NGO (http://searchforhealth.ngo/)
• RV INSTITUTIONS (https://www.rvinstitutions.com/)  

PadmaShri Dr Abhay Bang and Dr Rani Bang operate SEARCH NGO in Maharashtra's rural districts. They've selected us to support them with three projects.

• Mental Health: SEARCH has a psychiatrist at its headquarters and over a dozen counselors spread throughout several taluks and districts. Because counselors are not fully licensed to administer medication, psychiatrists utilize our app to videoconference with counselors and patients to address issues and prescribe medication.
• General OPD: SEARCH currently has only three doctors in the OPD clinic, and they want to use our app to connect walk-in patients with other senior doctors from the city.
• Community Health: SEARCH just provided smartphones to all of its existing community health workers throughout villages. They will be available to connect their patients at the village level with the senior Doctor sitting at the Headquarters. Due to bandwidth limits in some tribal communities, we are only deploying in places with good connectivity. 

Status: Pilot field test is completed and successful. Sent the initial agreement for signing.    

RV Institutions have a number of colleges across several fields. They have adopted six villages around Bangalore and have promised to give us manpower in the form of Doctors in the city and health workers on the ground. We will conduct medical camps in all these villages with the help of Nurses / Health workers and connect rural patients with the City Doctor with Assisted telemedicine model. This is a similar field test to SEARCH NGO and once successful we will expand to several villages in Karnataka.

Basically, it is the same App used for different project requirements. We also provide a Dashboard to all these organizations where they can track all the consultations and their details.

As a startup, our primary objective is to set up Rural clinics across India. Either with the help of our own network or through NGO support we wish to set up 6-7 clinics every month.

With every clinic, we will measure the number of Rural communities we are able to impact on UN Sustainable Development Goal 3: Good Health and Well-being.

This challenge's major purpose is to improve the lives of those who suffer from rare diseases. Covid is a rare disease that caused havoc on the entire world in 2020. And there are still many different variants of this disease in the world, mobilizing doctors from all over the world is much more difficult. To reduce the effect of these rare diseases, the best approach is to make the most of our doctors' current abilities. Also, limit the amount of time they spend with each patient so that they can look at a wider number of patients on a daily basis. With our unique assisted telemedicine for rural populations, doctors can benefit from the following advantages.

• Does not require travel to remote villages
• Simplified process for Doctors
• Privacy for Doctors
• Access to Local Health worker
• Access to Patient’s health history for augmented insights

We have built a mobile app for both Andriod and IOS devices. The front end is developed in Flutter and the backend in Laravel. We have also integrated the video and audio capability into the platform using Agora.io software. Razorpay is used to build the payment capability and for all, the API calls we use the AWS services.

We're currently enhancing our platform with an AI-powered, video-based, software-only solution that will enable any one in need of real-time health data to easily extract a wide range of health indicators from mobile phones/laptops with the end-user agreement. For example Heartrate, Stresslevel, Blood pressure, Respiration, and Oxygen Saturation.

Out of 6 member team, we are 4 males and 2 females. We believe in diversity, equity, and inclusion and hope to bring a balance in the ratio in the near future.

Of the 2 members founding team, 1 is male and 1 is female.

We also work with health workers who come from low-income groups and are proud of creating employment opportunities for them through our platform.

Our business model is B2B2C:

Our primary target customers are NGOs & Hospital networks with whom we are able to run independent telemedicine clinics managed by them where we provide the below offerings or the NGOs use our platform to run their dedicated Healthcare programs.

Only Platform: Caare will provide only the platform, on which both the Doctors and Nurses / Health workers are deployed by their respective organizations.

Platform + Caare Doctor:  Caare will provide the platform and also provide access to Caare Doctors for Individuals or organizations who want to utilize their services.

Platform + Caare Doctors + Caare Nurses:  Caare will deploy a Nurse physically for consulting either with Caare Doctors or Doctors of that specific organization.

We are also exploring the possibilities to work with PSUs, Corporates, and production houses to provide our software.

We are looking to sustain primarily by selling our software platform. We will offer our solution as a white label solution to NGOs and Hospital networks.

As we engage with NGOs we will also collaborate with them to jointly raise funds through donations or grants to support their Rural Healthcare programs.

We just started our first Rural Telemedicine clinic with the help of an NGO in the month of June 2022. We are currently working on setting up another 6 clinics by end of June 2022. We have addressed nearly 10 patients using the platform. We hope to multiply the number of patients using our platform by end of June 2022 and continue to set up a minimum of 10 clinics every month.

We are completely bootstrapped and looking to raise seed funds through Startup India with the help of our Incubator BITS BIRAC BIONEST.