World Telehealth Initiative

Half of the people in the world lack access to the most basic healthcare services. As a result, approximately 8.6 million people in middle- and low-income countries die annually from treatable conditions. Lack of access to healthcare is a global crisis.  

People with diseases or chronic health conditions often struggle to find adequate local care, especially in fragile communities. Challenges include lacking financial resources, transportation, or access to specialists to treat their specific needs. Without access, thousands are suffering unnecessarily from otherwise treatable conditions.

Telehealth offers an increasingly reliable solution to remove access barriers and upskill providers across the globe. Despite advancements in technology and prioritization among governments to increase connectivity, healthcare must be faster to adopt digital health technologies at scale. Acceptability of telehealth across the globe has been at an all-time high since the COVID-19 pandemic, creating an opportune moment to support the scaling of World Telehealth Initiative's successful program model to address access gaps faced by more than half of the world's population.

As noted in a 2020 Med-Tech article by Risa Ravitz, technology has been rapidly adopted across many sectors. However, human connection is still sought after and desired in healthcare. World Telehealth Initiative offers a blend of both –connecting people across the miles with telehealth technology while staying firmly rooted in relationships and building collaborative partnerships among clinicians so they can better care for their patients.

The corporate world has seen great success using now-familiar mobile apps to modernize booking transportation and vacation rentals and address accessibility issues. Similar implementation has been slow within the non-profit sector because it takes skilled engineers and financial resources to create custom platforms for large-scale needs. World Telehealth Initiative believes there is an opportunity to experience a similar network effect within the philanthropic healthcare space with an international ecosystem supported by a custom-built matching platform.

World Telehealth Initiative has launched successful programs worldwide, offering collaborative, on-demand, remote support to bridge the gaps in health systems. Our low-cost, scalable solution provides sustainable medical expertise in thousands of vulnerable communities worldwide through clinical consultations, emergent care, surgical mentoring, and peer-to-peer didactics.

World Telehealth Initiative is building a technology-based matching platform that will link providers with specialized training with clinical counterparts in resource-constrained and fragile contexts across the globe. Our matching platform and mobile app will allow us to scale our philanthropic network and enable on-demand clinical support to places that face some of the most significant challenges in healthcare delivery and accessibility.

To address healthcare access at scale, we will expand our customized platform to enable the matching of physician specialists to the clinical needs expressed by our local hospital partners in LMICs so providers can collaborate, consult, and care for patients without the burden of travel, financial constraints, or transporting fragile patients.

Suppose a hospital needs an oncologist to care for its patients. In that case, the local provider can open our app, search for the available physicians who meet their needs, and schedule consultations, mentoring, training, and/or emergent care. 

Physicians can also search the platform for clinics and hospitals requiring their expertise. If the physician is only available one day a week or has expertise in pediatric oncology, they can find those support opportunities through the platform. Additionally, physicians can issue support opportunities for program sites to engage in scheduled didactic sessions. The bi-directional relationships are critical to our approach.

The platform development was divided into three key phases, employing the agile development process to ensure we continuously roll out improvements based on feedback and insights gained from each version. The platform will provide tools for recruiting, vetting qualified volunteers, searching, scheduling, instant messaging, and more. The flexible nature of WTI's design enables us to adjust to the needs of the community week by week, year by year.

Much like common phone apps have revolutionized transportation or vacation rentals, WTI aims to transform healthcare delivery with a platform that will streamline service delivery in fragile contexts. We are also working on an advanced algorithm to analyze clinical qualifications, spoken language, and physicians' availability within our network and match them with clinical colleagues in lower-resource settings with limited training opportunities.

We use React and Ruby on Rails to build the platform. React provides the user interface on the front end of the design, allowing for faster development and more reliable performance. Ruby on Rails is used for the back-end design, providing a robust and reliable framework and extensive libraries (gems) for the database and models.

Eventually, we will further automate and improve the process through AI and API automation, connecting our platform to Teladoc Health's global cloud-based technology. This will allow WTI to work in the most remote places in a responsive, adaptive manner. Our telehealth ecosystem is a sustainable solution that enables clinicians to share knowledge and resources to strengthen local and global health systems.

World Telehealth Initiative focuses on providing resources for the most vulnerable communities worldwide, including thousands across the Global South who lack access to physicians, nurses, and therapists. We accomplish this by focusing on upskilling providers to strengthen the local health system, ultimately benefitting thousands of current and future patients treated by the providers.

Our healthcare providers represent over 50 specialties, including surgery, obstetrics, pediatrics, neurology, cardiology, pulmonology, endocrinology, and oncology. Many of our supporting physicians are the diaspora of the location they are assisting. 

For example, a Ukrainian diaspora trauma specialist currently working in Chicago can deliver telehealth surgical mentoring services to hospitals in Ukraine. Not only does he have the expertise they need, but he also appreciates the cultural nuances and can speak Ukrainian. Connecting providers during times of crisis or when local resources are limited helps the medical team and, ultimately, the patients.

Telehealth technology can also support hospitals when transporting patients is impossible. For instance, a fragile premature baby in Argentina cannot be transferred 100 miles to the nearest neonatal intensive care unit. Instead, a neonatologist can beam into the hospital from their laptop, connecting to the telehealth device at the remote hospital. The neonatologist can speak with the onsite physician and parents, view the baby's vitals, and review laboratory tests and scans. The neonatologist can hear the baby's heartbeat and respirations with a peripheral stethoscope - from 100 or 1,000 miles away. The specialist can be available immediately for a timely and potentially life-saving response during a crisis - expediting a care plan and stabilization of the patient. 

Telehealth addresses and achieves the basic tenants of Healthcare Reform: providing the population access to improved and convenient, high-quality, patient-centric care, enhancing outcomes while reducing per capita expenditures. Telehealth is reshaping the landscape of healthcare delivery across the globe. Studies have shown that the benefits of telehealth include significantly improved outcomes, efficient care delivery, and reduced mortality rates, hospitalizations, length of stay, readmissions, and healthcare costs. World Telehealth Initiative sees transformational changes in communities worldwide.

World Telehealth Initiative was established in 2017 by Dr. Yulun Wang and Sharon Allen. Dr. Wang founded InTouch Health, where he developed and deployed the state-of-the-art global cloud-based telehealth network. With the rapid adoption of telehealth in the United States and other high-income countries to deliver more accessible, lower-cost, and higher-quality healthcare, Dr. Wang and Sharon saw an opportunity to use the same technology in under-resourced communities to upskill local providers and improve patient care.

Sharon Allen is the Co-Founder and CEO of World Telehealth Initiative (WTI) and has become a recognized leader in international philanthropic telehealth. She has traveled extensively to understand the needs of low-resourced healthcare clinics and hospitals worldwide. Under her leadership, WTI developed an innovative model that leverages remote philanthropic physicians to provide sustainable medical expertise via telehealth.

Sharon serves on the World Health Organization Digital Health Board of Advisors and Roster of Experts. She is currently working with WHO on their Telehealth Roadmap for the Underserved.

The WTI team includes public health specialists, engineers, and development staff who work collaboratively with our onsite and volunteer providers to ensure quality healthcare is available for those in need. Our team works closely with the healthcare providers to ensure each program site design meets the unique needs of the providers and patients. WTI is mindful of the unique cultural contexts at each site and works collaboratively to respect providers' learning and communication styles, patient privacy, and other factors.

Our solution's ultimate beneficiaries are providers working in fragile contexts, who often overcome staffing shortages and resource limitations to provide quality care, and their patients, who must overcome additional time and resource challenges to access that care. To date, WTI has impacted well over 1,000 onsite and supporting healthcare providers in over 20 countries, who, in turn, affect an immeasurable number of patients, all of whom are supported across our 40 existing programs by specialist care otherwise unavailable.

We know that our telehealth sessions are rarely a 1:1 event, meaning most often there are several providers and frequently a patient receiving support from a provider through the telehealth device, making our sessions 1: many. Considering this, our estimated people served should be viewed only as a minimum estimate that only accounts for the number of providers. Patient-level data collection through telehealth is a challenge, given the many patients an upskilled provider can reach outside a single telehealth session.

Adding to the initial challenge is that the providers at many of our host sites are already at capacity supporting their communities, making additional data collection a burden. With the launch of our platform, we will be able to collect critical impact information with minimal time required or interruption to our site partners. Our first data points implemented will include the context of the session (I.e., didactic vs. clinical consultation), the number of persons present during the session (providers and patients), and clinical and skills-based outcomes. These data points will help inform WTI's programming and provide an understanding of telehealth's potential to increase healthcare access in some of the most challenging environments in the world.

Being selected as a participant in Solve's program will open doors to World Telehealth Initiative that are vital to our future success. Not only can Solve provide the financial resources needed to develop and launch the custom-built platform that will allow us to scale and strengthen our programs, but it will also connect us with experts in marketing, technology, monitoring and evaluation, and strategy.

We are confident that our program design works because we have seen the impact on thousands of patients and hundreds of healthcare providers worldwide. Mothers and babies are alive after difficult labor and deliveries. Children with cancer have the medical care they need. Men with strokes are being identified accurately and treated for the condition in their local hospitals. Trauma injuries are appropriately treated through our interactive surgical mentoring programs.

Sharing our impact with the world requires a robust network of ambassadors, volunteers, and partners. Connecting with experts through MIT Solve and engaging in the mentoring program will strengthen our ability to transform global healthcare as we embark on the next phase of WTI's growth. 

World Telehealth Initiative is a part of the solution to provide accessible healthcare to people worldwide. And yet, we are unknown to many. Building our brand and sharing our impact through media and conferences would also help us develop collaborative relationships with corporations, non-governmental organizations, and community leaders. Every human has a right to healthcare and a life lived in dignity. Together, we can make that right a reality for thousands worldwide.

World Telehealth Initiative is the only philanthropic organization providing telehealth services with a full complement of applications. Providers can engage in collaborative telehealth sessions for clinical consultations, peer-to-peer didactics, surgical mentoring, and emergent care. The custom-built platform will allow us to scale, reach more needy patients, and connect volunteer physicians to providers at low-resource hospitals and clinics.

Through a partnership with MIT Solve's community and other like-minded partners, WTI can scale to meet a portion of the global demand for accessible healthcare in fragile communities.

The custom matching platform will transition WTI from a manual pairing process to a more automated, interactive system. Timely and effective medical care is crucial during conflicts, natural disasters, or pandemics. World Telehealth Initiative collaborates with the Ministry of Health and local hospitals to ensure communities have the support they need during critical times. The platform will facilitate a more streamlined method to promptly get the proper care to patients in rapid response and scheduled consultations.

In 2023, World Telehealth Initiative aims to transform global healthcare by expanding from 40 to 65 total program sites. WTI will add 500 new volunteer physicians to our community to support the new program sites, providing over 50 medical specialties to clinics and hospitals worldwide. With over 1,500 supporting clinicians by year-end, we can bring life-changing healthcare to thousands more people in fragile contexts. Much like a hospital has on-call physicians, WTI can offer the same level of responsiveness to local needs with a global community of volunteers.

The network effect will facilitate growth as more program sites experience successful support and more volunteers experience the benefit of connecting with hospitals and clinics through telehealth, reducing cost, travel, and time off work.

The WTI tech team completed the backbone in Phase One and transitioned our previous database to the new platform allowing robust searching capability and deeper data collection.

In Phase Two, volunteer physicians use their portal for registration and entering their data which is essential to the matching algorithm. This phase ensures transparency with global health partnerships. We are currently in the rollout stage for Phase Two.

In Phase Three, the platform will be implemented with our partner sites, allowing the hospitals and clinics to directly find the specialists they need to meet the needs of their patients in a responsive, customized way. This phase will offer integrated matching of support opportunities.

Launching the next phase of our custom-built platform will facilitate the recruiting and onboarding of new volunteers and program site providers in a more efficient, accessible manner. The increased capacity is crucial to our ability to scale our programs.

In the next several years, we anticipate the platform will be available through a phone-based app, allowing program sites to reach out to physicians "on-demand" and volunteers to join calls from anywhere.

WTI tracks the number of volunteers, their specialties, the length of telehealth sessions they provide, and the program locations. With the launch of the custom-built platform, we can track more qualitative and quantitative metrics, such as the length of mentoring and didactic sessions provided, training topics, provider satisfaction surveys, and other aspects of our programs.

World Telehealth Initiative addresses many of SDG 3's key targets to ensure healthy lives and promote well-being.

To address maternal and neonatal mortality (Targets 3.1 & 3.2), WTI is expanding support for maternity centers through hub-and-spoke models in several countries. Linking remote clinics with referral hospitals with telehealth provides on-demand support in time-critical patient care, such as during labor and delivery.

WTI supports patient care for those impacted by epidemics, infectious diseases, and neglected tropical diseases (Target 3.3) by bringing together experts to create care plans that meet the patient's unique needs and the community's available resources.

Achieving universal health coverage (Target 3.8) is more sustainable, lower-cost, and responsive when provided via telehealth. WTI addresses the burden of expenses related to travel, off-site training opportunities, and poor patient care through the network of physicians, nurses, therapists, and technicians working together through our four support applications.

The lack of quality, affordable, and timely healthcare is a global crisis. World Telehealth Initiative aims to revolutionize global healthcare by providing quality medical expertise where and when required. To achieve these ambitious goals, we must work synergistically with Ministries of Health, non-governmental organizations, community leaders, corporate sponsors, and investors to find sustainable solutions for communities that make sense culturally, financially, and logistically.

Activities or Inputs:

·      Identify and establish partnerships with healthcare organizations, local clinics, and Ministries of Health in fragile, hard-to-reach, resource-limited areas.

·      Provide training and support to onsite providers through donated Telehealth technology and access to WTI's network of medical experts.

·      Collect essential information on telehealth sessions and WTI's program to measure health, knowledge, and acceptability outcomes quantitatively and qualitatively.

·      Disseminate results with key stakeholders and international health organizations to expand programs and inform and improve telehealth service delivery to reduce healthcare access gaps worldwide.

Outputs:

·      Increased access to medical expertise and training

·      Increased provider knowledge and skills development, both clinically and in telehealth technology skills

·      Creation of best practices guide/model to inform philanthropic, international Telehealth program implementation

·      Critical data on telehealth programming (acceptability, feasibility, and performance), Inform telehealth policy)

Short-Term Outcomes:

·      Improved diagnosis and treatment of individual patients

·      Increased medical knowledge gained

·      Increased access to healthcare for underserved areas, including primary and preventative care

·      Data on program effectiveness

Intermediate Outcomes:

·      Reduced healthcare costs (decreased length of stay, decrease in number of unnecessary referrals)

·      Improved population health outcomes in the community both through our support network and by connecting existing provider resources within the region (e.g., improved management of chronic disease)

·      Increased patient engagement and increased acceptability and trust of medical professionals in the community

·      Improved provider ability to use Telehealth technology

Long-Term Outcomes:

·      Decreased burden of disease

·      Increase healthcare innovation

·      Sustainable improvement in the healthcare system and linkages

·      Provider retention

Our evaluation plans are based on our hopes to effectively measure telehealth's short, intermediate, and long-term outcomes on improving healthcare in resource-limited settings. Our monitoring and evaluation framework is still evolving. It will include conducting surveys, focus group discussions with key stakeholders (including site partners and supporting providers), and collecting crucial data points via our platform.

The implementation and completion of our platform will revolutionize our ability to collect essential information to inform and improve telehealth in resource-limited settings. The data points that our platform will capture include the type of session, number of providers present, diagnosis reached, and other health outcome information, including avoiding a referral or a change in patient care based on the consultation. With the launch of our matching platform, we will continue improving our monitoring and evaluation processes to measure the short- and long-term impacts of WTI's programs.

World Telehealth Initiative is underpinned by over $200 million of investment in telehealth technology. WTI uses a cloud-based telehealth system to power connections between clinical needs and the medical experts that can fulfill those requirements.

Teladoc Health's InTouch Lite V3 telehealth device has the highest connectivity and network performance, top-of-the-line audio/video capabilities, and immersive design. Purpose-built for healthcare with proactive monitoring and connection optimization technology to manage highly variable network conditions, a constant state of readiness is maintained for all devices and locations. We comply with all relevant state, national, and international laws and regulations, including the U.S. Health Insurance Portability and Accountability Act of 1996, known as HIPAA. We also regularly validate the controls we have in place through annual assessments and audits, including SOC II, Type Two, and HITRUST certification.

Physicians use diagnostic devices such as ultrasound, intraoral cameras, ECGs, and stethoscopes connected to the InTouch Lite to assess and treat patients accurately - from 100 or 1,000 miles away.

The custom-built matching platform currently in development uses industry-proven secure and scalable programming tools: Ruby on Rails is used for the server-side back-end (data storage, matching logic, etc.) and React for the front-end UI/UX (input forms, custom controls, etc.).

The priority of World Telehealth Initiative is to advance health equity and provide access to quality care for all. 

We are proud to have a dynamic and representative group of providers from diverse backgrounds working with us to make a positive impact in each of our global programs. By fostering a team of healthcare professionals that reflects the diversity of the communities we serve, we are better equipped to address the unique health needs and disparities in access to care. 

A diverse and inclusive team strengthens our mission of providing equitable healthcare to all. We are dedicated to fostering a culture of inclusiveness and belonging, where all employees are appreciated for their unique qualities and given equal chances to succeed and grow. Diversity based on race, religion, gender identity, sexual orientation, age, nationality, socioeconomic status, disability, or any other marginalized status is welcome and valued.

From our employees and the communities we serve to our stakeholders and our suppliers - we are committed to modeling diversity, equity, and inclusion in global healthcare - and hope others will join us in embracing it for every person in every community.

As 50% of the world lacks access to quality healthcare, our target market is vast. World Telehealth Initiative has an unprecedented capability to enable healthcare access by leveraging the in-kind donations of volunteer medical expertise and telehealth technology. Our site partners receive immense value for a fraction of the typical cost of a telehealth program.

WTI addresses the global healthcare crisis through a partnership model customized and unique to each health system and community we work with. With the ongoing rollout of our custom-built matching platform, we will continue offering responsive, flexible support opportunities, with the onsite providers articulating their needs and qualified supporting clinicians responding to bridge those gaps. Through didactics and consultations, upskilled providers can eventually care for their patients independently.

Clinicians in low-resourced health facilities often need opportunities to advance their careers and keep abreast of the latest in medicine. It is difficult to leave their busy practices. Training events also usually require travel that they cannot afford. WTI brings the training to them via telehealth.

Each unique program implementation requires the following:

   1. Program design and use case evaluation

   2. Initial technical review

   3. Ministry of Health approval and local policy verification

   4. Community outreach and education

   5. Physician training and development

   6. Asynchronous and synchronous care coordination

   7. Ongoing monitoring and evaluation

The key to transformational and robust health systems lies within each community. By connecting providers working in low-resource communities directly with healthcare experts for didactics, surgical mentoring, clinical consultations, and emergent care, WTI enables physicians, nurses, and therapists to access on-demand support.

WTI brings transformational change to the entire community. Strengthening the world's health systems is vital to our global survival. The potential to scale is limitless.

WTI has recently introduced Health System Memberships. This innovative volunteer program is designed to reduce burnout and enhance job satisfaction among clinical staff, thereby helping health systems attract and retain talented professionals. The hope for the membership program is to have a sustainable revenue stream of funding for the programs at WTI moving forward.

World Telehealth Initiative uses various fundraising strategies such as targeted campaigns, relationship building, corporate partnerships, stock gifts, and seeking grant funding through family foundations, donor-advised funds, and funding foundations. We recognize that it takes a diverse support network to provide health services in vulnerable communities worldwide.

World Telehealth Initiative recognizes that operating a non-profit organization requires a multi-pronged approach to building relationships and raising funds to run successful, long-term programs.

WTI is fortunate to partner with Teladoc Health. Using Teladoc Health telehealth devices and network enables the delivery of healthcare expertise anywhere in the world with an internet connection. The in-kind donations from Teladoc Health represent approximately $425,000 in value.

The physicians who volunteer their time and expertise with our partner sites represent approximately $350,000 in professional time. There is immeasurable value in the relationships built and collaborative partnerships established by networking experts with the common goal of improving patient care.

Since WTI launched Health System Memberships in 2023, four health systems have committed to supporting WTI with volunteer providers and financial resources. To date, we have $200,000 pledged or actualized, with another four health systems discussing the opportunity with WTI. One of the health systems members has many Spanish-speaking providers, which will benefit our programs in Puerto Rico, Ecuador, Argentina, and future program locations where Spanish is the working language. We also seek similar partnerships with French-speaking providers who can support Francophone countries and those who are fluent in more region-specific languages.

Virtual care and telehealth offer an opportunity to provide a cost-effective solution that ensures patients receive medical services where and when they are needed most. WTI's method significantly improves global healthcare at scale and a fraction of the typical cost.