My Rahnuma

Access to appropriate healthcare is a crucial problem in Pakistan and globally due to multiple factors, such as lack of education, information asymmetry, and poor health literacy. The scale of the problem is vast, with over 400 million people worldwide lacking access to essential health services, as estimated by the WHO. Additionally, over 100 million people are pushed into extreme poverty due to out-of-pocket healthcare expenses.

Pakistan faces a particularly challenging situation as it has a low healthcare spending rate of only 3.4% of its GDP, according to the World Bank. This limited funding has led to limited healthcare facilities and a lack of access to care and information needed for people to make informed health decisions.

The public primary healthcare system in Pakistan is drowning in major challenges such as, including but not limited to structural disintegration, scarcity of resources, ineffective operations, lack of specialized functionality, insensitivity towards gender issues, and limited accessibility. The limited budget allocated to healthcare is mostly consumed by curative services at the tertiary level. COVID-19 resulted in further regression of already fragile healthcare infrastructure.

Pakistan is very far from achieving universal health coverage, the out-of-pocket expenditures in healthcare and a failing public primary healthcare system make it difficult for the country's poor and underprivileged to receive essential services. Pakistan although has a well-developed public primary healthcare system consisting of basic health units (BHUs), district, and tehsil hospitals it is majorly underutilized (less than 20% consumption) due to a shortage of qualified healthcare workers. Nurse and physician-to-population ratio and hospital bed-to-population are far from the optimal standard dictated by World Health Organization (WHO). There is an increasing trend of utilizing specialist physician services with the under-consumption of primary preventive care services.

Another problem in Pakistan's healthcare system is that patients can book appointments in private specialty clinics without proper information about the healthcare professional's expertise and whether they are even relevant for their disease or health issues. This ultimately leads to suboptimal utilization of already limited health facilities and poor patient outcomes, causing additional costs and time before a patient can find the relevant doctors. The lack of knowledge and education also makes it challenging for individuals to make informed healthcare decisions. Currently, the health system focuses on secondary or tertiary prevention and curative services.

In conclusion, inadequate access to appropriate healthcare in Pakistan and globally is a significant challenge that affects a vast number of people. Insufficient healthcare spending, poor infrastructure, and lack of education and awareness contribute to this problem.

My Rahnuma is a platform that offers a unique solution to a fragile healthcare infrastructure by connecting care seekers with 4th or 5th-year medical students with relevant medical training to discuss their health concerns. Our platform aims to bridge the information gap between patients and healthcare providers, particularly in areas where access to healthcare services is limited. Here are three key aspects of our solution:

1) Cost-effective: By leveraging the expertise of medical students, My Rahnuma offers a cost-effective solution that efficiently utilizes limited healthcare resources. Our platform helps care seekers access the care they need while providing medical students with practical experience and building their clinical skills.

2) Efficient Triage System:  Using our pyramid-based approach, medical students take detailed histories from care seekers and provide guidance on appropriate healthcare options. For minor health conditions that don't require a physical appointment, medical students can direct care seekers to house officers or junior doctors with medical licensure for remote teleconsultation. This efficient triage system enables care seekers to access healthcare services without having to physically visit healthcare facilities.

3) AI-Assisted Process: As we continue to expand our services, we plan to leverage advances in artificial intelligence and natural language processing, such as ChatGPT, to further optimize the history-taking and triage process. ChatGPT can assist in capturing relevant information from patients, identifying potential risk factors, and prioritizing cases based on symptom severity, before routing them to the appropriate healthcare professionals at My Rahnuma. A demo of the beta version of the My Rahnuma bot can be viewed here.

The pyramid-based system used by My Rahnuma refers to a hierarchical structure for triaging patients according to their medical needs. At the top of the pyramid, an experienced physician oversees the process, and at the bottom, medical students interact directly with care seekers to take detailed histories and provide guidance on appropriate healthcare options.

In conclusion, My Rahnuma is a platform that provides access to healthcare services to people who may not have had it otherwise, developing health literacy for the utilization of primary preventive care. Our solution aims to bridge the information gap, efficiently utilize healthcare resources, and enhance the efficiency of healthcare services while ensuring that patients receive the best possible care from experienced professionals. We are committed to expanding our reach to benefit communities in need and are excited about the potential impact of our solution.

At My Rahnuma, we are working to directly and meaningfully improve the lives of care seekers who currently face barriers to accessing appropriate healthcare. Our target population includes individuals who have access to a digital medium of communication such as smartphones. This population can include people from various socio-economic backgrounds, including working-class individuals, students, business professionals, and anyone who needs guidance on accessing the right care. Pakistan is a growing digital society with over 50% ownership of smartphones and increasing mobile internet connections.

Women are also a significant part of our target population. Pakistan ranks 145 out of 146 in the gender inequality index. Often, women in Pakistan face cultural and social barriers to accessing healthcare services, and digital platforms like My Rahnuma offer a safe and accessible way for them to communicate with healthcare professionals and get the guidance they need, especially for essential health services such as family planning and antenatal care, which in turn will also impact sustainable development goals attainment in Pakistan.

Our target population is currently underserved due to a lack of access to quality healthcare services, particularly in rural or remote areas, as well as a lack of information and health literacy. By connecting care seekers with medical students who can provide guidance on appropriate healthcare options, we aim to address these needs and improve the lives of individuals who may not have had access to the care they need otherwise. Our solution improves patient outcomes and reduces the cost and time spent on accessing appropriate healthcare.

Our core team has 3 members who have lived experiences and have close proximity to the community they want to serve. 

Saad one of the core members of the team has had a significantly life-changing event in his final undergrad semester. A severe injury to his right hand resulted in multiple visits to the hospitals, these interactions made him aware of the challenges people face while accessing care and also influenced him to strive towards improving care for others. Saad recalls that the lack of information after his surgery left him in anxiety and he spent 3 months at a suboptimal rehab clinic luckily he changed his care provider and the difference was massive. It turned out Saad should be visiting an occupational therapist instead of a physical therapist. These experiences influenced Saad to think about why this information gap exists and how can it be fixed.

Mayera’s medical degree and experience working at a vital statistic health registry in Karachi's urban slum areas, with health service delivery for antenatal, family planning and child physician services via smart phone application made her deeply aware of the problems women face while accessing care and also the biases associated. While rotating within different specialties at the hospital as a medical student she is deeply aware of the importance of patient history and communication. Her thesis for her Master in Public Health on misconceptions regarding the polio vaccine made her visit slum areas and hear firsthand account about the beliefs and misconceptions people have regarding vaccines. A course in social determinants and how they impact health outcomes of individuals made Mayera an advocate for women and she wants to make sure they are empowered to be able to make their own health decisions. It is her dream that Pakistan can attain sustainable development goals of 2030 to reduce maternal and neonatal mortality and move closer to providing universal health coverage.

Fatima also a medical graduate has experience working at large hospital systems in Karachi. She understands how cost and lack of universal healthcare coverage in Pakistan affect people's ability to get the care they need. She has seen firsthand how a lack of information results in people visiting the wrong specialty clinics resulting in suboptimal care or waste of time for both patients and providers. She believes that medical students in their final year and house officers are an untapped resource in our health system who can bridge the gap between attendings and patients by helping patients make informed decisions about their care. As an aspiring physician-scientist with an interest in pediatric and family medicine, she is an integral part of the team who brings a wealth of clinical acumen and insight to our team’s solution.

My Rahnuma, has moved beyond the conceptual stage and is now a functional prototype. We were able to connect patients with medical graduates and receive feedback on appropriate healthcare options, which shows that My Rahnuma has been tested in a real-world setting.

During the testing phase, we received positive feedback from both care seekers and medical students who have used our solution.

Furthermore, we have a clear and defined plan for scaling our solution and developing a comprehensive platform that any care seeker can access to get the health information they need. 

As a prototype, our solution is not just a theoretical idea but a tangible product that has undergone testing and is ready for further development and expansion. We believe that our prototype has the potential to make a real impact in the healthcare industry, particularly in areas where healthcare services are limited.

Overall, My Rahnuma addresses a critical need in the healthcare industry by bridging the information gap between patients and healthcare providers. Its success in improving patient outcomes and addressing this need makes it a clear prototype. As we continue to refine and expand our solution, we have the potential to make a significant impact on communities in need.

My Rahnuma has served more than 10 care seekers through our testing phase on platforms such as Whatsapp and other social media platforms. However, our goal is to expand the reach of our solution and make it accessible to a wider audience.

Our team is excited to apply to Solve for the support and guidance we need to take our solution, My Rahnuma, to the next level. While we have made significant progress in connecting patients with medical graduates and improving patient outcomes, we face several challenges that we believe Solve can help us overcome.

Firstly, we need guidance in developing a sustainable business model that will enable us to scale our solution in its early stages. We believe that with the right support, we can create a platform that can reach a wide audience and make a significant impact on communities in need.

Secondly, we need financial support to help us scale our solution and expand our reach. We believe that Solve can connect us with partners who can provide the financial support we need to take our solution to the next level.

Additionally, we need technical support to develop a mobile app platform that will enable patients and healthcare professionals to connect easily and efficiently. This will help us expand our reach and provide access to healthcare services to people who may not have had it otherwise.

Finally, we need mentorship and guidance on developing culturally appropriate communication channels. We believe that by tailoring our communication strategy to the unique needs of our target audience, we can create a community of care seekers and medical professionals who will work together to advocate for better and accessible health for all.

Overall, we believe that Solve can provide the support and guidance we need to overcome these barriers and take our solution to the next level. We are excited about the potential impact of My Rahnuma and look forward to working with Solve to make it a reality.

"My Rahnuma" harnesses the expertise of medical students and recent medical school graduates who have been shown to improve patient care and satisfaction through their unique perspectives, clinical knowledge, and ability to communicate medical information clearly [1]. Studies have also demonstrated that medical student involvement in patient care leads to better patient satisfaction [2]. By connecting care seekers with these trained professionals, My Rahnuma aims to bridge the information gap that often exists between patients and healthcare providers, particularly in areas with limited access to healthcare services.

We also propose a novel use case of AI to help triage and streamline workflow for experts at My Rahnuma to optimally utilize our limited resources.

By connecting care seekers with medical students, our solution bridges the information gap that often exists between patients and healthcare providers, particularly in areas where healthcare services are limited. This approach empowers care seekers to make more objective decisions about their health and increases their trust in medical and health services.

Furthermore, My Rahnuma has the potential to catalyze broader positive impacts in the healthcare industry. As more care seekers begin to trust medical and health services, it could create a community where people advocate for getting preventive primary care on time instead of delaying it to the last second. This could lead to earlier diagnoses, better health outcomes, and more efficient use of limited healthcare resources.

In addition to the positive impact on care seekers, our solution also provides medical students with practical experience that prepares them for their future careers. This is a significant advantage that traditional healthcare models do not offer.

Overall, My Rahnuma has the potential to change the market by offering a cost-effective and efficient solution that utilizes limited healthcare resources. By leveraging the expertise of medical students, our solution empowers care seekers and helps them make more informed decisions about their health. We are excited about the potential impact of our solution and believe it has the potential to transform the healthcare industry.

Our impact goals for the next year and the next five years are centered on creating a transformational impact on people's lives through our solution, My Rahnuma. 

In the next year, we plan to create an online community where people can openly discuss their health issues and get guidance from medical students. We believe this will empower individuals to make informed decisions and increase trust in health services. Our focus for the next year will be on college/university students and working professionals, enabling them to access the right health information and guidance they need.

Over the next five years, our impact goals are even more ambitious. We want to create a network of brand ambassadors in teaching hospitals throughout Pakistan to improve maternal and child health and access to primary health information and services in rural areas. By leveraging the expertise of medical students and junior doctors, we aim to bridge the gap in healthcare service delivery and access and empower individuals to make informed decisions about their health. Our ultimate goal is to transform the healthcare landscape in Pakistan by creating a community of informed and empowered individuals who advocate for their health and well-being.

We are committed to working towards these goals and to making a positive impact on the lives of millions of people in Pakistan, doing health promotion and utilize primary care preventive services.

Although the solution is still in very early stage of development we would like to monitor its progress by achievement of target 3.4 mortality and morbidity due to non-communicable diseases, target 3.7 access to sexual and reproductive health service and target 3.8 access to universal essential health services such as safe and quality medication and vaccines.

Our theory of change is based on health belief model, that perceived susceptibility and severity to a disease, action cues, perceived barriers and its benefits dictate an individual's engagement in health related behavior. Thus, by leveraging medical students and junior doctors in the final year of their training or recently graduated, we can bridge the information gap between care seekers and healthcare providers. We aim to promote health literacy, resulting in more objective decisions by care seekers, better health outcomes, and efficient use of resources. 

Our solution helps care seekers make more informed and objective decisions by providing them with information about the unique abilities of different doctors and their areas of specialty. This, in turn, leads to more effective and efficient utilization of resources with people effectively utilizing primary care services. Medical students and junior doctors gain important and useful real-world experience by serving as our solution's ambassadors, preparing them for their future careers while also contributing to the community's well-being.

By creating trust between care seekers and healthcare providers, our solution can build a community that advocates for better health and well-being, ultimately leading to healthier communities. Through our brand ambassadors at each teaching hospital in Pakistan, we aim to improve maternal and child health and access to primary health information and services in rural areas. 

Overall, our theory of change based on health belief model is based on empowering medical students and junior doctors and bridging the information gap, we can improve health outcomes, create trust between care seekers and healthcare providers, and ultimately create a healthier and more informed community.

Our solution leverages the popular messaging app Whatsapp as a communication channel. However, as we scale, we plan to create our own app that will allow us to automate certain processes and create a more efficient system. We recognize the need to filter requests and ensure that they are routed to medical students or graduates with the appropriate expertise. To address this challenge, we plan to integrate Large Language Models such as ChatGPT, which can summarize information and improve the efficiency of our system.

We also recognize that many vulnerable communities in local areas may have limited education and literacy levels, and may prefer to communicate through voice messages. To address this, we plan to integrate voice-to-text AI models that can help us automate voice messages and route requests appropriately. By leveraging technology, we aim to create a more compelling and user-friendly experience for our care seekers, while also improving the efficiency and scalability of our solution.

Overall, our core technology is focused on leveraging digital communication channels and AI-powered solutions to provide accessible and reliable health information and guidance to our target population. We believe that this approach will help us achieve our impact goals and drive positive social change.

At My Rahnuma, we believe that diversity, equity, and inclusivity (DEI) are critical to our mission of improving health outcomes for all. We recognize that diverse perspectives and experiences are essential to developing solutions that work for everyone, particularly those who have historically been marginalized or excluded from decision-making processes.

To that end, we are committed to promoting DEI in all aspects of our work. This includes building a diverse leadership team that brings a range of perspectives and experiences to the table. Currently, two out of our three key team members are women, one with a post graduate public health degree and furthermore, we are actively working to recruit team members from a variety of backgrounds and communities.

In addition, we are committed to creating a work environment that is welcoming and inclusive for all. This means fostering an environment where all team members feel comfortable sharing their perspectives, ideas, and concerns, and where everyone's contributions are valued and respected.

Finally, we are committed to ensuring that our solution is accessible and inclusive for all users. This includes designing our app and other tools to be accessible to people with disabilities, as well as considering the needs and perspectives of diverse communities in our product development and outreach efforts.

We recognize that promoting DEI is an ongoing process, and we are committed to continuously learning and improving our approach. We welcome feedback and input from our users and partners on how we can better incorporate DEI into our work.

My Rahnuma's business model is to provide affordable and accessible healthcare services to people who may not have had access to healthcare services otherwise, particularly in under-resourced areas. Our business model focuses on providing value to two key customer groups: care seekers and healthcare professionals. 

For care seekers, we provide a range of services, including guidance from medical students, telemedicine consultations, support before and after appointments with doctors, and access to our community forum to post health-related questions. These services are designed to provide high-quality, affordable healthcare advice and support, particularly to those who may have limited access to healthcare services due to financial or geographic constraints.

For healthcare professionals, our platform provides an opportunity for medical students, house officers, and junior doctors to gain practical experience, build their clinical skills and work towards obtaining medical licensure while contributing to the broader goal of improving healthcare access and outcomes for underserved communities.

To generate revenue, we plan to offer paid services such as telemedicine consultations, interpretation of reports, and additional support services for patients who require ongoing care management. We also plan to partner with healthcare facilities and organizations to provide referrals and other value-added services. 

Overall, our business model aims to provide affordable, accessible, and high-quality healthcare services to underserved communities, while also providing an opportunity for medical professionals to gain valuable experience and contribute to the broader goal of improving healthcare outcomes.

My Rahnuma plans to become financially sustainable through a combination of revenue streams. One revenue stream will be through charging patients for telemedicine consultations with house officers or junior doctors. We will also offer additional services such as the interpretation of medical reports for a fee. 

Additionally, we plan to offer specialized services to corporations and businesses to provide health support to their employees. This will not only provide a new revenue stream for us but also help promote health and wellness in the workplace. 

We also plan to seek grants and donations to support our mission and fund our operations. We will actively seek out partnerships with donors and organizations that share our vision for improving access to healthcare services in underserved communities. 

In the long term, our revenue streams are expected to cover our expenses and ensure that we are financially sustainable. We will continue to explore new revenue streams and partnerships to further support our mission of bridging the information gap in healthcare and providing access to quality healthcare services for all.

We have not raised any investment or capital so far. MIT Solve is the first place we are applying to after testing our idea in a limited setting.