Virtual System Change

During the 2020 pandemic, it was revealed that there was a gap in healthcare coverage for minorities. More specifically for African Americans. African American men and women who were front-line workers were shown to have the biggest disparity in healthcare. African American men more than women showed a greater disparity in healthcare due to a variety of factors. One is a lack of access to healthcare because of distance, immobility, and affordability. Another factor is distrust in the system due to bias, racism, and a lack of cultural sensitivity toward African Americans. But the greatest factor is a lack of healthcare literacy which can lead to misunderstandings about health conditions and inadequate use of healthcare services. Men are also less likely to seek out mental health services which could lead to a higher propensity for suicide. It is also shown that men are less likely to go see a doctor and less likely to take preventive steps for their health. And when they do see a doctor they are less likely to follow the advice given, and if medication is prescribed, some men fail to finish their entire medication. This means more trips to the ER for this population

Our solution to the problem is to increase access to primary care and healthcare literacy by connecting individuals and families to community-based organizations led by minorities along with minority medical providers or culturally sensitive providers. We accomplish this with our platform and app that utilizes video-conferencing, data collection, facial recognition, and machine learning to deliver to an individual a "health score" from physiological data, social determinants of health data, and mental health data. This system will be unique to each patient. Each patient has a dashboard with their aggregated score and is designed to connect patients to minority and/or culturally sensitive medical professionals. In order to make healthcare more affordable we are looking to connect individuals that are immobile, without reliable transportation, and far from a facility to a medical provider and a case manager from a community-based organization with the help of our outreach staff.

This project is being developed using a “Patient-Centric Design'' approach to improve health outcomes for minorities such as African American and the Latin X community using a value-based model. Past approaches to healthcare delivery have left many minority Americans unsatisfied and suspicious of our healthcare system. Especially in black and Latino communities where the dissatisfaction is highest. By providing a better experience with healthcare accessibility and delivery among these populations we wish to serve, the adoption of this system can spread. With greater adoption, we can promote more preventative care to improve, engage, empower, and motivate individuals, families, and communities to enhance the quality of lives and sustain health gains. Using this approach, we can build the trust of the U.S. healthcare system back into these communities.

Me and the two members of my medical advisory board, are minorities and come from minority communities where community members suffer from multiple chronic conditions. One of my advisory board members is a practicing ER physician at a clinic near the Mexican border of San Diego. Access to primary care and health literacy are sub-par in neighborhoods where there are a low number of affordable clinics to serve the community. Because of this many minorities have a higher chance of developing a chronic condition compared to their counterparts who have a higher level of access to primary care. I've experienced this personally as an emergency medical technician, certified nurse assistant, and a home healthcare nurse of a cerebral palsy patient. I and the members of my board have worked closely with community-based organizations that have worked in minority communities. As part of the design, we will partner with community-based organizations that are in minority communities to connect with community members and get direct information on the needs of the community.

In 2019 we attained funding from a Southern California foundation for the purpose of developing technology to help low-income minorities and the homeless receive primary care here in southern California. During the 2020 pandemic, we were able to form a partnership between a community-based organization and a federally qualified health clinic with the purpose of verifying if our telemedicine technology would be accepted and utilized by providers and their beneficiaries. During the pandemic, we serviced over 100 individuals and performed over 20 virtual visits using our platform.

We are a tech-enabled healthcare services company committed to improving access to healthcare services for minority communities. These communities usually have residents that are low-income individuals and families, as well as a higher elderly population and homeless individuals. We especially want to target the men of these communities due to data showing a higher propensity of having multiple chronic conditions. We want to be a key facilitator and outreach partner for healthcare providers and established social organizations by connecting underserved patients to services through our SAAS technology. Because we are a small group we have gaps in our team that we hope SOLVE will fill. Individuals who have experience in medical law, as well as developers who are familiar with EHR systems and developing platforms to work with these systems would be very helpful in our development. 

Access to healthcare services changed greatly during the 2020 pandemic. Hospitals had to change the way health care was being delivered during the pandemic and needed to reduce staff exposure to ill persons, preserve personal protective equipment (PPE), and minimize the impact of patient surges on facilities. Healthcare systems had to adjust the way they triage, evaluate, and care for patients using methods that do not rely on in-person services. Telehealth services help provide necessary care to patients while minimizing the transmission risk of COVID-19, to healthcare personnel and patients. Telemedicine was seen as a way to reconnect patients with chronic conditions to their doctors for continued care. Unfortunately for African American and Hispanic communities access to digital technology wasn’t equal to their Caucasian counterparts. The odds of owning a computer or having access to the Internet were one-fifth as likely in the African-American communities with Hispanic Americans owning a computer one-third as likely and having access to the Internet was less than one-half as great as for the European-Americans. Those who received Medicaid assistance were less than one-half as likely to use either the Internet or digital health information as were those who did not receive Medicaid and a little more than half as likely to own a computer. Our approach to solving these problems mentioned above is by taking hardware to the patient along with a medical extender to facilitate a telemedicine visit. By using a medical extender, video-conferencing software, and a machine learning model we can reduce the digital divide to access care among these populations.

Our focus will be on populations that are close to 50% and 30% of the Average Median Income (AMI) here in San Diego, including individuals and families. These economic metrics will help us target the “very low income” and “Extremely low income” groups that have a very high probability of having health disparities. decreasing health disparity due to poverty is one of our goals. Poverty is one obstacle that can affect our patients’ health. Beginning in utero and continuing throughout an individual’s life, poverty affects health via complex mechanisms. Life expectancy, learning abilities, health behaviors, and risks for developing the disease are affected by poverty, as are educational, work, and lifestyle opportunities. The degree to which an individual’s health outcome is affected is filtered by his or her level of “host resistance” to poverty. Poverty does not automatically determine an individual’s health status, although it can significantly influence it. Recognizing and measuring Social Determinants of Health is our second goal. Partnering with Community-Based Organizations (CBO) will help us identify who we should focus our efforts on in the community and who fits into the categories we want to target. Using the database of CBOs as a resource, we want to target a minimum of 25 individuals a month or 300 encounters a year for the duration of the project (Individuals and families). We define a successful encounter as the completion of an “Initial Health Assessment” and completion of the “Social Determinants of Health'' survey. An added benefit will be to have a telemedicine exam scheduled to engage with a medical professional. Our third goal is to establish more meaningful relationships with primary care professionals with every person we encounter. We are looking to partner with local Federally Qualified Health Clinics and doctor offices as part of this project to help with telemedicine visits. With each encounter, we will get permission to collect health data to build a dashboard for each patient we encounter and inform each participant how we will use the data. The health data that is collected will be analyzed and tracked to show trends in the health outcomes of the populations it is studying as well as to be used to improve the machine learning model of our platform and provide data for the providers in these relationships we want to establish.

We will measure our progress by the number of virtual visits we accomplished per week, month, and year. Along with connecting with hospital systems and recording the number of individuals from a community who enters their ER in a day, month, or year. 

Technological advancement in the medical industry has been steadily growing since the inception of the National Institutes of Health (NIH) in 1887. Unfortunately, early access to these breakthroughs has been only accessible to Americans who can pay cash to access these technologies or by individuals who are enrolled with an insurance company that allows the use of the technology (specified by the insurance company and implemented into a managed care plan). For instance, the introduction of medical and scientific advances such as the CT scanner in 1972 and being able to implant a cardiac stent in 1986 comes at an increased cost to recipients of the technology. Despite notable health technology like a glucometer which is available through medical coverage and affordable to the general public, most medical technology when first brought to market is expensive and out of reach for most Americans. Generally, aspects of healthcare such as healthcare delivery, which is convenient, quickly accessible, and easy to schedule, are difficult to achieve for individuals who are on government insurance plans such as Medicaid.  Many factors contribute to this, yet there continues to be an alarming disproportionate burden of illness among persons from poor economic backgrounds, in which racial and ethnic minority groups make up the largest portion of the population who experience health disparities. The bottom line, racial and ethnic minority groups suffer health disparities because they are the last to receive access to technological and medical procedure breakthroughs because of economic status. We propose a digital system of “care management” for improved health outcomes. Through easily accessible technology and supervised medical extenders as primary tools in this system, it will produce a User Experience (UX)  “Health Score” profile on our platform that will aid in providing primary care in an affordable fashion. Our technological approach uses video-conferencing and Machine Learning software to provide support to primary-care doctors so that they can oversee and address the chronic care needs of patients directly instead of relying on patient accountability or independent disease-management programs. By virtually connecting racial and ethnic minority groups with physician Assistants and Nurse Practitioners of Federally Qualified Health Clinics or doctor offices, we can reduce the cost of “care management”  by reducing the burden of meeting a doctor at a facility. We believe this approach will drive the adoption of a value base model in the healthcare industry and improve the lives of these populations, reduce costs for medical facilities that provide care management, as well as grant access to minorities and ethnic groups high-quality care.    

Our platform and app will utilize video-conferencing technology for data collection and use facial recognition software to feed our machine learning algorithm to deliver to an individual a "health score". This will be a combination of physiological data, social determinants of health data, and mental health data. This system will be unique to each patient. Each patient has a dashboard with their aggregated score and is designed to connect patients to minority and/or culturally sensitive medical professionals.

The way we incorporate diversity, equity, and inclusion is by first setting up our executive team starting with the CEO. Our CEO is an African American and our preliminary CTO is a data scientist and members of our medical advisory board are of Asian descent. This design will allow the hiring of minority employees in the continuation of the development of our infrastructure as we grow. From HR to engineers to medical providers, we partner with the diversity of our executive team which will allow us to be open to bringing on more members of this team that diverse.

We've developed a B2B business model where we will offer our services and platform to clinics and doctor's offices that have minority medical providers or work in minority communities. We want to offer a per member/ per month rate for the service and platform, or a per month subscription fee just to use our platform. We will connect patients of these clinics and offices to their physicians using our platform from their homes. If a primary care physician isn't available we would be able to connect with a minority medical provider to address their primary care needs. Our platform will connect patients to a physical but also connect patients to other professional services such as a therapist or case management if our machine-learned "Health Score" feature recommends it. This feature comes from input social and behavioral data input by patients and professionals working with the patient. The collection of the data for each virtual visit and each time the patient visits the platform updates the score. Customers we would like to target are the managers of smaller clinics and doctor's offices located in African American or Latin X communities. Our main user would be a healthcare provider such as a doctor or therapist who treats members of the community. Providers need a simple platform/app that their patients can use to communicate their primary care and health literacy needs. The app will allow providers to have a virtual exam with their patients without requiring them to visit a facility. This model keeps patients out of the ER and strengthens the provider/patient relationship which leads to trust.

We have bootstrapped the development of our software and progression over the years but also have been funded by a foundation through a grant to perform our pilot in 2020. We designed our organization as a C-corp to obtain funding to grow from venture capital once we have enough traction to be attractive. We will generate revenue from selling our service to medical organizations and our subscription service along with the licensing of our software. 

In 2019 we obtained funding from a Southern California foundation called the Alliance Healthcare Foundation for the purpose of developing a strategy to help low-income minorities and the homeless receive primary care here in Southern California. We implemented that strategy during the 2020 pandemic, we were able to form a partnership between a community-based organization and a federally qualified health clinic with the purpose of verifying if our telemedicine technology would be accepted and utilized by providers and their beneficiaries.