Hub and Spoke Tele medicine for Equal Access to Healthcare

According to the World Health Organisation , Africa carries 25% of the global disease burden yet only 3% of the global professional health work force is located on the continent .It should be noted that the big number of professional health workers available on the continent are concentrated in urban and peri-urban areas leaving the rural patients in the hands of the semi skilled healthcare service providers located in these rural areas. These lack the training skills and WHO current guidance they need to accurately assess the health risks of their patients.In the end ,this increases the risk of the poor diagnosis, wrong medication and recurrence of sickness among the rural communities in Africa.

In the efforts to democratise access to healthcare services for the rural patients in Africa,Chil uses  an Artificial Intelligence guided Hub & Spoke Tele medicine Model to extend key scarce professional medical resources of ;

a-doctors

b laboratory 

c pharmacy  

d.referral  services.

 1-We identify and  partner with rural  local Health facilities with No  capacity to attract and employ stationed Doctors/specialists  as their full time staff.

 2-Offer them our Tele-medicine AI  platform  together with compatible Tele-medicine devices .

3-Train the facilities’  semi skilled Nurses on how to use the technologies & WHO guidelines

 4-When a  partner rural health facility gets a patient , the trained Nurse initiates a call with our E-Doctor based at our  Hub(own hospitals )/globally.

 5-The doctor can ask the patient to carry out a given test and if the facility does not have a laboratory , an  E-lab test request is made to our Hub or partner Laboratory if our Hub is far  on testing ,the results are uploaded on the patients EMR account and a copy sent to our E- doctor who does E-prescription  .If the the treating Spoke does not have the E-prescribed drugs, then through our E-pharmacy portal drugs are then ordered from our Pharmacy or partner pharmacy if ours is far away

6-For complicated cases that require further management , our Spoke Electronically refers them to our own Hubs or partner hospitals  if our hub is far away . •

At  the end of the day, our doctors(based at our hub and globally) become the e -doctors for our partner rural health facilities just like our pharmacies and partner pharmacies become our spokes pharmacies hence improving the quality of health care ,clinical evaluation and treatment practices for the people living in rural and hard to reach  areas of Africa without putting pressure on their pockets to pay for transport fees to cities where such kind of care was previously accessed

https://drive.google.com/file/...

When a person from the rural area falls sick, they run to the immediate nearby clinic for medical attention .Its unfortunate that these clinics are most of the times run by semi skilled nurses who even sometimes dont have any medical background and lack  current WHO  guidelines on how to offer the Minimum standard medical care .At the end of the day , patients find themselves experiencing poor diagnosis which results into wrong medication and hence disease recurrence and death from treatable diseases like malaria ,maternal related  diseases etc  .

For those who strive to seek proffesional medical care ,they have to endure moving long distances to cities where quality medical care can be found . This costs them alot of money to move and even when they get services from a far away service center ,they strive hard to get follow up services since they can't keep moving to cities for reviews .

At chil femtech center, we majorly target these rural clinics with no Stationed doctors,No Pharmacies nor Laboratories on site.We offer them our telemedicine technology that links them to any medical resource they need directly from our own hubs and partner hubs globally. When patients visit these partner health facilities , they can have access to any services they require just like those in the cities and towns .This saves them time and resources in terms of transport to move to cities for medical care .

Chil Femtech Center  team is composed of 39 full time staff with a total of over 400 Years of Tele medicine experience  and  has more than 70% of the team members who in the past have  been affected by lack of proffessional medical care in their villages . This  is  led by 

Dr. Nabuuma Shamim  Co-founder and CEO- Shamim is a Medical doctor by training who opted to join medical school because at the age of 13 she lost a mother to cervical cancer . She belives that had her mother gotten early medical care from a near by local health facility where she used to get pain killers when ever she got pain , she would have survived .She has worked for key Tele-medicine companies like Teladoc and has over 8+ years in running Digital health startups .

Agaba Peter Co-Founder and Chief technical officer   - He is a chief technical Officer . He holds a masters in Machine learning. Agaba lost a  mother and her only brother to malaria . He believes that had the local rural health facility had access to a proffesional doctor , his  brother   would not have died due to lack of blood . For the  last 10 Years, Agaba has used his Artificial Intelligence skills to develop technologies that extend medical services to people in rural areas 

Kanda Dorothy - Head of  Marketing & Co-founder  - For so many years, Dorothy was  battling fistula  which she got when the nurse at local health facility forced her to push an over weight baby . She has used her masters in Marketing to promote products that extend key medical services to rural people . She believes if there was a way to electronically get services from a professional obstetrician, she would have been  advised to seek services beyond the local health facility where she almost died from.  

Chil's first operation country was Uganda in 2021. 2022 it expanded its operations to Kenya and in 2023 it entered Tanzania market.Since 2021 when  the  first Pilot of the Hub and Spoke Tele-medicine was done, we managed to reach 170,189 patients through a network of 922 partner local health facilities . Of the 170,189 patients that were served , 35.90% were children ( 1-14years )28.44% were women (25-65 years not pregnant ) ,6.63% were men (50-75 years ) ,25.03% were ( Expecting Mothers). In  the year 2022 , we became the first Tele medicine company to intergrate sign language interpretation in our platform and this has enabled 501 disabled people to use our Tele medicine services . At the end of 2023 we  managed to enter a  software rental agreement with the government of Burundi . The few cancer doctors in Burundi's capital now can offer E-consultation to  cancer patients in deep rural areas of Burundi .

We are a young company that requires mentorship and training in various aspects like fundraising, Marketing among others. Knowing that winners will have free mentorship from industry leaders made us apply in order to tap into such a great opportunity . The training that is offered  from the industry experts will empower our company. 

We are a female led company and it is very difficult for us to get investment even though we were among the first telemedicine companies in Africa. We know that  being selected avails companies like ours to immerse opportunities in terms of  wide range media opportunities  where global investors in health can come to know about our work.

To us, this was reason enough to apply for this opportunity. It comes with great pride to be associated to brands like Solve. Being associated to such brands does bring a young company with social capital it needs to attract more opportunities.

Chil Femtech Center works in Uganda, Kenya and Tanzania and our competitors include Rocket Health Uganda, Zuri Health Kenya and Agakhan services in Tanzania.

Unlike our competitors who strive to establish vast empires, taking full responsibility for patient care and running their own e-pharmacies ,We are an ecosystem builder driven by the belief that empowering local and rural clinics is crucial in transforming healthcare in Africa.We do believe that if telemedicine is to revolutionise and democratise access to quality healthcare, it must work with the existing work flows. We identify ,partner with rural local health facilities , give the semi-skilled nurses at these facilities the capacity  building in current WHO guidelines and how to use our technologies 

More to that, unlike our competitors who target the insured , town based customers ,We envision an Africa where even the rural population have access to professional medical care. Therefore us moving beyond where every competitor of ours targets and expand our scope to the rural population makes us different.

Our platform is not just a video conferencing platform , it is compatible to more than 16 Tele medicine devices like Blood Pressure machine , stethoscope, ESG Machine among other devices . The E-doctor does not depend on what the nurse at the partner health facility but rather hears and sees any medical measurement on a patient on real time .

I should also note that chil femtech center is the only tele medicine company that offers Tele medicine for the disabled . When a disabled person visits our partner health facility, the nurse sets up a consultation with a doctor and through our Artificial Intelligence platform (accessible via App and web) , the patient can speak to our E-doctor in sign Language and this  is auto-Translated into audio and the response from the doctor is translated into sign Language for a patient to understand . It should be noted that this communication can only be accessible in Only English and its real time

We believe that by establishing a centralised hub connecting various rural health facilities lacking essential resources to a network of on demand healthcare providers, pharmacies and laboratories, we can improve access to vital services through our pay per user model, we aim to empower these facilities to efficiently procure the services they need, there by enhancing healthcare delivery in underserved areas. By facilitating this collaboration and resource  allocation,we envision reduced barriers to accessing quality healthcare, ultimately leading to improved health outcomes and well being for rural populations in Africa.

Chil Femtech Center measures both 

1.  Access

• Average Patient Waiting Time  ( in minutes ). 

  We  measure ,track and assess the number of minutes the patient takes to wait for our e- doctor for consultation upon arrival at the spoke.Upon getting services , our platform  auto sends an E- Questionnaire to the patient/ care taker and among the things to capture is the time they spent waiting  to see the doctor .Its from these responses that we calculate the  average waiting time for patients.

  Percentage of Telehealth Emergency Referrals. 

  We assess the number of patients that sought services vs those who required referral services .This helps determine the percentage of patients that require Tele-health Emergency referrals 
  

• Population Coverage (Tele-Consultation) by country.

  We capture the number  of patients that seek e- consultation in a given country vs the total number of patients that seek e- consultation services from all the countries of operation.

   Population Coverage (Tele-Prescription) by country .

  This is  done by calculating the number of patients that only got E-prescription  services in each given country vs the total number of patients that seek e- prescription services from all the countries of operation.

•  Quality
  

• Percentage of Medication Errors Related to Teleconsultation.We calculate the number of the patients that got wrong medication . This is calculated by the number of patients that sought our consultation and prescription services and then wrong medicine was ordered by the nurse on duty at the partner health facility 

• Percentage of Telehealth Patient Satisfaction. We calculate the number of patients that are satisfied with the services they got through our platform vs the total  number of patients that received our services. Periodically ,during patient E-follow up sessions , our doctors administer a questionnaire to assess whether a patient is satisfied with what we offer 

• Percentage of Telehealth Spoke Satisfaction. We calculate the number of  partner local health facilities  that are satisfied with the services we offer to their patients vs the total number of partner health facilities that register on our platform. 

  
  

  More about how our key performance indicators and how we can track them can be found in the below link document;

  https://drive.google.com/file/...
  

  
  

We use an artificial Intelligence Telemedicine platform accessible via web and app  to extend key scarce resources to patients in rural areas through a network of partner health facilities. Its development involved  incorporating several technologies  to ensure secure communication and efficient spoke and Hub  interactions. 

Programming Languages:  Our team used Python  

Frameworks:  Django was used and this was chosen because of its ability to provide a solid foundation for web-based applications. 

Real-time Communication: WebSocket was used for its ability for real-time communication to facilitate live interactions between patients & nurses  at  our spokes  and doctors at our hub . 

 Authentication and Authorization:We Implemented robust authentication mechanisms using Oauth(Open Authorisation) to  ensure only authorized users access sensitive medical information in the electronic medical records . 

Database: we used a secure and scalable MongoDB database framework  for storing patient data and medical records. 

Natural Language Processing (NLP):We Integrated NLP libraries (spaCy) to understand and interpret user queries about symptoms, medications, etc. 

Video Conferencing API:We Integrated Twilio Video conferencing API to enable virtual consultations between patients and healthcare providers. 

Cloud Services:Use cloud platforms like AWS

Full Time -37

Part Time -209

Contractors -11

7 years

We strive to make our team more inclusive in terms of gender, nationality &disability among others.Unlike other years where recruitment was not based on any human resource manual. 2023 ushered  us into  a new era where women ,people with disabilities and indigenous applicants with the required experience and skills are given priority. This means that it is now the company policy that for any given position if there happens to be a woman or a person with disabilities with the skills we require , the job opportunity will be offered to them first.

More to that , chil is  a female founded and focused company .Out of the 5 C executves of the company , 4 are women , this means that female related issues are given top priority at the highest adminstrative organ of the company. More to that out of the 39 staff , 29 are women and 4 of these head various departments .

1.B2B PAY-PER-USER MODEL

CHIL’s central telemedicine platform   provides services to multiple partner health businesses (the "spokes"), which, in turn, offer these services to their patients.

Here's how it works:

A. HUB PLATFORM

CHIL Femtech Center operates an artificial intelligence central platform that offers various telemedicine services, such as virtual doctor consultations, e-pharmacy, e- laboratory, e-referral, and remote monitoring.

B. SPOKE BUSINESSES

These are partner health businesses that subscribe to our telemedicine service for their patients. They pay a fee based on the number of patients who access the platform.

PAY-PER-USER FEE

Spoke businesses pay a fee for each patient who accesses CHIL’s telemedicine platform. This fee structure allows businesses to control costs based on the actual usage of the service.

2.B2B COMMISSION ARRANGEMENTS

A. HUB AND SPOKE STRUCTURE

The CHIL central hub is the main platform that connects multiple partner Health Businesses (spokes) to partner pharmacies and laboratories . The hub manages operations, technology, and customer service, while the partner pharmacies/ laboratories  fulfill orders made by our spokes and handle local logistics via our technology .

B. COMMISSION STRUCTURE

The hub charges a commission to the partner pharmacies /laboratories for each order they fulfill. This commission is always 2%and 4%  a percentage of the total order value for pharmacies and laboratories respectively .

More about the hub and spoke can be shown in the photo below

Our Model is highly adoptable and revenue generating . This  is evidenced by the sharp increment of revenue from 335848 USD in 2021 to 667000 USD in 2023 .This improvement has been achieved regardless of the limited investment the company recieved in a period of 2 years . Chil femtech center  has already commitments from our previous investors (Reckitt ) and they  will invest  $ 600,000 and lead our our current round where we seek to raise 1.5 Million dollars for an extension of our seed round .We have also signed a contract with the Governement of Burundi and the contract to rent them our technology will bring it $ 3.9 Million  in a period of 4 Years . We hope to also capture the signature of the Ministry of health Tanzania for the same rental agreement .We also applied for USAID Development Innovation Venture and Hoping this will bring in more money to push our mission .