Flare: Global on-demand emergency services for all

Five-billion people lack access to emergency response - 2.75 billion live in cities. While many countries have adequate emergency vehicles, system-level coordination is lacking. In Kenya, like much of the world, top runners complete marathons faster than it takes an average ambulance to reach the hospital. Flare utilizes today’s latest technology and advanced systems to route ambulances to the scene quickly and efficiently. Flare’s Uber-like technology places ambulances on a digital map. Medically trained dispatchers connect the nearest available ambulance to the scene and provide over-the-phone services to patients. We believe no matter who you are and no matter where you are emergency response should only be minutes away. Since 2017, Flare has helped thousands during the worst moments of their lives by reducing response times by 87% in Kenya. The solution is designed to scale, meaning Flare has the potential to save millions of lives around the world.

95% of Africa lacks 911. 

The African continent has the fastest growing population, expanding megacities, and greatest mobile growth. By 2035, half of Africa’s population will live in cities. In 7-years, 300-million on the continent will have access to a mobile phone, and half will own one by 2023. 

More than a dozen cities across Africa already leverage on-demand services, like Uber and food delivery. Emergency services remain disjointed and inaccessible. We saw this as a perfect opportunity to innovate an industry where on-demand services are truly needed, and leverage technology to have enormous impact. 

Fifteen women die daily giving birth in Kenya, because they are unable to reach a facility. Over 90% of all injury-related deaths occur in countries without 911 - road traffic accidents are a leading contributor. Many of these deaths of preventable if treated in time. Flare reduces response times and saves lives.

One-hour is the emergency response standard - those who reach the hospital within “the golden hour” are most likely to survive. Before Flare, it would take 162 minutes to reach a hospital. Flare has helped thousands during the worst moments of their lives, while reducing response times by close to 90%.

We impact not only the individuals who are experiencing an emergency to help them get faster care, but also empower and enable many EMTs and paramedics to provide better services. 

We launched in Nairobi in 2017 and have saved thousands of lives in two years. We have expanded to other urban areas throughout the country, such as Mombasa, Nakuru, and Kisumu, where available ambulances and hospitals exist. In general, we follow on-demand taxis, as we know there is a market that wants and understands how to connect to such services. 

Since the beginning, we have worked hand-in-hand with ambulance companies and operators to understand their challenges. We work to provide them with the right tools to reach patients faster and provide better care. From the patient's side, our most noteworthy innovation is the introduction of a subscription product - done in large part because of our market research, pilots, and follow-on pilots we have conducted in the region. Most people at the point of an emergency don't have the cash on hand to pay for the services or they are too expensive. The membership services give everyone affordable access to an essential system for all.

Since founding Flare in Kenya two-years ago, we have assembled a network of 65 ambulances in Nairobi, and over 500 nationwide. These providers, along with a growing number of fire and security responders, use our platform to track fleets, coordinate life-saving rescues, and receive dispatch requests. Most importantly, Flare has brought independent (public and private) providers onto a single, location-aware dispatch platform, and has reduced network-wide response times by 87% (from 162- to 21-minutes). We have seen first-hand how real-time, location-based data solutions for emergency response increase health provider revenue and save lives.

We work in cities where there are available resources of emergency response providers, and integrate our technology into ambulances, security vehicles, and fire engines to create a true, comprehensive 911 for cities. Most ambulances and other emergency providers previously operated a small unit of a few vehicles. Once on our system, they are part of a network that can actually respond effectively to individual and mass-casualty emergencies. 

In our 24/7 dispatch center, highly trained professionals use our dispatch platform to identify the nearest available emergency response provider. On the patient side, we introduced a membership model where households, families, or businesses subscribe on an annual basis to access services. We have signed-up more than 35,000 members, mainly in Nairobi, and have provided thousands of responses to medical emergencies.

Flare is replicable. Devices are fitted to any ambulance, and the technology is easy to use and built with numerous features, like offline maps that enable it to be used in low bandwidth situations. Following the fitting of devices and training of ambulance crews, the ambulance is instantly live on the Flare command and control system and can begin taking dispatches. Based on previous experience, it takes Flare an average of 3 hours to equip and train new ambulances.

In 2018, the company began expanding outside of Nairobi and enlisted ambulance providers in Mombasa - Kenya’s second largest city. To-date, we have integrated over 60 ambulances in Nairobi, 6 in Mombasa, 4 in Nakuru, and soon will be launching in Kisumu. In Kenya, there are more than 700 ambulances across the country that we aim to leverage on our system. In 2019, Flare expects to become the largest network of responders in Kenya, onboarding 300 vehicles and ensuring that 80% of vehicles are actively engaged. 

In the US and Europe, emergency response systems rely on outdated landline frameworks that require a widespread address system in order for ambulance dispatch to work and substantial multi-billion dollar investments to set-up. Landline infrastructure is nonexistent across many low- and middle-income countries, and addressing is limited, which creates a unique opportunity to design, develop, and implement a more advanced system in these regions using today’s latest technology, such as automated GPS navigation and location based services.

We are the first mover in Africa and the only end-to-end solution for emergency response. Alternative options include calling hundreds of providers to assess availability and location, or not receiving care at all. Similar initiatives in sub-Saharan Africa are focused on building solutions to address one or two sides of the provider-customer-dispatch system, but not all three. We are dedicated to building a comprehensive system that addresses the market from all sides. Our strategy is more complicated, but we are confident that the only way to build 911 is to build a brand new and sustainable infrastructure. 

Unlike traditional systems, Flare utilizes today’s technology to create an integrated, low-cost, ready-to-scale solution for emergency response. It is cloud-based and runs on a mobile phone and laptop. We built Flare mobile-first and for low-resource contexts. A fully automated solution, we utilize the latest digital technology and are leading the way for the IoT transition in global emergency response.

Flare’s cloud-based software coordinates vehicles onto a real-time digital map. In an emergency, the technology selects and dispatches appropriate ambulances automatically, thereby collecting real-time data, reducing the potential for human error, and ensuring response quality in life-threatening situations. 

We provide ambulances with smart phone devices for GPS tracking and Google Maps navigation. We operate a 24/7 dispatch center, where emergencies are managed by professionally trained medical dispatchers. 

We have digitized the way people receive care, making it easier to call 911 than ever before. Everyone has access to Flare through our innovative membership model. We have integrated our technology with rideshare companies, which connects drivers to Flare automatically by pressing an SOS button on their app. We are working to identify when someone needs help through leveraging wearable smart technologies, and are constantly finding better ways to connect 911 to the actual hardware of devices through Emergency Location Services.

The technology is new, but the systems we are building around that technology are truly changing global emergency response. Not only are we building a system that previously did not exist, we are building it much smarter and better with tools of the future.

Through our inclusive membership, technology, and systems (activities), we provide increased access to emergency response services and reduce time-to-care (outputs), and minimize societal-level morbidity and mortality, while providing peace of mind to all (outcomes). 

Early on, we evaluated and assessed the solution with local populations across Kenya, and built our solution based on that research. For the past two-years, we have been operating in the market, and continually improve our operations, using feedback from members and providers. We have seen enormous uptake on every level - from more ambulances joining the platform, to diversifying our emergency response providers to fire and security, to reducing response times and providing our service to over 35,000 members. Across the board, our key stakeholders report increased peace of mind for having coverage in case of emergency (members) and the increased ability to do their jobs better and save more lives (providers). 

One in 10 people die in emergency situations in places without 911. Without our solution, that statistic will remain. We are actively working to make sure that people in cities can access basic services that make their lives better, easier, and ultimately allow them to survive emergency situations. 

The problems we are solving will only become larger as cities grow, and additional stress is placed on dated and incomplete emergency response infrastructure. With close to a billion people living in African cities in 20-years, an advanced solution for emergency response is paramount to ensuring safe, healthy cities for people across the continent.

Last year, we provided lifesaving rescues to over 1,000 people in Kenya. This year, we are on track to save more than 2,000 lives. In five years, we expect lives saved to grow exponentially, as we expand to new cities in the region. We estimate that by 2024 we will provide coverage to over one million people and save roughly 50,000 lives.

The number of providers on our platform continues to grow across several cities in Kenya. When we started two years ago, we had relationships with a handful of ambulance providers, who were the first to join our fleet. Today, we have assembled a network of 65 ambulances in Nairobi, and over 500 nationwide. Additionally, we have expanded our emergency response network to include fire safety and security providers, making Flare a comprehensive solution to emergency response.

Two-thirds of the world lack access to a 911-like system. This amounts to 5 billion people spread across Africa, large parts of Asia, South America, and Eastern Europe. While we launched in Nairobi, but the opportunity extends massively outside of Kenya. Globally, we estimate there is an average of 400 million emergencies per year in these markets. 

Over the next 5 years, we are focused on 8 specific cities across 5 countries in Africa. Our target cities include Lagos, Kano, Kampala, Accra, and Dar es Salaam. The market we are immediately addressing is a population of 54 million who experience 3.8 million emergencies annually, but the global opportunity is much larger. 

We aim to scale to cities where Uber exists, where there are plenty of existing service providers, and where the populations are high. We will also continue to scale into different verticals to provide a complete 911, including fire and security. 

People across Africa are moving more and more from rural areas into cities. Our goal is to establish the infrastructure now, so we will be ready to keep up with population growth and multiply our impact.

In Nairobi, we have reduced response times to as low as 6-minutes. However, when an ambulance arrives on-scene, a patient’s journey is just beginning. 

In Kenya, like most emerging markets, there is a shortage of specialists needed for many life-saving medical interventions. Specialists rotate between hospitals, making it difficult to predict the availability of critical services, even in the most well-equipped facilities. 

Critical patients are routinely taken to hospitals that are unable to treat them. These patients often travel long distances to other facilities with no guarantee of admission, or wait days for an initial consultation. In trauma cases, this means being left to die. This reality disproportionately impacts low-income patients who use public facilities.

Our data collection is helping to change this reality for thousands. Before Flare, 0% of public facilities recorded data on rescues and referrals in-line with the  Health Sector Referral Implementation Guidelines (2014). Under Flare, this is improved to 100%. Flare works directly with public healthcare workers, namely nurses and EMTs, to provide them with technology and systems to make their jobs easier. Flare works directly with public sector health managers, including Health Ministers, to ensure they understand and can operationalize data outputs. This understanding is crucial to improve resource allocation, utilization of public services and identification of where additional resources are required. Flare also work with the private ambulance providers and hospitals to network them into the broader health system and ensure the public sector can leverage them when needed. 

Our goal is to increase chances of survival for patients, while optimizing providers’ time and hospitals’ resources. To this end, we are looking to track, predict, and optimize professionals’ rotation schedules, help first responders find medical services, and look for patterns in service availability to better organize system-wide resources. 

For the past year, we have been collecting static data on medical services, facilities, and specialist schedules to select hospitals for critical patients, but this data changes daily. With a growing number of emergency calls and API requests handled by our system, it is increasingly difficult to manage routes to care.

Location integrations using Google Maps, proprietary data, and architecture have saved our patients hours in emergencies, thereby preventing unnecessary deaths and countless complications. We are ready to take these life-saving features to the next level with real-time data and engagement of medical professionals and facilities.

We operate in the market as Flare, but are legally registered as Capsule Global.

Full-time Staff: 16

Part-time Staff: 2 

Contractors: 2

Flare has an exceptional leadership team and dedicated staff. Co-founders, Caitlin Dolkart and Maria Rabinovich, have worked on health and technology initiatives in sub-Saharan Africa for over a decade. Caitlin received her MBA from MIT Sloan, and has a comprehensive understanding of health systems in low resource settings from years of managing the Clinton Health Access Initiative’s malaria work in Africa. A product designer and developer, Maria has spent her career working with corporates and technology startups in both New York and Nairobi, focusing on software development, product design, and strategy. 

Together, they founded Flare, which today employs a dedicated team of experts in technology, health systems, and business development. They place a strong emphasis on hiring local talent, especially in leadership positions, and will continue to do as Flare scales beyond Kenya.

Flare’s initial success is a result of key partnerships and mentors in Kenya and the US who have contributed to the design and development of the product, and who will be instrumental in our expansion phase. We received financial support from several organizations, including MIT with awards such as 100k Competition, IDEAS, and Legatum Center for Entrepreneurship. Our advisory board includes a specialist in logistics and transportation, a leader in one of the US’ largest ambulance providers who has set up ambulance companies in Argentina and Peru, a former director at International SOS, a political advisor, and tech & product leadership from Uber and Pivotal Labs.

Flare partners with ambulance providers, corporates, and local governments. 

We would not be able to do the work that we do without our main partners - emergency response providers. Flare has over 500 ambulances on our wider network, and has mapped facilities across all of Kenya. We have information on the number of hospital beds in each facility, and level of care capacity for each ambulance. These partners do the incredible work of saving lives everyday. 

We work with large companies, such as factories and rideshare technology companies. In many cases, we partner with companies to provide bulk membership to employees who are at high risk of injury, such as drivers or factory workers. Flare has also integrated its technology into the rideshare app for Bolt. Now, drivers can simply press an SOS button on their app to receive emergency response from Flare.

We are working on our long-term partnership strategy to boost efficiency, accountability, and reliability in Kenya’s public system. In 2019, Flare signed an MOU with Laikipia County. Now, and for the first time, ambulances are now online and arriving on time in Laikipia through integrating Flare technology and systems into standard processes. 

We offer our membership product, Rescue, to the populations we serve through three distinct coverage options to streamline sales. Facility-based membership covers throughput and traffic on a facility level. For example, a shopping mall or a hotel with this membership would receive emergency services for any patron while they are on the property. Employee member benefit covers all employees (and sometimes their families) in or outside of the company facility. Direct to consumer includes retail sales to families and individuals. 

Our value proposition to each customer segment varies, but we structure packages as follows: 1) we offer facility or employee/member benefit packages to corporates and NGOs, and 2) we offer direct to consumer memberships to individuals, families and households.

We generate revenue primarily through the Rescue membership product. Additional revenue will come as we develop our new model of charging our key partners (ambulance, security, fire, and municipal partners) for premium enterprise features. The distribution channel of the membership is through our Rescue website, the app, and through corporate sales. For an individual, our membership cost structure is a fraction of an actual ambulance ride and ensures there are no payment delays in the event of a rescue. 

Our key resources are our people, including customer relationships, and essential partnerships with ambulance providers, health professionals, governmental players, and businesses. Our key activities include horizontal and vertical growth, and our key partners, which include customers, advisors, and health sector professionals, are essential to this growth. 

Our revenue model is similar to that of insurance - each member contributes a small amount to support the overall system. We use case fees for non-members, as well as additional services, like event coverage. Our membership costs $24/year. Each time someone uses an ambulance it costs the system $100, meaning we cover the cost with every fifth person. In reality, 1/100 members have an emergency and use the service in a given year, therefore our profit is $2,300 for every 100 members (100 * $24 = $2,400 - $100 = $2,300). Other costs, such as running our dispatch center and staff time, further reduce our margin to 67% on average. 

We wanted the membership fee to be as affordable as possible in order to provide access to the greatest number of people. We ensured that the membership product costs cover our expenditures, and also tested the price in the market to get feedback. Setting the price less than $24/year made people question whether it would work, and setting it any higher would have made the service inaccessible. 

We expect to be cash flow positive by 2021. Until then, we expect to fund the deficit through grands, investments, and revenue. We have raised $2-million USD in convertible notes, and continue to raise and look for other options. It is not feasible to take on debt locally, but there are some governments abroad that have innovative financing options for early stage companies in emerging markets that we are exploring. 

Our main motivator for applying to Solve is to gain access to the incredible network of cross-sector entrepreneurs and changemakers within the MIT network. In particular, we would love to partner with key players in a similar space to help fuel our growth, particularly as we expand beyond Kenya. We are in the process of piloting County-level partnerships in Kenya, and would appreciate mentors that can help us navigate the challenges involved in ensuring our solutions is available not only to those who work within certain companies, or have access to private funding, but to everyone. Our focus now is on ensuring financial sustainability of our system, while building public-private partnerships to ensure equal access for all. We believe the Solve network is perfect for this challenge, since it is such a global group of innovators, who are well versed in bringing solutions to global scale.

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We are interested in partnering with corporates and large organizations that may be interested in incorporating our solution into their employee benefit package. Additionally, we aim to partner with government stakeholders, who are able to help us bring our solution to scale for all people within each country we operate.

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Flare is using technology to fuel a community-based solution for emergency response. Our solution makes cities safer through improved coordination of medical help, as well as providing real-time data on the types of emergencies that are occurring and where. 

The data we collect are sourced, maintained, and used ethically. Each emergency incident is tracked digitally and shows location-based information in real-time and retrospectively, and data are stored in the cloud. While we do not currently give out our data, our aim is to create long-term partnerships with governments and other reliable, social decision-makers to use the data in a way that helps prevent incidents in the future by tracking prevalence of emergencies over time (i.e., car accidents, guns, demonstrations, etc.), and using those data to improve prevention efforts during peak times in certain high prevalence areas. 

We would use the funding from the Everytown for Gun Safety Prize to kickstart this effort, starting with a pilot in Nairobi, where we would establish partnerships with public, private, and academic partners, and work with them to plan and implement a data strategy to better address and prevent emergency incidents across the city. We would use this pilot to inform our broader data strategy, which we would first implement in more rural areas of Kenya, followed by other emerging markets as we scale. 

Fifteen women die every day giving birth in Kenya. This is roughly one woman every hour and a half, simply because they are unable to reach a health facility. Despite this, 40% of women still deliver away from the formal health system, largely due to transportation challenges. Effective emergency response has the ability to prevent nearly 100% of obstetric deaths, saving both mother and baby.

In Nairobi, Flare has dramatically improved health outcomes of mothers by reducing response time for obstetric and gynecological cases to 29-minutes, and providing obstetric care training to its ambulance fleet.

Today, over 50% of Flare members are women, and 32% of calls by women are maternity related. Half of these are for typical labor and delivery events, and the other half are for pregnancy complications, like post-partum hemorrhaging. 

We are dedicated to granting immediate assistance and comprehensive healthcare to women, while providing them peace of mind and the autonomy to use their own voices to call for help themselves when they need it. We are able to find the nearest ambulance, which is essential during labor and postpartum complication situations, as they often become races against the clock. We also help coordinate transfers to higher level facilities for women who require c-sections or are in need of more advanced care.

By reducing response times and increasing access to reliable transportation to health facilities, Flare is saving the lives of women and children every single day.

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Co-Founders, Caitlin Dolkart and Maria Rabinovich, launched Flare to improve emergency response using today’s latest technology. The company has since grown to provide thousands of people with the peace of mind that they are covered in case of an emergency.

Flare uses an Uber-like platform to place the fragmented market of emergency response vehicles on a single map. A medically trained dispatch team works around the clock, using the technology to route the nearest available ambulance to each emergency scene, reducing response times and saving lives. Dispatch provides over-the-phone care to patients who are waiting for an ambulance to arrive, meaning when an individual calls Flare they are connected to a trained health worker in seconds. 

Flare provides routine and comprehensive training to ambulance providers and health workers to ensure a standard quality of care. From medical training to personal hygiene and uniform requirements, Flare ensures that health workers are ready to provide the highest level of care.

Today, over 50% of Flare members are women who secure memberships for themselves and their families, and 32% of calls are maternity related. Dedicated to granting immediate assistance and comprehensive healthcare to women, Flare provides women with the ability to call for help when they need it. 

If selected for the UN Women She Innovates Prize for Gender-Responsive Innovation we will use the additional funding to provide increased access to women and children in rural and underserved urban areas through piloting alternative forms of transportation, such as motorcycle ambulances.