The AI-enabled OBGYN

Access to trusted, proactive and personalised reproductive health care remains limited especially in middle-low income and minority populations undermining pregnancy and newborn health outcomes. The reality is many maternal and newborn health complications start at the preconception stage yet most support is provided only after a problem has arisen. . 

To address this problem we propose a data-driven technology solution providing personalised preconception health guidance including health assessment, management, and monitoring during a woman’s reproductive years through a mobile app.  Our solution will have three key components: 

1. An AI-enabled health assistant to assess and monitor a woman’s health providing guidance for ways to improve health and answering common questions.

2. Online courses providing best practice content linked a peer group community to aid women in behavior change to improve health.

3. Live community of health experts to provide public answers to personal questions thereby providing an open collaborative resource for all women.

Globally one in four pregnancies end in miscarriage, one in seven couple struggle with infertility, and one in three women report depression related to fertility. These challenges are more pronounced in low-income and minority populations. Research by the American College of Obstetricians and Gynecologists (ACOG) shows that black women in particular are more than twice as likely to experience infertility, nearly twice as likely to have a preterm birth, and over twenty times as likely to have complications such as gonorrhea. Black adults also have the highest prevalence of obesity, a key factor complicating fertility health and outcomes. These factors have a significant impact on maternal and newborn health. For example poor nutrition and nutrition of mothers prior to conception have been linked to low birth weight. 

Countless studies, including the Harvard Nurse’s Study, demonstrate how early intervention and lifestyle changes matter. Indeed women in the Harvard study who followed three or four of the recommendations were 66% less likely to have problems conceiving. However, few women are able to access qualified women’s health services. 

The model for care delivery is broken and unable to scale. The result is avoidable suffering, poor health outcomes, and rising pressure on health systems.

We propose a virtual AI-enabled OBGYN combined with an open-source community of women’s health experts enabling women anywhere to access trusted gynaecological care. Our solution sits between general practitioners and OBGYNs. We will enable the women-centric care many GPs are unable to provide a first line of support due to the limited number of specialists. Essentially we aim to provide women all the services short of physical procedures she would normally access in a OBGYN clinic.

Through a mobile app women will access a virtual OBGYN to conduct initial and recurring gynaecology assessments, get answers to questions, and get alerts of issues to investigate and how to take action. The virtual OBGYN will be linked to expert-led online courses providing written and audio content combined with online forums to learn with other women. She will also be able to submit questions anonymously to a qualified OBGYNs and receive answers in a public forum while also being able to see the questions and answers of other women -- thereby providing an open resource for all women.  

Our technology platform will use AI to personalise recommendations, inter-relate text questions, optimise OBYGN responses, and provide predictive insights to empower women with proactive guidance.

We aim to serve minority women in low-income populations in both developed and developing countries. The demographics of this population is predominantly women of black and hispanic ethnicity aged 20-45 with an annual household income less than $40,000. We have already established an understanding of this group and their needs through our existing work and technology platform where we have engaged over 3,000 women to support their gynaecological health. Over the past year we have reached women in over 81 countries providing online assessments to improve their health knowledge. 

Through this experience we have interacted with many women from this specific demographic group but intend to conduct further user research to deepen our understanding of their needs. To ensure effective solution development we would create a specific initial cohort group comprised of women fitting this demographic to test our solution. We practice rapid agile software development so would quickly iterate on our solution based on their feedback and data captured through their activity in the software. 

Through these efforts will will develop a easily accessible, trusted source of support prompting raised awareness and proactive action to improve women’s health needs and mitigate maternal and newborn health risks.

Improving preconception health is fundamental to addressing maternal and newborn health complications. Many mental and physical health complications are rooted in maternal pre-conception health. Interventions at this stage mitigate future complications and improve overall fertility health. Further, improving preconception health also helps ensure women are able to remain active and productive in their family and work life.

Our solution addresses the limited access to care women experience, especially those in minority and low-income populations, by providing trusted care through a mobile application. By eliminating barriers to access we help women reduce risk and empower them to achieve their goals.

The current predominant standard of care for women remains polarized with two extremes: 1) general practitioners accessed through public health systems with limited time and limited expertise in women’s health, and 2) expensive fertility clinics typically providing reactive care for those already struggling with their health. Our innovative approach uses data and technology to bridge this gap and provide expert trusted care that is both accessible and affordable. Our data model maps the best practices of qualified OBGYNs yet engages women on their terms providing personalised support and guidance through a mobile application. We also engage a community of live experts to continuously build and “train” this model by providing answers to questions from women directly. We believe this community-driven data learning is unique and provides a enduring competitive advantage.

A key unique element of our approach is to combine mental and physical health in a single care pathway. Mental and physical health are often delivered in siloes however they are intimately interwoven for women -- particularly when it comes to reproductive health.  In 2019 we conducted a study with the Wellcome Trust and UCL researchers where we assessed 400 women on Adia to validate the efficacy of our solution. The resulting data demonstrated how access to trusted care improved reported wellbeing and health outcomes together. These findings underpin our user experience and approach to the data model we are developing.

We have built a fairly simple but scalable and cost effective technology architecture using Ruby on Rails, a Postgres database, and hosting through Amazon Web Services to deliver our application. 

Underpinning this application and user experience on the back-end is a suite of data models that assess reported women’s health indicators and provide recommendations and guidance for action to take -- whether that is further learning on the Adia platform or escalation to a health professional. Our data model is also continuously learning as we monitor preferences, actions, and feedback on reported well-being and health indicators so we can enhance the user experience to improve outcomes. 

We have integrated a messaging and bot service to provide interactive experience with the intelligence embedded in our model and to deliver content and guidance in a easily accessible manner. Women will be able to message the Adia bot, just as they would in Whatsapp to a friend, to get answers to their questions as well as receive nudges and recommendations to support their health journey. The messaging component is highly scalable to millions of users and integrates seamlessly with the user’s health profile in Adia.

The core technologies we use as described in the previous section are widely adopted and commonly used in a web software development.  In data science we employ a variety of standard machine learning approaches to support our model and tools for users that are also widely used. For example our IVF predictor model relies upon the Cox Proportional Hazards model (https://en.wikipedia.org/wiki/Proportional_hazards_model#The_Cox_model) which was found to produce predictions at a reasonable level of accuracy, while also being resistant to biases in our training data set. The success of these tools and approaches is more dependent on the quality of data and analysis rather than efficacy of the technology itself. We do not foresee any technology risk related to our solution or areas of innovation. 

Fundamentally we believe a key constraint to improving maternal and newborn health is the lack of awareness and difficulty women face accessing gynaecological support prior to conception. The overall outcome we seek to achieve is more women, and especially those from minority and low-income groups, accessing trusted proactive gynaecology support prior to trying to conceive. 

The outputs we are focused on producing to achieve this overall outcome include: 

• A easily accessible software application providing automated personal health assessments and answers to common questions.

• A library of expert-led courses and support programs to provide personalised guidance to women on their health journey. 

• A vibrant community of peers and expert practitioners to raise awareness and support each other in mainstreaming proactive gynaecological and reproductive health.

The key activities we will conduct to enable these outputs involve research, development and outreach including: 

• Research and review OBGYN guidelines to enhance and expand our existing models

• Program commonly asked questions into a bot system to provide question and answer functionality

• Enhance recommendation models to provide more personalised guidance for women based on their health profiles and interactions on the platform

• Outreach to minority and low income communities to raise awareness of our solution in order to nurture and grow our community

• Partner with media and advocacy institutions and influencers to raise awareness more generally about the importance of proactive gynaecological health  

• Outreach to and engage with health experts to expand and deepen our health courses and guidance for women providing new engaging experiences to assist their learning.

• Engage cohorts of users to conduct research and iterative solution development based on their feedback.

A priority short term outcome beyond delivering our outputs will be to monitor and validate the success of our solution in improving well-being and health outcomes. We will closely monitor activity data and reported health indicators to analyse our impact and inform ongoing improvements.

We are currently serving 3150 women across 81 countries. We have recently experienced increased growth, partly due to the shift to digital health relating to the Covid-19 pandemic. We anticipate that with a modest further investment we can increase our growth significantly and engage over 30,000 users by the end of year 1. Over five years we have ambitious plans to build upon our already global footprint and engage over 1 million women on Adia. For all of these women we would deliver their personalised health profile and virtual assistant to guide their journey -- whether that is for a few months or over many years. 

Our key goals over the next year are to: 

• Grow our user community 10x to over 30,000

• Deploy and validate our solution and positive impact on health

• Create a vibrant and growing community and is self-propelling and supporting

• Establish a sustainable business model and growth to enable us to expand our impact exponentially

Our goals over five years are to:

•  Grow our user community to over 1 million

• Pioneer and reshape new modes of health care delivery and research for women including in area such as gynaecology and genetics, mental and physical health, and miscarriage.

• Achieve profitability and be able to invest resources into research as well as further expanding access to under-privileged communities.

Overall we would like to be able to demonstrate through data, including user reported health indicators, that we have measurably improved the lives of over 1 million women in over 100 countries and reduced the incidence of maternal and newborn health complications.

One key barrier is awareness and the ability to engage the target groups in minority and low income populations. Many women only think about their reproductive health after they conceive, when many complications have already been present. Through partnerships in the Solve network we believe we can raise awareness of this challenge and gain access to target groups. 

A second barrier given the medical nature of our work is to cost effectively collaborate with experts who can thoroughly review and test our solution and data model. It is not our aim to replace the role of doctors and medical experts and nor is it our aim to be a non-scientific wellness care provider. Thus we need to ensure we are consistently validating our solution in science through engagement with experts. We plan to expand upon our existing medical advisory panel to engage new experts through MIT with specialized knowledge in data science, gynaecology, and fertility heath.

Furthermore there are market barriers to the adoption of health support due to the way health insurance markets function. Many minority groups have limited access to health insurance and limited ability to pay out of pocket for additional health support. While we aim to provide a range of support for free in order to establish a sustainable business we will, or the medium-long term, need to engage insurance providers and other market participants to incorporate this solution into their offerings. The Solve platform will provide an excellent foundation and network to support such outreach.

To raise awareness among target groups we plan a combination of partnership and direct marketing. We have already had positive experience engaging with influencers on social media (unpaid as they are motivated by our mission) to reach  such groups. We've also partnered with charities and public sector organizations to enable targeted distribution. Our community-centric approach will be critical to overcoming this barrier by empower initial adopters to involve those in their network. We have already seen women referring Adia to their friends so plan to focus more on this. 

To address the expertise barrier we will further utilize engage our existing networks and new communities, such as Solve, to engage experts in our solution. We have 25 experts across fertility, mental health and nutrition operating actively on the platform and each of them provides input into the solution. We will explore offering equity to experts who are committed to get involved as an advisor. Our business model will enable other experts to also earn income by engaging users in our paid offerings while providing input. 

To address market barriers to adoption we plan to create product offerings that can seamlessly integrate with existing health care solutions. We have already receive inbound interest from a range of insurers but have not had the capacity to respond nor engage proactively. We believe communities such as Solve as well as our existing networks such as graduate school (Wharton - University of Pennsylvania) and others to access leaders across the industry in key organizations.

We currently have 2 full-time staff, which includes just the two founders, and 10 contractors. At this stage of our growth it has been advantageous (for the company and staff) to maintain contractor relationships.  

Adia is led by an experienced management team and supported by leading medical advisors. Our Founders created Adia through their own experience with the problem we are address so have an intimate understanding and empathy for our target population. 

• Lina Chan (CEO) is a renowned advocate for women’s health and empowerment and is regularly featured in publications such as Forbes demonstrating her ability to lead others and raise awareness. 

• Tyler Christie (Co-founder) is a serial technology entrepreneur who has successfully built and grown data-driven technology products in high growth venture-capital backed startups. 

• Our medical advisors are practitioners and leading researchers in the NHS system who have unique insight into best practices, current problems relating to access to care, and cutting edge research in this domain.

• Our technology team is led by experienced developers with over 15 years of experience working in esteemed organications including the BBC’s Research & Development Unit. 

Together our team has the unique combination of customer knowledge, experienced leadership, scientific domain expertise, and proven capacity to build highly effective and scalable technology solutions.

At present we do not have active partnerships. In the past we have partnered with organizations for resaerch purposes such as The Wellcome Trust and University College of London. We have also partnered with advocacy organziations and community groups including Tommy's in the UK and various yoga studios. We were also involved in a partnership program with Sanofi to help explore applications of our solution in new areas. 

At present we are exploring partnerships with professional obstetrician member organizations as well as women's health brands. These are currently in development but we expect to be public by the end of August.

Our planned business model is to provide a freemium service of content and community paired with a paid membership offering premium content, products and services. Women on the free tier will be able to access their personal virtual health assistant, educational content, and the community of other women. They will also be able to submit questions in the open forum to live qualified health professionals such as OBGYNs and nutritionists. The paid membership tier, starting at £9/month will enable members to access premium content, submit questions privately to experts, and will include laboratory tests such as for fertility hormones or sperm health. 

To deliver the product we will produce content and contract health experts to author content on the platform as well. We will also enable experts to monetize their content and other services in addition to the membership tier. 

Our research has demonstrated that a membership price similar to a gym is attractive given the high priority women place on this area of their health yet the inability to access affordable support elsewhere. For low-income populations our free service will provide the personalised initial care as well and the pricing will enable them to easily upgrade for a short period of time if desired without significant time commitment or upfront cost.

We plan to generate revenue through membership subscriptions and grow membership organically at low cost. Given the membership offering will mostly include content we will have a near marginal cost of delivering the service. We have architected a highly efficient and scalable technology platform that does not require high maintenance cost even at scaled usage. 

If needed we may explore raising additional investment capital or grants however our aim is to achieve financial profitability over the coming year at least at the unit economics level.

The Solve Platform will play a unique and critical role in powering our growth to be a global leader in our space and achieve our mission of revolutionise reproductive health care. We’re excited to join this community and support and benefit from the interaction with other solves and experts on the platform. Given the combination of medical research, data-driven technology, and artificial intelligence we would benefit greatly from a network of experts with deep experience across these areas. Specifically we believe Solve will provide 3 key benefits to support our growth and mission: 

1. Expertise: The ability to efficiently access world-renowned experts to provide input into our research and development activities -- specifically in the areas of women’s health, the healthcare industry including public health, and data science. 

2. Partnership: Our mission is to fundamentally change the approach to reproductive health, which requires and awareness raising. To do this cost effectively, rather than through advertising, we need to access influential communities. The opportunity to partner with the Bill & Melinda Gates Foundation would be amazing and we believe the MIT network can open doors to many other leading institutions.

3. Scale & Distribution: Our growth strategy is to partner with global and national organizations to engage target communities and integrate our services within health systems. Accessing strategic and tactical support throug the Solve community will strengthen our execution and impact.

Our partnership goals include: 

• Raising awareness of our mission and solution to open new opportunities for proactive reproductive health support

• Honing our data model to optimize support and enhance our unique approach and competitive advantage. 

• Forge partnerships with institutions to fuel growth and strengthen our business model to achieve financial sustainability.

We would be excited to partner with several key organizations through Solve including: 

• The Bill & Melinda Gates Foundation to collaborate on expanding access to health care in developing countries through support for our technology innovation, raising awareness, and gaining access to new potential partners ranging from insurers to health care providers.

• MIT Medical to engage with experts in the field of gynaecology to review and provide input into our solution. To date we have built our company wiht leading health practitioners in the NHS in the UK and are keen to continue this approach while incorporating input from more experts in new specialised areas.

• MIT Media Lab to engage experts in the area of machine learning to provide input into our pioneering data model that underpins the virtual OBGYN solution.

We also believe we can gain an incredible amount through support from other Solvers as we share best practice tactics and strategy to execute our solution and growth plans. We initially started Adia through a 6-month accelerator - Zinc.VC - where we truly valued the peer support in our cohort and are keen to have that same experience for this next chapter.

Our solution is squarely focused on improve the health and well-being of women. As a woman-led and minority-led business we are particularly well positioned to be advocates of change and empowerment for women globally. 

Furthermore, the issues we are focused on addressing around gynaecological health are all too often shrouded in taboo. This limits access to health care, research in these areas, and collaboration between women who share common struggles. 

Receiving this prize would greatly enhance our ability to raise awareness, breakdown these taboos, and reach our target audience particularly in low income and minority populations.  

Our solution operates as a community whereby we engage health experts to input into the data and solution while also delivering direct care. In doing so we are also creating a networked community of practice among women's health experts. We have already seen how experts from various disciplines, such as OBGYNs and nutritionist, who do not normally collaborate in the public health system are able to work together and learn together through Adia. 

We have also found that exposing health practitioners to each other, to the intelligence in our system, and directly to users is an excellent form of training. For example we are able to support general practitioners doctors in gaining more knowledge and experience in dealing with women's health issues. 

Thus we have an opportunity to expand the supply and diversity of health practitioners who are able to support women in preventative preconception health globally. 

Our solution is underpinned by artificial intelligence by creating a data driven health assistant to provide responsive and proactive care to women. As expressed elsewhere in our application, research clearly shows that intervention at the preconception stage has enormous benefits for maternal and newborn health as well as the role of women in society. 

Far too little research has been conducted on women's health issues -- ranging from endometriosis to miscarriage -- and this must change. Women represent over 50% of the global population yet the vast majority of research funding and studies conducted revolve around men. 

Winning this award would help us access domain experts in the area of data science to further strengthen our solution and help address this gender gap. We will develop a unique artificial intelligence to further the health and well being of women globally. 

Our solution is focused on improving maternal and newborn health in low income populations both in developed and low-income countries. We currently support women across 81 countries including many in Latin America, India, Southeast Asia and Africa. We have already developed our solution in concert with the public sector as all our medical advisors are leading practitioners in the UK's National Health Service. We have designed our solution to be completely consistent with NHS guidance and best practices. 

With this award we would seek to further expand our efforts in low-income countries and leverage the foundation's amazing network to engage and collaborate with public sector orgnizations and advocacy groups. We would also develop additional tailored offering for women in these areas to address their specific circumstances. For example we would seek to develop preconception nutritional advice that is practical in areas of food poverty. We would seek to develop low data software services including simple and free text messaging to reduce the need for energy consumption and data cost for users.  Overall this grant would enable us to dramatically expand access to preconception health services globally and, in doing so, more rapidly improve our data models and intelligence for the benefit of all women.