Naija Telemedicine

Access to quality healthcare services are the major causes of high mortality rate in developing countries. Nigeria was rated 187th out of 191 countries in global quality healthcare delivery and the child/maternal mortality rate is among the highest in Africa. A woman’s chance of dying from pregnancy and childbirth related cases in Nigeria is 1 in 13 (UNICEF). The average life expectancy of Nigerians is estimated to be 54.4 (WHO).These poor health indicators have necessitated the call to consider creative ways of quality healthcare delivery in the country.

Naija Telemedicine (NT) is a system that allows healthcare professionals to evaluate, diagnose and treat patients at a remote location using telecommunications technology. This will make quality healthcare more accessible, inclusive, cost-effective and convenient. On a global level this project will  improve the health of even the most remote communities around the world by eliminating barriers to healthcare delivery.

Health security and pandemics: this project is focused on "strengthening access to affordable primary healthcare systems, enhancing disease surveillance systems, and improving healthcare supply chains".

Nigeria accounts for about 19% of the global maternal deaths, with a maternal mortality ratio of 814 per 100,000 live births and the probability of dying under five per 1 000 live births is 120 (WHO).

These statistics are realities in my community where 1 out of every 10 women die of childbirth related complications. 79% of pregnant women aged 15-49 deliver their babies at home due to lack of healthcare facilities in the area.

It recently became obvious that availability of a standard healthcare services/system for responding to emergencies such as COVID-19 is lacking in the area. The few public healthcare facilities around the region function below standards in terms of the availability of equipment, medications, professionals and infrastructure.

Naija Telemedicine will allow physicians to see more patients without the need to hire more staff or build medical edifice and it will eliminate socio-demographic barriers to healthcare services in the area. Patients who previously had limited access to primary healthcare services due to their socio-economic status can now do so with confort.

Naija Telemedecine is a customized system that enables delivery of quality primary healthcare services to patients remotely when the provider and patient are not physically present with each other using telecommunication infrastructures.

Professionals will provide healthcare services via video conferencing without the need for an in-person visit. NT will be focused on;

• Interactive platform: where professionals and patients can communicate in real time. These sessions will be conducted in Telemedicine posts located at the target communities.

• Ambulance services: A 24 hours ambulance service at the Telemedicine center to ensure prompt transport of patients to tertiary healthcare facilities in the cities if need arises (in emergency, surgical cases).

• Electronic Medical Record: Patient's information can be stored, shared with physicians at other locations in case of emergencies.

• Online Pharmaceutical services: Patients prescriptions will be sent online to the nearest pharmacy store ( already on our database ) and the patient walks in to obtain the medications.

The technology entails video conferencing with real-time messaging, content sending and patient vital signs sharing instantaneously. It is easy to start, join, and collaborate across any device. It is supported by End-to-end encryption for all meetings, user security and password protection.

The project location is at Maraba village and its surrounding, outskirt of Bauchi city. The dwellers of Maraba village and its surrounding environments comprise of people who fled Boko Haram and other crises ravaging northeastern Nigeria. They left their ancestral home and resettled at this location.

Major chunks of the population in this area are the society's poorest. This group lives on less than $1 per day. The most vulnerable members of this community are the elderly, poor pregnant women, beggars, orphans, people living with disabilities, displaced, unemployed, retirees and the sick. Surprisingly, these people still pay out of pocket for healthcare services.

For the past five years we have been engaging people in this area on how to successfully implement the NT project. The community heads are also stakeholders in the project and they have allocated a piece of land for the project.

This project will lead to:

• Delivery of quality healthcare for the target group and at the right time.

• Healthcare will be cost-effective and convenient.

• Socio-demographic barriers to healthcare in the area will be eliminated.

• Quality healthcare delivery with minimal resources

• The project will reduce the further spread of the COVID-19 by decreasing exposure at public hospitals.

The NT project perfectly aligned with the Solve Challenge - Health Security & Pandemic, on the themes ;

• "preventative and mitigation measures that strengthen access to affordable primary healthcare systems"; the NT project will provide comprehensive, quality primary healthcare services to society's vulnerable at underserved communities and mitigate the region's health security threat.

• "enhance disease surveillance systems, improve healthcare supply chains"; the information from NT databases (medical records) will serve as raw data to prepare, detect, respond and for disease surveillance in the area. And the Online Pharmacy as explained above will enhance the healthcare supply chain across these communities.

Among the major market players in Nigerian Telemedicine market are:

1Dokita: is a network of health service providers and the clients who require them.

Mobilehealth: is a database of 100,000 licensed professionals in Nigeria for online access to the public.

ChadelCare Pharmaceutical is an indigenous pharmaceutical outfit offering retail, wholesale and other pharmaceutical services online.

TalktomeDoc is a Health company driven by technology that connects Doctors to patients using mobile apps.

Naija Telemedecine however identified a crucial gap in the Nigerian telemedicine sector and is poised to fill it. All the existing companies capitalized on the online audience, most of which are urban dwellers. However 50% of the total Nigerian population reside in rural communities. A major chunk of this population don't have access to Android phones, meaning they can not make use of the existing telemedicine innovations in Nigeria presently.

The NT project is unique because:

• Our Telemedicine carts are located directly at these remote locations, where users without an Android phone nor formal education can use these gadgets.

• The NT project is targeted at vulnerable people who still pay exorbitant fees, out of pocket for healthcare services.

• NT connects marginalized people in rural Nigeria with highly skilled medical personnel in any part of the world.

• NT uses Electronic Medical Records to store and transfer with consent patient's information from our database if need arises from another physician.

• Our online Pharmacy uses tele prescription methods to provide accurate billing and eliminate prescription errors common in other systems.

For now, the NT project makes use of the Zoom Video Software/mobile app: using this technology, healthcare professionals will evaluate, diagnose and treat patients via video conferencing and smartphone communication, without the need for an in-person visit. Ninja Telemedicine will focus on two major services, viz;

Interactive platform: with the Zoom software/mobile apps our healthcare providers and patients can communicate in real time. These sessions will be conducted in mini clinics located at the target communities.

Online Pharmacy: with names, addresses and contacts of all licenced pharmacy stores on our database, patients' drug prescription will be sent via SMS to the agent and patients can easily collect the medications at those remote locations.

Electronic Medical Record: patient information, like lab results will be stored on our database and can be transferred to physicians at another location wherever they need be.

The technology entails video conferencing with real-time messaging and content sharing. Patients' information, like vital signs, can be shared instantaneously. It syncs with the calendar system and delivers streamlined enterprise-grade video conferencing from desktop and mobile. Support scheduling or starting meetings from Outlook, Gmail, or iCal. It has HD video and audio quality and support for up to 1000 video participants and 49 videos on screen in case there are multiple health professionals attending to the patient. End-to-end encryption for all meetings, role-based user security, password protection, waiting rooms, and place attendees on hold. This will ensure medical ethics of "patient information privacy" compliance.

In poor settings where provision of healthcare facilities, skilled professionals and equipment are inadequate (as the cade in Nigeria), the use of information and communication technology for health care delivery holds a good prospect in improving the health conditions of the people.

The system of healthcare using interactive audiovisual and data communications, diagnosis, consultation and treatment, as well as training and the transfer of medical information, has progressively advanced the course of health care delivery in Nigeria recently. Already, the Nigerian government had formulated policies aimed at increasing adoption/acceptability of telemedicine to optimize healthcare delivery in the country. The use of telemedicine innovations for healthcare delivery is a common trend in developed countries.

There numerous evidence to prove that the use of video conferencing for healthcare services have been successful. These links below will buttress this claim:

https://www.google.com.ng/amp/s/www.healthrecoverysolutions.com/blog/benefits-of-video-conferencing%3fhs_amp=true

https://www.vidyo.com/video-conferencing-solutions/industry/telehealth

Theory of Change for NT.

Need or Purpose: Naija Telemedicine is focused on:

Providing high quality primary healthcare services to dwellers of rural communities to mitigate threat to health security in the area.

Eliminating socio-economic barriers to healthcare in these underserved communities and the people will have easy access to affordable primary healthcare and improve the medical supply chain.

Reducing visit by the people to public hospitals in order to reduce manifestation and spread of infectious disease like the current COVID-19.

Context (Conditions):

The environment is a typical African rural setting where the cultural and religious beliefs of the people influence medical practices.

The few private medical facilities also see medical humanitarian projects as a threat or competition, thus they must be well informed about the project mission.

Community stakeholders are key to acceptability of this kind  project in the area, hence we recruit this set of people to be members of the project team.

Inputs: Building of Telemedicine post at strategic location around these communities.

Installation of our customized telemedicine cart at the telemedicine center.

Recruiting of volunteer professionals.

Licensing of professionals.

Fund sourcing.

Collaboration and alliance with community heads.

Activities: Provision of comprehensive, quality, cost effective and inclusive primary healthcare services to the people.

Provision of Electronic Medical Records for patients.

Rendering online Pharmacy and e-prescription services to people of Maraba and its surrounding environment.

Outpups: The NT project provides affordable quality primary healthcare services to about 1, 600,000 rural pregnant women, 1,400, 000 rural children under 5 years of age and 4,000,000 adults across Nigeria.

Outcomes: Drastic decrease in childbirth related complication deaths among pregnant women across these communities.

Increase the number of safe deliveries across these communities.

Improved health for children under 5 years.

Healthy living and healthier population.

Increase individual (human) productivity and a better economic status.

Reduced health security threat in the area.

Increase food supply from community farmers (especially males) to cities.

Currently, our telemedicine post at Maraba provides about 100,000 people with primary healthcare services across these communities.

In the next  one year, after expansion to the other 12 Local Government Areas (LGA) in Bauchi state, Nigeria. The NT project will provide about 1,300,000 people across the state with primary healthcare services.

One of our goals is to extend the NT project to all the six geopolitical zones in Nigeria by year 2025. Hence in the next five year, the NT project will provide about 7,000,000 Nigerian with high quality primary health care services across the entire country.

In the next one year, we plan to set up telemedicine facilities in at least one strategically selected rural community across the 13 Local Government Council Areas in Bauchi state. This will increase the population of patients that the NT project will serve to about 1,300,000 in this state.

Nigeria is made up of six geopolitical zones namely Southwest, Southsouth, Southeast, Northcentral, Northwest and Northeast regions.

Our long term goal is to establish by replication and extension of branches, the NT project to all the six geopolitical zones (in Nigeria) in the next five years of our operations. This will in turn multiply the number of people that will use the NT applications and facilities to about 7,000,000 people all over the entire country. However, we planned to start with the terrorist (Boko Haram) ravaged Northeastern zone, as a form of contribution to the rebuilding of the part of the region.

In the next five years of operations, will planned to make the NT a household name in the telemedicine industry in Nigeria. We want to position the NT as one of the major market players and leader in the telemedicine business sector in this country. One of our major targets is to incorporate this company into the Nigerian Health Management Organizations, to serve in the National Health Insurance Scheme (NHIS). Finally, within the next five year frame, we want this company to be among the few listed healthcare companies in the Nigerian Stock Exchange.

Identified barriers agsinst acomplishment of the NT project  the next year are:

1. Healthcare professionals recruitment.

1. Reliable Internet services availability.

1. Patient interaction and communication.

1. Public/community acceptability.

1. Advance medical cases.

1. Patient's record confidentiality.

1. Funding.

1. Poor power supply.

Identified barriers against accomplishment of the NT project  the next five years are:

1. Change in government and policies.

1. Retention of experienced, trained and skill staff.

1. Market competitions/competitors.

1. Sufficient coverage for the society vulnerables.

1. Security issues.

1. Advance technology adoption.

We plan to overcome these next year barriers as follow:

1. We planned to depend mostly on volunteers staff at the next year of operation. The National Youth Services Corps (NYSC), where new graduates serve Nigeria and get paid some stipend by the government before going into the labour market, is our major source.

1. Subscribe to the four major internet providers in Nigeria. If one provider fails the others will serve as an alternative.

1. Telemedicine assistance at project locations (communities), to assist users as most may not have formal education.

1. Community heads will be involved by making them stakeholders in the NT project.

1. Provision of a stand-by, 24 hours Ambulance service, to convey patients on medical and emergency cases.

1. Information is secure with end-to-end encryption technology, to comply with medical ethics of patient's information.

1. Funding will be sourced from founders, donor agencies and from government interventions.

1. Use of alternative sources of energy like solar option.

We plan to overcome these next five year barriers as follow:

1. We make the project plans as flexible as possible to accommodate changes in whatever policy alteration that may arise.

1. Implementation of adequate staff benefits,incentives and motivation policies.

1. Continuous innovations, fast adoption of new technology and rigorous market strategies.

1. Priority will be given to underserved communities.

1. Telemedicine center at the  safest part of the community, implement a lot local security strategies and employ the local security personnel.

1. We will Network and collaborate with experts and technology stakeholders/companies to facilitate fast technology adoption.

Business Canvas for NT.

Value Proposition:

Mother/child safe delivery.

Improved health for children under 5 years.

Healthier population.

Increase individual productivity.

Better living standard (economic)

Reduced health security threat.

Customers and Beneficiaries: Dwellers of rural communities in Nigeria;

Pregnant women,

Children,

Elderly,

Displaced people,

Marginalized,

Low income earners,

Rural adults.

Services: The NT project will provide:

Affordable, comprehensive, inclusive, timely quality primary health care services.

Convenient online pharmacy and e-prescription;

24 hours Ambulance services;

Electronic Medical Records, storage and transfer of patient information in case of emergency.

Channel:

Telemedicine carts stationed at the target location (telemedicine post).

A telemedicine assistance will be attached to the post to aid users.

Ambulance to convey emergency patients.

Online pharmacy for medication supply.

Internet transfer of medical information from electronic databases.

The Need:

Lack of health facilities in these remote areas.

Lack of professionals to man the few available facilities.

Lack of medical equipment.

Poor health indexes in rural communities.

Poverty.

Low productivity.

Key Partner:

States and federal ministries of health,

Banks,

SDG Department, Nigeria.

NYSC,

Nigeria Medical Association (NMA).

Key Resources:

Human Resources( Professionals).

Computers and other ICT equipment.

Telemedicine post (small room).

Project vehicles.

Medical equipment.

Customer Relation:

Cheap services when quality is a factor.

Value focused on social impact.

Customer's benefits first.

Customer's autonomy.

Revenue streams:

Consultation fees,

Commision from medications supply.

Sales of medical materials.

Health insurance.

Cost Structures:

Administrative,

Operating expenses,

Equipment,

Vehicles,

The organisation business model is an embedded form where enterprise and the social program are one and the same. However we planned to generate revenue for the organization from:

Mother organization; Essa-adaje Global Resources Limited has pledged a portion of her profit to finance the NT project.

Founders; funds are sourced from individual donations from founders.

Grants; we also plan to source for funds from corporate sponsors and donors.

From healthcare services; we generate from the various medical services rendered by the organization to ensure sustainability.

We are applying to the Solve opportunity to;

Network: with expert and stakeholders working on a similar project. We intended to relate with relevant profesionals in order to learn more about our chosen business sector.

Partnership: with succesful organizations working on similar project from the Solve network. We are willing to learn and collaborate from others.

Funding: to explore the Solve opportunity for needed financial resources required to implement the NT projec.

Exposure: to current trend in telemedicine industry and subsequent adoption of such.

Marketing partnership to enable NT service meger areas without investing in additional infrastructures or expanding their distribution network.

Brand Awareness: we want to form alliances with other service or consumer companies to increase brand awareness for NT.

We want to enter in partnership to promote greater creativity and spur innovation.

Partners may have strengths that we lack, and vice versa, so each party can benefit from the relationship.

MIT Faculty: to learn more about medical entrepreneurship ICT and technology.

Solve Members: to collaborate towards achieving our common goals and objectives.

We volunteer to partcipate in the fight against the current COVID-19 pandemic in Nigeria. We devoted our time and put our life on the line  on the course of contact tracing, individual assesment and we  distributed palliative to affected people free  from our own pocket

The NT project is built on the use of ICT in combination with AI to serve humanity. Some of our current application uses the AI to evaluate vital signs like body temperature, pulse rate and blood presure measure from phone camera. We plan to develope more applications using the AI and the knowledge of human physiology in the nearest future.

Mr Olajide kabir own B.Sc.and a masters degree in human physiology and thus wishes to make more reseraches, discoveries and innovation in this field incoporation with AI technology.

Our sister project tagged SheGrow Naija was targeted at empowering rural women in the field of agriculture. This project have empower about 1000 women across rural communities in Bauchi state giving them the capacity to lend their voice on political issues at their communities.

We have chain of project all working to achieve one or two SDG theme on different fronts.

We are more grounded on the project scalabilit and sustainability. We very much open to the future planet caputal price and willing to provide documents to achieve this milestone.