MediLinkUp : eHealth-as-a-Service(eHaaS)

Poor health information systems have been identified as a major challenge in the advancement of health-care systems in many developing countries across Africa.The first three challenges identified were inadequate human resources (34.29%), inadequate budgetary allocation to health (30%), and poor leadership and management (8.45%). The leading solutions suggested included training and capacity building for health workers (29.69%), increased budgetary allocation to health (20.31%),and advocacy for political support and commitment (12.31%).

A simple, user-friendly, and cost-effective software to assist African medical and healthcare professionals to manage diseases, analyze data, and to provide quality patient care across Africa.

Government and health institutions: EMR systems help decrease the costs associated with the storage of paper records.Easy exchange of healthcare information amongst many authorized users in different healthcare settings

Patients: Patients who are unable to travel long distances or who are not located close to medical facilities also benefit from the interconnectedness of providers

Sub-Saharan Africa is a resource-constrained region that suffers a top-heavy share of the world’s burden of disease.

According to the World Health Organization (WHO), about 12% of the world’s population lives in sub-Saharan Africa, yet the region suffers 27% of the world’s total burden of disease.

Timely as well as accurate patient information is essential to meet the health-care needs of any patient in any population.

Physicians and other care providers require high-quality information to make sound clinical decisions; however, their information needs are often not met.

The first three challenges identified were inadequate human resources (34.29%), inadequate budgetary allocation to health (30%), and poor leadership and management (8.45%). The leading solutions suggested included training and capacity building for health workers (29.69%), increased budgetary allocation to health (20.31%), and advocacy for political support and commitment (12.31%).The critical need for good health information systems in sub-Saharan Africa has become the current focus of attention.

Many studies conducted in different health-care settings have indicated that EHRs will assist health professionals to reduce medical errors, achieve better effective care coordination, improve safety and quality, and also, it can reduce health-care costs. 

Electronic Medical Records (EMRs), Electronic Health Records (EHRs) Personal Health Records, eHealth-as-a-Service(eHaaS). 

First, though an important starting point, training alone is insufficient to engage and build capacity for facility and community health workers. Stakeholder meetings, data reviews, and mentoring use of data as a basis for decisions have been utilized to engage health workers and managers and demonstrate the value of data, HIS quality, and ownership of tools to summarize data and guide decision making.

 A second lesson learned is that it is critical for HIS interventions to be developed in the context of the national HIS, which has been feasible across PHIT Partnerships and is crucial to ensuring the sustainability of the programs beyond the project lifespan. 

Finally, in two of the PHIT Partnerships, the increased availability of mobile phone technology has facilitated the introduction of EMR systems in rural, resource-constrained environments. These ICT innovations have come at a high initial financial cost to build infrastructure, modify software, and build human resource capacity for their use.

Our main focus is to provide scalable and intelligent applications in Africa's health space. This project will enable us to achieve that through the use of data science and machine learning in health.

Africa is predicted to be one of the slowest growing continents in terms of implementation of electronic medical records by 2024. Weak health information systems (HIS) are a critical challenge to reaching the health-related Millennium Development Goals because health systems performance cannot be adequately assessed or monitored where HIS data are incomplete, inaccurate, or untimely. 

• Fewer than 50% of Africans have access to quality healthcare

• Furthermore, of those who had access, 42% reported difficulty obtaining needed care. 

• The current COVID-19 epidemic places an increased  burden to have timely and accurate patient information. 

Government and health institutions: EMR systems help decrease the costs associated with the storage of paper records

Healthcare providers: Easy exchange of healthcare information amongst many authorized users in different healthcare settings

Patients: Patients who are unable to travel long distances or who are not located close to medical facilities also benefit from the interconnectedness of providers

HIS technology in decision-making by health workers and managers has been shown to be of great value. This was achieved through engagement of stakeholders and health workers through stakeholder meetings, data reviews and mentored data usage. In order for HIS technology to be effective and have a sustainable lifespan it has to align with the national HIS. In this context, PHIT Partnerships have made it feasible to achieve this and these partnerships have resulted in an increase in the availability of EMR systems in resource limited areas through mobile phone technology. This has however come at a high start-up cost. 

MediLinkUp is an innovative cost effective e-health software involving the use of AI, Electronic Medical Records (EMRs), Electronic Health Records (EHRs) and Personal Health Records for early disease and symptom prediction and detection. This solution features an innovative system that integrates digital health technology to bridge the health information technology (HIT) gap in Sub-Saharan Africa.

MediLinkUp provides a radical improvement for health professionals & patients, changing the approach in which healthcare is delivered. It is built to assist health professionals manage disease burdens while delivering quality patient care.

Unique qualities include:

Resonance: MediLinkUp solves the issue of lack of high-quality information for health professionals to make sound clinical decisions and in doing so, it shows its ability to have an impact/positive influence on health information technology (HIT) in Sub-Saharan Africa. Possessing a deep understanding of the problem provides MediLinkUp with an advantage of resonance (identifying, analysing & eradicating). 

Adaptability: Our technology paves the way to improvements in data management, training of health workers and making referrals. Our solution assists health professionals to reduce medical errors, achieve more effective care coordination, improve safety & quality, and finally, reduce health-care costs. Our adaptability feature enables the easy use of our software in urban, rural & hard-to-reach areas. 

Accessibility: MediLinkUp makes health information accessible by the inclusion of a multilingual feature in our software. This enables the easy use and accessibility of our software & health information in different local languages. This gives us a cutting edge.

MediLinkUp offers eHaaS MediLinkUp, a new innovative digital health systems solution, which operates on a new efficient technological infrastructure, designed to adapt to external systems that will interface.

Its deployment is done by interfacing via a webservices to health information systems hosted in hospitals, clinics and other public or private health centers.

The eHaaS MediLinkUp application environment (the web server, the application server and the database) communicates with all of types of health information systems.

Customers devices (Smartphone, Tablet, Computer) connect to the web server via URL (Web Portal) and Mobile App (Mobile Application) in the most secure manner possible.

It is a modular solution deployed on the following technological infrastructure:

• a Database server for securing and storing data;

• an application server necessary for the execution of the eHaaS MediLinkUp applications;

• a web server for managing http / https sessions;

It requires the establishment of an IT platform for: 

• production;

• test and integration;

• training;

• backup.

Features include Data collection, Machine learning, eHealth, disease, symptoms, detection, prediction, early detection using AI,EMRs,EHRs, Personal Health Records, eHealth-as-a-Service (eHaaS). 

 The system will allow an authenticated user  to signup and create patient data. The patient data will include their biodata, anthropometrics data, and disease symptoms related data.

The system will apply Machine learning and Data Analytics (on the data collected) to predict disease outbreak in specific geographical areas and also for early detection of diseases in individuals. Health officials can then take steps to prevent further spread of certain diseases and/or apply early treatments.

Companies like THINKMD through collaboration with eHealth Africa have created applications such as MEDISINC, app primarily targets community health workers to perform an integrated illness severity assessment for respiratory distress, dehydration, sepsis, malnutrition (none-moderate-severe) and other childhood illnesses. Since it's inception in Kano State, Nigeria, there has been a 26% increase in IMCI compliance by CHWs, 40.8% increase in WHO-IMCI compliance, > 40% increase in the acquisition of key IMCI danger signs,  > 50% reduction in training cost when implementing MEDSINC platform.

eHealth Africa has also created the electronic Integrated Disease Surveillance and Response system (eIDSR), which was created to improve the flow of information within health systems. The tool is integrated in the national health system through its compatibility with the health information system DHIS2 which is used in over 45 countries, including many with vulnerable health systems. eIDSR mobile application collects and reports data from the community level up to the national level. They offer a user-friendly solution that enables public health workers to collect, report and analyze data.

Helium Health which has been operating since 2016, has taken hospitals, clinics and other health facilities digital using their Electronic Medical Records/Hospital Management Information System (EMR/HMIS) product. They are used by >300 providers, >5,000 health professionals and manage >165,000 patients monthly.

Although not all these systems are directly EMR systems, they prove that eHealth systems in Africa are on the rise and are changing the way in which Africa tackles data collection and reporting for decision-making within health systems.

The aim is to initially establish a sense of urgency (as part of the awareness campaign), create a guiding coalition (using early adopters of the system to motivate others to join), to communicate our vision and strategy (using multiple media forms) with our stakeholders and to take time to understand our end-users (to gain pre-implementation data). We will do this by using surveys, focus groups, or interviews to gain an understanding of the needs, wants, expectations, and attitudes of all our user groups; and create urgency by showing videos that share the personal repercussions of preventable medical errors, or the success stories of other hospitals that have successfully implemented an EMR.

 We will also share knowledge about what an EMR is and is not, and deal with any misconceptions or unrealistic expectations our stakeholder may have. Stakeholders will then be able to test out the EMR to see if it meets their needs. Training will be provided to decrease the perceived complexity of the system.

Once implementation of the system has commenced, dedicated teams will be created to deal with unforeseen system or user problems as they arise, and information about what else is achievable or what other health care organizations are doing can be shared to help sustain the change.

Overall, the EMR technology will give health care providers information in formats that are not possible with paper charts. The EMR will also provide access to information and resources that point primary care providers toward the best approach to the various conditions they encounter in practice. Disease outcomes can be improved. With meaningful use, the EMR data will provide the physician with valuable practice-level information. The EMR will improve communication and relationships between physicians and their team members. Chart summaries, medical notes, and consultation letter templates will provide consultants and various team members with legible, structured information. The EMR will allow clinicians to see a larger number of patients through better access to comprehensive patient histories that include clinical data, which might help physicians spend less time searching for results and reports.

MediLinkUp : Early prototype

The current number of people: 0 

The number  of people in one year :108 000 patients 

The number  of people in five years :  5,000,000,000 patients 

The project implementation will be carried out in the following steps:

1. A web application development

2. Data collection

3. Develop an AI detection model

In the first step, we plan to develop a web app for collecting data related to patients' symptoms. This will enable us to create a large database epidemiology data for identifying coronavirus symptoms. The collected data will be made available to other researches via APIs while putting privacy at the forefront. Patients will have an option to allow (anonymous) public use of their medical data or not. 

Our medium to long term plan would be to develop applications (web and mobile) that allow for offline data-collection which can be later sync to the central db. This is especially important for remote areas in Africa where internet is not available, slow or epileptic

The following are also key aspect of our implementation:

1. Discussion with the national team 

2. Getting authorization 

3. Geography: Freetown, Sierra Leone; then urban and lastly the entire country. Once it is established with a working business model, it can be expanded to other countries.

4. Technology and resources: Python, Django, MongoDB, Cloud Database, Server, Tableau, Data labeling, Established team of data scientists, web developers, public health professionals, and business developers, and UX/graphic designers. 

5. Funding from investors, grants, or private equity.

   Funding from investors, grants, or private equity.
   

   
   

Finance and Budget :

The main obstacles that MediLinkUp can face are finding and obtaining the funding they need to grow. It needs particularly significant funding due to the inherent costs linked to Research and Development and necessary for the research of new markets. And to date, it is obviously very difficult to convince investors immediately to invest in projects.

Qualified health workers for project support:

In an Africa where the health field is not advanced and has many incompetent health workers who are not up to date in the field of information technology and digital, this can be a big barrier able to delay the project during its execution. MediLinkUp will face this barrier by educating health workers to bring them to a satisfactory level of understanding to properly accept the project.

Legal, Compliance and Security:

As the information on the health of patients is very critical, their protection becomes a major daily challenge, especially with the law and compliance of user data protection required in developed European and American countries, this aspect is not well respected in Africa. Considering this as a barrier, MediLinkUp recommends to respect and to make respect the standard of GDPR as regards the protection of user data. 

To address these barriers, and in addition to the expertise of its team members, MediLinkUp will mainly use investors to help it meet challenges during its start-up project activities. 

MediLinkUp will implement a business strategy to stabilize its development for  5 years.

By making my research and development project sustainable, I will be able to attract the investment and meaningful partnership and collaborations.

Through partnership with the relevant stakeholders in the sector we will conduct capacity building programs on the health workers and will be able impact them with digital  skills. The knowledge will  boost their confidence and passion in their line of duty.

Space to overcome  the various barriers mentioned, we will proceed with innovative strategies.: 

• Finance and Budget :

  This can be in the form of grants or one-time payments
  for infrastructure and hardware costs, reimbursement incentives.

  Equity financing
  

  Personal savings

  Crowdfunding
  

  Grants
  

• Qualified health workers for project support: 

  Training of EHR users was also reported in studies to be an effective strategy for getting end users’ acceptance. Training should be both initial and ongoing. Physicians and other EHR end users have to set time aside to study how the system is operated and how their workflow should be redesigned to allow for an efficient use of the system. Training, however, should commence with the most interested EHR users, the so-called local champions who will subsequently be used to motivate the others and developed to “super users” to handle most basic hardware and software problems locally

  
  

• Legal, Compliance and Security: 

In the African Countries that lack the data protection law in partnership with the relevant stakeholders and including the people we will lobby and petition it to be part of the law governed in the African countries.

1.  Dr Garba Moussa,Project owner,  data scientist, project manager, team leader - He  will also take charge of the database, data analysis, algorithms development.Full time

https://www.linkedin.com/in/dr-garba-moussa-3559a73b/ 

2. Benny Moja Developer and startup owner (South Africa), other workers

https://www.linkedin.com/in/benny-moja/

3. Nontsikelelo Noluvuyo Ncwadi, Student at Walter Sisulu University, public health and science engineering . 

https://www.linkedin.com/in/ntsiki-ncwadi-1b6ab61a6/ 

4. Charles Effiong, PhD  Developer , digital design at Apple. other workers

https://www.linkedin.com/in/ce... 

5. Mamane Lawal Wadataou, Experienced in information technology for almost 13 years.  other workers

https://www.linkedin.com/in/ma...

6. Stephanie Ede, Physiotherapy student , public heath & policy enthusiast 

            https://www.linkedin.com/in/st...

MediLinkUp has a team of experts, engineers and qualified professionals in several areas including economists for macroeconomic analysis and assessment of African countries, data scientists who are responsible for management, analysis and operating massive data within the company in this era of big data, public health experts, information technology experts for the development of IT solutions and IT infrastructure installation. These experts combine their knowledge by providing analysis of the problems to a solution in our African societies.
In this new digital era, MediLinkUp staff have solid knowledge in digital transformation of activities in public and private healthcare centers. During project management perfect communication will be made to enable all stakeholders to have a clear view of the work to facilitate the acceptance of the changes underway.

The interaction of these skills in multidisciplinary fields gives MediLinkUp the know-how to deploy this solution effectively in order to serve as it was thought out and meet the expectations of end customers. And the sense of professionalism, teamwork and sense of responsibility will lead to the correct outcome of the solution eHaaS MediLinkUp.

 Mamane Lawal Wadataou , Experienced in information technology for almost 13 years, with an expertise in governance and management of information and technology (COBIT 5), in Risk and Security of Information Systems (RSIS), in Projects Management (PRINCE2) and IT Service Management (ITIL v3).

Benny Moja is  Co-Founded a Social Enterprise called PeninsulaBusiness Club (PBC) now called BeBold, which promotes innovation and entrepreneurship in Institutions of Higher Learning in South Africa.

The MediLinkUp solution does not really have partners at the moment but it has been subjected to hackathons like AfricavsVirus and quarantine hackathon.

MediLinkUp was selected i top15 in quarantine hackathon and Top  100 with AfricavsVirus. 

MediLinkUp business model of the is for the supply of software to customer demand to meet the specific need for improved health of the African population. Also, this software can be provided as a SaaS (Software as a Service) for customers who want this architecture. Access to this solution is possible for both cases whether in SaaS or owner and the choice depends on the client. To support it in this important project, MediLinkUp is looking for investors who will finance all or part of its activities for the first two years. Once the operation is stabilized, will put a strategy of management and development of these activities over 5 future years. 

One of the principles of this business model is to allow members to access reliable and quality information on products and services in a very secure manner. Indeed, our business model is ideal for users who are looking for quick, easy, simple and innovative solutions in the health field.

Therefore, the revenue will be generated through the services delivery and supports provided to customers. MediLinkUp will strive for the fidelization of its customers and partners for a long term of activities. And MediLinkUp will put a single pricing structure of software as a whole for these customers or opt for the one that depends on their choices.

The main objective of the MediLinkUp business model is the long-term growth of the startup with a constant increase in accessibility and delivery of an adaptive solution to customers in Africa.

The startup MediLinkUp is a new creation, in this sense it does not have a budget allowing it to finance all its activities immediately. The solutions that MediLinkUp offers are very important for the development of society in the health field in relation to new information and communication technologies, it requires for a start of its activities the help of investors or any other assistance enabling it to deploy these solutions. As a result, a return on investment will be felt in various ways once the functioning of MediLinkUp is well stabilized.

So, in the short term MediLinkUp is looking for reliable partners and investors to help it start its activities properly. MediLinkUp will then implement a business strategy to develop its financial activities over 3 to 5 years by looking for new opportunities and customers all over the African continent to sell its solutions and train clients in using of eHaaS MediLinkUp.

In the long term, firstly MediLinkUp will have a return on the investments and financing received from its partners, that will generate revenue and bear operating costs by paying employees, suppliers, partners etc… Secondly,  return on investments will allow sustainable development in health in African societies and will help to have reliable results on patient treatments, analysis reports and an excellent backup of patient data in health centers.

The MediLinkUp' solution was proposed in a context of hackathon but we still continue to improve this solution.

The world today is more interconnected than ever before. Improving access to technology and knowledge is an important way to share ideas and foster innovation. Coordinating policies to help developing countries manage their debt, as well as promoting investment for the least developed, is vital to achieve sustainable growth and development.

The goals aim to enhance North-South and South-South cooperation by supporting national plans to achieve all the targets as business model, solution, Funding and revenue model and Marketing, media, and exposure. 

First, though an important starting point, training alone is insufficient to engage and build capacity for facility and community health workers. Stakeholder meetings, data reviews, and mentored use of data as a basis for decisions have been utilized to engage health workers and managers and demonstrate the value of data, HIS quality, and ownership of tools to summarize data and guide decision making. A second lesson learned is that it is critical for HIS interventions to be developed in the context of the national HIS, which has been feasible across PHIT Partnerships and is crucial to ensuring sustainability of the programs beyond the project lifespan. Finally, in two of the PHIT Partnerships, the increased availability of mobile phone technology has facilitated the introduction of EMR systems in rural, resource constrained environments. These ICT innovations have come at a high initial financial cost to build infrastructure, modify software, and build human resource capacity for their use.