MaiSoin

There are two primary problems that MaiSoin tries to address. 1. The overall access to quality healthcare in Cote d’Ivoire and 2. The poor understanding of community level disease epidemiology. 

We are solving these problems by developing a mobile application used by our network of health professionals to provide household level care. The application will facilitate the collection of data during the consultation and provide them with relevant health history to make better decisions. Increasing the number of people receiving care at their home will allow for more effective preventive care and better health outcomes.

When scaled, we will be able to develop a granular understanding of disease epidemiology allowing us to provide guidance to public health institutions. Public health decision makers will be able to target more appropriately their interventions. Moreover, our platform will act as a monitoring system that would rapidly identify disease outbreaks.

African urban health systems are unadapted for their population's health needs. As urban centers grow, health structures are overburdened by non-urgent patient visits and pandemics, such as Covid-19.

Over the next 25 years, the African urban population is expected to double from 472 million in 2017 to over 900 million. In Côte d’Ivoire, where MaiSoin is headquartered, the government currently allocates ~5% of its budget to healthcare instead of the 15% committed in the 2001 Abuja Declaration. The population that is most impacted by a lack of resources in the public health system is the informal sector because they rely on daily wages and typically don’t have access to health insurance. In Côte d’Ivoire, the informal sector accounts for up to 77% employment. When the public health system has significant barriers to care, individuals tend to opt for riskier alternatives such as informal clinics and fake medication purchased in the market. 

Within a pandemic setting, health “nodes” become overcrowded, increasing transmission.

In addition, as a result of fragmented, and non-standardized approaches to data collection, public health policy makers do not have the relevant data to efficiently implement their interventions.

Our solution is to create a mobile application that allows health providers to connect with patients and provide household level care when appropriate. 

Patients will be able to request medical visits at their home, even without the internet, for themselves or their family members and can also use the application to track and monitor their health history, post reminders for themselves, and request consultations. Using the application, health centers can publish tasks, decentralizing their operations, based on their patients’ needs and are able to be completed at the household level such as replacement of post-surgical bandages, follow-up for chronic diseases, maternal health consultations, or even ensuring that patients have taken their tuberculosis medication. By using a gig economy-style network of health professionals, we ensure that there is always a qualified individual nearby to initiate the care. This also allows us to reduce transport costs and heavy administrative expenses. 

We use a cloud-based platform that ensures that only the user or their primary provider can view their health history to ensure patient confidentiality and security. By having a platform used by multiple health partners we are more effectively able to establish uniformity in data collection and improve comprehensive data analysis.

The population that we are targeting are individuals and families that work in the urban informal sector. Among many others, they are store owners, market vendors, construction workers, taxi drivers and the families they support. Before starting MaiSoin, we conducted customer discovery surveys and interviews in our target communities to understand the challenges they faced when seeking medical care and determine our proposed solution appealed to them. As we begin our activities and test our product, we plan to continue doing face to face customer interviews and engagement, as well as USSD code based surveys to review the quality of the care being provided and how we can continue to improve upon their needs. 

Our solution addresses their needs by:

1. Providing at home care at affordable prices

2. Limiting the time they spend at the health center or hospital to avoid taking them away from their revenue generating activities

3. Tailoring the care provided to the individual patient

4. Using data to more appropriately guide interventions that are designed based upon their needs and their realities

We address the Health Security & Pandemics challenge.Our solution is appropriate for this challenge because of the depth in which we seek to strengthen the health system. 

By providing household level care, we are able to reduce barriers to entry for individuals, increasing trust in health professionals and limiting exposure to unregulated healthcare. This also reduces the overcrowding of health infrastructure. An additional factor to providing care at patients’ homes is that we are able to collect more precise, accurate data on the patient. When properly analyzed, this data can significantly improve our understanding of disease within a given population.

There are a number of solutions that approach increasing access to healthcare using technology, particularly with a focus on telemedicine. In Côte d’Ivoire alone, we have identified 3 primary competitors: Affiya, UMed, Docteur a Domicile (DAD). Each of these solutions has a different approach and specific segment of the population that they target, which are primarily towards providing care to families with high income levels. The cost of care is generally very high and specialized. 

Our solution eliminates many of the high costs involved and targets lower income individuals, specifically those in the informal sector that don’t have access to health insurance and rely upon the public health system. 

In addition to targeting a different, and significantly larger segment of the population, we are also orienting ourselves to strengthen public health institutions and organizations through the collection and utilization of data. 

As we scale and increase our technological sophistication, this data-based solution will allow us to create more accurate systems for treating patients as well as identifying patient needs more appropriately to ensure higher care outcomes.

Considering that we are at the very early stages, our solution uses existing technology to optimize and make our new business model more efficient. Currently our MVP uses an application built into Google Suite. As we grow and increase in complexity, we anticipate developing our own technology upon which we can scale. 

In the future we hope to incorporate elements of AI and machine learning to optimize the matching of the care provider with the patient. Further down the road, we plan to incorporate blockchain technology to secure health history to ensure permanent health records.

At this stage, our technology is not new. Our MVP uses forms and an application that collects data while we leverage individual health professionals to execute the primary care services. This data is then analyzed to create a stronger understanding of disease epidemiology. The basis of this technology is used for data collection and epidemiological analysis by most non-government organizations, government agencies such as the CDC, and WHO. Our uniqueness and innovation comes in how we mobilize and manage these resources to be most effective for patients and the public health decision makers.

Eventually, we hope to develop significantly more sophistication within our systems through:

1. Artificial intelligence that would allow us to connect patients with the most qualified, appropriate health professional.

2. Machine learning that would allow us to transform the application into a tool that improves caregivers decision making when visiting a patient

3. Blockchain to ensure immutable, reliable health histories

MaiSoin imagines a world where everybody has access to healthcare that is oriented towards their needs driven by accurate, relevant data. 

Our inputs are the following:

1. MaiSoin develops a network of health professionals by:

   1. Verifying health professionals credentials before signing up  

   2. Managing health professionals availabilities 

   3. Equipping each health professionals with a kit possessing all the tools necessary for at home care

   4. Determining each health professionals at home care zone of activity 

2. MaiSoin application that allows:

   1. Patients to be matched with health professionals according to availabilities, localisation and qualification needs

   2. Health professionals to collect data during the consultation 

Outputs:

• Quality at home care 

• Less time spent waiting for healthcare 

• Less use of informal, unregulated healthcare and medicine

• Accurate and granular health data and information 

• Use of a single platform for all health data collection  

Outcomes:

• Improved decisions and policies by decision makers and public health organizations

• Improved health indicator outcomes

• Increased value placed on health

• Improved relationships and trust between people and the health system

• Lower transmissible disease spread

• Minimize outbreak impacts on the community

We are still working on creating partnerships and finalizing the regulatory requirements, therefore we are not currently serving any customers. However, if we hit our expansion targets and appropriate partners, we hope to be serving up to 10,000 people per month within the first year. Within five years we hope to be serving 500,000 people per month across multiple cities and countries. 

Our goal within the first year is to establish ourselves as the leader in household level healthcare in Abidjan with over 500 health professionals within our network while opening locations in other large cities in Cote d’Ivoire such as Yamoussoukro and Bouake. 

In the next three years our goal is to expand regionally, creating offices in urban centers in Senegal, Ghana, and Benin. Within five years we hope to have expanded to countries in other regions where urbanization is rapidly growing and technology is becoming more integrated such as Nairobi, Addis Ababa, and Johannesburg. We do not plan to simply be a temporary solution in improving access to healthcare, but the primary player in removing healthcare barriers and improving data collection standards with an aggressive growth strategy throughout the continent. 

We are also planning on sharing our technology for data collection with other health organizations in order to create a standardized platform used widely.

Over the course of the next year, we expect to need to overcome significant legal hurdles to ensure that we follow the appropriate regulatory requirements. These are often very slow, bureaucratic processes that while we have already initiated, will take time to finalize. This will initially limit our growth within Cote d’Ivoire, but once we have overcome it, should give us a strong competitive advantage against others trying to enter the market. 

In addition to the legal barriers, there are cultural and financial challenges that we may encounter. Certain members of the medical community are concerned that our model limits the role of the doctor and over empowers the nurse. 

Financially, if we are to achieve financial sustainability and scale, we will have to continue doing research and development efforts to limit the cost implications for the customer themselves. Our intention for creating MaiSoin is to expand access and limit costs to the customers. If we do not establish the right price points, we risk excluding these customers entirely, removing a significant impact that we wish to have. 

As we expand outside of Cote d’Ivoire, each of these challenges will repeat themselves based on the individual population and the regulatory environment and cultural individualities within each country.

We plan to overcome the barriers as follows:

Regulatory

• Regulation, especially around data protections, is increasing within the region. We have identified specialists in the legality of data storage and management in Cote d’Ivoire and plan to work with them to ensure our compliance. These are primarily based upon European Union laws.

• As we grow regionally, we plan to rigorously follow GDPR obligations and identify local specialists to maintain compliance with any local particularities.

Financial

• In order to ensure access to the greatest number of people, we want to keep our fees as low as possible. While this may cover general operational expenses, it requires significant scale to reach profitability with only this revenue stream. This is one of the core reasons why we intend to responsibly commercialise the data that we collect. By using it as a secondary revenue stream we are not only improving the efficacy of public health organizations, but we are reducing our general operating costs, allowing us to maintain profitability and growth.

• To collect sufficient and valuable data takes time, therefore we plan to raise funds in order to sustain ourselves financially until the time that we break even and eventually become profitable. 

Localization

• Each country and individual city will have their cultural and financial realities. Identifying leaders not only in the country but within the individual cities will be crucial to creating the proper partnerships and adapting MaiSoin to the realities on the ground.

Currently we are a team of:

- two co-founders

- a medical director 

- two temporary recruitment agents to develop the network of health professionals. 

Our team is uniquely positioned to solve this problem because of deep experience developing and implementing large scale community health based programs focused on active surveillance. We believe that without the active searching of cases and removing barriers to healthcare access, we cannot control disease outbreaks. 

Two of our team members have been part of the largest active surveillance in the world and worked to design the rollout of a mobile collection program, greatly increasing efficiency in data reporting and analysis. 

Our medical director is also specially qualified to address this solution through his experience with household care companies in the past. He even attempted to start his own but was not able to get off the ground due to a lack of funding. 

Furthermore, we have studied social entrepreneurship and worked within entrepreneurial ecosystems and have supported companies from the idea stage to financing.

We do not currently have any finalized partnerships. However, we are in conversations with a few organizations and clinics locally with the intention of collaborating closely.

Our business model has multiple facets based upon customers and the services we provide.

The primary service that we provide will be to individuals or their family members who are sick. For each consultation or service that is provided through the platform, we will charge a small fee to cover operational costs. 

The secondary service will be based upon the collection and analysis of healthcare data. The security and privacy of this data is paramount to MaiSoin and its functionality. We plan to leverage the anonymized data to sell to public health organizations such as international organizations, non-government organizations, and the government. These organizations often lack the data they need to make decisions and regularly have to do surveys or needs assessments prior to beginning their work. This will allow them to better understand the health problems within the community and more appropriately target their interventions to serving the populations they are committed to supporting. We hope that the leveraging of this data will allow us to lower costs and fees for providing primary care to the population.

We plan to fund our work through the connections between health professionals and patients. For each service provided, we will take a small facilitation fee to cover operating expenses and cash transfer fees. We plan to begin by partnering with clinics and hospitals to gain traction and demonstrate proof of concept. In this case, the clinics will cover the fees, however, as we expand and begin providing our services more directly to individual patients, this fee will be covered by the patient themselves. While this may not be financially sustainable initially, as we scale and increase our technological sophistication through AI and machine learning, we believe that this revenue stream will become financially positive.

Over the medium to long term, we plan to use the data we collect as a secondary revenue stream. We believe that the value of this data will allow us to reduce and potentially eliminate the consultation service fees, increasing the accessibility to our services to a broader target market.

As a nascent startup working in a country and a region with little access to a strong entrepreneurial ecosystem, we are excited to have the opportunity to tap into a community such as Solve and MIT. While we have access to many of the basic talent and organizational needs, we don’t want to be a normal company. We want to revolutionize the way that healthcare is provided and thought about within West Africa and eventually throughout the world. To do this, we need to talk to leaders in the field, be guided by experts who have already scaled companies, and look to create a technological advantage that not only makes us a dominant player but allows us to protect our customers' data privacy while receiving the best care possible. 

We believe that the Solve community is uniquely placed to provide us with these needs and we are excited to have the opportunity to apply.

We know that coming up with a solution and creating a products that revolutionize our approach and the community’s relationship with healthcare is not easy. To do this, we need to have experts that are ready to creatively build new concepts in ways that go beyond our founders’ expertises and experience. Considering the relationship with MIT and the depth of experience that Solve has with utilizing technology for the worlds’ most challenging problems, we hope that we can identify individuals and organizations that have a similar vision and are open to helping us achieve these goals together.

In general we are actively seeking partnerships with local and regional health organizations that have similar missions and objectives. Particularly, we would be very interested in partnering with the Ivorian Ministry of Health and their Institute of Public Hygiene which is responsible for the COVID-19 response in the country. We believe that a strong partnership would allow us to properly align our data, permitting them to have a better understanding of community diseases and better identify cases of transmissible diseases that are going underreported. 

With regards to the Solve community, we are very interested in faculty and students that are interested in predictive epidemiological technology and how to use AI and/or machine learning to create tools for health professionals.

Specifically, we are very interested in partnering with:

• Ada Health to understand their technology and how it could help our network improve health indicators 

• CareMother in order to use Fetosense during our prenatal monitoring visits and create a focus specifically around maternal care

• MedicMobile or ClickMedix for technological support in developing our mobile technology and workflow

• SimPrints to utilize their biometric patient identification to ensure patient confidentiality and follow-up