H+Bank

My name is Raquel Fidelis, I'm 20 years old, Brazilian, one of creators of the H + Bank project, certified by HarvardX in the entrepreneurship course in emerging economies and passionate about solving problems in health systems. Participant in the minicourse "Trajectory of digital health in Brazil" offered by a federal university in partnership with the Ministry of Health, I am enthusiastic about understanding the complicated reality of my country in this area.

My role in the project is to align partners with our moral vision and lead them to achieve our goal of running health management software that identifies trends in epidemic outbreaks based on artificial intelligence.

Software developed to reach an optimization on health professionals’ attendance, an antecipated detection of epidemic outbreaks and a better integration betweenn the different responsibles for public health. With this system, which database is developed by the utilisation of digital medical records, is possible to provide a better comprehension of community realities to the public power and health professionals. Using resources as symptomatic patterns identifications and the medical records’ database, becomes possible to notify potential abnormalities, suggest diagnostics and treatements based on other doctors’ experience, acces the registrared population’s vaccination coverage, and information’s fast trasmission to the epidemiologic surveillance and responsible health departments. Hence, besides generating an efficiency gain with the digital medical reports, H+ Bank’s enables to better prepare, detect, respond to emmerging epidemic or new deseases and also provides a bigger optimization of public health spending.

The decision making’s delay and the absence of an effective and real-time communication between health care agents.

In 2020, it was noticeable the delay on the recognition by the WHO of COVID-19 as a pandemic.

The slow decision making reflected directly in the preparation capacity of 81 countries that had not been infected until that moment.

The failures were not only present in this case, but also since several countries up to it’s microregions.

The lack of data management efficiency and of tendencies identification of new diseases in real time brought a slow defensive response againt the virus dissemination to other localities.

H+ Bank has as a focus the supply to the Brazilian market of 209,5 million people, which generates a spending of R$ 6 billion per year with epidemiologic surveillance. Initially, the H+ Bank intends to act the population of the newest state capital in Brazil, with 220.000 habitants. Posteriorly it will pursuit an expansion to bigger and different regions, all around the world.

The H+ Bank operates on clinics, basic health unities ou hospitals, where will use the database provided by digital medical reports made on its platform.  The contained informations have the goal of make the surveillance and the control in the case of na epidemic outbreak. The artificial intelligence will learn the manifestation pattern of the deseases and its symptoms on the regions, and notify cases that outrange the pattern. Thus, it is able to detect abnormalities on early stage, to inform the responsibles for analyzing and combating the disease and to provide better data quality and circulation between the health agents. By optimizing actions and communication and having a database filled with valuable information, the H+ Bank becomes an ally on the combat of several deseases.

The application is being developed on the multiplataform React JS. On its structure, it has the Firebase, a platform that enables a bigger data cloud storage. Considering the need of a artificial intelligence, the TensorFlow was chosen as the framework. Pursuiting a better productivity and versatility on a more simple way of the application, the GitHub was used.

Initially, the solution will benefit the population in Pamlas- TO, which is supported by the SUS (Brazilian’s health unic system), like the other cities in the country. For a better comprehension of populations ‘s necessity, researches were made with members from the epidemiological surveillance, health secretaries, doctors, nurses and technicians, to better understand their experiences with the current system and to provide a more assertive and efficient service. Thus, the solution solves some system failures and ensures a faster and clear communication between health care agents.

Of the countries known for having a public and universal health system, as Uniter Kingdom, Canada, Denmark, Sweden, Spain, Portugal and Cuba, the only one with more than 100 million habitants is Brazil. The Brazilian model (SUS), for its big populational coverage, has administrative difficulties that become even more expensive because of gestion inefficiency. A World Bank’s analysis found that a efficiency improvement on the system would save R$ 22 billion every year. Hence, by disruption with the actual system, the incorporation of H+ Bank generates a bigger efficiency, viability and a big benefit to the countries and its public safes.

The key to solve the challenge is in the joint resolution of the three command verbs in the context of emerging epidemics, which are, for example, classified by the appearance or identification of an infectious agent. In this situation, the software prepares the community for a big health issue by the analysis of the application’s cloud database. Therefore, it is responsible for detecting outranges on symptoms and diagnostics and for notifying epidemiological groups, who will be in charge for analyzing the situation and providing the correct responses in a faster and more assertive way.

A close friend shows me the challenge of global MIT "Health security and pandemics" and ask me if I was interested in developing a solution with him. In April of this year, I accepted and the next day two friends were called to help us. Since the beginning everyone has been committed to thinking about the real problem, inspired by the observation of flaws in the rapid identification of emerging pandemics as observed in several countries and also by WHO. We work hard to create an innovative and efficient solution in a short period. As for me, it was my resilience, altruism that made this friend, consider me a great person to lead the project. In Brazil to enter a college, it can take months or years of preparation for the entrance exam even after finishing high school. I had been studying to take the medical exam for a while before the total dedication to the project. A short period of dedication to study our solution was enough to find me in the passion for entrepreneurship and social innovation.

Humanity has faced pandemics for centuries following the natural flow of the universe, in this year 2020 we face another with great impacts. On the other hand, a feeling of unity and altruism spread throughout the world. Just as professionals from different areas and ordinary people raised their efforts to fight COVID-19, my team was no different: 4 young people with different skills committed to achieving the purpose of having a positive impact on the community.

My team and I have contact with the municipal health secretary of our city, with the director of the Palmas School of Public Health and some health professionals. Through this connection with managers, doctors, nurses, we understand the local problem and turn it into a scalable solution for other locations.

What drives us is the opportunity to be innovative and solve a global problem even when we are young.

When I was 12 my grandfather was diagnosed with advanced liver cirrhosis and he quickly needed to go on the transplant list. Due to illness he spent many days in hospitals, I visited him daily and this was my first remarkable contact with any hospital environment. My family and the nurses who took care of him saw that I liked being immersed in that environment and was quite curious that they even gave me the function of measuring the amount of liquid in his urine bag. Yeah, I know it looks disgusting but I discovered my love for the area at that time. Some years passed and when I was 17 my mother suffered a stroke, I received the news and had to find the strength to inform my family. Visiting my mother in the ICU and questioning the doctors about all the procedures I was sure of the passion for the human body and for taking care of people. I still haven't managed to enter medical school but all my passion and dedication are being deposited in this project. From these and other experiences, I know what it's like to be a user of a flawed system supported by the Government. So, I am well-positioned to solve these problems through what I believe and with an excellent team.

The project is recent but my team and I have already faced two adversities that could have put an end to the project. First, as stated above we started to develop it to participate in the global challenge of Solve and be evaluated by the judges.

However, after publishing the complete solution according to the rules, we saw that a problem occurred: our texts that were posted in English were now appearing a large part in Portuguese. We believe that there has been a failure in the automatic translation site. Knowing that this is a reason for disqualification I sent emails to the platform but I couldn't get any help. That is the reason for applying the elevate prize. Our second major difficulty is getting access to the various databases of the Brazilian Ministry of Health that are important for the assertiveness of our software since there is no integration between them. We know that working with the Government is complicated but we believe in the benefits of our solution and that is why we are constantly looking for a network of contacts in addition to the one we have already established with the municipal health secretary of our city.

My leadership potential works perfectly in more human and creative endeavors like this project. During all my school education, naturally, I was in charge of work, discussions and was often elected leader of the class. My father is a salesman and self-employed so from an early age he taught me to practice essential communication and selling skills. In my first formal job at a pharmacy I performed well and I even received an internship proposal to take over the management of a store in the future.

During my life, I took the lead at various times, such as being in front of the group of church musicians and even taking care of my home while my mother was sick. Through this project, I seek to bring inspiration to young entrepreneurs and guarantee society a tool to avoid events that threaten public health security.

The H+ Bank provides a combination of (1) a better operational efficiency, by the use of digital medical records; (2) the record of patients’ previous results and diagnostics, providing a wider view of patient’s historic to the doctor and making possible a more precise evaluation; (3) an integration of information from different health areas and health agents, creating an information network that provides a wide view of the most different aspects and its geographic characteristics as the location, for example. It can be accessed by the registered government and private health departments, enabling a bigger comprehension of the situation and better assertiveness on money spending and effort expenditure; (4) the analysis of the database by the artificial intelligence responsible for notifying the epidemiological surveillance if some epidemic or emerging disease arises, making possible to work on the case more quickly; (5) the statistics over population’s vaccination and their geographic information, enabling the immunization processes and campaigns focus on the most threaten places; 

This combination and application of elements gives an innovative and superior analysis capacity over the health system and also provides valuable information over the system needs and weaknesses.

The world has shown a notable inefficiency on preparing, detecting and responding to emerging pandemics. The adoption of our solution would provide not only a bigger and broad security against new diseases or other outbreaks, but our database gives also a more precise vision over the health system for the health operators and agents, giving them the opportunity of better administrate the country’s health, the spending, the human efforts, the dealing with epidemics and it would be possible to comprehend more clearly population’s needs.

Furthermore, the population would benefit from the implementation of the H+ Bank by having a faster and more assertive attendance, provided by patients’ historical database, by the constant surveillance over emerging diseases and pandemics, and by a better health response from epidemic surveillance.

There would also exist indirect benefits to the population and other benefits to countries economy. According to the World Bank, an efficiency raise in 2019 on the Brazilian’s public health system would save an amount of R$ 22 billion, money that, if implemented efficiently, would provide significant changes on country’s situation. It corresponds to more than 20% of the total amount spent on education in 2019 (R$ 94,47 billion) and 19% of the total health spending in 2019 (R$ 114,18 billion). Hence, the efficiency improvements become important to a better country development in different areas.

The H+ Bank would also help on the vaccination operations and its organization in a national scale. On 2016, for example, the state of Amazonas had received 144,1 thousand doses of the HPV vaccine, but only 57,7 thousand were used. With the knowledge provided by H+ Bank’s vaccination database would be possible to have a better comprehension of the vaccination statistics on each region, to scale more assertively the amount of vaccines. Once the immunization statistics par localization are known on each city, it is possible to provide a better logistic to the population that would be immunized and also more effective campaigns to promote their vaccination.

Therefore, H+ Bank’s adoption promotes benefits for the population’s health, for government and health agencies operations and for the country finances.

The coverage of the solution will, first of all, depend on the capital raising that will be achieved. Without any resource capture, the H+ Bank is willing to attend more than 200 thousand people in a one year period and expand, in five years, to more than 10 million people.

In the case of a capture, the attendance of 200 thousand people would be a short term goal. In a one year period the goal would be raised to 4 million people and more than 45 million in five years.

Without any resource capture, in one year the H+ Bank would provide services to the country’s newest capital, Palmas- TO, and other smaller cities in the region. In a five year period we intend to expand the operations to at least 8 states. In the case of a capital raising, there would be, in one year, 4 Brazilian states with H+ Bank’s operations and, in 5 years, we will expand to at least 5 countries and will cover 30 million people in Brazil.

How we intend to provide B2G services for the willing of covering the population majority, there is a necessity of bidding processes to allow H+ Bank’s operations.

The capital raising is a factor that may influence our growth speed and the wideness of our operations.

The platform is software that needs installation and it contains a new technology for the utilization area, thus, it is necessary to install the software and to familiarize with its use.

The way aimed way to get the bidding is the invitation bids, since our services are different from the already existing ones and would not fit assertively the promoted bids. Furthermore, targeting to expand the operations, we intend to present the solution through roadshows, showing to the responsible authorities the benefits and values generated by the utilization of our system.

Our system is already under development. However, knowing that it could have a faster execution, we will search for possible investors on specialized health funds.

For the implementation and operationalization of our solution in the points of use, we adopt a remote installation, providing the users the capacity of installing the software themselves, supported by clear and simple orientations. They will also be able to request online assistance, assisting them on possible difficulties.

Our business model is mostly focused on a B2G model, since more than 70% of the Brazil’s population is supported by the public health system. However, we also pretend to extend our services as a B2B to enhance even more the effectiveness of surveillance operations.

While we intend to use bidding contracts to make a deal with the government, for private operators we will use conventional contracts. 

Seeing the high spending on health, the low efficiency (specially on public health), the surveillance difficulties and its increase for Brazil’s continental dimensions, we conclude that the population, the health agents and the government will benefit in four different ways: (1) faster attendances, since the majority of Brazilian attendances do not use digital medical records and do not count on a big medical historic for each patient; (2) a better and faster detection and response to epidemics; (3) a better focus and effectiveness on vaccination campaigns and vaccines production; (4) a bigger clarity on decision making and a better assertiveness on money spending.

We would need a capital raising to support the beginning of our operations and accelerate our growth. The MPV (15 basic health unities) would cost, per year, $ 45.000 and generate a $ 5.000 loss in a period of one year and attend 100.000 people. However, a bigger scale gain would make the solution more profitable. For a number of 100 attendance point, the cost would be, per year, $ 144.000 and generate $ 250.000 as revenue, an operational profit of $ 106.000 and would benefit around 1.400.000 people.

These numbers consider a small projection for our operations, since there are 42.000 basic health unities in Brazil, and two medium-big sized cities (one million habitants) may have this amount of 200 unities.

We hope to raise an amount of $ 200.000. As a first funding option, we intend to apply for capital raise of health investment funds, especially the ones that make smart money investments. However, we have other options, as searching for an angel investor.

Considering the actual exchange price (U$ 1= R$ 5,06), the first year of our MVP operations is expected to cost U$ 45.000 and to attend 15 basic health unities (Brazil has 42.000 unities), corresponding to approximately to 100.000 people. These expenses would cover technologic and structure costs, a cost aid for the entrepreneurs, employees’ salaries and other operational expenses.

The Elevate Prize help would provide a faster beginning and growth of our solution. The resource application would turn possible the roadshows execution, a better administration possibility of the received biddings, and, consequently, a bigger expansion and a better service rendered to country’s health system.

The solution will generate a wide database capable of giving a clear and specific view of the health system operations. It would also give the capacity to evaluate precisely each regions operation and each health service point. Thus, we intend to partner with organizations capable of use these data and provide a quality evaluation, certifying the high quality points of operation and evincing the system weak spots, and also would be important for us to be supported by a health authority, such as the Brazilian Ministry of Health, or World Health Organization.