Striata - Command Center for predictive distribution

Striata is central intelligence for the distribution of health goods and services. Striata has three core pillars: predicting who will show up for care and who won’t; predicting what will be used at each facility; predicting the capacity and capability of each health point and the system as a whole.

Benjamin Fels is the CEO of Macro-Eyes. Benjamin leads a global team and the global effort to make the delivery of healthcare predictive.

COVID vaccination efforts have been largely focused on procuring vaccines and organizing “hard” infrastructure – planes, trucks, refrigerators. The shortcomings of active vaccination programs highlight the need for a focus on “soft” infrastructure: intelligence, forecasting, personnel, and processes.

The soft infrastructure that supports current immunization efforts (and healthcare delivery writ large) is designed to document what has happened. It is transactional.  This has its place, but it is not transformational and will not keep pace with the need of COVID response or fast sweeping health concerns of the future. Systems that describe yesterday are not as useful as systems that indicate what will happen next.

To date, vaccine allocation has resulted in dramatic inequities in vaccine coverage, unacceptable vaccine wastage, and stalled progress toward vaccinating priority populations. The process will only get more challenging. To date, countries have sought to vaccinate captive, accessible populations. Hourly laborers, those unaccustomed to seeking care, the hesitant, and the remote in low income communicates will create a challenge for which we require predictive visibility at scale.

Striata serves decision makers in governments [today: Nigeria, Mozambique, Tanzania, Sierra Leone, California] and organizations that support equitable healthcare delivery [Direct Relief, Bill & Melinda Gates Foundation].

We have formed working groups active around the world that integrate multi-dimensional expertise to drive impact and to drive adoption and use of the insights. Our technical working groups include leaders from the Ministry of Health and Sanitation of Sierra Leone, DSTI, and the Bill & Melinda Gates Foundation and experts in AI from MIT, Imperial and Stanford.

The current approach for understanding the state of each health facility – and assessing readiness to deliver care - is the WHO SARA survey or similar World Bank frameworks. The SARA survey is resource intensive and organizationally intense: ~$1M and 9-12 months to create a static snapshot that is very often out of date by the time the data is published and accessible. This is the reason countries often only undergo the process every three to five years.

Today, health systems know patients won’t show up, but they don’t know who is at greatest risk, so they don’t engage the right people – meanwhile people who need care drop out of the system unengaged.

As a component of this work, Macro-Eyes will generate a white paper on the approach and develop a web based platform for national level visibility for global stakeholders for the purpose of assessing the state of health systems globally. As an organization rooted in rigorous science, it is our responsibility and mandate to make our work as transparent as possible. Macro-Eyes has made a legal commitment to make Striata available and accessible at an affordable price to governments that serve and support the most vulnerable populations globally.

The use of Striata means more people will receive care with the same resources. Striata ensures equitable distribution of health commodities, getting life savings supplies to the places where they can have the greatest impact. Striata means that health system leaders can invest and act with confidence based on clear ground truth insights in real time about every corner of their health system.

Striata’s ability to identify where priority population will likely seek care – and show for care – means that health systems can pre-position equipment, people and vaccines.

Striata’s ability to provide real time insight into the state of infrastructure at every site in their system means they can generate a hyper-precise shopping list where every dollar spent will maximally increase the capacity of their health system.

Striata’s ability to forecast utilization at every site across a system means that stockouts-due-to-forecasting will cease. The use of Striata means that wastage will be reduced enabling increased coverage without additional cost.

The technology has been deployed and tested at multi-national scale with success. Data infrastructure has been built. Integration and deployment APIs have been built and tested in numerous formats to meet data security and data sovereignty requirements across countries. 

Scale for Macro-Eyes Striata technology is based on an ability to make this solution known and accessible to government leaders. The majority of cost for Striata is in the implementation phase - augmenting models, aggregating data, generating feature sets from satellite imagery, integrating with existing technologies, and training on the use cases for the technology with health system stakeholders to increase adoption of insights as part of decision making processes. 

Macro-Eyes has established partnerships with local expertise and offices across the continents of Africa and Asia. These organizations have long standing relationships with national leadership that will enable rapid adoption. We are working with funding organizations and opportunities like the Gates Foundation, McGovern Foundation, USAID, and the MIT Solve Trinity Challenge to provide catalytic funding for scaling to new countries. Removing this early cost hurdle is essential for scale.

Macro-Eyes works with the Draper Richards Kaplan Foundation as a Portfolio Global Social Impact organization to develop our framework for measuring impact. Impact is a balance of scale and efficiency. We measure the number of people our technology reaches, the number of countries we engage successfully, the reduction in cost to our customers as we increase implementations, speed of technology integration and we hope to measure our financial impact over time. The latter will take additional time in country – likely over 5 years – before a meaningful trend statistic can be captured.  The technology is measured against a baseline of the status quo, and statistical measures of model accuracy (internally as F1 or R-sqaured, externally as a percentage of accuracy of prediction based on preliminary retrospective analysis).

We have worked across 7 countries, reached more than 100 million people, reduced our implementation cost by nearly 50%, and accelerated our implementation time from 6 months in Sierra Leone to 8 weeks in the case of California.  Core Macro-Eyes AI generates, in extremely challenging settings, accuracy between 85% and 93% based on the location and query and in Tanzania generated a 97% reduction in error when compared to the existing distribution model.

Macro-Eyes requires partners with long-term commitment to scaling Striata. As a small organization it is difficult to access partners at a global scale who can steward in-country relationships and provide sector and geographic context for a broad range of countries. MIT Solve Trinity Challenge has a far and wide reach through a plethora of high performing organizations and individuals. This community is a platform to steward support and focus required for rapid scale over time.

Macro-Eyes also requires catalytic funding to deploy Striata and spend time with government stakeholder in order to increase adoption. 3 year funding provides time to focus on deployment in a way that is sustainable. Deployments of technology continue to lack sufficient funding for essential human interaction, training, communication and adoption. All technology requires this effort. 

Macro-Eyes has a growing partnership with the World Bank to engage governments and allocate country-led, sustained funding of Striata. The  strength of the World Bank is its ability to sustain scaled solutions - and focus the attention of governments. The World Bank does not move rapidly. Trinity Challenge would be the seed funding for catalytic deployment and seed funding for the use of Striata in several countries. This will then generate sustained support for the technology through the World Bank (the ultimate partner for scale).

We have contracts and agreements with USAID, the Bill & Melinda Gates Foundation, JSI, PATH, Palladium, CHAI, InSupply, Direct Relief, the California Primary Care Association, AFWERX, the Air Force Research Laboratory, Air Force Special Operations Command, and VillageReach. We have an active teaming agreement with Pacific Architects and Engineers (PAE). 

The soft infrastructure that supports the current immunization effort (and healthcare delivery writ large) is designed to document what has happened. It is transactional.  This has its place, but it is not transformational and will not keep pace with the need of COVID response or fast sweeping health concerns of the future. Systems that describe yesterday are not as useful as systems that indicate what will happen next.

The Trinity Challenge is an opportunity to build the relationships and multi-year funding required to scale our Striata technology.  We are moving toward global scale and we are engaging the global community to support this effort. The Trinity Challenge represents a cornerstone of global health expertise who will see the value and incredible impact of this technology at scale. This community will be committed advocates with skin in the game as a key partner to macro-eyes. The Trinity Challenge is a statement. It is a derisking of our technology that cannot be achieved through metrics. It is the opportunity to generate voice at the same scale of our technological prowess.

The Clinton Health Access Initiative, Palladium, mSupply, JSI, DAI, and PAE would all be considered as in country partners to accelerate and steward relationships with key government stakeholders.