IsoAse

Training frontline health workers to treat mental disorders in resource-scarce regions using telemedicine. 

According to a report by the World Health Organization, there is a 12.1% lifetime prevalence of mental illness in Nigeria, which means that over 2 million Nigerians currently suffer from psychological problems. Unfortunately, as of 2006, there were only around 3,100 mental health professionals in practice to treat this massive patient population. Out of these workers, only 42 were psychiatrists and 20 were psychologists. Although these statistics have improved slightly over the past twelve years, extreme mental health inadequacies still plague Nigeria, with only 3.3% of the Nigerian federal health budget being allocated to mental health. Much of this problem is due to poor training available for doctors to specialize in mental health.

IsoAse addresses these challenges by training Nigerian frontline health workers to become fluent in treating mental health conditions. In English, IsoAse roughly translates to equal (iso) change (ase, a west african philosophy), which is what the platform hopes to create. Using mobile means to train Nigerian doctors is ideal because internet usage is widespread. In 2015 roughly 23 million Nigerian users owned smartphones. By the end of 2018, this figure is predicted to reach 34 million.

The app will provide users with video training modules in both English and Yoruba on how to identify and treat conditions such as depression and bipolar disorder, as well as serve as a messaging tool that would enable frontline health workers to contact hospitals when they are in need of immediate resources to treat underserved patient populations. Once deployed, it will also enable patients to receive near-instant prognoses by using an SMS gateway to text users back diagnostic test results.

The Nigerian federal government divides health activities into three categories (primary, secondary, and tertiary) that are conducted at local, state, and national-levels, respectively. This separation of medical practice can unfortunately segment doctors with different specialties from each other, which can reduce collaboration between colleagues across the country. Structurally, IsoAse bridges this communication divide between doctors and both their associates and patients using a “funnel” approach. Health workers first go through a series of trainings and short exams that ensure sufficient mental health knowledge. Patient users who are at an at risk mental state initially take a test that screens them for severe anxiety, depression, bipolar disorder, or schizophrenia and are then each paired with an appropriate health worker for their condition who will then confirm or amend their diagnosis. Treatment then occurs remotely using video conferencing, electronic prescription processing, and messaging services that allow doctors to check on patients at anytime and communicate with physicians across the country.

Partnerships with universities and hospitals in Nigeria will be established before expanding to other regions. Tackling the mental health crisis in Nigeria is challenging, but with collaboration and cooperation, IsoAse will help doctors gain the necessary skills and tools to serve the populations that need them most.

Telemedicine has been around for nearly the past half-century and has been implemented with varying degrees of of success. Managing electronic records is a part and parcel of the daily lives of doctors globally and IsoAse aims at continuing that. What sets IsoAse apart is that it will provide training modules and diagnostic/treatment tools in a culturally conscious way and manage the resulting data in a decentralized manner. Every data point collected from patients is not sent to one specific place, but instead exists virtually and equally distributes control of information to users from across Nigeria.

Video conferencing and instant messaging are essential aspects of the functionality of IsoAse. Since personal data of mobile users is dealt with, keeping their health information confidential is a top priority. End-to-end encryption and public blockchain ensure secure transfer of materials from phone to phone within the app. Using blockchain, anonymous data collected from users through messaging and screening tests will be accessible by all health workers who use the platform. Personal information is not stored and can only be viewed by physicians or other health workers who use the platform for remote care of patients.

Beyond prototyping and beta testing, growth from technology to product will be the main focus and goal for the next 12 months. The help of doctors who speak Yoruba will need to be acquired in order to develop training modules and features of the app that require a deeper understanding of cultural norms and formalities. Partnerships with hospitals, universities, or other organizations in Nigeria will be established using financial and technological incentives to expand adoption. The user base will also be grown through incentivizing app downloads and patients will receive small rewards for using IsoAse. 

Usage of IsoAse by health professionals and patients from every country is the long-term vision for this platform after successfully expanding from Nigeria to greater West Africa. The features of the app that have performed the best at delivering efficient and effective care electronically will be packaged into an easily translatable format that can be adapted to the needs of hundreds of regions globally. We will attract more users by providing financial and technological incentives for app downloads. Specifically, small sums of money, articles of clothing and sanitary products for physicians and patients could be given as rewards for use. 

IsoAse will be published for free on the App Store and Google Play to reach health workers and their patients. Revenue generated from the app (from ads) will be used to run ads on relevant sites to expand the user base and grow beyond Nigeria and West Africa.  Three Nigerian states, Abia, Anambra and Ebonyi will be targeted first due to their close proximity to each other and varying population densities (high, moderate and low). Locals from these states will access the app by downloading it on either an Apple or Android device.

According to data collected by the Medical and Dental Council of Nigeria, approximately 4,355 medical students become doctors annually. If a partnership with any of the 31 accredited medical schools in Nigeria is established, around 140 graduates could be approached to use the system. Assuming that each graduate who uses the app sees 10+ patients per day, if only 10% of their patients try the platform, over 35,000 people could be reached. In three years, 105,000 patients would be helped within just this sample pool and in five years potentially 175,000.

There are several skills that will allow IsoAse to draw funds and attract partnerships. Experience with programming and knowledge about the technologies that underpin telemedicine set the foundation for IsoAse to function properly and potentially succeed in the field of personalized health. More specifically, an understanding of C, C++, CSS, HTML, Java, and Javascript as well as a passion for global health and entrepreneurship will enable this venture to thrive and help patients thrive too. 

1. IsoAse has potential for long-term growth because all profits generated from ads will be put directly back into developing the platform further. If $5000 is made, $5000 will be used to expand the app to another nation.
2. The problem trying to be solved is specific yet the solution is broad. Mental health in Nigeria is a truly terrible issue that needs the proper amount of focus put on it. The platform that would be put in place could address and minimize much of the stigma and dysfunction that pervades a strained healthcare system on a national-level. By translating and slightly altering its features, it could also be adapted to completely different regions of the world. 

There are countless programs that fund ventures with the capital they need to survive. Unlike other organizations, Solve not only invests money into what they believe will make an impact, but they also invest their people into them as well. Being selected for Solve would provide a chance to be a part of a community of individuals who care deeply about the problems facing our planet and want to network with others who feel the same way. Having access to such an experience at MIT would be invaluable and worth more than any money given. 

• Cost: The availability of Nigerian doctors is limited due to high patient populations. In order to develop training modules in Yoruba, physicians must be willing to spend time working beyond their long hours and should be compensated for doing so.
• Culture: Piloting this app does not inherently require many resources, but there are many cultural norms that need to be understood before fully successful deployment can be achieved. 
• Access to the diverse network of people and opportunities that Solve provides would assist in tackling these hurdles. Any funding that could be potentially received is secondary, but would help tremendously also.