Airmed - Nursing at the Centre of Healthcare

A digital platform that is the customized, intelligent, and effective way for Care Organizations (COs) to hire and develop nurses and for nurses to find their best job and grow as professionals to avoid dearth of healthcare professionals during future emergencies.

Malik Ahmad Jalal

majalal99@gmail.com

Pakistan has 1/5th of required nurses compared to WHO’s minimum requirement - with shortage of 600,000 nurses in Pakistan by 2030 (Punjab Health Agency). Global shortage will be 12,900,000 nurses by 2035, resulting in loss of 28.3 billion nursing interactions.

NAHPs un-availability is a crisis, made worse by the pandemic. In addition, WHO estimates that one of six nurses will retire within ten years, weakening resilience and disease threat response capabilities of healthcare systems and reducing affordability of primary care, creating urgent need for a holistic data, capacity building, performance management and matching system for NAHPs.

In Pakistan alone, Airmed will positively impact 22 million patients and globally 550 million in 10 years.

Our solution addresses:

• NAHPs healthcare interactions with patients are a data black-hole and not tracked
• NAHPs shortage of 670K in Pakistan and 12.9 million globally by 2030, making primary and preventative healthcare systems vulnerable
• Lack of knowledge/good-practices share for disease treatment and safety
• In-efficient/ non-existent career pathways and matching between employers and NAHPs which makes nursing an unattractive profession Non-formal training and development mechanism

Our target audience includes 0.142 million NAHPs in Pakistan or 20.7 million across the world. Each NAHP can impact 880 patients a year minimum or 124 million patient interactions in Pakistan alone.

To understand the needs of NAHPs, we have conducted online surveys with 64 NAHPs, separately held 5 comprehensive focus groups with NAHPs in four cities, to collect data on experiences, technology usage, job searching, career planning and upskilling. During Human Centered Design (HCD) phase, engaged additional 15 NAHPs, 7 hospital administrators and 6 home-care users to map user journeys for optimal user experience. 

Interviews with Government’s Health Services Academy (HSA), National Institute of Health (NIH), Center of Economic Research in Pakistan (CERP) for effective NAHPs response in pandemics and developing NAHPs training opportunities.

Airmed will become a publically available digital space for the NAHPs and COs for skill match, recruitment, training and development, data capture and dissemination. NAHPs can register on the app for free and use the platform to find suitable recruiters and training and development. Under the free feature, NAHPS will be able to view their dashboard which will include their resume, past searches, job applications, etc. Airmed will also raise awareness by functioning as health threats and security early warning system through data sourcing from NAHPs

Under the paid subscription:

(1) NAHPs will be able to get their performance evaluated to show potential recruiters

(2) Airmed will provide career counseling / planning to NAHPs

Lastly, through Airmed’s partnership with Center for Business Economic Research in Pakistan (CERP), a paper will be published, preferably in Pakistan Institute of Development Institute (PIDE) on mobility of female NAHPs

FGDs highlighted a coordination gap between health departments, hospitals and NAHPs. Almost all NAHPs agreed on not utilizing a single digital space for recording data, recruitment, training, peer learning and performance evaluation. 

AIRMED’s Theory of Change

A) Output

1) A data-science driven digital platform focusing on NAHPs, functioning as one stop forum for health departments, hospitals and professionals to:

a) Source data on COVID19 by recording/ receiving data during health emergencies

b) Find and recruit NAHPs, matching with care needs

c) Connect nurses to trainings in health emergencies

B) Outcomes

a) Improved access to healthcare

b) Increased data for analytics/ decision-making

c) Coordination by policy makers/ healthcare managers in pandemics

C) Impact

C.1) NAHPs

a) Increased quality through better training

b) Increased quantity through more NAHPs

c) Decrease on doctors’ burden as nurses will do minimum 10% of doctors’ work

C.2) Data and Policy Making

a) AIRMED captures 88% patient healthcare interactions, through NAHPs

b) Improved response with better health information

c) Increased preparedness through awareness/ hygiene security

C.3) Uplifting Gender / Marginalized Community

a) 80% Pakistani-nurses are women and 60% belong to religious minorities

b) Improved employment generation and competency of the marginalized groups in Pakistan

The attached table gives a 5 year KPI/budget in terms of nurses reached, hospitals signed-on and patients impacted.

The numbers are per market and by end of year 5, we expect to be operating across 3 markets/countries:

Year 1:

Number of nurses placed: 3,320

Patients Positively impacted: 7.304 Million

Hospitals on Performance Evaluation System: 12

Number of Nurses on Career Progression Module: 1,000

Cities: 3

Year 3:

Number of nurses intelligently matched with organisations: 14,548

Patients Positively impacted: 32 Million

Hospitals on Performance Evaluation System: 34

Number of Nurses on Career Progression Module: 5.826

Cities: 7

Countries: 2

The quantum and quality of healthcare data in year 3 will be very significant, impacting healthcare business models.

AIRMED will be initially scaled up in Pakistan starting from one city to almost 7 in the next 2 years. The first phase of implementation will focus on ensuring quality and ensuring that AIRMED becomes known for being useful and beneficial among healthcare institutions and NAHPs in Pakistan and through its overseas hiring programs. From year 3 onwards, AIRMED will expand into three countries till the end of year 5, such as Malaysia, Bangladesh and UAE by replicating the model rolled out in Pakistan.

Airmed’s parent company Cordoba Ventures has an internal monitoring and evaluation department and has also developed partnership with Center for Economic Research in Pakistan (CERP) – one of the leading think tanks in Pakistan. The data obtained from the project will be routed to CERP for monitoring, evaluation and policy making. The monitoring and evaluation component will include progress tracking of outcome level data against set targets against the following indicators:

Outcome Level Indicators (internal)

(1) Number of registered NAHPs and COs on Airmed

(2) Number of NAHP placed / recruited both local and overseas

(3) Outreach (number of cities)

(4) Outreach (number of countries – from year 3 onwards)

(5) Number of patients impacted (modelled estimation based on updated benchmarks)

(6) Number of data gaps filled through NAHPs

(7) Number of nurses trained

(8) Number of women and religious minorities recruited

Impact indicators will be national level benchmarks having a causal relationship with Airmed

(1) Nurse to 1000 population ratio (annual update through WHO data)

(2) Average salary of nurses (annual update through WHO / Health Ministry’s data)

The monitoring of Airmed to date included, progress tracking against the following process indicators: 

(1) Research work for product development

(2) App development

(3) Partnerships (4) Fund raising

Next Year:

• Delays in achieving targets during COVID19: Put in place SOPs, including working from home during pandemic and technology development work can be done remotely
• Evolving  Changes to Healthcare System: Built on agile methodology to accommodate changes in design of the App. The product is based on extensive feedback from 50+ nurses, 7 hospital administrators with whom we are constantly engaging to keep abreast with the changes
• User dissatisfaction: Research team has been tasked with obtaining continuous NAHPs feedback on functionalities of the App. Necessary changes will be made based on the feedback received
• Financial: To address any funding challenges, we will focus on obtaining grants, winning business competitions, building strategic partnerships and engaging in low-cost activities. In medium run, equity participation/convertible debt is an option.

Next 3 Years:

• Technological hiccups and low connectivity: Rely on off-line usage of PWA and data upload when connected, will ensure the App uses minimal data
• Regulatory and compliance – Make the APP HIPAA compliant, built in cybersecurity systems. Our Chief Strategy Officer is a lawyer
• Public sector resistance: We have on-boarded partnership of Healthcare Services Academy, CERP and Duke DevLab to emphasize our thought leadership, research and impact mandate.
• Low uptake from the public sector and lack of incentives for NAHPs to use the platform– Will conduct awareness and on-boarding sessions Operative – Incentives for hospitals to utilize AIRMED for recruitment will be provided, including discounts and free-look windows

We are affiliated and have partnerships with the following institutions:

1) CERP (https://www.cerp.org.pk)

2) DevLab@Duke (https://www.devlabduke.com)

3) Health Services Academy (HSA, http://www.hsa.edu.pk)

4) Planning Commission of Pakistan (https://www.pc.gov.pk/)

5) University of San Diego, Design Lab (https://designlab.ucsd.edu)

6) King’s College Hospital, UAE (https://kingscollegehospitaldubai.com)

7) Al-Mustafa Welfare Trust (https://www.almustafatrust.org)

Our start-up has been formed by experienced professionals who have experience of public health, investment banking, private equity, executive management of local and international organisations.

1) MIT has engaged a community of world's bravest social entrepreneurs and change-makers through applied technology, business and social sciences. Being in the community and taking advantage of the Trinity Community will be a great learning experience for our founding team. The mentoring we will receive and experience of the peered will help us avoid business model and technology mistakes. The technology talent for cybersecurity, HIPA, AI/ML through MIT Trinity Challenge is the biggest attraction.

2) I did the course “New Enterprises” at MIT in 2011 and the ecosystem of MIT will be conducive to the growth of AIRMED, for example by finding a CTO or founding team members from the Trinity community or MIT.

In addition, the recognition of winning this challenge will enable us to build partnerships with WHO, UN, UN Foundation, GAVi and Gates Foundation that are big players in public health.

3) We are currently seeking grants, donors and angel investors for USD 500K to support further development of the technological solution and establishing outreach across multiple cities. Winning this challenge can raise visibility and help us secure grant or angel funding to scale the model across Pakistan.

Applying for Trinity Challenge will help us achieve the idea, output, outcomes and impact of our App that matches with the goals of MIT Trinity challenge.