DoctorNow

Getting medical care in Ghana is difficult: long distances, wait times, costs, and low approval ratings. Low rates of care in conventional medical systems makes detection and effective remediation of community health risks difficult and reactive.

DoctorNow has created a telemedicine platform focused on reducing friction to care. Our app provides primary and urgent care visits using video, talk, or text. Using this digital-first approach and human-centered design we have built and grown our application focusing on our customers' needs. Our beta test  garnered over 8,000 total registered users, 5 onboarded doctors, and 15+ waitlisted doctors. We believe improved rates of use will allow aggregation of the data collected at an individual level to provide insights at a population view. If the next outbreak were to occur in our communities our application and data would be at the forefront of discovering, slowing, and eventually stopping these health risks. 

The lack of available care at a population level limits the ability to track or respond to emerging health threats as well as reducing community resilience. Internationally there is a shortage of providers, in Ghana for example there are 1.36/1000 physicians per capita vs. the 2.6/1000 in America. Conventional care models characterized by limited and inflexible methods of patient intake are broken. Trying to improve upon these conventional models is limiting our collective ability to address the community's needs. 

Overall, this lack of access to care creates a large risk pool in instances of new disease outbreaks. With disparate communities and a lack of providers, there is no way to diagnose or isolate impacted communities. Without data, our governments have no insight from which to act, but without an improved experience, there are few ways of getting that data.

This lack of accessible care impacts hundreds of millions of people across Africa, and the world. In Ghana, only 40% of the population has health insurance, and the costs and time spent to obtain care are so large that most of the customers we have talked with leave receiving any formal care as a last resort. We plan to change that.

Using the explosion in adoption of smartphones and cellular service DoctorNow has created a digital-first healthcare model for Ghana and Africa. We provide video, voice, or text-based medical consultations for prices far below healthcare system rates. Digital-first care provides a model for simultaneously addressing the limitations of conventional care models and the needs of the community. Our company mission is to reduce friction to care. Our first product is providing primary and urgent care consultations to consumers.
 
We have partnered with physicians in Ghana and are actively working with the ministry of health to obtain a waiver to allow for Ghanaian doctor ex-pats to volunteer their time on the application with the goal of creating and inclusive model. 

By starting with primary and urgent care we hope to create a trusted solution for improving healthcare satisfaction. At scale, this solution would provide a network effect that would provide critical data to national or international organizations to track and monitor potential health risks as well as improving impact for limited national resources.  With the expansion of our services and subsequent data, our goal is to aggregate, detect, and mitigate emerging community health threats.

DoctorNow aims to build an app for Africa. Ghana is our initial market due to our team member's connection, but it is our earnest belief that we can develop a model that applies to nations across Africa. Our mission is to reduce friction to care and therefore increase rates of healthcare utilization. 

Ghana has a population of roughly 30 million people. 40% have access to a national healthcare insurance program. 50% of the population live outside of the cities. The average cost per outpatient visit: $5.16-$8.79 out of a yearly medical spending rate of $78. As stated before receiving care is costly, and includes long wait and travel time with low rates of satisfaction when complete. In customer interviews we learned that pharmacies are the first line of medical treatment and that people avoid receiving conventional care at all costs. We can only imagine the impacts on national health rates due to this dynamic. 

Our target population with the DoctorNow app is 20-45 year olds which is the population range that has widely adopted cell phone usage. Furthermore, by end of summer we are also working to launch a new home health platform where nurses visit the home to provide care to elderly family members.

We have taken a consumer-centric approach to development from the start. We have two team members with a human-centered design background and have actively sought out the consumers voice and perspective during product development and launch. Our aim is to create space for customers to provide feedback and to engage users to have purposeful conversation about our product. We have found the best resource for this is whatsapp. For example, we launched our product with just pre-scheduled primary care visits, but our consumers quickly notified us that urgent care was very valuable which we then added. It was similar feedback that led us to pursue home health visits as well when learning from a number of Ghanaian ex-pats about their concerns for their elderly family in Ghana.

Conventional healthcare was developed without the human element taken into consideration. We have a unique opportunity to re-imagine care optimizing for this human experience for both doctors and patients. How do we improve the experience? How do we improve outcomes? How can we provide the care people need faster? How can we create an inclusive model that supports the most valuable populations? These are the questions we ask ourselves as we continue to pursue change.

Community health risks are difficult to declare and track. Disparate  communities with a lack of care means new medical phenomena must reach a certain scale before being noticed. This is reactive.

Becoming a trusted health provider at scale DoctorNow will be at the forefront of community health vigilance. Capturing data from physicians and patients will allow for wider (population level) and deeper (individual level) data that can be parsed for patterns and emerging threats and escalated more effectively than before. Providing more clear insight that is essential for addressing these risks proactively.

We have just completed a 6 month beta of our application. During this time we released our tested application to market and began to test product-market fit and channels for growth. We registered over 8,000 users, onboarded 5 doctors, created a waitlist of over 15 further doctors, and provided over 300 medical consultations. We were able to learn about key product features and needs from our customers and physicians which will fuel our future growth. By testing market channels we were able to better understand our early adopter's profiles to create a more predictable funnel. We have had further conversations with multiple government entities for additional nations in Africa for the potential to expand our platform.

We are now making final updates and changes for a broader launch to general availability.

How do you create space for impactful care to be provided. Telemedicine and digital care is not new, but separating it from conventional care networks and providing it in a new market is. Most of our customers have never used a telemedicine platform before. In Ghana there has not been a fully video enabled consultation platform available. This technology is well established in the United States, but in markets where the technology is arguably far more valuable due to its ability to mitigate key friction points in the care continuum it is new. 

Our model is further implementing a new approach that could scale internationally. After launching we were connected to a cohort of Ghanaian doctors living abroad. They were interested in providing services at free or heavily discounted prices. Pre-covid they had considered raising money to start a hospital but have since had to cancel this plan. Their interest is to provide care and have an impact, but finding channels to do this has been challenging. We are now working with the Ghanian Health Ministry to receive a waiver to be able to use their talent and time. We believe this will allow us to multiply our impact by empowering inclusivity while not having to sacrifice the livelihood of local physicians. Our goal is to utilize their talent as well as our local physicians to create a care platform that anyone can use.

Current: 8,000 + registered users with 350+ consultations completed. With our services live in 1 country.

1 Year: 20,000+ registered users with over 1,500 consultations completed. With our services live in 2 countries.

5 years: 300,000 registered users with over 1 million consultations completed. With our services live in 8+ countries.

We are measuring our success in our platform's ability to promote good health and wellbeing. Our tactical measures are currently around growth and churn- number of downloads, number of registrations, number of consultations, number of repeat users, number of doctors onboarded, number of doctors on the waitlist, values around physician feedback, and values around app and service satisfaction. 

Even within the specific UN Sustainable Development Goals and subsequent targets, there is ambiguity in how to measure outcomes. 3.d "Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks." or 3.8 "Achieve universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all". Our app and the data we will collect from providing care to customers will move us toward these goals, but they fundamentally require adoption and utilization which is why we will continue to hold ourselves to hard metrics as we work to track the value and impact on the lives from our efforts.

We have 6 active team members who work on a part time basis until further funding or growth can be secured to bring people on full time. We also have a third party contract developer organization. 

We have 6 team members with a diverse set of skills and lived experiences. Our team is made up of 5 nationalities with team members that come from communities we are now working to support. 

Kwab is a data scientist and engineer originally from Ghana- he has worked in his last 2 jobs to build new digital solutions for customer problems. 

Bright is an accounts manager for Emirates and is also from Ghana. He has a strong network of friends and acquaintances who have been essential to our success.

Mario is a healthcare subject matter expert who works to shape healthcare strategies for military efforts. He strong connections to Guatemala and through his work background consistently pushes our team to improve our offerings.

Horatio is a full stack developer with years of experience building new applications. He is originally from Jamaica and understands how our technology needs to be shaped to fit the dynamic needs of a developing market.

Chinello is a UI/UX and human-centered designer currently in the MIT IDM program with a history in product and service design. She is originally from Nigeria and has a background interest in healthcare and its ability to impact her communities. 

Jake is a product manager and human-centered designer currently in the MIT IDM program with a history of new product development. He has a passion for healthcare innovation and has lived first hand the impacts of non-human-centered design in healthcare. 

Our founding team is made up of men and women from 5 nations around the globe. We have all lived and experienced the value that diversity, equity, and inclusion can bring and we hold this at our center as we look to grow. While we do not currently have a hiring plan or employees outside of our team we plan to formalize our interests in maintaining this diversity with specific metrics and goals. To build an inclusive and equitable technology you need an inclusive and equitable team, this includes race, ethnicity, sex, color, nationality, socioeconomic status, veteran status, mental or physical ability, genetic information, and learning styles. We plan on publishing our data to hold ourselves accountable.

Getting from zero to one on DoctorNow has been one of the hardest and most valuable learning opportunities of our lives. Our team has the fundamental skills but lacks much of the experience around bringing an idea to life with all the non-tangibles. There is so much beyond the engineering of the app, the onboarding of doctors, and the registering of patients. These intangibles are the reasons we want to join SOLVE. Through this process, we have learned we don't need to take on everything ourselves. We are best served, our customers are best served when help and support are available. 

We want to be challenged as we challenge ourselves to build the best possible product and company for our users. To reach this goal we want to be surrounded by like-minded individuals - mentors and members of the SOLVE cohort. We need help with funding, strategy, media, public relations, and more. We are excited to learn and we look forward to participating in this community by giving as much and more from our skills in return. 

We earnestly believe the healthcare model needs to change. We want to be a part of this change, pushing the boundaries of what is possible to provide value for our stakeholders. And we think SOLVE and its community and resources can help us reach our goal. It is rare to have an opportunity with such a large potential size and impact as changing how communities receive healthcare, help us reach this goal.

I would start this answer by saying we do not know what we don't know. So as we grow and develop I am sure we will need help in many of these categories. The items selected have been top of mind currently.

• Human Capital- We have been considering both a board of advisors and a medical board to keep us to task on maximizing value and impact for our community.
• Financial- We are actively preparing for a capital raise but having never been through it are learning as we go.
• Monitoring & Evaluation- Our aim is to develop

• Professors: Amar Gupta is an expert in healthcare telemedicine
• Solve Team Members/Advisors: Pooja Wagh- insights on results measurement and healthcare
• Solve Team Members/Advisors: Noel Shaskan- her experience with building partnerships in healthcare
• Solve Team Members/Advisors: Elizabeth McGovern- her connection with WEEMA and lessons learned with healthcare
• Solve Team Members/Advisors: David Moinina Sengeh- innovation in Sierra Leone and working through how to introduce innovation in new markets
• Organizations: Other innovators in the health space in Africa working to improve the care continuum such as mScan (mobile ultrasound scanner), or MDaaS (private diagnostic facilities)
• Open for recommendations- there are so many people to meet on related journeys and we are eager to connect with anyone who can share in our energy and drive

Receiving healthcare as a woman is difficult in the best of situations. Providing connection to care through a digital platform allows for degrees of protection and trust. Being able to ask the questions and address concerns directly without fear or discomfort is best facilitated through a telehealth consultation. This is even more so for sexual and reproductive health. We will not be able to execute on all care needs digitally but wee can be a strong first line and provide resources and guidance for follow on needs.