AlemHealth - Integrated Pandemic Hub

The problem we are solving is how do we move case detection as close to the home of the people affected as possible, to provide care at-scale, cost-effectively, with minimal stigma.

The IPH is an end-to-end patient care solution building health system resilience through an integrated network of AI-driven digital health tools.

The platform increases access to essential health services with minimal physical contact.

Case detection and diagnostics usually happens only at the clinic or diagnostic centre itself, which is too late to limit pandemic spread.

Accessing essential quality healthcare services without facing financial hardship or stigma, is a luxury that at least half of the world’s population does not have. The COVID-19 pandemic has exasperated the weaknesses in the most ‘resilient’ health systems around the world, with many countries facing huge loss to human life and severe disruptions in essential medical service, particularly for vulnerable populations.

 Therefore, the problem we are solving is how do we move case detection as close to the home of the affected as possible, to provide care at-scale, cost-effectively, with minimal stigma.

The Integrated Pandemic Hub provides a unified patient solution to ensure health systems and the population they serve are resilient during COVID-19 and future pandemics.

The IPH comprises of the following unified tools:
1. Pandemic Symptom App with built-in respiratory AI-based screening using cough recordings (the technology is currently used in AH’s COVID and TB programming). For patients without access to the internet, AlemHealth provide a free call centre connected to a screening phonebank run by locally licensed and AlemHealth trained physicians. The app also tracks PCR testing and vaccination records, alongside delivery of accurate information on the latest localized pandemic advice based on the patient’s geolocation.

2. If the patients are deemed symptomatic by the pre-programmed app, they are referred to the AlemHealth Telemedicine Triage Centre, where the patient will speak directly to a doctor for further triage and consequent referral or home treatment advice.

3. Dependent on the severity of the patient’s symptoms they will be referred for emergency treatment or for diagnosis to a partnering AlemHealth diagnostic centre for a CT or Chest X-Ray. All partnering centers will be connected to POC AI through AlemHealth’s radiology AI inference and RIS/PACS solution, specifically built for emerging markets with built in 4G and on-board battery.

4. The referring physician at the Telemedicine Centre will receive a notification when the patient’s diagnostic results are back and will provide the patient with feedback and ‘next steps’ in their care journey.

5. Patients with positive diagnostic imaging will be referred onto the national program for their particular diagnosis through AlemHealth’s partnerships with the Ministry of Health. Follow up services throughout treatment are available through the telemedicine service to improve treatment adherence.

The integrated pandemic hub simultaneously serves 3 groups; the vulnerable population who seek access to healthcare, government and public health officials looking to monitor pandemic outbreaks and coordinate the response, and finally, the Hub empowers physicians to work remotely.

In providing a remote service, the telemedicine center supports vulnerable families and communities that would otherwise be unable to seek quality primary healthcare. Whether geographically, financially or socially bound, AlemHealth’s service will reach patient’s that traditional health systems struggle to access. For women unable to leave the house to visit a healthcare facility, the phone-based consultation allows access to expert advice on managing their symptoms or caring for their children or elderly relatives. As primary caregivers, women must be given the most up-to-date and accurate knowledge in providing home treatment. In doing so, AH will improve the health outcomes of the vulnerable women, but also the people that care for.  AlemHealth will collate all of the information gathered throughout the programing in an interactive live public health indicator dashboard for governments and officials to coordinate real-time evidence-based response plans. 

What is more, the COVID pandemic has seen healthcare workers greatly impacted on the frontline. Remote telemedicine offers an innovative work-from-home option for clinicians using fully distributed tools and systems, enabling clinicians improved economic opportunities with safety precautions. 

The IPH solution has the potential to prevent any sort of direct physical contact, provide continuous care to the vulnerable and underserved communities, and finally reduce morbidity and mortality in pandemic outbreaks. Reducing the number of physical touchpoints in primary health coverage and diagnostics from 10 to 1, helps to improve success rates of detection and viral spread.

The telemedicine approach removes geographical and social barriers and improves essential healthcare services without financial hardship for underserved communities and groups. Moreover, the missed call phone center presents a low-cost, sustainable approach to telemedicine service provision by shifting the burden of cost from the patient to AlemHealth and its clinicians. 

Integration into existing social structures and health care systems is paramount to AlemHealth operations in bolstering a resilient health system. Whilst providing quality primary care to patients to discharge the burden on healthcare systems, the Pandemic Hub simultaneously acts as a referral system to local hospitals and diagnostic centres in an effective and efficient manner.

Finally, misinformation has and continues to play a negative role during this pandemic. Through the IPH, AH’s operators not only provide essential first-line care but help to dispel myths and false information, providing patients and community leaders with the latest up-to-date medical information and care. The personal communication between operators and patient is a powerful and impactful way of spreading a message, aiding other organizations efforts in strategic communications around the COVID-19 pandemic.

AlemHealth have successfully deployed the IPH model for COVID-19 and TB in Afghanistan.

 Our TV, radio and social engagement campaigns reached over 1.7 million in Afghanistan, with over 79,000 COVID-19 screenings of which 19% of patients were referred to the AH telemedicine service, with 15,000 + telemedicine triage calls since July 2020. The COVID-19 version of IPH still runs successfully in Afghanistan and consequently through combined efforts with other organizations, Afghanistan has seen relatively few COVID case outbreaks. 

 We are now looking to expand the model to other geographies, as well as developing a model that works with other respiratory viruses. Through the Solve programming AlemHealth hope to expand other geographies such as Nigeria and Bangladesh where AlemHealth have strong network of radiology centres. We would measure success through the percentage of patient’s being able to access essential healthcare without financial hardship that would otherwise be unable to.

The IPH is innovative in that it integrates multiple steps in the patient journey using technologies specifically designed for low-resource environments, into a unified digital platform to improve access to healthcare for patient and public health indicators throughout the journey for governments.

The integrated platform creates a cycle of resilient health by providing access and generating real-time reliable data to better inform policymaking and health infrastructure planning.

The two continually feed one another with information from remote endpoints synced directly into a larger system. Harnessing the power of existing technologies and data points into a cohesive platform, ensure that we have a ‘full-picture’ overview of the patient journey and the triggers and behaviors within it, to better plan for a resilient health system of the future.

AlemHealth have been running the COVID Hub in Afghanistan since May 2020, carrying out over

70,000 screenings and 59,000 telemedicine calls. The AlemHealth app is available in Dari and Pashto and our telemedicine centre is staffed by locally licensed doctors in Afghanistan.

In one year AlemHealth will aim to increase the number of patients being served to 15% (50% during pandemic surges) in an additional two geographies.

In five years, when the hub is serving patients across TB, COVID and other thematic health areas, AlemHealth to increase number in Afghanistan alone to 160,000 screenings.

In phase one, data collected from the integrated nodes of the platform will be compared to existing historical data around key metrics on Catastrophic Healthcare Costs in primary and diagnostic healthcare.

We will measure the cost of healthcare access amongst the populations based on traditional healthcare against our integrated approach. Data around diagnostic and treatment success will be considered on an annual basis, looking at the percentage drop-off rate from screening to diagnosis to treatment completion.

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AlemHealth a team of over 20 local technical operations and clinical staff in Afghanistan, Nigeria and Bangladesh, as well as a global hardware and software development team with decades of experience building low-cost, mission critical hardware and software.

In addition, AlemHealth has relationships with medical centers throughout the country as customers and partners in its activities. Our country managers in Nigeria and Afghanistan both have a strong network of relationships and existing installed base at hospitals and clinics throughout their respective countries. 

At AlemHealth Technologies (AH) we believe that diversity and equality is essential for improving the wellbeing of all women, men, girls, boys and gender non-conforming people and achieving inclusive sustainable development.

Beyond the funding which will help us to achieve the most optimal and sustainable solution to improve healthcare access, AlemHealth would like MIT Solve support in communications and networking, to gain exposure to interested partners trust such as the Gates Foundation and the Global Fund.

Gates Foundation and the Global Fund.

Patients

In providing a remote service, the telemedicine center supports vulnerable families and communities that would otherwise be unable to seek quality primary healthcare. Whether geographical or socially bound, AlemHealth’s service will reach patient’s that traditional health systems struggle to access. For females unable to leave the house to visit a healthcare facility, the phone-based consultation allows access to expert advice on managing their symptoms or caring for their children or elderly relatives. As primary caregivers, females must be given the most up-to-date and accurate knowledge in providing home treatment. In doing so, AH will improve the health outcomes of the vulnerable women, but also the people that care for.

Female Physicians

Running the COVID-19 Triage and Recovery Center remotely revealed that ‘working from home’ for healthcare professionals is not only possible, but also effective in Afghanistan. Remote telemedicine work allows female physicians to take part in the economy even more, without the safety and social constraints of facility practice. Moreover, for the first time, many of the AlemHealth operators working in the virtual telemedicine center have been treating as many men as they are women, which AlemHealth hope will help to change the perceptions in Afghanistan towards female clinicians. Many of the patients, both male and female, thanked the female operators for their valuable help and guidance, showing that high-quality service and care can transcend the traditional gender constraints that exist in Afghanistan.