Hia

Key facts:

• The Global Research on Antimicrobial Resistance report, published in The Lancet, found that more than 1.2 million people died from drug-resistant infections in 2019, while a further 4.95 million deaths were indirectly associated with antimicrobial resistance in the analysis of 204 countries and territories. This is more than the annual death toll from malaria or Aids.
• A review of AMR commissioned by the UK government warned that, by 2050, an extra 10 million people would die each year from drug-resistant infections. 
• Each year, 700,000 people die of AMR in Asia. Without action, the death toll could rise even higher, to as many as 10 million deaths annually by 2050 and cause a 3.8 per cent reduction in the annual gross domestic product (GDP), as identified in a 2017 report entitled 'Drug-Resistant Infections: A Threat to Our Economic Future. 
• The overuse of antibiotics in recent years for trivial infections means they are becoming less effective against serious infections. People are dying from common, previously treatable infections because the bacteria that cause them have become resistant to treatment.
• UK health officials recently warned that antimicrobial resistance (AMR) was a "hidden pandemic" that could emerge in the wake of Covid-19 unless antibiotics were prescribed responsibly.
• University of Washington, US, calculated that up to five million people died in 2019 from illnesses in which AMR played a role - on top of the 1.2 million deaths it caused directly.
• Using patient records from hospitals, studies and other data sources, the researchers say young children are at most risk, with about one in five deaths linked to AMR being among the under-fives.
• Deaths from AMR were estimated to be:
  • highest in sub-Saharan Africa and South Asia, at 24 deaths in every 100,000
  • lowest in high-income countries, at 13 in every 100,000
• Recently, a study in Malaysia by Ab Rahman N, Teng CL, and Sivasampu S aimed to fill this knowledge gap and found that one in five patient encounters with a primary healthcare centre resulted in an antimicrobial prescription. The antimicrobial prescribing rate was much higher in private (30.8%) than in public (6.8%) clinics. 
• In Bangladesh, Bangabandhu Sheikh Mujib Medical University hospital ICU physician AKM Habibullah reported that about 20 to 25 per cent of the patients admitted to the ICU were found with Antimicrobial -resistance.
• A study published in the March issue of the International Journal of Infectious Diseases showed that Escherichia coli, a bacteria available even in jar water or street food in Dhaka and the most common causative organism of urinary tract infection, was studied in 21 articles and found high resistance to commonly used antibiotics — ampicillin in 94.6–100 per cent cases, amoxiclav in 67.1–85.5 per cent cases, ciprofloxacin in 65.2–80.5 per cent cases and co-trimoxazole in 72–82.2 per cent cases.
• Resistance to ampicillin, amoxiclav, ciprofloxacin and co-trimoxazole was 100 per cent, 58 per cent and 67.4 per cent and 72.7 per cent, respectively, in Klebsiella bacteria that cause pneumonia.
• Co-trimoxazole was ineffective against 86.6 to 98.7 per cent of cases of tested Pseudomonas bacteria, which causes an ear infection, and 87.5 to 100 per cent ineffective against Enterococcus bacteria, common among people who lacked the practice of hand washing after defecation.
• There are about 2.3 lakh pharmacies and 4 lakh quacks in the country, and they sell or prescribe antibiotics rampantly.
• According to the World Health Organization's latest report on TB, the annual incidence of multidrug-resistant TB in Bangladesh is 8,400. In 2017, WHO found at least 5,800 cases of multidrug-resistant TB.
• It also says that 29 per cent of the multidrug-resistant TB patients took TB treatment in the past, but they grew resistant. Besides, among the newly identified TB patients, 1.6 per cent of them were already multidrug Resistant. More worryingly, at least 22 per cent of multidrug-resistant TB patients do not get treatment.
• Institute of Epidemiology, Disease Control and Research (IEDCR) in 2019 found that at least ten bacteria had become more resistant to 17 life-saving antibiotics used for treating patients with various infectious diseases across Bangladesh.
• Data from the following years (2020 and 2021), as well as from before (2017, 2018 and 2019), seems to confirm his fears—a report by The Daily Star on November 24, 2021, shows how the resistance trend of five of the most critical medicines listed by the World Health Organisation (WHO) has increased year-on-year.
• According to a review on the pharmaceutical industry business in Bangladesh by LankaBangla, the sale of antibiotics was Tk 1,687.61 crore in 2018, the second most sold medicines after acidity drugs. Bangladesh Association of Pharmaceutical Industries secretary-general reported that they produced pills on market demands.
• Reportedly, as many as 60 per cent of patients take medicines without consulting doctors or based on advice from informal providers like drug sellers and others. A 2021 IEDCR study states that doctors prescribed unnecessary antibiotics to Covid-19 patients in hospitals in 83 per cent of cases.

Antimicrobial medications serve a vital role in the control of infectious illnesses. However, their widespread usage - frequently abused and misused - raises doubts about their effectiveness. And we recognise that any coordinated effort in this regard must include a review and, if required, reform of the local drug stores' role (including those working in clinics and hospitals) as the primary supplier and regulator of these drugs.

We noticed that our target audience (Middle and lower-class people) who do not have simple access to primary healthcare are accustomed to visiting their local drug store to purchase prescriptions based on their self-diagnosis or consuming non-prescribed medicine. The aggregate patient recovery (in terms of response to medical treatment) data in Bangladesh's middle-tier healthcare delivery system are lost due to a lack of progressive documenting and monitoring. At the same time, this is more common at PHCs due to insufficient follow-up protocols, facilities, and medical professionals to consult. As a result, patients are seen not prioritising follow-up care appointments, which would have provided closure on the treated patient's health recovery status.

Pharmacists can assist patients in understanding how to take their drugs and how they function for their specific ailment. Furthermore, by keeping an eye out for prescription falsifications or changes, pharmacists can act as the first line of defence in identifying dangerous patterns in prescription medication usage.

Pharmacies are frequently the first and last point of contact for individuals in healthcare-seeking. The global expansion of the pharmaceutical business has resulted in the rapid growth of pharmacies in many resource-constrained countries' urban and rural areas. While this expansion provides previously underserved populations with access to professional advice and medicines, medicine sales at these pharmacies are primarily driven by pharmaceutical companies' aggressive marketing, which offers attractive incentive schemes, bonuses, and gifts for increased sales.

Pharmacists are uniquely positioned as front-line health care practitioners to prevent indiscriminate antibiotic usage and promote safe and effective administration of these drugs. Unfortunately, data indicates that self-medication and improper antibiotic use are often linked to pharmacists' frequent and inappropriate antibiotic dispensing practices, inadequate compliance, and weak law enforcement.

According to published evidence, the public often obtains non-prescribed antibiotics from private pharmacies. While pharmacist compliance and adequate distribution techniques are critical to enabling optimal antibiotic consumption among the general public, research documenting antibiotic dispensing patterns is currently non-existent in the Bangladeshi context.

While investigating the reason, we discovered the general lack of accessibility and affordability. We believe now is a great moment to look at this more holistically and harness technology to construct the urgently needed healthcare infrastructure in the country.

Hia helps you find qualified doctors and affordable first-class primary healthcare services in your neighbourhood hospitals in a data-driven way. We cooperate with local drug stores and hospitals around the country to deliver primary health care that provides rapid, accessible, cheap, and high-quality medical consultation to underprivileged areas to minimise Antimicrobial resistance and non-prescribed prescription usage.

Our target market primarily consists of middle and lower-income people and underserved communities (the orphans, the illiterate and the widows). Poor adherence is a significant problem among these social classes, partly because they are generally underserved and often have lower health literacy -- the ability to understand basic health information and make health decisions. We empower patients with the right education to enable the discovery of the right doctor/hospital within their affordability (By providing up to 40% discount offer), prevent non-prescribed medicine consumption, and deliver better health outcomes with care.

Hia is a network of hospitals providing healthcare for the masses. Hia's proprietary technology allows hospitals to serve patients at lower costs, provide a better experience, and maintain high medical quality standards, enabling patients with affordable treatment and surgery services. In Bangladesh, the shortfalls of the existing healthcare system – lack of defined treatment protocols, lack of transparency on pricing and a general lack of infrastructure have all come to light during the pandemic period. We have brought solutions to this problem with the help of technology and networking with local pharmacies and small and medium-sized hospitals. We ensure standardising health care delivery, pricing, procurement, enhancing overall patient experience, and increasing hospital visibility in selected areas per their locations. 

Patients tend to recall the bad or good previous experiences with sickness events, the healing process, the therapeutic itinerary adopted, and the prescribed medications and their sources to socially construct the need for antibiotics and decide to demand them. Despite the tremendous pressure physicians receive from patients to prescribe antibiotics, our partner pharmacists and physicians are alert to the patient's expectations for antibiotics. Additionally, our partner physicians are alerted to be more vigilant in their prescribing practices. They are instructed to give special attention and explanation to the patients, mainly those in need of antibiotic prescriptions, explaining and clarifying the utility, the effect on that specific health condition healing process, the side effects and the care patients ought to have while using the prescribed antibiotic. These actions together are helpful to discourage patients from misusing their health information and control their expectations for antibiotic prescriptions.

We know that in a country like ours, where there is a chronic shortage of medical professionals across the board, digitalisation has the potential to improve results significantly. Hospitals must develop clinical pathways that provide uniform treatment methods with favourable outcomes. A system that gathers vital data from hospital personnel and patients after discharge is necessary as a follow-up approach for monitoring outcomes. Hia wants this feedback loop to run automatically while providing a solid technological foundation for it to scale. This digital technology will also boost responsibility as patients' can assess healthcare options with more meaningful information.

Finally, we collaborate with hospitals to ensure that this information is communicated as clearly as possible, allowing patients to receive the comprehensive care they require.

Local drug stores are uniquely situated in our solution to influence patient care with quick interventions. 

Interventions may take place in any setting the patient chooses, do not require formal arrangements, and are brief, making them appropriate for patients who come to a local community drug store or even when obtaining their hospital discharge prescription. Targeting interventions based on local patterns are given special consideration to minimize problematic drug use among our target audience. Drug store owners/operators are on the front lines of patient care wherever they practice. With accessibility comes sensitive and complex situations, and professionals must be appropriately trained to help patients.

We collaborated with these local drug stores to provide them with technology that allows them to refer patients who came to him for antibiotics based on self-diagnosis to the appropriate doctor depending on the patient's symptoms. We pay pharmacists a reasonable commission that exceeds the incentives given by pharmaceutical companies. We do frequent shadow research to verify that our partner pharmacies do not offer non-prescribed drugs to patients.

On the other hand, patients receive services from our Service representatives (SRs) throughout their healthcare journey, including a digital profile, health cards, and flat discounts. When patients are advised to undergo diagnostic tests or surgery, they are at a loss as to what to do next. This decision-making process is complex for patients when they require the most assistance. Hia aspires to be a digital partner for patients at every stage of their hospitalization experience, addressing their long-term requirements. Our SRs provide comprehensive guidance, support, and service, including ensuring priority appointments with top doctors and the best hospitals, obtaining a second opinion if necessary, assisting with all documentation, and coordinating with hospitals for admission and discharge processes post-operative and lifetime follow-up care. 

They can assist clarify questions they were unable to ask the doctor or arrange for a follow-up session if they believe you require more clarification. If the patients are unsatisfied with their initial consultation, SRs would gladly refer them to other doctors. Hia follows up with the patient's medical status and symptoms three days later via its call centre. If the disease continues, we help patients make an appointment with a qualified physician or advanced health facility for a comprehensive evaluation and more rigorous investigations, stopping them from purchasing antibiotics without a prescription.

We have designed and built a next-generation tech-driven business model to create affordable and data-driven healthcare for the masses to integrate the entire healthcare ecosystem. We deployed our solution in one hundred pharmacies and three hospitals. As a result, we are controlling the sale of non-prescribed medications and enabling hospitals to better coordinate patient care across specialities and clinical disciplines. This allows healthcare practitioners to preserve transparency, empower smarter decisions, and promote healthcare excellence. 

We partnered with three separate extreme cases for our first three POC/hospitals. We believe that these three situations represent three of the platform's more practical uses. As Our platform coped with all of these scenarios, we are confident we can ensure that our platform will be able to scale to our goal of 5.4M users and beyond.

Since 2015, we have provided services to our TG socioeconomic segments and groups. We understand their social, educational, and health issues since we are aware of the demands in the medical and healthcare sectors. We immersed ourselves in their culture, religion, and community to improvise and make our solution more human-centric.

The R&D team comprises people from various cities, economic backgrounds, and genders.The Senior Management team consists of multi-sector organisations' experienced health informaticians, monitoring and evaluation specialists, medical experts, and a software engineer who can influence and build necessary collaborations and engagements. The team has extensive commercial experience in the healthcare industry in Bangladesh and has witnessed all aspects of our TG social class's life. The team members' collective experiences across healthcare projects have vastly engaged the community and stakeholders in understanding patient needs and building usability and partnerships. The team has worked with caseworkers, frontline health workers, and primary healthcare centres in the country to understand and integrate a suitable workflow into Hia, having worked in understanding health data requirements at multiple levels.

We are confident that by designing and building our product in Bangladesh, we are addressing the issues we have witnessed firsthand.

Hia began operations in late 2020, making it a relatively new option. Since then, we have developed the service and business model to make it scalable and sustainable. We have also tested the solution and researched the target audience. 

As a result, we have seen how the solution may affect our target group and positively impact several areas. We have had difficulty elevating the answer, however. We often ask ourselves the following questions: (1) How can we increase the effectiveness of our solution? And how do we evaluate the impact? (2) How can we win over the confidence of potential clients? How do we get more collaborations? How can we persuade Bangladesh's traditional and conservative patients that we offer them a better alternative? (3) How can we reduce CAC while increasing the retention rate? As a result of the Novel Measurement for Performance Improvement Challenge sponsored by MIT Solve and the Bill and Melinda Gates Foundation, we have realized that this challenge will enable us to examine our approach from several angles and get essential ideas.

Additionally, we require funding for (1) the cost of acquisition of pharmacies and potential patients, (2) team growth to enhance our operations, and (3) other related expenses. (3) Increasing commercial operations in other cities. We think that Hia would have the ideal chance to develop and put into practice the plan to benefit all the communities in Bangladesh. For our current solution, this is precisely what we desperately want.

Technology allows for a patient to be at the centre of healthcare delivery is a thesis that we strongly believe in. Hia's objective of transforming the patient experience for hospitalization and consultation, paired with the founding team's outstanding execution history, makes this an attractive investment prospect for us.

We believe Hia plays a unique role in the transition to aligned, value-based care, but we know we can do much more by collaborating with others. As MIT Solve and the Bill and Melinda Gates Foundation believe in the possibility of improvement, we'd love to explore opportunities with you. Let's empower healthcare Together.

We have designed and built a next-generation tech-driven business model to create affordable and data-driven healthcare for the masses to integrate the entire healthcare ecosystem. We deployed our solution in one hundred pharmacies and three hospitals. As a result, we are controlling the sale of non-prescribed medications and enabling hospitals to better coordinate patient care across specialities and clinical disciplines. This allows healthcare practitioners to preserve transparency, empower smarter decisions, and promote healthcare excellence. 

We partnered with three separate extreme cases for our first three POC/hospitals. We believe that these three situations represent three of the platform's more practical uses. As Our platform coped with all of these scenarios, we are confident we can ensure that our platform will be able to scale to our goal of 5.4M users and beyond.

Since 2015, we have provided services to our TG socioeconomic segments and groups. We understand their social, educational, and health issues since we are aware of the demands in the medical and healthcare sectors. We immersed ourselves in their culture, religion, and community to improvise and make our solution more human-centric.

The R&D team comprises people from various cities, economic backgrounds, and genders. The Senior Management team consists of multi-sector organisations' experienced health informaticians, monitoring and evaluation specialists, medical experts, and a software engineer who can influence and build necessary collaborations and engagements. The team has extensive commercial experience in the healthcare industry in Bangladesh and has witnessed all aspects of our TG social class's life. The team members' collective experiences across healthcare projects have vastly engaged the community and stakeholders in understanding patient needs and building usability and partnerships. The team has worked with caseworkers, frontline health workers, and primary healthcare centres in the country to understand and integrate a suitable workflow into Hia, having worked in understanding health data requirements at multiple levels.

We are confident that by designing and building our product in Bangladesh, we are addressing the issues we have witnessed firsthand.

In primary health care, a timely diagnosis of the patient and the early detection of outbreaks and diseases. To achieve therapeutic success, reduce unnecessary actions, and improve the population's health. 

We are providing medical care through the Intelligent Medicine System. As a result, any physician can record the patient's physical condition and see all possible medical needs of that patient. In addition, through this system, any medical centre can see and purchase the emergency medicine of the patient at the medicine shop adjacent to the medical centre. 

We aim to develop an integrated patient monitoring system designed to connect drug stores in small hospitals with large hospitals. The company's technology will allow rural and remote healthcare facilities to be associated with city/capital providers, enabling healthcare providers to save time and effort to maximize treatment.

Impact goals for Next year:

1. Expanding the market to 70 neighbourhood areas in 3 major- cities of Bangladesh (Dhaka, Chittagong, Sylhet). 
2. Ensuring Government collaborations to invest in UHC (B2G)
3. Ensuring data-driven healthcare to 215k middle and low-income patients through UHC cards  (currently, 1300+ patients are attended as of August 2022)
4. Establishing the first government partnership to cover more people in rural areas in Bangladesh.
5. Increase availability of at least one service (testing, supplements, medications, supplies, presence of qualified staff) by 20>#/span###
6. NPS > 80%, satisfaction 9,5/10

Impact goals for Five years,

1. Expanding the market to other Southeast Asian countries where primary healthcare is inaccessible to cover more people who need primary healthcare services.
2. Becoming the largest provider of data-driven primary care in Bangladesh without owning any hospital or drug stores
3. Ensuring UHC to 5.4 million people
4. Making the business sustainable so that the solution can provide the service with more economic value to our patients 
5. Making the business sustainable so that the solution can provide the service with more economic value to our patients
6. NPS > 85%, satisfaction 9,7/10 every year 

Currently, the measurements that we are using is

1. Number of Subscribers to the platform
2. Number of Patients treated
3. Amount of patients referred
4. Detailed reporting on all metrics around medicine

We are firmly aligned with SDG 3 - "Ensure healthy lives and promote well-being for all at all ages."

Specifically, we are working towards achieving Target 3.8 - "Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all."

We will measure this by the number of patients treated on our platform and the number of Pharmacists we can train and support through it. To ensure indicator 26- "Consultations with a licensed provider in a health facility or the community per person per year, we will track the average number of consultations – including preventative and curative services – with a licensed provider." Hia's Licensed providers in health facilities include all adequately trained personnel registered and integrated with the Directorate General of Health Services (DGHS). 

Along the way, we will find other metrics we can measure, but as we start our journey, we feel the most significant impact is getting treatment from people. 

We believe that initially, understanding the community in terms of nature, customs, norms, and viewpoints is necessary. As a result, an in-depth community analysis will be carried out to identify two significant factors: unmet demand and obstacles to service acceptance. Hia will perform another evaluation to determine the capacity and quality of the service delivered. The community will then be linked to the provided care, with a complete understanding of the availability and quality of services. Finally, a comparative study and evaluation of the improved services will be devised and implemented for periodic assessment.
 

From the inception of Hia, we have catered to more than 1200 patients with free doctor consultations in 3 different neighbourhood hospitals located in three neighbourhood areas. These patients were looking for accessible and affordable ways to cure their disease, and with the help of our local drug stores, Hia counselled them not to take unprescribed medications. Instead, they should make appointments to diagnose the problem first.

While they were going through the free appointments, our service representatives guided them throughout the journey from start to finish, making them understand that organised healthcare is accessible for them as well.
We believe in having this impact on a larger scale once we operate in large numbers. Since antibiotic resistance is becoming a threat, we have the power to change that by empowering middle and lower-income people with necessary data and information about the adverse effects of unprescribed medicines. 

The actual change will be seen when the rate of Antimicrobial resistance decreases due to the drug stores nudging against the sale of non-prescribed medication. Also, patients are getting a holistic experience from the Hia hospital chain.

Our solution comprises three web-based platforms for the end user (Patients, doctors, and hospitals). We are currently offering solutions to the target audience through these web-based applications. To create these platforms, we've used 1. PHP, MySQL in the Backend, and 2. HTML, CSS in the frontend.

We aim to introduce AI and Machine learning within a short time with three objectives in mind. These are: 
1. We aim that our AI and machine learning technology will make some diagnoses without human intervention.
2. Our AI and Machine Learning will analyze the patient's medical history (diseases, allergies, health conditions) and recommend which medicines can or cannot be prescribed to the patient.
3. Improving patients' lives by providing them with lifestyle suggestions based on their previous health reports and prescriptions

In the roadmap, with AI, we aim to start machine learning and make some diagnoses without human intervention. Our AI will analyze the patient's medical history (diseases, allergies, health conditions) and recommend which medicines can be or can not be prescribed to the patient. This will enable more patients to be seen with fewer interactions from a very scarce resource, the Healthcare worker. 
Also, by automating certain functions, we hope less qualified personnel can be employed with backup from professionals, thus creating employment and giving a more excellent standard of care.

Any simple outpatient electronic health record can integrate with this clinical decision support tool. The EHR must have lab and drug order entry and structured data fields (rather than free text) for patient concerns and diagnoses. The most challenging part of implementation is the cultural change of bringing guideline adherence to the forefront of primary healthcare service delivery. From a technology standpoint, any mobile internet (3G or better) is sufficient and could be accessed via laptop, tablet, or even a mobile phone.
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Hia app is developed by PlexusD Technologies Ltd. (the parent company) as Microsoft® Windows® software, programmed in Microsoft, PHP, using a modern object-oriented PHP programming language in Windows Forms. The application's executable is presently only 600KB; the entire payload is about 5 MB, which makes it suitable for delivery via download to any android device. We have already finished 60% of the work to launch the app for apple users.

We use the existing workforce that our partner hospitals and drug stores have to collect the basic patient contact information. Hia has provided them with the necessary technology and infrastructure. 

As the patient comes to our partner hospitals, our SRs registers them in our system. The software automatically compiles and assembles data according to our needs. Then, the system shares only the required information with the end user while maintaining data privacy compliance that doesn't violate the HIPAA protocol. We pay the SRs an amount of USD 150 per month.

Hia is a pioneer in its field, working at the forefront of the healthcare ecosystem in Bangladesh, growing to face the challenges in the country. Hia has brought together a team of professionals who strive for excellence, accountability, and integrity in all aspects of our work. Whether s/he is a fresh graduate or an experienced professional, if they are passionate about making a difference and confident in your strategic skills, then Hia might be for them. We have set up a multidisciplinary team of skilled professionals comprising management, technical, health content, and advisory. The members include persons from all genders, marginalized communities and persons with special abilities.

Hia tries to ensure a diverse workforce by providing equal opportunities to everyone, irrespective of race, age, gender, sexual orientation, HIV status, class, ethnicity, disability, location, and religion.

Hia's business approach is that of a forward-thinking primary healthcare provider: We serve low-income families with direct healthcare services. Most of our patients pay out-of-pocket cash for any treatments they receive (consultation, lab, imaging, pharmacy, procedures, etc.). We strive to transition more patients from a fee-for-service approach to a subscription-based (capitation) model. Whether fee-for-service or subscription, our business model demands significant scale to generate a profit at the modest margins we provide our consumers.

In addition to our B2C clients, we have a rising number of B2B customers through contracts with hospitals and drug stores. This government segment is also expanding and will likely be a significant income source as the government continues to spend on UHC.

Our essential consumers and key benefactor are low-income families looking for high-quality healthcare. 
We understand that trustworthy alternatives for our consumers are limited since offering an excellent healthcare experience for less than ten dollars is challenging.
 
Our market is vast. We are treating over 100 patients per day and can grow to 500 patients per day at our current capacity because we are open to uninsured and developing insurance markets. Within Bangladesh, our current TAM is $6B. However, by extending to additional cities and Asian countries, we anticipate our market size will surpass 1 billion people.
 
On vital resources, Dhaka's hospital and drug stores allow us to provide direct healthcare services to patients and families. This physical network, which took seven years to construct and now supports our integrated healthcare approach, is an essential resource. Our doctors can always "get it right" because of the Clinical Decision Support in our electronic medical records (EMR). For a business of our size and goals, the data backend will provide thorough insights into our performance and operations.
 
Social media platforms are essential for increasing patient awareness and traffic to Hia's numerous channels. Hia communicates with patients and potential clients in Dhaka through Facebook, Twitter, and Instagram.
 
Additionally, we believe that B2B and B2B2C are efficient client acquisition methods. We can access extensive employer networks thanks to the proliferation of our corporate sales. We also consider B2B and B2B2C to be effective customer acquisition channels. Our corporate sales proliferate and allow us to tap into large employer networks. We also work closely with insurance companies to design new products for emerging consumers.
 
Hospital and Back Office Costs are the two primary cost sources Hia may use to break down its cost structure. Labor (35%), COGS (mainly doctor and agent fees) (25%), and OpEx (rent, utilities, general supplies, etc. = 15%) are the three highest costs in hospitals, in that order.
 
Regarding back office costs, the leading influencers are clinical operations experts, IT (front-end and backend software systems, such as EMR, ERP, email and collaboration tools), finance (cash controls, credit management, especially insurance claim management), procurement and supply chain management, and external affairs (government relations).
 
Most of Hia's revenue is generated directly through patient care operations. Approximately 80% of our patients pay cash out of pocket, with the other 20% covered by medical insurance or a third-party payer, such as large employers. In addition to patient care revenue, Hia is looking for a mix of stock and impact grants to grow our operations and maintain quality as we approach total business profitability.

Since commencing operations, we have raised almost half a million to research, pilot and grow our solution. Hia is already generating positive cash flow from the partners we are currently working with. We generate revenue from the following operations:

• Issuing of Digital health cards ($1 per card)
• Service charges obtained through the diagnostic facility, Pathology lab
• 4% Commission from each patient referral

We also have other revenue models:

• SMS Marketing

We will continue to secure funding from private foundations, individual donations and government grants to Generate USD 2.02M in revenue in 18 months.

We have already prototyped our subscription model (Health Card) in more than 12 small chambers and have generated positive cash flow within two months of our service. Since our pilot launch in 2020, we have generated $3960 of revenue.

The co-founders have invested $55k to finance the major capital expenses and business operations. We are now looking for a pre-seed fund of $100k to scale our business in next six months.