MedBot: SMS Text Based TeleHealth with Offline Forms

INTERNET ACCESS / THE DIGITAL DIVIDE 

Improvements in primary health care have been and are happening in transformative ways: people are living longer; increasing funding and incentives for high-quality care; there has been renewed attention to the training and development of medical staff; and access to preventive health care and immunization. Internet access is also hampered by the affordability of smartphones where lack of access to technology has been called a social determinant of health. There are worries that LMICs who may lack the devices, internet access, or skills to take advantage of telemedicine, will get left behind as telehealth options increase in the western world.

The implementation of electronic health record (EHR) software at healthcare facilities in low- and middle-income countries (LMICs) is limited by financial and technological constraints.An example would be internet reliability in places like Africa where less than a third of the continent's 1.3 billion people are connected to broadband where we found that the areas with the low-income population had the lowest CCI score, and that commercial districts and the central business district had greater connectivity.  In medical healthcare space there are data silos, records of valuable data is siloed between institutions which increases cost, time, and a higher latency leading to higher medical wait times for patients. For those who live in low density rural areas, access to doctors is difficult (example during the COVID19 pandemic).

However, in the developing world health problems disproportionality affects the most vulnerable like women, childern, and seniors. Underserved communities have and use technology, but digital health solutions are not tailored to older people or those with lower digital literacy.The digital divide is perpetuating inequalities that already divide countries and communities with two thirds of the world’s school-age children have no internet access at home. This is dangerous because the lack of accessibility to healthcare isolates them from the world with a focus on global events like COVID19 or MonkeyPox.

• A low-speed internet connection
• Times of the day when there's low bandwidth because of network usage in an area.
• Low-bandwidth periods because of outages local to neither the hostpital nor to doctors, but, which affect performance nonetheless.
• Non-bandwidth issues (for example, issues with hardware) that masquerade as low-bandwidth issues.

INCREASING ACCESS TO PHONES 

Widespread mobile phone use and improved broadband connectivity are expanding the possibilities for developing countries to improve access to healthcare. Despite performance improvement systems vary around the world, key metrics to measure primary health care performance improvement are available. Despite robust measurement standards, limitations in how performance is measured are common.These problems are accelerated by the growing digital divide in LMICs. One of these methods is through SMS-based text surveys sent by Twilio. By 2025, it is expected that almost three quarters (72.6 percent or 3.7 billion people) of internet users will access the web solely via their phones. The use of phones can be used for ensuring improved connectivity and access.

It is important to help primary care practices achieve the goal of improving access to care and the care experiences of their patients.  It is perfectly acceptable for doctors, nurses, and other healthcare professionals to communicate with each other – and even patients – via text message within laws and regulations. Text messaging in healthcare for contacting patients for appointment reminders, follow-ups, and instructions streamlines communication between all members of the care team, patient handovers are improved which reduces the potential for errors, and the ability to text staff members eliminates phone tag and hours of wasted time and slow wait times. Example: the use of simple and easy-to-navigate user interface, low-skilled and low-literate communities will access farm information decreasing the growing digital divide in LMICs.

LACK OF DATA STANDARDS FOR BENCHMARKING

In the developing world, there is no standardized, practice-based tool that allows primary care practices to measure and monitor the experiences of healthcare patients in order to make improvements to the quality of care delivery.

There is no solo workflow so medical systems unfortunately making the multi party workflows difficult to manage. The constant changing data with no digitized history is difficult to maintain as there is no common data model. With privacy regulations we know that stakeholders who break regulations like HIPAA can be fined from $100 to 50,000 per record. In terms of data interpretability, integration with current healthcare systems can go from patient, insurance, company, doctors, to pharmaceuticals, all varying before it reaches a final bill number.

The gathering of data is important for getting ideas, making comparisons, testing a change, or making improvements. Doctors have difficulty with standardizing measurements of indicators aligned with system priorities and creating benchmarks. Without these benchmarks, there is no way to tell if an patients health is getting better or worse. With benchmarks, workers have a better understand of how patients, teams and organizations can improve healthcare outcomes from a current state to a future state.

Measurement in quality improvement allows a healthcare workers to demonstrate current performance with a benchmark, set goals for future performance, and monitor the effects of changes as they are made.

DATA ENCRYPTION:

Current data collection systems is that they eliminate the use of paper surveys and allow data to be quickly exported for data analysis and reporting but the data is not encrypted. This is a problem as many text messaging platforms do not feature end-to-end encryption so data can be intercepted in transit.which can be a huge problem Messages can remain on devices indefinitely creating a major privacy risk and if mobile devices are lost or stolen, text messages containing electronic protected health information could easily be viewed by unauthorized individuals. Maintaining anonymity, confidentiality, integrity, security problems are some issues with text communcation. There is no control over where messages are sent, messages are not encrypted so they can be intercepted in transit, and messages can be stored on service providers’ servers for long periods of time and could be accessed by unauthorized individuals. It is important for the safety that doctors reassure patients that their feedback will be confidential. 

MEDBOT 

To bridge the digital divide in healthcare, MedBot uses SMS Text-based communication to provide a telehealth service to bridge the digital divide in low and middle income countries to support to all primary care practices and providers. Research has shown that healthcare organizations that have adopted secure text messaging platforms have reported improvements in productivity, quality of care, reductions in patient stays, faster transfer times and patient throughput, shorter waiting times, improved bed utilization, better resource optimization, fewer medical errors, improved continuity of care, reduced costs, and better staff morale. 

Solving remote healthcare addressing a large medical issue in society which affects many people daily, yet is often overlooked. Medbot solution can potentially contribute to the improvement of the medical system. By accessing quality healthcare through SMS texting, Medbot offers enhanced measurement techniques that are affordable, appropriate for their intended use, shareable across information systems, and simplified for health data collectors. We use text-message surveys to gather information from rural communities who are far from healthcare workers. Text messaging is a fast, efficient, and convenient method of communication that allows patients to schedule a visit or appointment with their primary care provider on the same day, or on a day of their choice reducing wait times.

Offline data collection 

No wifi or cell? No problem. Designed for easy offline data collection, our form builder lets you build forms that can collect and save data offline and later sync them when connected to the internet. Data is collected via SMS phone services and sent to a custom excel sheet form allow healthcare workers to collect data without the internet. Data gets stored locally and is synced to the cloud whenever the user is back in an internet zone. Offline forms allow researchers that are working in places with unreliable internet to store a backup of their data on their mobile device and upload it once an internet connection is available. They can export the data in Excel format or connect a Google Sheet to which this data is pushed in real-time. Offline data collection apps require very little loading time and are less likely to drain your battery.

Medbot's simple and easy-to-navigate user interface, low-skilled and low-literate communities will access farm information decreasing the growing digital divide in LMICs. Offline data collection apps are more likely to be used in areas of poor connectivity. These apps are essential for industries or tasks carried out in areas with limited WiFi or data connectivity. Mobile phones have great potential in the delivery of health care in low-resource settings. As researchers today see the immense advantages of using mobile survey apps over paper-based forms, the number of data collection solutions grows. With this article, we hope to answer the question of which of these options may suit your research purposes best with a market segementation in LMICs with a focus on remote areas.  The data will be synced when you are connected to the Internet again. When stored locally, the data has little to no chance of getting breached. 

How it works 

1. Create a custom form as per your need
2. Users can collect data without the internet. Data gets stored locally and is synced to the cloud whenever the user is back in an internet zone.
3. Export the data in Excel format
4. Connect a Google Sheet to which this data is pushed in real-time

Surveys are the first part of Medbot's MRV system - Measurement Reporting Verification system which enables practices to have confidence in the results and, if they choose, compare their performance to that of their peers and establish shared benchmarks. This is done using a systematic approach to making changes that lead to better patient outcomes and stronger health system performance. These SMS text-based surveys are used to measure primary health care performance improvement. Medbot considers the actions below when dealing with issues reported by heatlhcare workers in regard to having the best meeting experience. Considerations were made for disabling video altogether, so no one could enable it, and media bit rate. This is so we can associate these online clickstream events to offline data that contributed to the conversion. They allow for healthcare workers to measure and monitor the experiences of their patients in order to make improvements to the quality of care delivery with inclusive human-centered design to provide the essential services a person needs throughout each phase of life. Since offline data collection apps require very little loading time and are less likely to drain your battery, Medbot uses a human-centered patient referral workflow that is resilient to connectivity issues that allows for effectiveness of task-shifting interventions by allowing both parties to share data on cases that require further treatment or followup where health care workers can store the patient data digitally on a mobile data collection platform and additionally provide the patient a paper copy of the referral information.

Benefits of SMS text based Solution

• Reducing wait times
• Improved office efficiency and patient flow
• Improved patient, provider and staff experiences
• Improved provider access contributing to organizational targets 
• Improved provider access that contributes to achievement of Health Link performance targets 

Medbot sends Systematic Random SMS health surveys with Interactive Voice Responses:

Text messaging allows healthcare workers to target and contact hundreds of patients within minutes making it one of the best ways to contact patients. Medbot automates this process as it sends a survey regarding basic primary health questions. Messages can be sent from virtually any location to mobile devices. Instant messaging solutions support the sending send audio and video files, images, and other file attachments via text. Text messaging in healthcare streamlines communication between all members of the care team, patient handovers are improved which reduces the potential for errors, and the ability to text staff members eliminates phone tag and hours of wasted time. Medbot was designed with and for people living in low and middle income countries, underserved communities, and the solution team demonstrates proximity to the community and embodies and addresses diversity, equity, and inclusion through their solution.

Choose patients at regular time intervals until you have gathered the
requisite number of surveys

• Survey every fifth patient every day
• Survey the first appointment at the top of every hour
• Survey the last appointment at the end of every hou
• Survey in the afternoon one day each week, vary the day every week

Medbot can handle appointments:

We increase the line of communcation such that doctors can communicate to patients on an ongoing basis within rules and regulations. Patients can also cancel appointments by text, which has drastically reduced the number of no shows. Messages are often sent to patients advising them about delays, which reduces wait times and improves the patient experience.  Medbot considers the actions below when dealing with issues reported by heatlhcare workers in regard to having the best meeting experience. Considerations were made for disabling video altogether, so no one could enable it, and media bit rate.

Medbot may collect baseline data to determine your starting point. 

• Fasting blood sugar
• Cholesterol
• Liver function
• Kidney function
• Blood Pressure

Medbot can send medical messages:

SMS reminders for in-person or telehealth based on general health, lab tests and your medical history.

• Appointment reminders
• Appointment confirmation messages
• Post-op or home healthcare instructions
• Post-discharge information
• Results from the lab
• Prescription notifications where prescription reminders are often sent to patients by text, which has reduced the number of uncollected prescriptions.

Medbot can handle admin work:

• Accounting notifications
• Billing information
• Collection messages

Medbot stores data on the blockchain:

Blockchain is fundamentally changing how we store, use, and ensure the validity of data. With the global digital health market reaching over $200 billion in the year 2020, there has never been a better time to innovate in the healthcare space to provide business value to provide actionable insights for stakeholders. Factors like medical urgency, necessity, timing, and support create a need for a medical blockchain for insurance health claims, and electronic health record. 

Healthcare professionals who access the patient's information through the institution's certified database which can securely offload data from the blockchain. One of the main problems with remote medical healthcare is the way highly identifiable sensitive medical patient's data is stored. Instead of records in physical files, we have EPR - an Electronic Patient Record system. The lack of consistent communication between healthcare providers is a large issue in the medical industry. This interface can allow all professionals to have immediate access to patient history and conduct data analysis without changing the data itself. Workers have a separate interface which allows them to read-only, but have complete access to their own personal history. One of the main problems with remote medical healthcare is the way highly identifiable sensitive medical patient's data is stored. Instead of records in physical files, we have EPR - an Electronic Patient Record system. This increases transparency between medical professionals and patients and allows patients. Information on user friendly web and mobile interfaces to allow for a positive user experience for all stakeholders.

Offline integration of healthcare data with SMS/Call triggers:

1.Electronic health records.

2.Administrative data. 

3.Claims data. 

4.Patient / Disease registries. 

5.Health surveys. 

6.Clinical trials data.

User logged in as a primary care provider and they can select insurance ID which is a hash that allows for traceability on this Ledger. We can refer patients selecting for insurance information like receiver encounter ID procedure appointment priority, what the diagnosis is this medical information is then sent to the secure ledger. Medbot is an SMS text based medical blockchain for insurance health claims and electronic health records.Our health insurance verification system for credentials leverage leverages smart contracts for health insurance that makes it standardized where digital certificates are verifiable, portable, and tamper proof.

 IPFS is a content-based distribution system and uses cryptographically verifiable hashes so this can store images like medical radiographs for medical diagonsis. This works by sending bio-metric data to IPFS and hash storing in chain options with nodes. Token-based authentication will help with security, where the token is a random IPFS hash assigned to the user and they can reset it at any point if it has been stolen. Allow the token to be passed in through the Medbot network. Each transaction must be signed by account's unique seed. It has two forms: Mnemonic that is human-readable and raw that is a sequence of digits and letters.

These shared workflows allow risk reduction data transparency and real-time information flow accelerating innovation for health insurance claims. on the application front-end we have react components that connect to blcockahin libraries with an authentication token issuer. As seen from the video with files were compiled for our blockchain model. For low connectivity in healthcare, we noted how primary focus for low-bandwidth issues is meetings; specifically, video in meetings. One of the most concerning areas for low-bandwidth situations has to do with videos.  Medbot considers the actions below when dealing with issues reported by heatlhcare workers in regard to having the best meeting experience. Considerations were made for disabling video altogether, so no one could enable it, and media bit rate. This is so we can associate these online clickstream events to offline data that contributed to the conversion.

Medbot removes medical data silos between healthcare stakeholders like health clinics, insurance, companies, and government with a trust based digital verification software. The peer to peer protocol and the use of smart contracts with uniform authorization protocols is transport agnostic allowing access to healthcare information:

1) User creates a new stakeholder where each has configurable smart contract permissions.

2) Healthcare provider can set up a medical appointment date with the patient.

3) Proof that you have received medical treatment with blockchain immutable verifiable credentials that can be sent for health insurance in three easy steps we leverage smart contracts to disrupt the medical space with demo technology.

This makes it easy to streamline healthcare data through multi party workflows by optimizing the healthcare supply chain. This allows every stakeholder to have transparent real-time views were permissions and optionality for users. For encryption, blockchain technology to store patient profiles within block ledgers to securely store all historical data about a patient like examinations, medical procedures, lab tests, and medications anywhere with the patient's permission. Blockchain for a secure way to transfer and centralize patient data to allow access to patient data for all certifies healthcare institutions and patients. Using blockchain encryption for data privacy and point security in order to protect personal identities online. Medical data remains secure and authentic, maintaining data integrity and a chain of trust.

• Changing the ways of old by disrupting the entire framework of how we manage our healthcare data.
• Enables stakeholders to track, trace, match and manage their heathcare data while simplifying data-driven allowing for benchmarking and standards
• Proof and immutability for the real world impact of measuring changes - allows LMICs to use the immutable ledger to track healthcare assets and liabilities.
• Medbot's smart contract’s logic and data trigger are viewable on the blockchain by all stakeholders, leading to transparency and independent verification of all outcomes.
• Tamperproof execution and data delivery to heatlhcare data, resulting in doctors and patients being able to trust that they will get the land based on accurate data metrics.

INCREASING ACCESS IN LMIC

Technology advancements for smart environments of the future have helped us as a society grow more and more connected. Since we are working with healthcare data which can be intrusive, t is important to ask for consent before we text advertising or marketing materials to patients both verbally and written. This is done during the first meeting with a welcome packet or an electronic form and revisited and updated at regular intervals to avoid breach of confidentiality. The main advantage of telemedicine is that it can improve access to health care, often by increasing the speed with which a specialist opinion can be obtained or by reducing the need to travel.

Mobile line subscriptions reached 98.7% of the population in developing countries. In India we have $10 phones like Jia. In nations with low or medium-level economies, there are more people with access to mobile devices than to water or electricity, according to the World Bank. In poorer regions, mobile technologies have become an opportunity to boost economic, health, educational and technological development. As smartphones are still in the minority, these services often use basic technologies such as SMS messaging.

For the inhabitants of developed countries, a mobile phone is a useful complementary tool for our economic transactions; it allows us to operate with our bank accounts, financial products and credit or debit cards. But for those who don’t have access to bank accounts and the like, a mobile phone is often the only tool available. It’s important to showcase the benefit of SMS texting to the overall economy of the LMIC and how it aligns with the country's agenda.

Since this is an opt-in process, Medbot only sendS text messages to those patients where consent has been recorded for you to undertake this form of communication where we can use SMS to help accelerate digital adoption. 

Positioning Statement Medbot is a free, high quality support system for LMICs, that provides them with information and resources for telehealth, in a comfortable and culturally acceptable setting

Customer Archetypes 

Aisha (primary care) Aisha is a 16 year old married pregnant women living in rural Bangladesh. She is Muslim, only speaks Bengali and has limited education. Aisha’s goals are to have a healthy pregnancy all while fulfilling her duties within her society. She currently understands the traditional methods of dealing with a pregnancy from her elders but sees the women in her life passing away from the lack of healthcare resources and information.

Benefits to pregnant women: Aisha is able to get the best recommendations on a regular basis only only through visits from her CHW but also by simply getting in touch with Aunty Aisha is able to avoid leaving her comfort zone by engaging in a “conversation” with her new and informed Aunty, just like she would in her regular day-to-day life Aisha is empowered with tailored health information to manage her pregnancy and care for her baby

Zainab (Doctor) Zainab is a 38 year old woman in rural Bangladesh with basic level of education. She has access to both a smartphone and tablet and uses it during her 800-1000 appointments per month. She has limited training, doesn’t speak english and works very long hours each day. Zainab is typically worried about getting to all ~45 of her appointments per day and therefore does not have enough time to prepare for each. During her appointments she is focused on updating Aisha’s profile with notes and recommendations and therefore needs quick access to her records. Zainab’s ultimate goal is to help her patients survive their pregnancies and early childhood.

Benefits to Zainab: Zainab is able to identify high risk pregnancies instantaneously Zainab has easy access to her patients’ records, risk factors and appointments Zainab is now able to prioritize high risk pregnancies and make them her greatest focus Zainab is able to do her job more efficiently Aunty takes some of the logistical requirements of Zainab’s job off her hands and make her job more efficient (ex. Aunty sends automated reminders for appointments and tracks the patient's’ birth plan and due date)

Slogan “Have you called Medbot Yet?”

1. Referral Program (generate awareness) Use influential and credible pregnant women within the rural communities to promote Medbot's SMS texting telehealth Incentive such as no wait time during their next clinical visit is provided to these women when they refer and successfully secure a new user Why: This strategy was chosen because rural LMICs is very collective and social. Therefore, successful early adoption relies heavily on word-of-mouth generated by the influential people in the community

2. busin (reminder advertisement) Partner with popular brand in rural LMICs (ex. A beauty brand) to incorporate Metbot phone number, logo and slogan to their packaging Why: This will make Medbot information more readily available and will prompt thepeople to call right away.

LMIC MARKET SEGMENTATION HEALTHCARE

In the current state of our world, there has never been a greater need to build tools that benefit public health. With the implementation of telemedicine in LMICs, we can use technology for good making the world a better place. In high-performance areas, both men and women are very likely to be internet users, with 80% of respondents from both groups claiming to use the internet. However, in low-performance areas, there is a gender disparity in internet usage as only 59% of women claim to be internet users, compared to 68% of men. Women therefore have greater potential for increased internet use. The solution is designed with and for people living in low and middle income countries, underserved communities, and the solution team is interested to providing good for to the community and embodies and addresses diversity, equity, and inclusion through their solution.

The implementation of electronic health record (EHR) software at healthcare facilities in low- and middle-income countries (LMICs) is limited by financial and technological constraints. The market segmentation includes Hispanic and Black Americans, seniors, rural residents, and those living in poverty are more likely than other groups to lack internet access. Medbot maintains a balance between giving frontline healthcare workers the chance to take part in performance improvement initiatives and their primary duty as healthcare providers where most of the growth in phone use will come from China, India, Indonesia, Nigeria and Pakistan in order to make sure telehealth is suitable and workable for usage in these countries. Medbot considers the actions below when dealing with issues reported by heatlhcare workers in regard to having the best meeting experience. Considerations were made for disabling video altogether, so no one could enable it, and media bit rate. The problem is that the current centralized healthcare systems lack feedback mechanisms for the data collectors themselves. Improvements and innovation are still desperately required even if essential measures for tracking the performance improvement of basic healthcare already exist. As medical investments scale, they will make remote healthcare more accessible for everyone.

Text messages can offer greater convenience and flexibility for both patients and doctors. By collecting data, establishing a baseline and analyzing this information, the practice can improve and redesign processes, Medbot reduces frontline health professionals bear the burden of data gathering. Example, text messages can be easily translated to different langauges like Swahili (200 million), Yoruba (45 million), Igbo (30 million), or Fula (35 million).  We can even adapt to low literacy contexts with images, emojis, and symbols that help communicate the message. Low internet use in some communities was attributed to a host of other social problems such as literacy, income, and interest, rather than simply lack of access to the infrastructure.

The goal is to balance opportunities for frontline health workers to participate in performance improvement efforts with their primary responsibility as care providers with SMS-based telehealth with methods to improve access or booking appointments. To continue progressing, different stakeholders in the healthcare sector, including patients, frontline healthcare workers, policy makers and all others, need a way of understanding by sending surveys to paitents and using survey results to monitor progress over time, and improve patient experiences.

BLOCKCHAIN

Blockchain technology is used as an uconventional  data storage system to provide information on improving primary health care performance. We Utilize current community networks, systems, and workflows to speed up data collection and analysis in order to promote the meaningful use of primary health care data in order to provide health care administrators, funders, and/or providers with accessible, actionable insights that can be leveraged to improve the efficiency of primary healthcare. These messaging platforms incorporate safeguards to prevent message tampering and mechanisms are in place to ensure that in the event of the loss or theft of a mobile device, messages cannot be accessed by unauthorized individuals. This allows Medbot to quantify patient experiences on a regular basis provides a systematic and objective way on an immutable ledger where we can apply data analytics.

In Medbot's go-to-market stratgey, we included simple and easy-to-navigate user interface, low-skilled and low-literate communities will access farm information decreasing the growing digital divide in LMICs. In high-performance areas, both men and women are very likely to be internet users, with 80% of respondents from both groups claiming to use the internet. However, in low-performance areas, there is a gender disparity in internet usage as only 59% of women claim to be internet users, compared to 68% of men. Women therefore have greater potential for increased internet use. We are interested in data collection for patients, staff and community to improve quality through focused targets and actions because mobile use is accelerating due to lower costs and greater availability of devices with inclusive human-centered surveys.

 When planning to survey patients, it is important to consider:
o How many patients do we need to survey?
o How frequently do we want to survey?
o When do we know we have enough data for our baseline?

For example, in order to reach 100 completed surveys it would be necessary to schedule:
o Year-round rolling surveys:
 2-3 completed surveys each week
 8-10 completed surveys each month
o One week per month: 8-10 completed surveys
o One week per quarter: 25-30 completed surveys 

Barriers MIT Solve can help Medbot by providing support and mentorship the the following situations to use SMS to help accelerate digital adoption. 

1.Financial

Biotech business model 

2.Technical

Integration of low-connectivity software solutions and expand mobile broadband

3.Legal

Health legal laws with biometric data

4.Cultural

Langauge translations in LMICs and ability scaled to affect the lives of more people living in low and middle income countries.

5.Market barriers

Go-to market strategy

To address the next wave of global health challenges in the next 5 years, we must be creative, committed and resourceful.We can accelerate our progress by prioritizing new innovations that will lead to improved access to quality care for the world’s most vulnerable and underserved populations. Our ability to innovate will be critical to achieving our long-term goals, however our innovation will be iterative allowing Medbot to adapt to quick changes using Artificial Intelligence: Training an AI algorithm this way requires a set of computationally intensive calculations, quantum computers can perform multiple complex calculations with multiple variables simultaneously, they could exponentially accelerate the training of such AI systems with electronic health records (EHRs) Medical claims and billing Product and disease registries Patient-generated data 

Medbot will be collecting biometric data evidence to demonstrate that therapy or a treatment is producing its effects and benefiting the patient. Leverage big data and analytics to improve healthcare. Assessment factors could include: number of jobs created, number of high-paying jobs, project-related revenue growth, etc. Optimization Deep Learning to Strengthened scientific evidence base and policymaker capacity for evidence-based decision making. This can help with sequential decision making of healthcare stakeholders. Helping the research teams, and occasionally key local stakeholders, to make their assumptions and mental models about their respective interventions explicit and to learn from implementation. Revising the ToCs fostered recognition of the adaptive nature of health systems and emphasized the time, space and flexibility that health systems strengthening programmes must have in order to cope and thrive in such complex adaptive systems.  

In the future we hope to scale Medbot by: Creating extensive diagnostic questions and recommendations Creating an SMS feature to alert healthcare workers of appointments and nudge paitents in LMICs to follow-through on recommendations Develop a scheduler  to manage appointments Support pre-pregnancy and postnatal (up to a year) Develop a partnership with the government so that they have access to the Medbot database in order to make better healthcare resourcing decisions

We can accelerate our progress by prioritizing new innovations that will lead to improved access to quality care for the world’s most vulnerable and underserved populations by tracking quality of life of citizens to ensure healthy lives and promote well-being in healthcare  for all at all ages helping support UN's sustainable development goals:

https://www.un.org/sustainabledevelopment/health/

When the government uses tax money to create a public park, everyone in the neighborhood may benefit from its use, even those who pay no taxes. This is the same with advancing teleheatlh technology in LMICs. The first step in building any new healthcare network that supports innovation should be the development of a "strategic intent" statement. This can be done in many ways, but in general, it focuses on defining the growth path of innovation, whether it is the following innovations or all of the following innovations: new areas, markets, channels, business models.

Use strategic and technical goals to identify ideas that match your interests. From outside and outside, look for specific groups, individuals and organizations that focus on innovation and technology development in these fields. Establish early relationships with informal exchange events and forums. The focus of these early work can be just to share best practices in the group. As informal activities continue, it will become important for a more formal approach to manage the process more effectively and ensure that the network is focused on solving the problem statement in the original charter.

• Number of hospital beds per 1000 people for each country: https://www.kaggle.com/hamzael1/hospital-beds-by-country or https://www.kaggle.com/ikiulian/global-hospital-beds-capacity-for-covid19

  • Number of ICU beds per county/state: https://www.kaggle.com/jaimeblasco/icu-beds-by-county-in-the-us

• Weather data https://www.kaggle.com/johnjdavisiv/us-counties-covid19-weather-sociohealth-data

  • Seasonality and monthly temperature
  • Impact of temperature and humidity on transmission rate https://www.kaggle.com/noaa/gsod
  • Joined each region in the Johns Hopkins University data to the nearest weather station

• Economic indicators

  • Unemployment, consumer spending, and GNP.
  • The World Bank's World Development Indicators https://www.kaggle.com/theworldbank/world-development-indicators

• Social dynamics between vulnerable groups affects transmissions.

  • For instance in the case of HIV, mixing and contact depends on age groups.

• Release of measures like stimulus checks affecting

• Confidence intervals, death rates, hospitalizationrates, ventilators needed.

• Coronavirus Retail Restrictions by region https://nrf.com/coronavirus-retail-restrictions-state

• Air conditioning and Covid spread

  • China https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article 
  • Korea  https://www.latimes.com/world-nation/story/2020-12-09/five-minutes-from-20-feet-away[…]south-korean-study-shows-perils-of-indoor-dining-for-covid-19

• Number of seated resturant diners at restaurants per day since the end of February https://www.kaggle.com/jaimeblasco/opentable-state-of-the-restaurant-industry

• Air transport, passengers carried

• GDP per capita, PPP (current international $)

• International migrant stock, total, International tourism, number of arrivals, International tourism, number of departures

• Labor force participation rate, total (% of total population ages 15+) (modeled ILO estimate)

• Mortality rate attributed to household and ambient air pollution, age-standardized (per 100,000 population), and Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene (per 100,000 population)

• Number of Nurses and midwives (per 1,000 people)

• People using at least basic sanitation services (% of population), People using safely managed sanitation services (% of population), and People with basic handwashing facilities including soap and water (% of population)

• Number of Physicians (per 1,000 people)

• PM parts million 2.5 air pollution, population expoled to levels exceeding WHO guideline value (% of total)

• Poverty headcount ratio at $3.20 a day (2011 PPP) (% of population)

Reach: Communication is the key to influence with connecting healthcare networks to underserved communities. Healthcare providers need to attract audiences who can make the most of your work or benefit from it. Effective coverage requires active communication within and outside the normal network to obtain the best knowledge. This is why SMS text based mobile technology helps with increasing the reach to create an improved healthcare environment.

Engage: Help the LMIC audience understand the healthcare research innovations in telehealth by adapting relevance and pertinence to their needs and expertise. Ideally, the project will attract healthcare stakeholders to participate. Improved knowledge of technical best practices through extension and outreach to communities with scientific evidence base and policymaker capacity for evidence-based decision making. This can help with sequential decision making of healthcare stakeholders. Helping the research teams, and occasionally key local stakeholders, to make their assumptions and mental models about their respective interventions explicit and to learn from implementation. 

Change: The real healthcare impact requires changes-attitudes, practices, policies, processes and products. We can't improve anything if we don't have a way to measure with a benchmark. Accounting for the time, space and flexibility that health systems strengthening programmes must have in order to cope and thrive in such complex adaptive systems. Medbot's business can help this process by establishing relationships with individuals and organizations that can conduct research like  organizations, caregivers, and goverment organizations. 

Amplify: Change is the beginning of impact, but to achieve the size of the effect, a consensus must be reached on the effect. The use of advocates, cooperation and the media are the key to a major, far-reaching and lasting impact. Our ability to innovate will be critical to achieving our long-term goals, however our innovation will be iterative allowing amplifying the voices of those left unheard in the healthcare system. 

Policy: Strengthening of marketing and governance structures of cooperatives and unions within LMICs. Advise and provide support to to put in place efficient regulation and legislation to enable private-sector-led development business. Build nationwide institutional capacity to develop and implement policy, as well as to monitor and evaluate gains in healthcare through relevant ministries to get the government involved. 

LMICs include the following countries:

Afghanistan
Albania
Algeria
Angola
Argentina
Armenia
Azerbaijan
Bangladesh
Belarus
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Central African Republic
Chad
China (People's Republic of)
Colombia
Comoros
Democratic Republic of Congo
Congo
Costa Rica
Côte d'Ivoire
Cuba
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Eswatini
Ethiopia
Fiji
Gabon
Gambia
Georgia
Ghana
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
India
Indonesia
Iran
Iraq
Jamaica
Jordan
Kazakhstan
Kenya
Kiribati
Democratic People's Republic of Korea
Kosovo
Kyrgyzstan
Lao People's Democratic Republic
Lebanon
Lesotho
Liberia
Libya
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Nicaragua
Niger
Nigeria
Niue
Pakistan
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Rwanda
Saint Helena
Samoa
São Tomé and Príncipe
Senegal
Serbia
Sierra Leone
Solomon Islands
Somalia
South Africa
South Sudan
Sri Lanka
Saint Lucia
Saint Vincent and the Grenadines
Sudan
Suriname
Syrian Arab Republic
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
Uzbekistan
Vanuatu
Venezuela
Vietnam
Wallis and Futuna
West Bank and Gaza Strip
Yemen
Zambia
Zimbabwe

We beleive there is untapped healthcare potential in many developing countries with factors including populations who experience systematic, economic, or geographic barriers in terms of access to software and tech solutions for healthcare. With the widespread increase in phone use and improved broadband connectivity are expanding the possibilities for developing countries. As Medbot's software scales, it is important to make diversity, equity, and inclusion considerations with groups research design, implementation, and outcomes. This will ensure gender equity and the inclusion of other marginalized groups research design, implementation, and outcomes:

Female-led with a diverse representation in the founding team. We are dedicated to increasing the representation in STEM research. Collect sex disaggregated statistics, with gender-sensitive baseline. Youth STEM outreach programs to encourage young people from underrepresented communities to be interested in healthcare data collection and support development of a young class of future scientists through training and financing.  Scale up and replicate successful programs to raise access to quality healthcare for everyone everywhere, including community-based programs like heath-care outreach; and advocacy for greater government allocation to healthcare interventions by strengthening partnerships, cooperatives and unions to promote collaboration for the healthcare community. Economic advantages of DEI includes increasing income and addressing broader economic and social development goals and boost learning, innovation and job creation, especially for skilled youth.

Economic advantage : increasing income and addressing broader economic and social development goals and boost learning, innovation and job creation, especially for skilled youth. Prioritize a DEI workforce which strives for equity, and respects, accepts and values difference by requiring all incoming employees to participate in DEI training session - Develop and manage review committee, made up of multi-disciplinary experts Monitor surveys that include demographic information about users  Mentor and teach historically underrepresented groups with inclusive lesson plans inclusive of Indigenous education leaders to deliver proactive community-based outreach. Reduce barriers for Indigenous communities and financial obstacles faced by low-income by offering free software Research how certain age-related illnesses will affect researching inequalities and/or underserved populations

Business to Business : Software as a Service

There has been an increase in the commercialization of telehealth technologies after Covid. Medbot is using SMS texting to collect data in places where internet access excludes over half of the world’s population who remain disconnected from the web, with more than half of Africa still offline, and 37 percent of rural US households with no access to broadband. This is an enormous missed opportunity: connecting the rest of the world could add $6.7 trillion to the economy and lift 500 million people out of poverty.

As medical investments scale, they will make remote healthcare more accessible for everyone. Medbot's  go-to-market strategy is Software-As-A-Service being offered to healthcare professionals through a monthly subscription based model. The healthcare market includes health and wellness, home care, residential care, medical care. Individual members (seniors), family/friend caregivers, or personal care workers will be able to purchase the product. Stakeholders include manufacturers, medical distributers, group purchasing organizations, big pharma like pharmacies and drugmakers, and healthcare organizations like LMIC goverements, speciality clinics, and hospitals. . Further, access to commerce, credit lines, safety nets, and saving mechanisms are key for a global economy where nearly 2 billion people remain unbanked, and more than 60 percent of the workforce is informal.

We considered  multiple revenue streams like pricing, flat fee, or percentage.  This will be done with a Subscription based business model. Recurring revenue models lead to higher revenues and stronger customer relationships adding to the LMIC healthcare peer network. This compounding growth is what makes customers so powerful here. Through subscription, customers become more valuable the longer they use your product. This will be done with a Subscription based business model. Recurring revenue models lead to higher revenues and stronger customer relationships. This compounding growth is what makes the farm network so powerful here. Through subscription, crop data becomes more valuable the longer they use the computer vision machine learning model process:

Annual subscription with maintenance contract

o   Low entry price

o   Clearer ROI

o   Not tied to specific healthcare provider

o   Closely align cost to use

o   No product training required

o   No additional resources required

o   Software is not "cut off” when subscription expires

o   Set price is easier to budget for

o   Software is always up to date

o   More affordable with a predictable payment schedule

The first step in building any network that supports innovation should be the development of a "strategic intent" statement. This can be done in many ways, but in general, it focuses on defining the growth path of innovation, whether it is the following innovations or all of the following innovations: new areas, markets, channels, business models.  Recurring revenue models lead to higher revenues and stronger customer relationships. This compounding growth is what makes customers so powerful here. Through subscription, customers become more valuable the longer they use your product. 

Positioning Statement Medbot is a free, high quality support system for LMICs, that provides them with information and resources for telehealth, in a comfortable and culturally acceptable setting

Slogan “Have you called Medbot Yet?”

1. Referral Program (generate awareness) Use influential and credible pregnant women within the rural communities to promote Medbot's SMS texting telehealth Incentive such as no wait time during their next clinical visit is provided to these women when they refer and successfully secure a new user Why: This strategy was chosen because rural LMICs is very collective and social. Therefore, successful early adoption relies heavily on word-of-mouth generated by the influential people in the community

2. Partnership (reminder advertisement) Partner with popular brand in rural LMICs (ex. A beauty brand) to incorporate Metbot phone number, logo and slogan to their packaging Why: This will make Medbot information more readily available and will prompt thepeople to call right away.

Business to Business : Software as a Service

Selling the software to the government.

Funding for this telehealth project would towards: 

• Business model (e.g. product-market fit, strategy & development) 
• Legal or Regulatory Matters 
• Monitoring & Evaluation (e.g. collecting/using data, measuring impact

Project Budget and Financing. The funding will help build a working active prototype for pilot projects : -       Personnel -       Subcontracts -       Subgrants -       Capital Assets/Equipment -       Travel -       Supplies -       Other Expenses -       Indirect Costs

-       Getting data. Training data for this super expensive because we  need to find specific rare disease scans that are labelled. In order to increase accuracy we need hundreds of thousands of images.

-       Costs associated with salaries/back fill costs for the research, software engineering team

-       Hire UI/UX design help for the front-end of the project

-       Equipment and hardware

-       20% budget will go towards server space, infrastructure, data, web hosting, and using Amazon Web Services and Sandbox training costs.

-       Indirect costs, up to a maximum of 10% of total budget

-       Reasonable travel costs (outside Covid19 times)

Further, access to commerce, credit lines, safety nets, and saving mechanisms are key for a global economy where nearly 2 billion people remain unbanked, and more than 60 percent of the workforce is informal with financial support for:

•Develop decentralized database to collect data

•Disease care plans and campaigns.

•Have all content reviewed and certified by a medical team specialists.

•Recommend individual plan of action for aftercare.

•More precise treatments and best outcomes.

•Add better classical data processing.

•Include health diagnosis and medicine recommendations.

•Increase efficiency of code.

•Add additional privacy considerations for medical data.

The digital economy excludes over half of the world’s population who remain disconnected from the web, with more than half of Africa still offline, and 37 percent of rural US households with no access to broadband. This is an enormous missed opportunity: connecting the rest of the world could add $6.7 trillion to the economy and lift 500 million people out of poverty.

• Business model (e.g. product-market fit, strategy & development) 
• Legal or Regulatory Matters 
• Monitoring & Evaluation (e.g. collecting/using data, measuring impact)