MedTrack EHR System

We are dealing with the Health in Fragile Contexts Challenge.

Health records in Ghana and most parts of Africa are fragmented, with no interconnection between different healthcare delivery points. This makes individual healthcare interactions confined to the point of care without relation to previous or subsequent health records. This causes duplications in health data, increased costs to patients and delays in health care access and delivery, leading to overall reduced quality of health care.

This problem cuts across the entire African continent involving Africa's over 1 billion population, as most Africans' health care is sourced from multiple facilities and points of healthcare delivery.

Access to complete and accurate patient information is crucial for healthcare providers to provide timely and effective care. Without such information, patients may experience significant delays in diagnosis and treatment, resulting in worse health outcomes. Shockingly, the World Health Organization has reported that up to 70% of medical errors are due to delays in diagnosis and treatment, highlighting the urgency of addressing this issue.

Unfortunately, the lack of access to electronic health records is a widespread problem in many parts of the world, especially in Africa. For example, in the Gomoa East District of Ghana, where MedTrack is implementing a pilot program in partnership with the Ghana Health Service, none of the 31 public healthcare facilities serving a population of 322,000 people have access to any form of electronic health records. As a result, patients face long wait times and delays in diagnosis, which can ultimately lead to recorded deaths.

Epidemiological records are also unavailable due to the lack of credible clinical data to track the determinants and distribution of diseases to formulate health policies to tackle local health challenges and predict and manage epidemics and pandemics. This is due to the fact that many healthcare facilities in Ghana still rely on paper-based records. Electronic Medical Records (EMRs) on the market are not interoperable, leading to silos of health data that are difficult to access and share.

Digitization of the health space is to aid data gathering for individualized care as well as community-based policy and solutions for specific groups. Hard-to-reach and marginalised populations make up an important but often neglected demography. Health service providers have the additional difficulty of not having access to electronic devices for data entry and also internet access to allow for interoperability to enable the transition from paper to electronic records.

MedTrack offers a decentralised platform for healthcare providers such as hospitals/clinics, diagnostic centres, doctors, community pharmacies, and telemedicine providers. The decentralised design of the platform allows for easy expansion across facilities and secure access. With a patient-focused approach, the system facilitates collaboration between healthcare providers for better patient care management, reducing the cost of service and improving healthcare delivery.

The Ghana government has successfully issued a national biometric digital ID card to over 85% of the registered population as of January 2023. MedTrack uses this free nationwide resource to bring portable Electronic Health Records to every citizen. Health records are securely saved, retrieved or shared across different platforms or facilities using the digital ID number as unique identifiers for patients. We are currently the only solution with an interoperable platform integrated with the Public Health System.

By implementing a system for seamless transitions from one point of care to another, we can significantly improve mortality rates by about 30% and improve hospitalization outcomes by as much as 80%. It also reduces patient waiting times and improves overall patient satisfaction by 75% from data gathered from our pilot centres. 

Electronic health records (EHR) is the way forward in healthcare; MedTrack is a system that allows providers to share patient data with other physicians, diagnostic centres or community pharmacies efficiently while also allowing third-party providers access to the data collected.

About $141m was invested in health tech startups in Africa as of 2020. By enabling these next-generation health tech solutions, such as virtual care and telemedicine platform, to connect to our health records database securely, we can ensure that the patient information is available in one place for rapid access. This eliminates further data fragmentation as these technologies become ubiquitous, and developers do not have to reinvent the wheel by investing in developing their own databases.

We are executing a pilot program in collaboration with the Ghana Health Service via the Gomoa East District Health Directorate. Our primary objective is to introduce and evaluate the efficacy of our program within the district. The pilot program has been launched in two public healthcare facilities - Buduatta Health Centre and Nyanyano Health Centre - and one private healthcare facility - Millennium City Hospital. These three facilities were selected because they cater to a significant number of individuals, with a combined population of over 322,000.

Our pilot program aims to address some of the critical healthcare challenges posed by the absence of electronic health records and interconnectivity. By working in conjunction with the local healthcare authorities, we are confident that our program will significantly impact the community's health and well-being. MedTrack also employs a data-driven approach to identify the gaps in the existing healthcare system and work towards developing solutions that can improve the overall quality of care.

The public health facilities in this district lack the most essential resources, such as computers and mobile devices, needed for a successful transition from the paper-record system, which is present in some of the tertiary health facilities in urban centres. Our involvement, therefore, is pertinent in providing the solution and the peripherals upon which the solution rides to promote inclusivity.

In the long run, we aim to scale up our program to cover all districts' health facilities, including private healthcare providers in Ghana and across the sub-region, using each country's National Digital ID system. The World Bank ID for Development, UN SDG 16.9 and the AU Agenda 2063 is our north star to scale across Africa.

1. Team

Our founding team is comprised of a diverse group of experts in the Ghanaian healthcare industry. With three practising medical doctors and three technical co-founders, each with unique skill sets, we have a well-rounded team with extensive experience deploying health information systems in low and middle-income countries (LMICs). 

We leverage our product design and development expertise to deliver effective solutions and avoid outsourcing critical components. Our Co-founder/CTO manages the codebase, ensuring our core team has complete control over the development process. This approach allows us to deliver updates faster and avoid outsourcing challenges like communication barriers and misaligned goals.

2. Partnerships and Collaborations

We have an agreement with the Ghana Health Service through the Gomoa East District Health Directorate to deploy MedTrack in 31 public health facilities within the district, serving a population of 322,000 people. This agreement is a significant milestone for us. It demonstrates the trust and confidence that the Health Directorate has in our ability to deliver innovative solutions that improve access to quality healthcare.

In 2022, MedTrack was the only African venture among three WFP Digital Health Innovation Accelerator Program (DHIAP) winners. The program is powered by the WFP Innovation Accelerator and BMZ digilab, initiated by the Federal Ministry for Economic Cooperation and Development (BMZ) in collaboration with GIZ, the German Development Bank KfW, and the Bill and Melinda Gates Foundation. 

Additionally, we are excited to be working with MTN Ghana, the largest telecommunication network in Ghana, to Zero-Rate the MedTrack Platform. This will enable healthcare facilities and providers, especially those in low-resourced communities, to access the platform without incurring data costs, making it more accessible and affordable to those who need it the most.

3.Proximity 

Although we have partners and colleagues from around the world, our main workstation is located in Accra, about a 30 - 45 minute drive from our pilot community, Gomoa East. Our core MedTrack team lives and works in Ghana, and we are proud to be based in the country at the heart of our mission to improve healthcare delivery.

Our field coordinator, who is based in our pilot community of Gomoa East, is an integral member of our team. He worked within the district in healthcare and emergency response for three years before joining us, giving him an in-depth understanding of the local terrain and enabling him to foster excellent relationships with key decision-makers in the health sector. 

4. Evidence-based deployment

We have successfully conducted the first comprehensive health systems assessment of all 41 healthcare facilities in our pilot district. This assessment has provided valuable data and insights into the healthcare system's challenges and has enabled us to develop targeted interventions to address these challenges.

In addition to the health systems assessment, we conducted a baseline survey of 20 health facilities, collecting 1444 data points. This survey has helped us to identify key areas where improvements are needed, such as reducing wait times, continuous care and coordination, and improving access to critical patient information.

1. 322,000 Populace within Gomoa East District

2. 160,000+ linkages to National ID

3. 7,000+ patient records processed monthly

4. 84 Physicians

5. 25 Healthcare facilities

As a participant in the World Food Programme's accelerator program, we received valuable guidance from a skilled coach who helped us refine our solution and focus our efforts. However, we recognize that there is still much work to be done to achieve our goal of revolutionizing patient record-keeping and data management in Africa, and we are eager to collaborate with additional experts in the health-tech space to further refine and direct our solution.

We are actively seeking partnerships with like-minded industry experts who share our passion for improving healthcare delivery in Africa. Our hope is to connect with individuals and organizations that can offer valuable insights, resources, and networks to help us achieve our mission.

In addition to seeking partnerships, we are also excited to tap into the leadership coaching and mentoring resources available through the Solve and MIT networks. We believe that access to these resources will be instrumental in helping us refine our leadership skills and navigate the challenges associated with scaling our solution to reach a broader audience.

We are the first and only solution in Ghana with an interoperable platform that is fully integrated with the Public Health System. Our innovative platform is designed to provide comprehensive and patient-centric health information that can be accessed and updated from any location, thanks to the common unique identifier (national digital ID) that we have implemented. 

One of the key benefits of our system is that patient health information is connected to their national ID, making it easily portable and always available when and where needed. This portability allows for seamless and efficient healthcare delivery across various healthcare providers, resulting in improved patient outcomes. Ghana's national digital ID cards have achieved widespread adoption, with over 85% of the population already issued with the cards. This makes the national digital ID the most accessible means of identification available to every Ghanaian citizen, regardless of social status. The universal availability of this unique identifier allows us to offer a patient-centric approach to healthcare that is interoperable with the public health system. 

Another essential feature of our platform is the health records database and API. This unique feature allows health tech innovators to develop new products and services using a single patient record repository, promoting data standardisation and improving healthcare delivery quality.

Our platform is built on modern and scalable technology, making integrating with existing health systems and other health tech solutions easy. We aim to continue expanding our platform and services to serve better the needs of patients and healthcare providers across Africa.

We aim to create a significant social impact in the healthcare sector by spearheading the development of an interoperable health records database that links patient information on national biometric identification systems in Ghana and Africa. Our vision is to become the pioneer and leading health-tech organization that achieves this goal, facilitating better healthcare outcomes for over 1 billion African citizens.

Within the next year,

• Deployment in 21 of 31 public health facilities in our pilot district. Our electronic health records system provides a digital interface for all the services provided in the clinical setting. We aim to onboard 21 of the facilities in the district onto our platform and cause an interlinkage between all healthcare providers, thereby populating the health data of all citizens in the district. This marks the first phase of the solution and will also include the training of the users of the solution.

• Providing a monitoring dashboard to the health directorate as the monitoring wing of this solution. The health directorate is a governmental wing that oversees the implementation of these solutions and requires a dashboard to keep track in real time. This also requires the training of the end users.

• Provision of cellular devices in all registered facilities to allow for implementation and utilisation of the solution across the district. 

• Reaching an agreement (which is in progress) with cellular data providers to offer free data services on our platform or zero rate our services to allow these healthcare providers in these deprived areas to continue service delivery, eliminating cost as a barrier.

• Onboard at least 15 prospective private healthcare providers.

Over the next two-five years, we plan to move at least 70% of healthcare facilities in Ghana that currently rely on paper-based systems onto our Electronic Health Record (EHR) system. This transition will enhance the efficiency, accuracy and accessibility of patient records while reducing the potential for medical errors and improving overall health outcomes.

We also aim to expand our reach to at least five African countries, thus providing millions of people access to our innovative EHR system. By establishing our health database as the prime source of determining disease distribution and pandemic response, we aspire to play a critical role in helping governments and local health authorities establish effective health policies.

We are committed to promoting interoperability, data privacy, and security in our EHR system. We understand that these features are crucial to building trust among healthcare providers and patients alike. We are dedicated to providing ongoing training and support to ensure our system's successful adoption and utilisation.

Impact assessment framework of MedTrack Electronic Health Records (EHR) system on improving patient outcomes for our pilot project.

Metrics

Outputs:

• Wait times

• Reduced medical errors due to lack of information

• Attendance at follow-up visits

• Frequency of referrals

• Readmissions

Outcomes:

• Mortality

• Miscarriages

Key Indicators

Wait times:

• Average wait times before and after implementation of the EHR system.

• Reduction in the number of patients who leave the facility without receiving care.

Reduced medical errors due to lack of information:

• Number of medical errors recorded before and after implementation of the EHR system.

• Type of errors and their severity.

Attendance at follow-up visits:

• Percentage of patients who attend follow-up visits before and after implementation of the EHR system.

• Reasons for non-attendance.

Frequency of referrals:

• Number of referrals made before and after implementation of the EHR system.

• Type of referrals and their appropriateness.

Readmissions:

• Number of readmissions before and after implementation of the EHR system.

• Reasons for readmission and their appropriateness.

Mortality:

• Number of deaths before and after implementation of the EHR system.

• Causes of death and their preventability.

Miscarriages:

• Number of miscarriages before and after implementation of the EHR system.

• Causes of miscarriage and their preventability.

Methodology:

• Collect data on the indicators before implementation of the EHR system.

• Implement the EHR system.

• Collect data on the same indicators after implementation of the EHR system.

• Compare the data before and after implementation to determine the impact of the EHR system on the indicators.

• Analyse the data to identify any trends, patterns or relationships that may indicate the effectiveness of the EHR system.

Conclusion:

• Based on the impact assessment, draw conclusions on the effectiveness of the EHR system in improving patient outcomes.

• Identify areas of improvement for the EHR system, if any.

• Use the findings to make recommendations for further improvements to the EHR system or to implement the EHR system in other healthcare facilities.

MedTrack TOC (Link)

1. SaaS 

2. Mobile App 

3. Health Information Database and API 

We are a dynamic and innovative Ghanaian startup founded by a team of young professionals from diverse sectors of society. We take great pride in our commitment to inclusivity and accessibility, which is reflected in our team composition and our approach to product design and development.

Three out of our six founders are Northern Ghanaians, hailing from traditionally underprivileged parts of the country. We are deeply committed to promoting diversity, equity, and inclusion as a company. This is reflected in our strong female representation at both the founding and management levels - a rarity among technology companies focused on technology solutions.

Our team works tirelessly to create a culture of inclusivity and accessibility, ensuring that all can use our products. We take a multi-faceted approach to achieve this, incorporating various technologies across the design, development, and deployment stages. Our solutions are designed to work seamlessly across various platforms, catering to the needs and capabilities of different users - from text messaging alerts that can be delivered to any mobile phone used by beneficiaries to simple logins on any internet-enabled device for health care providers.

We provide free training, workshops, demonstrations and installation of MedTrack to all participating community health centres. The cost of internet-enabled devices such as mobile phones, tablets and computers for public health facilities are pre-financed by our project; however, a payment plan agreement will be enforced to allow repayment over a 5 - 10 year period. The flexible payment plan allows participation and eliminates entry barriers due to cost. Additionally, we are working on partnerships with internet service providers (ISPs) to ensure that our platform is zero-rated, providing data-free access to all participants, including patients. This means that users can access our platform without incurring any data charges, making it easier to manage their health information and communicate with healthcare professionals.

The cloud-based Electronic Health Records system allows all healthcare industry stakeholders to have real-time access to their patient's medical histories through an easy-to-use web application without requiring additional hardware or software installation. By linking health records with national digital identity numbers, we can standardize health data that providers and patients across different facilities can securely access. All facilities, including patients, are free to join and use the system.

Our revenue models include the following:

1. Patient record processing fees: We charge a transaction fee of GHC 5 ($0.41) per complete patient record processed. This is charged on transactions that occur while attending to a patient on the system, e.g., fulfilled prescription and laboratory report delivery. It does not cover the cost of securely storing and managing electronic health records and providing instant access to authorized healthcare professionals.

2. Integration with external health facilities: For facilities that need connection/integration with external service providers (hospital/clinic connection to community laboratories and pharmacies), we charge a fee of GHC 10 ($0.82) per fulfilled lab request or dispensed medical prescription. This fee covers the cost of securely transmitting health data between different systems, ensuring accuracy and maintaining privacy.

3. Custom deployment and consultancy services: We provide customized deployment and value-added services to health facilities that require additional or personalized services, such as workflow integration and other web services. We work closely with such clients to ensure a smooth and efficient implementation.

Our business model is designed to ensure sustainable growth while delivering value to our users. Our primary revenue stream will be transactional billing of patient health records on our platform, which is aimed at private healthcare providers. We offer a range of pricing options to suit different needs, from per-transaction billing to subscription-based models.

In addition to transactional billing, we also offer consultancy services to organizations looking to improve their healthcare systems. Our team of experts work closely with clients to identify their needs and develop customized solutions that meet those needs. Our consultancy services cover everything from system design and implementation to training and support.

Grants and investments are also key funding sources for us, especially in the beginning stages. We presently rely mainly on grants, especially for our social innovation, to ensure inclusivity for low-resourced and marginalized populations, and we are seeking investment opportunities to grow and scale our solution. 

Our financial model is carefully crafted to ensure sustainable growth while also providing value to our beneficiaries. Our primary revenue stream is generated through transactional billing of patient health records on our platform, targeted primarily at private healthcare providers. We offer a range of flexible pricing options and partnership agreements for public health facilities such as those in our current pilot in Gomoa East. Our recent agreement with the Gomoa East District Health Directorate provides a sustainable public-private sector partnership strategy projected to generate up to $15,000,000 in the next three to five years.

In addition to our transactional billing services and partnerships, we offer consultancy services to organisations seeking to enhance their healthcare systems. Our team of experts works closely with clients to identify their specific needs and develop customised solutions that align with those needs. Our consultancy services encompass all aspects of system design and implementation, as well as training and support. We have generated over $32,000 since the beginning of 2023 from MedTrack value-added services.

Grants and investments play an essential role in our funding strategy, particularly during the initial stages of our operations. In 2022, we were awarded a grant of $250,000 from the WFP DHIAP. This funding has also allowed us to receive invaluable mentorship support from industry experts and extend our runway. While we rely mainly on grants for our social impact initiatives that promote inclusivity for low-resourced and marginalised populations, we actively seek institutional investment opportunities to expand and scale our solution.