PMedi

The problem that we are working to solve within this program is to Improve the rare disease patient diagnostic journey by reducing the time, cost, resources, and duplicative travel and testing for patients and caregivers.

Caribbean and Latin America region consist of many patients living with a rare disease. An example of a rare disease In the Black and Hispanic community is sickle cell. The average rate of sickle cell in Jamaica is 1 in 10. Sickle cell, like many other rare diseases, including but not limited to neurological rare diseases often time affects the patient by making them unresponsive and unable to give healthcare provider coherent feedback on their medical history. This results in duplicated treatments or test, delayed treatment and drug allergic reactions resulting in higher expenses for the patients and wasted resources by the healthcare system. Also, poor information often time results in unnecessary antibiotic prescription, medical and surgical procedures and hospitalisation.

According the Humana Health insurance report that an average of $700 billion is wasted in the health care system. A major result of this due to poor management or lack availability of medical history present at the time of visit. Also, it is reported that 1 in 1,200 persons dies yearly due to medical mistakes such as overtreatment and delayed diagnosis making it the third leading cause of death after heart disease and cancer.

PubMed Central Journal describes Overtreatment as being directly associated with patient harm as evidenced by studies of antibiotic overuse leading to resistance and Clostridium difficile infection, overuse of diagnostic testing, such as pap smear and colonoscopy and the inherent postoperative complications from unnecessary surgical procedures.

The reason for medical doctors overtreatment alludes to the difficulty accessing prior medical records and the lack of adequate information regarding previous medical history. Poor medical records management have shown to have disastrous consequences which are life-threatening such as medication errors, treatment lapses, and missed diagnoses, among other things. Medical record mismanagement creates more vulnerabilities for both the patient and the caregiver.

For the communities in Jamaica (and Caribbean region), the problem is even worst with poor health record management. Many patients have limited access to records which can take months to receive at which point the patients and public systems has spent on duplicated tests/treatments, wasted resources and time. This can be even dangerous if the individual is unconscious and have a rare disease. This problem scales to all health care facility in the region. According to a Jamaica’s local newspaper article on the topic of poor medical recording results in;

• adverse reactions to prescribed drugs to be 2.2 million per year
• The number of unnecessary antibiotics prescribed annually for viral infections is 20 million per year (antibiotics are useless against viruses).
• The number of unnecessary medical and surgical procedures performed annually is 7.5 million per year. The number of people exposed to unnecessary hospitalisation annually is 8.9 million

The solution is a device that uses advance innovation in Quick response and NFC technology that is cost effective and affordable for all patients. It provides comprehensive and chronological reporting of medical history in real time. Wherever the patient decides to seek medical attention, the healthcare provider will be able to catch up on the patients history (including all doctor visits and treatments). The doctor is only required to open up the information on their device and quickly review the past doctor visits and treatments. This will greatly impact any patients ( especially those with rare diseases) in a great way because it helps the caregiver to gain access especially if the patients is unresponsive. Therefore greatly reducing;

• Delayed treatment
• Duplication of treatment
• adverse reactions to prescribed drugs.
• The number of unnecessary antibiotics prescribed.
• The number of unnecessary medical and surgical procedures performed
• The number of people exposed to unnecessary hospitalisation.
• Unnecessary expense by the health system and most importantly by the patient

PMedi is Jamaica’s first medical digital record NFC device for patients. This portable and convenient digital health record was designed to provide patients with access to and provide healthcare providers with their medical record and history in real time.

With PMedi, the patient will have their medical record on hand to optimize their treatment and save lives. PMedi intends to ensure that patients get timely and correct diagnoses by avoiding potential allergic reaction, unnecessary surgeries and overtreatment.

This easy-to-use solution requires medical practitioners to scan PMedi device to access patients’ comprehensive and chronological medical record in seconds. After this, the health care provider that administered patient will have this information uploaded to the patient PMedi electronic system creating a very useful data base.

This solution is also valuable during times the patient is unable to communicate (unresponsive) and the device can be activated by the caregiver to show the patient medical record whereby immediately cutting diagnosis time and immediately providing the correct treatment without accidently inducing allergic reactions.

Well-kept medical records make life easier for the healthcare provider and the patient. Having a comprehensive view of a patient's medical history makes it easier for the physician to deliver appropriate treatment. Having up-to-date, well-stored medical records can be the difference between life and death if a physician needs to make a quick medical decision. This is further supported by HSN article that 90% of the patients diagnosis is in the history. An experienced doctor can make the diagnosis from it alone in 75% of cases. In 20% we also need an examination. 5% need both combined with tests (e.g. urine and bloods test, and/or an x-ray). At every doctor visit, the patient would just simply hand over the device that contain prior medical report with results and treatments.

Firstly, this solution does not discriminate but focuses on equality, equity and inclusivity of all persons who need the best technology in healthcare because health care is a human right. Due to the nature of the solution, patients that have rare disease, elderly, disability and children would benefit far greater based on the frequency of their medical visits.

 These people resides in communities of Jamaica and the Caribbean and are the target population. This is because they have similar health care and cultural practices in how they deliver and receive health care in terms of access to medical record for effective and safe healthcare. Therefore, the solution was developed in mind to help lower income earners, rare disease patients, disabled, elderly, children and many other people of the population who does not have access to medical record due limited record access. This solution is breaking the barriers that prevents the access to their medical record for immediate use when visit another health care provider.

Our team in particular is quite affiliated with the target group because we interact with the community both locally and regional. We experience the same limitations as our target group. We have witnesses family (both parents) and community members with rare diseases or disability and is unable to produce a medical record. This has resulted in delayed treatment and retesting when treatment could have administered earlier.

People from inner-cities or the projects are unable to maintain a healthy and monitored lifestyle due to not having access to technology that will encourage them to make the right choices for their health. Marginalized groups including people of colour in poverty-stricken communities are unable provide a up to date medical report.

Often time literacy is a factor as to why some person from the community are not able to express themselves clearly for fear and intimidation of the people in white coat. Other circumstance includes people may be embarrassed to speak about their medical history and therefore provide fraudulent information. This also waste money, resources, caregiver’s time and potentially leading the patient to be exposed to medical errors that may result in fatality.

The team has been engaging in discussion with members from the health care/ government and community leader. They have been instrumental as they have contributed through their feedback. The dialogue had all parties agreeing on the  impact  of the solution in their communities. They express that most times marginalized group are at a disadvantage and lack information on available technology centred healthcare service. Coupled with the fact that they are unable to report prior health record.

The interaction with the target group also expresses heavily on the details of the type of reason someone may be unresponsive. This could be due to existing illnesses or act of violence. When these individuals are taken into a healthcare, but the health provider finds it difficult to get response on medical history. This leads to an indecisive action made without prior update on the person lifestyle and history. All persons are separate and different “and one cap does not fit all” thus resulting in a solution encouraging a more effective way of administering personalized medicine.

Firstly, the team consist of individuals that interact with the public due to their background in science and technology, as a fellow of the Young Leaders of the America (YLAI) US state Department, social policy analyst, public office, corporate planning and youth development.

Our experiences through US YLAI fellowship, careers and daily activities places us in the heart of our target group. With that said, our team is the right group to deliver this solution because we are also apart of the target groups that is affected by the system. We identify with the target group because of our personal experiences by being a patient that is unable to provide medical record or being a public servant that requires us to engage with the target group and hear their pain.

We live in these communities, these people are our neighbours, parents of children in the youth organization, other fellows of the YLAI Caribbean and Latin America group and individuals we provide public service for. We ourselves are apart of the marginalize group and it is our aim to have all individuals experiencing the best that health care has to offer through technology and convenience.

We are engaging both sides of the target group; caregivers and patients. They have been instrumental in us understanding their problem. They have helped us to look at areas that we didn’t consider such as safety of e-record and other elements that would make it user friendly for them. Their contribution has been valuable to have made the solution with the target group centred.

Our involvement and dedication go beyond as we have experience loved ones and community members who have lost family members due to lack medical history/ record resulting in medical errors or delay in treatment. Therefore, we do have as much passion and drive of the implementing of this solution alongside the community which it will serve greatly.

I have built the actually device that will enable the person to have the stored recorded information on and can select the devices they want to carry. They will provide it to the health professionals who will be to access it to help with their diagnosis. They are not restricted by borders nor culture if they do desire to visit other countries and use their health services.

The financial prize will be used in several areas to ensure that the solution deliver on its goals. The funds will be allocated as follows; 40% technical, 20% legal, 20% cultural and 20% market.

• Technical- The device and platform will require additional development for it to meet its intended to scale and demand. the health sector is a very active market and is demanding. This will also aid in the development of user interface/ interaction by the patients and on the side of the caregiver. Another technical area that is to be consider is the storage of the data by the target group. Additional storage will be required as the solution scale to serve more communities. More cloud storage will be required to store the data. There is also the support that require investment in increasing security functions to ensure that the stored data are safe and secured from breach. Secured function will only grant accessibility through the appropriate authorization channels.
• Legal- due to the nature of the solution and current requirement to support data protection laws. Partnership with a legal entity is an investment that speaks to the importance of protection. This will ensure the solution is made availably to the community but does not infringe on the rights of anyone. It will also provide clause for considerations and protection for all parties that involved. Also, it provides a sense of peace to our target group that the required steps are being implemented to ensure safety and clarity.
• Cultural and marketing barriers – It will require a combine investment of 40% to ensure we educate and understand the cultural differences that may exist between community within country or region. Currently, our country/community has great ambition to encourage technology use and experience in the health sector. Our solution would help to drive that ambition and encourage to shift the culture to be accepting of technology and its offerings. Marketing is also a required and important investment.it would provide an avenue for the target group to become familiar of its availability and the potential of engaging with the device. Marketing would include the use of eye-catching advertisement that would be inclusive to all. We would be visible on social media, at health provider offices, partnership through the health ministry functions and programs and include sales representative. Sales team will be used to speak and engage the with community members and healthcare provider to ensure all person irrespective of their literacy or disability has access to the information about the solution.

The team leader has connections to the community because he is apart of the community. He has lived his whole life and have interacted with the same health care system. Jamaica, like many other countries in the Caribbean region is known for similar health care system problems.

He is also familiar with many people that suffers from many rare diseases such as sickle cell (which is prevalent in the black community and Hispanics) and neurological diseases that require special assistance. He has witnessed, first-hand when the individuals become unresponsive due to an episode caused by the disease, and it was difficult for the health care provider to get the medical history from someone that is unresponsive.

He has had the opportunity of travelling to other Caribbean countries in the region where he has taken the time to interact with the system and found similar issues that the solution intends solve.

The culture of these communities is similar. He has had the opportunity and experience of meeting and spending time through discussion regarding leadership and economic development. These influential leaders and stakeholders from all Caribbean countries in the region including Haiti and Latin America have expressed similar conditions. He has spoken to medical practitioners, parliamentary leaders and business leaders from across the region and have received feedback that the solution is needed due to its relevancy and necessity.

His partnership with these community/region-based leaders (healthcare provider, politicians/community leaders, business leaders, education/ counselling practitioner among many others) will provide an instrumental opportunity for the solution to scale and be accessible to the people/target group immediately.  

Our solution approaches from the stand point that there is a desire for the healthcare system to implement technology in order to streamline operation in the health sector. Especially when it comes on to the documentation and medical records. Our region does not do a good job in maintaining them manually especially when short staff. The system have a high attrition of health workers that have place a stress in maintenance of the medical record however we providing this through out solution.

Patients usually finds themselves at different doctor offices whether by proximity or by an incident that forces you to be taken to another health facility to seek attention. The questions are always the same " when was your last visit, what was the diagnosis.. what treatment ...have you been ever tested for... what was the name of the drug.. (5 years ago)..." and the list goes on and on. The patients do become frustrated and alter information due to pressure or fear of revealing their circumstances.

 This solution is innovative in that persons can walk around with their health record which is safe and can be accessed through the appropriate authorization. Unlike other solution that focuses on only one group of person or one of the problem, this solution covers all the areas. Everyone wants to have access to their health record. It helps doctors and healthcare providers  to know what has been happening with the persons as a collective situation so they can make an appropriate diagnosis. 

This solution can change the market through implementation affecting culture and and technology normalization. This will increase convenience and save cost for the health sector and patients from over spending on test and treatments that would not required additional service. 

Generational change is imminent. This change will affect children interaction with the health system. Children do not have good medical record since birth. With this solution, parents can have the child health record stored and and when they become of age, they can hand it to the children as they leave home to start life. Whenever they do visit a health facility they would be proud to present new doctors  their well recorded history of their medical activities. No need to look unsure when the doctor ask questions. Just provide them with the digital record.

Vulnerable people would have this as a life style change for example like a medical passport that display all your journeys and interaction with the health care system whether locally or abroad. 

Due to its great impact, the government and private stakeholder sees this as a game changer for their communities and states that they serve. The ease at which this is scalable and cost effective, leading to all persons being required to take the device along with your ID.

Our impact goals are surrounded around the impact it has on the people we so happily serve. We intend to continue providing them with convenience through technological implementation and culture.

The impact goal for next year is to have these devices in the hands of all individual in the target regions as a commodity that must be, a must have. This will be achieved by strategic marketing especially having the health ministry and doctors issuing them to their patients as the new way of experiencing health centers. This impact will see many as 1 million person owning their smart device to keep record of their health. It would be a normal situation for doctor to request for your Pmedi instead of asking "when last you visited a doctor or what medication are you on?" it is all there on Pmedi.

We also foresee other groups getting involved such as pregnant people, minority groups, very ill persons, elderly and the poor using this as it helps them to communicate effectively. This save them from medical errors or expenses due to resources or time wasted.

In five years time, the impact would be a cultural shift to a digitization of  personal health record health system. This would be like a requirement for all children to have when enrolling in school or as a way to indicate that the child medical and health needs are being looked after and not being abused nor neglected. 

All vulnerable persons would also be encouraged to always have their Pmedi on them at all times especially, if they suffer from a rare disease and may require assistance if they become unconscious in public. This also go for anyone because accidents do happen and can leave them in state of unresponsiveness. Pmedi will provide your health provider clarity in to your medical history.

Our solution takes in account several SDG's such as but not limited to SDG(3,5,12,17)

1.Health and wellbeing- 

Strengthen the capacity of our communities for early warning, risk reduction and management of national health risks through access to personal health records. This also includes the strengthening of the international Health Regulations (IHR) capacity and health emergency preparedness

This solution is foremost at its core a health solution base on digitizing information to streamline operation for health profession and patients.  We also can meet the overall goal by supporting  the International Health Regulations (IHR) capacity and health emergency preparedness . All person that uses the device will be in state of preparedness for health emergency especially those that are affected rare diseases. Another goal that is to be achieve is providing more flexibility for our health providers by relieving the stress of managing medical records.

2. Equality- 

Enhance the use of enabling technology, in particular information and communications technology, to promote the empowerment of women through our solution. Also to track and make public allocations for gender equality through participation in the solution.

the solution is already build in features through marketing to encourage our females and other marginalized group to get involve. This is an opportunity to be apart of a solution that was built with them in mind.

3. Responsible consumption-

Substantially reduce waste generation through prevention, reduction, recycling and reuse which is embedded in our solution core intent.

 One aspect of the solution is ability to reduce waste in resources. The healthcare system waste a lot due overtreatment through duplication of treatment and test. Both the patient and health sector is wasting money and time.

4. Implementation for partnership for sustainable development- 

Promote the development, transfer, dissemination and diffusion of environmentally sound technologies to developing communities through the application of the solution.

in order to reach the 5 year goal there needs to be strategic partnership that encourage development that is sustainable. That's is why solution is positioned to scale through successful partnership of local and regional public sector leaders.

5. Leave no one behind- we ensure that all our solution functions is well diverse and  adaptable to any individual whether their interest, status or condition are different. 

Activity

Information sharing session and forums with patients and health care providers.

This is possible due to the relationship with stakeholders  such as members of the health ministry and community leaders.

Output

Target group sensitized about the solution and its opportunities.

This is how culturally new technologies is received in the community.

Outcome

Group accepts and use solution.

Based on interviews, all participants would use the solutions

Strong theory of change

PMedi is used across the health sector which is easily accessible due to the digitization of personal health records.

The government and stakeholder have been sold on the digitization of the health sector.

The solution is technology base because it uses NFC and Quick response technology. The implementation of this kind of technologies is pioneering new devices to carry out data transfer functions. Data transmission using NFC is considered more secure than data transmission over Bluetooth or WIFI. This is a result of the very short range of the NFC tag, only a few centimeters.

That is why this form of technology is suitable for this type of solution because safety will be a priority.

Full time 1

part time 2

The team worked has been working on this for 1 year

In our group, we are proud to say that we are very inclusive and do support equity and equality. We are all from a marginalized group and one of our team leader is a female. We all work and never complete about what each others is doing. We operate like a family and do the job that is to be done because if we don't then who will.

We all take these value that MIT Solve promote and are fully accepting of them. We pride ourselves that by working together and finding great talent irrespective of whatever group you are from, we welcome you.

In order to encourage inclusivity, we hosts a snack time event that will have each team member  bringing something creative to share with the team. This is rotated month after month.

Our key customers are patients and they will be provided with smart technology devices that will enable them to store medical records and have them presented to the health care provider during visits. The devices will be available through the doctor offices, pharmacies and online.

Based on the interaction and market validation with target group, they express the desire for a technology that would provide them convenience when visiting the doctor office. Also, it takes long for the patients to get medical records and may have to pay for it to be expedited. An important factor is that you are able to give your doctor the opportunity to make more effective treatment and diagnosis around the history of your medical report.

In order for the solution to have outstanding impact we do require the partnership of the health care sector, government, community leaders, US embassy, pharmacist, doctors and nurses association. These partnership can also support us with grants and funding, brands, networks and introductions.

The key activities includes the production and distribution of the devices. Then we need to have meeting at forums and sessions, media marketing and sensitization. 

The impact measure would be the number of patients uses the card, doctors who accepts this form digital records, optimize operational efficiency for doctor to attend to more patients and the reduction of long line the registration office.

Cost include device/storage service maintenance and update, marketing sensitization, device productions and staff. While the revenue come from the contribution that the patient makes to secure the device. Any surplus would be funnel as donation to hospitals (especially for children) equipment, furniture and capacity expansion.

The plan to becoming financially sustainable relies on the sales of the product. The expense has already been factored into the price although a profit is generated. The business will be self sufficient. 

However to scale it will require grants, capital investment and government funding to support the operational support to make the solution rapidly available to another region.

So far an investment of US$1000 as been invested.