Denebola: Bridging Healthcare Gaps.

Africa bears 25% of the global disease burden yet possesses only 3% of the global healthcare workforce. 

600 million Africans face difficulties accessing essential healthcare, and approximately 97 million Africans, constituting 8.2% of the continent’s population, face "catastrophic healthcare costs." This results in 15 million people being pushed into poverty annually due to out-of-pocket expenses. 

In Uganda, with only 38% of healthcare posts filled, 70% of Ugandan doctors and 40% of nurses/midwives are in urban areas, serving only 12% of the population, worsening healthcare access disparities. 

Out-of-pocket health expenditures in Uganda, at 40%, double the WHO limit, lead to catastrophic spending for 20% of households, pushing 1.5 million Ugandans into poverty. 

The prevalent "cash and carry" approach in private health facilities exacerbates inequality, hindering progress towards Universal Health Coverage.

We developed a hub-and-spoke-AI-assisted chatbot Telemedicine software technology platform integrated with remote telehealth diagnostic devices to help connect patients in underserved communities to timely quality and affordable specialized healthcare services.

 Our hub and spoke model is likened to a bicycle wheel; we partner with existing local rural health facilities serving as "spokes," manned by low cadre medical personnel like nurses or facilities unable to hire specialist doctors. These spokes are connected to our central hub- where our specialists are centered. 

Equipped with our AI-assisted chatbot telemedicine software platform integrated with remote Telehealth diagnostic digital devices, our partner spokes enable patients to access timely specialist consultations and examinations seamlessly. This model reduces the need for long-distance travel, mitigating high out-of-pocket health expenditures. 

Additionally, we implement a "Get Treated Now, Pay Later" scheme to alleviate high health-related out-of-pocket costs, benefiting patients who are members of organized rural saving groups.

Our innovation minimizes financial burdens, ensuring efficient healthcare access for underserved communities. Link; 

https://drive.google.com/file/...

Our solution serves a diverse range of underserved populations, including:

1. Rural communities: We partner with existing local health facilities (spokes) to provide timely access to quality specialized healthcare services, addressing various medical conditions such as infectious diseases, noncommunicable diseases, cardiovascular diseases, diabetes, cancer, and common illnesses like colds and flu.

2. Humanitarian settings: Our solution extends to humanitarian settings, including refugee camps and prisons, where access to healthcare is limited. By collaborating with existing clinics, we address the healthcare needs of vulnerable populations in these settings, ensuring they receive essential medical care and support.

3. Youth: Through collaborations with our partner spokes,we also focus on addressing the sexual and reproductive health needs of youth, providing them with access to information, counseling, and medical services to support their reproductive health and well-being.

4. Schools:Our telemedicine technology offered to school clinics allows access to healthcare services and information to support students' health and well-being.

5. Elderly patients:We provide support for elderly patients in nursing homes, ensuring they have access to quality healthcare services and support tailored to their specific needs using our telemedicine technology.

6. People with disabilities: Our solution extends to groups of people living with disabilities, ensuring they have access to inclusive healthcare services and support.

Additionally, organized groups of people, such as rural saving groups, benefit from our "Get Treated Now, Pay Later" schemes aimed at alleviating high out-of-pocket costs. 

Our team is deeply embedded within the communities we serve, providing us with a unique understanding of their needs and challenges. With firsthand experience, we were well-positioned to design and deliver a solution tailored to their specific requirements. Our Team Lead has extensive experience working in rural and underserved communities, having spent several years providing healthcare services in these areas. This direct involvement has given them a profound understanding of the community's needs, guiding our approach to designing and implementing our solution.

Over the past 3 years, we have established one hub and partnered with 32 doctors, servicing 128 remote health facilities (spokes) across underserved communities. Through these partnerships, we have reached nearly 100,000 lives, providing them with access to timely, quality, and affordable healthcare services.

Furthermore, our team is composed of members from various African settings, providing us with firsthand experience in dealing with the limitations of rural healthcare infrastructure and the struggles of geographically isolated populations. We recognize the importance of cultural sensitivity in healthcare delivery, designing the platform's interface and functionalities with cultural nuances in mind to overcome potential language or technological barriers.

Throughout the design and implementation process, we prioritize community input, ideas, and agendas. Our solution is shaped by the direct feedback and insights provided by community members. We actively engage with community leaders, local healthcare providers, and representatives from various community groups to ensure that our solution effectively addresses the most pressing healthcare needs.

We adopt a co-creation approach, involving community members in the development, testing, and refinement of our solution. This ensures that our solution is not only relevant but also culturally appropriate and sustainable in the long term. By working closely with the communities we serve, we ensure that our solution truly meets their needs and improves their access to quality healthcare services.

We selected the "Growth stage" because we have already built and tested our solution, achieving significant traction and impact. Over the past three years, we have successfully raised $50,000 in pre-seed funding from an angel investor. We have established one hub and partnered with 32 doctors, servicing 128 remote health facilities (spokes) across underserved communities in Uganda. Through these partnerships, we have reached nearly 100,000 lives, providing them with access to timely, quality, and affordable healthcare services.

We are applying to Solve to access the support and resources needed to overcome key barriers in scaling our solution. Specifically, we seek assistance in addressing financial, technical, market, legal, and visibility challenges. Solve's network can provide valuable support to expand our operations, enhance our technology, access new markets, navigate legal and brand visibility complexities and ultimately increase our impact in underserved communities across Africa.

Denebola's Telehealth solution combines the hub-and-spoke model with AI-powered diagnostics, expanding access to specialist consultations and empowering local healthcare workers.

We cater to diverse underserved populations beyond remote villages, including humanitarian settings, prisons, educational institutions, and specific health needs like sexual and reproductive health services or disabilities.

Our platform's culturally sensitive design overcomes language and technological barriers, ensuring user adoption in diverse communities.

Denebola's model can be replicated across various African regions, fostering broader access to specialist care and improved healthcare delivery.

Our success can inspire other healthcare innovators to focus on culturally sensitive, community-driven Telehealth solutions, influencing policymakers to invest in infrastructure development and policies supporting Telehealth implementation across Africa.

By standardizing Telehealth practices, we ensure quality and interoperability across different healthcare systems, while building sustainable Telehealth ecosystems within rural communities.

Denebola's Telehealth solution is expected to have a significant impact on the problem of limited access to healthcare in underserved communities through the following steps:

Activities:

1. Establishing Hub-and-Spoke Model: Partnering with existing local health facilities (spokes) and setting up a central hub equipped with AI-powered telemedicine technology.

2. Integration of Telehealth Diagnostic Devices: Integrating remote telehealth diagnostic devices with our platform to enable comprehensive medical consultations.

3. Community Engagement and Training:Engaging with community leaders, healthcare providers, and representatives to understand their needs and provide necessary training.

Immediate Outputs:

1. Improved Access to Healthcare: Patients in underserved communities can now access specialist consultations and examinations remotely.

2. Enhanced Medical Services: Local healthcare workers receive support in making preliminary diagnoses and treatment recommendations, enhancing the quality of care.

3. Cultural Sensitivity:The platform's user-friendly design ensures accessibility across diverse populations, overcoming language and technological barriers.

Longer-Term Outcomes:

1. Reduced Healthcare Disparities: By providing timely access to quality healthcare services, we aim to reduce healthcare disparities in underserved communities.

2. Improved Health Outcomes; Timely diagnoses and specialist consultations lead to better health outcomes for patients, reducing the burden of disease.

3. Financial Relief;  By reducing the need for long-distance travel and high out-of-pocket expenses, our solution helps alleviate financial burdens on families and communities.

Evidence:

1. **Third-Party Research: Existing research supports the effectiveness of telemedicine in improving access to healthcare and health outcomes, especially in underserved communities.Refining the Implementation of a Hub-and-Spoke Model for TelePain Through Qualitative Inquiry | Journal of Technology in Behavioral Science (springer.com)

Using the Hub and Spoke Model of Telemental Health to Expand the Reach of Community Based Care in the United States | Community Mental Health Journal (springer.com)

2.  We have conducted interviews and received feedback from our target population, confirming the effectiveness and impact of our solution.

3. We have conducted an impact evaluation to measure the long-term outcomes of our solution and further strengthen our theory of change.

Impact Goals:

1. Improved Access to Healthcare:

   - Percentage of Patient Waiting Time (minutes): Decrease in waiting time for patients accessing healthcare services through our platform.

   - Population Coverage (Tele-Consultation) by country: Increase in the percentage of the population covered by teleconsultation services in each target country.

   - Population Coverage (Tele-Prescribing) by country: Increase in the percentage of the population covered by tele-prescribing services in each target country.

2. Enhanced Health Outcomes:

   - Percentage of Telehealth Emergency Referrals: Increase in the percentage of emergency referrals made through telehealth consultations.

   - Percentage of Medication Errors Related to Teleconsultation: Decrease in the percentage of medication errors associated with teleconsultation services.

3. Reduced Healthcare Disparities:

   - Percentage of Patient Satisfaction: Increase in patient satisfaction with the quality and accessibility of healthcare services.

   - Percentage of Spoke Satisfaction:* Increase in satisfaction among healthcare providers at remote health facilities (spokes).

   - Percentage of Complaints Against Telehealth Services: Decrease in the percentage of complaints received regarding telehealth services.

Progress Measurement:

1. Number of Patients Served:

   - Total number of consultations, examinations, and treatments provided through our platform.

2. Health Outcomes:

   - Changes in health status, disease management, and adherence to treatment plans among patients.

3. Geographical Reach:

   - Number of remote health facilities (spokes) connected to our central hub.

   - Percentage of underserved communities covered by our telemedicine services.

4. Financial Impact:

   - Reductions in out-of-pocket healthcare expenses for patients and families.

   - Number of households lifted out of poverty due to reduced healthcare costs.

5. User Satisfaction:

   - Feedback from patients, healthcare providers, and community members regarding ease of use, accessibility, and overall experience of our platform.

6. Long-Term Health Trends:

   - Analysis of long-term health trends and outcomes in the communities we serve to assess the sustained impact of our solution on population health.

Denebola's core technology is our hub-and-spoke AI-powered telemedicine platform. 

Key Features

1.Hub-and-Spoke Model:Our platform employs a hub-and-spoke model, connecting remote health facilities (spokes) to a central hub where specialist doctors are stationed.

2. AI-Powered Telemedicine: Our solution integrates AI-powered chatbot technology to provide preliminary diagnoses and treatment recommendations to patients, improving the efficiency and accuracy of consultations.

3. Telehealth Diagnostic Devices: We integrate remote telehealth diagnostic devices into our platform, allowing for comprehensive medical examinations and assessments to be conducted remotely.

4. User-Friendly Interface: Our platform is designed with a user-friendly interface, making it accessible to diverse populations, including those with limited technological literacy.

5. Data Security: We prioritize data security and privacy, ensuring that patient information is protected and compliant with relevant regulations.

Technology Stack:

- Programming Languages: Python, JavaScript

- Frameworks: Django, React

- Database: PostgreSQL

- AI/ML Tools: TensorFlow, PyTorch

- Telehealth Diagnostic Devices: Remote monitoring devices for vital signs, ECG, spirometry, ultrasound, and other medical examinations.

Denebola Technologies:  Departmental Staffing (48 Employees)

C-Level;   04

Full Time; 18

Part-Time; 26

Leadership Team (4):

• CEO

• COO

• CFO

• CTO

Hub Operations & Telehealth Specialists (14):

• Hub Manager (1)

• Quality Assurance Specialist (1)

• Head of Clinical Services (1)

• Telehealth Physicians (2) 

• Nurse Practitioners (2) 

• Laboratory Technologist (2) 

• Pharmacist (1) (Part-Time) 

• Pharmacy Technicians (2)

• Receptionist/Cashier (2) 

Patient Engagement & Support (4):

• Patient Support Representatives (2) (Part-Time)

• Billing and GNPL Program Coordinator Coordinator (1)

• Regional Manager (1) (Part-Time)

Spoke Network (7):

• Telehealth Coordinators (3) (Part-Time: 2)

• On-Site Medical Assistants (4) (Part-Time)

Marketing & Outreach (13):

• Business Development Manager (2)

• Marketing Manager (1)

• Community Outreach Coordinators (10) (Part-Time). link:https://drive.google.com/file/...

We have been working on our solution for 3 years.

Denebola is committed to creating a diverse and inclusive team to better address the needs of the communities we serve. Here's how we ensure diversity and inclusion:

•  We prioritize diversity in our leadership team, aiming for representation across gender, ethnicity, and professional backgrounds.

• We continuously refine our recruitment and onboarding processes to eliminate barriers for individuals from diverse backgrounds.

• We promote open communication and respect among team members, offering training on unconscious bias and creating a supportive work environment.

• We regularly assess our progress and seek feedback from team members to identify areas for improvement.

Denebola's Telehealth Business Model caters to various stakeholders, including local health facilities (B2B), public health institutions, governments (B2G), and large organizations (B2B). 

For local health facilities, our partnership offers access to our Telehealth platform, AI diagnostics, and training. This enables them to expand their services, leading to increased patient volume, improved diagnostics, and an enhanced reputation for quality care.

Public health institutions and governments benefit from our Telehealth platform, which helps improve healthcare in underserved regions. By providing better health outcomes, reducing the burden on healthcare systems, and offering potential cost savings, our platform ensures improved access to quality care for all.

Large organizations can avail of tailored Telehealth solutions designed for specific populations. This not only improves access to care but also offers potential cost savings for organizations investing in healthcare services.

Our revenue streams include a Pay-Per-Use model, where patients pay a small fee for specialist consultations. Additionally, we offer a "Get Treated Now, Pay Later" scheme, providing flexible payment options for patients. Subscriptions are available for both government institutions and local health facilities, ensuring ongoing support.

We prioritize partnerships with local health facilities, leveraging their existing infrastructure and expertise. Collaborations with governments, public health institutions, and large organizations ensure wider implementation and tailored solutions for specific populations.

Denebola's sustainability is ensured through scalability, with costs distributed across a larger user base. Diversified revenue streams, including Pay-Per-Use, subscriptions, and potential grants, further contribute to our sustainability and long-term impact.

Here's how we plan to fund our work and evidence of our success so far:

Revenue Streams:

1. Pay-Per-Use and Subscription Model (B2B & B2G):

• Patients pay a small fee for specialist consultations through our platform.

• Over the past three years, we have served close to 100,000 patients through our Pay-Per-Use model, generating revenue that contributes to our operational expenses.

• We have established partnerships with 128 remote health facilities, serving as our spokes. Additionally, we have secured subscription agreements with governments and public health institutions, contributing to our recurring revenue.

Get Treated Now, Pay Later Scheme:

• Flexible payment options are provided to patients, allowing them to access care and pay later.

• Our "Get Treated Now, Pay Later" scheme has enabled patients with financial constraints to access healthcare services, increasing our patient volume and revenue.

Partnerships and Service Contracts:

• We partner with governments, public health institutions, and large organizations to provide tailored Telehealth solutions.

• We are in talks to secure partnerships with various organizations, including UNHCR, and have provided Telehealth solutions tailored to their specific needs, generating revenue through service contracts.

Grants and Investments:

• In addition to revenue from our operations, we have successfully raised $50,000 in pre-seed funding from an angel investor, which has supported our initial development and expansion efforts.

• We are seeking grants and investments that will enable us to develop and scale our Telehealth solution, expanding our reach and impact.