Telemedicine services for Persons with Disability in Karonmajigi

Karonmajigi is a disability colony in a rural area outside Abuja, Nigeria. In 2009, the federal government of Nigeria created this local area for people with disabilities in order to prevent them from begging on the streets of the federal capital territory. Over 2,800 PWDs were moved to this unkept, isolated, and insecure area without shelter, healthcare facilities, access to clean water, social amenities, or educational support for their children.

In 2020, my organization; Poverty and Disability Initiative in Nigeria (PADIN), fully registered with the Nigerian government (registration number CAC/IT/141708), recorded 9,420 persons with disabilities in this local community where they were kept. We carried out both media, institutional, and policy advocacy in order to ensure that PWDs in this area were empowered by the government, still, all my team's efforts were in vain, yet the population of PWDs in this settlement keeps on increasing on a daily basis.

Karonmajigi Disability Colony lacks clean water and healthcare facilities, which causes 2.5% of their children, ages 0 to 4, to die every year as a result of tuberculosis, malaria, typhoid, and cholera. All these diseases occur as a result of contaminated water in the community. Healthcare facilities are in urban areas, and it is challenging for people with special needs to access them since these healthcare centers are very far from their settlements.

Our organization is dedicated to addressing health disparities in underserved communities, like Karonmajigi, by establishing a telemedicine center. Our approach uniquely combines technology and human interaction to provide accessible healthcare. Patients visiting our center are connected to medical professionals in urban hospitals through platforms like Google Meet. During these virtual consultations, patients discuss their health concerns, and doctors conduct examinations, recommend appropriate treatments, or provide emergency first aid if needed. In cases requiring physical examination, we facilitate appointments for patients to visit city-based medical facilities.

Our solution incorporates innovative technologies like Blockchain to ensure secure and tamper-proof storage of patient data, as well as Electronic Health Record (EHR) systems for comprehensive medical information access. Crucially, our system leverages Video Conferencing for real-time communication, enabling visual examinations and consultations.

What sets us apart is our holistic approach, combining both a telemedicine application and a physical center functioning as a virtual hospital. While other solutions may focus solely on mobile applications, our model prioritizes direct patient interaction and comprehensive healthcare delivery.

Our initiative targets the disability community of Karonmajigi, which consists of over 10,000 Persons With Disabilities (PWDs). These individuals were relocated by the Federal government of Nigeria from the streets to this underserved area to discourage begging on the streets. Unfortunately, Karonmajigi lacks essential amenities like hospitals, schools, and clean water, with the nearest health center situated 48km away, making it inaccessible for the disabled population. Tragically, numerous deaths have occurred due to the absence of healthcare facilities.

Our project aims to benefit the Karonmajigi community by providing convenient access to healthcare through our center located within their vicinity. This accessibility will facilitate timely interventions during emergencies, addressing critical health needs that were previously unmet. Furthermore, our solution will promote health equity and inclusion for the people of Karonmajigi, mitigating the discrimination they often face when seeking medical assistance from distant health centers. Additionally, telehealth can benefit vulnerable populations, such as individuals with disabilities, elderly individuals, or those with limited mobility, by providing them with easier access to healthcare services. Lastly, our intervention will alleviate financial burdens associated with healthcare, such as transportation costs, for the community members.

Our team is uniquely equipped to implement this solution effectively. To start, we have established an office right in the heart of Karonmajigi, demonstrating our commitment to serving this community. Importantly, our organization director, who spearheads this initiative, is not only deeply passionate about improving the lives of the residents but also shares a personal connection as a person with a disability. This personal connection fosters trust and understanding within the community, as they see us not just as outsiders but as individuals who empathize with their challenges and are dedicated to addressing them.

Our track record further solidifies the community's trust in us. Just two months ago, we undertook a significant initiative to distribute over 1000 crutches to the residents of Karonmajigi. This act of tangible support not only met an immediate need but also demonstrated our ongoing commitment to enhancing the lives of persons with disabilities in the community. Through such actions, we have established ourselves as reliable partners who prioritize the needs and well-being of Karonmajigi's residents above all else.

Additionally, we have strategically involved key community members in our team to ensure that our efforts are well-aligned with the community's needs and aspirations. One such vital member is the community elder, who holds significant influence and respect within Karonmajigi. Their involvement not only provides invaluable insight into the community's dynamics and challenges but also helps us navigate and access more demographic parts of Karonmajigi effectively. With the community elder's guidance and support, we can ensure that our interventions are inclusive, culturally sensitive, and responsive to the diverse needs of all residents.

In summary, our team's local presence, personal connections, demonstrated commitment, and strategic partnerships uniquely position us to execute this solution in Karonmajigi successfully. By leveraging these strengths, we can overcome barriers, build trust, and effectively deliver essential healthcare services to the underserved disability community, ultimately improving their health outcomes and quality of life.

The project was launched in a donated office space graciously provided by a respected elder in the Karonmajigi community. Recognizing the digital literacy gap among community members, we conducted comprehensive literacy training sessions to empower them with the necessary skills to navigate digital devices effectively. Our collaborative efforts resulted in fruitful partnerships with three hospitals and the Federal Ministry of health. Leveraging platforms such as Zoom and Google Meet, we facilitated seamless interactions between patients and healthcare professionals from our partner hospitals located in urban centers. Throughout this process, we were able to extend our services to more than 300 patients, underscoring the tangible impact of our initiative in bridging healthcare accessibility gaps in the community.

Ensuring robust data privacy and security measures is paramount in telemedicine, addressing concerns surrounding patient confidentiality and information integrity. Presently, our collaboration with a firmware-based company has revealed reliability issues, prompting the need to seek partnerships with more dependable firms in this domain. Strengthening these alliances will fortify our telemedicine infrastructure and bolster confidence among patients and healthcare providers alike.

Expanding our telemedicine services to communities in other countries presents an opportunity to extend healthcare access globally. To achieve this, we aim to establish partnerships with ministries of health in target countries, fostering collaborative efforts to implement telemedicine solutions tailored to local healthcare needs and regulatory frameworks. Such partnerships will enhance cross-border healthcare delivery and promote knowledge exchange, ultimately benefiting communities worldwide.

In order to scale our telemedicine center and enhance service reliability, securing adequate funding is imperative. We recognize the importance of financial support in expanding infrastructure, upgrading technology, and sustaining operations. Seeking strategic partnerships with investors, philanthropic organizations, and governmental agencies will enable us to realize our vision of delivering high-quality, accessible healthcare to underserved populations, both locally and internationally.

Our approach introduces a novel solution to address the limitations of mobile application-based telemedicine services prevalent in Africa. While existing services primarily cater to individuals with access to smartphones and financial means, our telemedicine center revolutionizes accessibility by providing a physical hub where vulnerable populations, particularly those in rural areas, can readily access healthcare services.

Compared to mobile applications, our telemedicine center offers several advantages. Firstly, it eliminates the technological barrier faced by individuals who lack smartphones or reliable internet connectivity. By providing in-person consultations facilitated by trained healthcare professionals, we ensure that even those with limited digital literacy or financial resources can receive quality healthcare.

Moreover, our telemedicine center promotes a sense of trust and familiarity within the community. By offering services in a physical location, individuals feel more comfortable seeking healthcare assistance, thus encouraging greater utilization of telemedicine services. Additionally, our center allows for personalized care and support, as healthcare providers can offer face-to-face consultations and address patients' needs comprehensively.

The broader positive impacts of our telemedicine center extend beyond improved healthcare access. By demonstrating the viability of this model, we catalyze positive change within the telemedicine space by highlighting the importance of inclusivity and community-centric approaches. Our success inspires other organizations and stakeholders in the field to reevaluate their strategies and prioritize solutions that address the needs of underserved populations.

Furthermore, our telemedicine center has the potential to reshape the market landscape by challenging the dominance of mobile application-based services. As more stakeholders recognize the value of physical telemedicine hubs in reaching marginalized communities, we anticipate a shift towards greater investment and innovation in this direction. This could lead to the proliferation of telemedicine centers across Africa, thereby democratizing access to healthcare and driving meaningful improvements in health outcomes for all.

Our telemedicine center makes healthcare more accessible to people in rural areas who face barriers like a lack of technology and financial resources. Here's how our solution works and why we think it makes a difference:

1. Activities:

   • An established physical telemedicine center with trained healthcare professionals.
   • Providing in-person consultations and medical services to people in rural communities.
   • Conducting outreach and education programs to raise awareness about our services and how to access them.

2. Outputs:

   • Increased access to healthcare services for vulnerable populations in rural areas.
   • Improved health literacy and awareness within the community about available healthcare options.
   • Enhanced trust and confidence in telemedicine services due to personalized, face-to-face interactions with healthcare providers.

3. Outcomes:

   • Immediate: Reduced barriers to healthcare access, leading to more individuals seeking timely medical assistance and preventive care.
   • Longer-term: Improved health outcomes among rural populations, including early detection and management of diseases, decreased morbidity and mortality rates, and overall better quality of life.

We believe our solution has a positive impact on the problem because:

• By providing a physical telemedicine center, we directly address the barriers of technology and financial resources that hinder access to healthcare for rural populations.
• Offering in-person consultations builds trust and familiarity, encouraging more people to seek medical help when needed.
• Through education and outreach efforts, we empower communities to take charge of their health and make informed decisions about healthcare options available to them.

Our impact goals for our telemedicine center are centered around improving healthcare access and outcomes for vulnerable populations in rural areas. Here are our impact goals and how we are measuring progress towards them:

1. Increased Healthcare Access:

   • Impact Goal: Ensure that individuals in rural areas have equitable access to healthcare services, regardless of their technological or financial constraints.
   • Progress Measurement:
     • Number of patients served at the telemedicine center.
     • Proportion of patients from rural communities compared to urban areas.
     • Accessibility metrics, such as distance traveled by patients to reach the center.

2. Improved Health Outcomes:

   • Impact Goal: Achieve better health outcomes among the served population, including reduced morbidity and mortality rates and improved overall well-being.
   • Progress Measurement:
     • Monitoring changes in health indicators such as blood pressure, blood glucose levels, and BMI among patients over time.
     • Tracking rates of disease detection, early intervention, and treatment adherence.
     • Conducting patient satisfaction surveys to assess perceived improvements in health status and quality of life.

3. Enhanced Health Literacy and Awareness:

   • Impact Goal: Empower individuals in rural communities to make informed decisions about their health and actively engage in preventive care practices.
   • Progress Measurement:
     • Conducting pre- and post-intervention assessments to measure changes in health knowledge and awareness.
     • Tracking attendance and participation in health education workshops and outreach programs.
     • Assessing the adoption of preventive health behaviors, such as vaccination uptake and adherence to screening recommendations.

4. Community Empowerment and Engagement:

   • Impact Goal: Foster a sense of community ownership and participation in healthcare initiatives, leading to sustained impact and long-term sustainability.
   • Progress Measurement:
     • Monitoring community involvement in the planning and implementation of telemedicine services.
     • Tracking the establishment of community health committees or support groups to promote health advocacy and peer support.
     • Assessing the extent of community feedback and input in shaping program priorities and strategies.

By systematically tracking these indicators and analyzing trends over time, we aim to demonstrate the tangible impact of our telemedicine center on the target population and continually refine our approach to maximize effectiveness and sustainability.

The core technology that powers our telemedicine solution is a comprehensive telehealth platform integrated with traditional healthcare systems and supported by innovative communication technologies. Here's an overview of the key components of our technology:

1. Telehealth Platform:

   • Our telehealth platform serves as the backbone of our solution, facilitating secure and seamless communication between healthcare providers and patients.
   • Features include video conferencing for virtual consultations, secure messaging for asynchronous communication, and electronic health record (EHR) integration for streamlined documentation and information sharing.
2. SMS Technology:

   
   

   • Recognizing the prevalence of basic mobile phones in rural areas, we leverage SMS technology to deliver essential healthcare information, appointment reminders, and educational content to patients.
   • SMS-based communication also enables patients to initiate consultations or request medical assistance when needed, bridging the digital divide and ensuring inclusivity.
3. Blockchain Technology:

   
   

   • Blockchain technology is utilized to enhance the security, privacy, and integrity of patient health records and transactions within our telemedicine platform.
   • By implementing blockchain-based solutions for data storage and encryption, we ensure tamper-proof audit trails and protect patient confidentiality in compliance with data protection regulations.
4. Internet of Things (IoT):

   
   

   • IoT devices, such as connected medical devices and sensors, are integrated into our telemedicine solution to enable remote patient monitoring and data collection.
   • These IoT devices transmit real-time health data, such as blood pressure, heart rate, and glucose levels, to our telehealth platform for analysis and interpretation by healthcare providers.
   • By leveraging IoT technology, we can remotely monitor patients' health status, detect early warning signs of potential health issues, and intervene proactively to optimize treatment plans and improve patient outcomes.

By leveraging these advanced technologies, our telemedicine solution addresses the complex challenges of healthcare access and delivery, ultimately benefiting individuals and communities by improving health outcomes and promoting well-being.

In our solution, we are working with 17 full-time staff and 4 part-time staff.

We have been working on the solution for two and a half years now.

Ensuring diversity, equity, and inclusion (DEI) within our team is a core value that we prioritize in every aspect of our organization. Here's how we approach fostering diversity and creating an inclusive environment:

1. Diverse Leadership Team:

   • Our leadership team reflects a diverse range of backgrounds, experiences, and perspectives. We actively seek out individuals from different ethnicities, genders, socio-economic backgrounds, and cultures to ensure diverse representation at the decision-making level.
   • We believe that diversity in leadership not only enriches our team's collective knowledge and creativity but also fosters a culture of inclusivity and empathy.

2. Goals for Diversity, Equity, and Inclusion:

   • We have established clear goals and objectives for promoting diversity, equity, and inclusion within our team. These goals are integrated into our organizational values, strategic planning processes, and performance metrics.
   • Our goals include increasing the representation of underrepresented groups within our team, creating equitable opportunities for professional development and advancement, and fostering a culture of respect and belonging for all team members.

3. Actions Taken to Achieve Diversity and Inclusion:

   • Recruitment and Hiring Practices: We implement inclusive recruitment and hiring practices to attract candidates from diverse backgrounds. This includes using diverse hiring panels, conducting bias-free job interviews, and actively seeking out candidates from underrepresented groups.
   • Training and Education: We provide diversity training and workshops for all team members to raise awareness about unconscious bias, privilege, and systemic inequalities. This helps foster a culture of empathy, understanding, and allyship within our team.
   • Supportive Policies and Practices: We have implemented policies and practices that support work-life balance, flexibility, and accommodation for diverse needs and circumstances. This includes offering flexible work arrangements, parental leave policies, and resources for mental health and well-being.
   • Regular Feedback and Evaluation: We solicit feedback from team members through regular surveys, focus groups, and one-on-one discussions to assess the effectiveness of our diversity and inclusion initiatives. This feedback informs continuous improvement efforts and ensures accountability at all levels of the organization.

By actively promoting diversity, equity, and inclusion within our team, we strive to create a welcoming and inclusive environment where every team member feels valued, respected, and empowered to contribute their unique perspectives and talents towards achieving our mission.

he telemedicine initiative focuses on serving the Karonmajigi community, predominantly composed of Persons with Disabilities (PWDs). Situated a considerable 48 km away from the nearest health center, Karonmajigi faces significant challenges in accessing healthcare. The project plays a pivotal role by bringing essential health services closer to the community's doorstep, offering a wide array of telemedicine solutions including virtual consultations, remote monitoring, second opinions, prescription refills, and mental health counseling. This endeavor holds immense value for the community, contributing to a reduction in maternal mortality rates, facilitating easy access to healthcare services, promoting health equity and inclusion, ensuring timely interventions, and ultimately lowering healthcare costs.

Our project employs cutting-edge technologies such as secure video conferencing platforms and electronic health record (EHR) systems, with the potential inclusion of remote monitoring devices. These tools are instrumental in facilitating seamless interactions between healthcare providers and PWDs in Karonmajigi, ensuring efficient delivery of telemedicine services.

Collaboration forms the cornerstone of our project's success. We have established partnerships with four hospitals to extend our reach and provide comprehensive healthcare coverage to Karonmajigi residents. Additionally, our dedicated team of staff members works tirelessly at the telemedicine center, comprising medical professionals, IT experts, and administrative personnel. Together, we are committed to delivering exceptional healthcare services and improving health outcomes for the community.

To sustain our operations and ensure the long-term viability of the project, we have implemented various revenue streams. These include fee-for-service payments, where users pay for each telemedicine consultation or service availed. Additionally, we offer telemedicine infrastructure services, granting access to our secure platforms and technologies for a nominal fee. Membership fees are also available for individuals or organizations seeking priority access to our telemedicine services. Furthermore, we explore partnerships with insurance providers to offer telemedicine coverage as part of their healthcare plans, thereby enhancing accessibility and affordability for Karonmajigi residents.

Ensuring the sustainability and scalability of our telemedicine project is paramount. We prioritize local capacity building, empowering community members with the skills and knowledge to manage and maintain telemedicine infrastructure independently. Additionally, we explore opportunities for expansion beyond Karonmajigi, leveraging lessons learned and best practices to replicate our model in other underserved communities regionally and nationally.

Our project is strategically poised to achieve financial stability through a multifaceted approach. Firstly, by fostering Hospital Partnerships, we aim to seamlessly integrate telemedicine services into existing healthcare systems, thereby expanding our reach and enhancing patient access to quality care. Additionally, by exploring revenue-sharing agreements and joint ventures with partner institutions, we seek to create mutually beneficial collaborations that drive sustainable growth and innovation in telehealth delivery.

Advocating for expanded insurance coverage and reimbursement policies for telemedicine services is a cornerstone of our financial sustainability plan. By actively engaging with insurers to negotiate favorable reimbursement rates and ensure adherence to billing requirements, we aim to create a conducive environment for widespread adoption of telehealth solutions.

Furthermore, our strategy includes leveraging Grants and Donations to secure additional funding from government agencies, philanthropic organizations, and private foundations committed to advancing healthcare innovation. By showcasing the potential impact of our telemedicine initiatives, we endeavor to attract support from individuals and corporate sponsors who share our vision for improving healthcare accessibility.

Moreover, our focus on Employer Health Programs presents an opportunity to tap into the corporate sector's interest in promoting employee wellness. Through targeted outreach and negotiations with employers, we aim to establish contracts to provide telehealth services as part of employer-sponsored health plans or corporate wellness programs, thereby expanding our revenue streams and reaching a broader audience.

In a significant milestone, we successfully secured a grant worth $4000 from the Resolution Project following a rigorous pitching exercise. This achievement not only validates the merit of our project but also provides a crucial financial boost to support our ongoing initiatives and lay the groundwork for future growth.

By diligently pursuing these activities and continuously adapting our strategy to evolving market dynamics and stakeholder needs, we are confident in our ability to achieve financial stability and drive sustainable impact in the field of telemedicine.