Citizen Observatory for Access to Medicines and Health Supplies

México is a country with significant inequality in access to healthcare services and medication. Our health system is fragmented. On one hand, there is a population of 55 million with formal employment that has access to social security services; on the other hand, there are over 65.6 million people without formal employment who rely on free services provided by government institutions. Both populations are facing a significant shortage of medication. 

In the past five years, there have been changes in the mechanisms for procuring medication, such as the intervention of international organizations, centralized planning management, and the elimination of two institutions responsible for healthcare for the most vulnerable population (Seguro Popular and INSABI). These changes have recently culminated in the inauguration of a mega-pharmacy in the center of the country.

These fluctuations in strategies have endangered the human right to health protection for the population; according to the Zero Shortage Collective, legal protections for medication shortages increased by 950 percent from 2018 to 2021.

There is no homogeneous source of information, each institution, and even each medical unit, has its own control system, which can range from a physical record to more complex digital systems. Furthermore, the absence of structured and continuous evaluation of the system's performance prevents planning, procurement, and distribution of medication from meeting the real needs of the population and the country's epidemiological profile, further exacerbating the population's health.

The lack of technology implementation is generating inefficiencies and deficiencies in resource management, which has negatively impacted the access and availability of medication for the most vulnerable population. Besides, accessing public information entails a lengthy and cumbersome process, which serves as a disincentive for research and discourages cross-sector participation.

We propose to establish an advanced monitoring and analysis system on medication access across Mexico, designed to democratize information and facilitate the generation of indicators and cross-sector recommendations. This system capitalizes on the comprehensive analysis of heterogeneous and vast volumes of prescription data collected from major public health institutions. By deploying a skilled operational team, it meticulously identifies, classifies, and catalogs essential data points and variables, transforming raw data into actionable insights.

Central to our system is a robust ETL Platform (Extract, Transform and Load) the ability to efficiently organize and manage over 1 terabyte of data in more than 10,000 files in many formats and shapes, encompassing nearly three billion medical prescriptions, derived from about 1,500 information requests. We have developed a centralized database that acts as a foundational platform for detailed analysis and widespread data accessibility.

The next phase of our initiative involves crafting a user-friendly no-code data analysis tool with visualizations, filters tables export and dashboards that showcases real-time strategic indicators. These indicators are continually updated, ensuring they mirror the latest data and trends. The dashboard's design permits access at various hierarchical levels—from individual medical units to broader institutional and geographical categorizations, including therapeutic groups. This multi-level accessibility ensures that the system can meet the diverse needs of researchers, healthcare professionals, patient societies, and administrative personnel, supporting a broad spectrum of analytical and research activities.

A key feature of our system is its ability to preemptively identify potential shortages or discrepancies in medication supply. This proactive capability allows healthcare stakeholders to make informed decisions swiftly, thereby guaranteeing the sustained availability of essential medications and facilitating efficient supply chain management.

Moreover, the system enhances transparency and accountability within the healthcare sector. By providing precise and timely data on medication supply and distribution, it enables a more accurate evaluation of the performance of health authorities and institutions. This is particularly crucial in Mexico, where the system’s insights can guide better management of healthcare responsibilities and resource allocation.

Additionally, the system will serve as a pivotal resource for research into medication usage, particularly in areas critical to public health such as adherence to care protocols and the fight against antimicrobial resistance. By analyzing data on how medications are prescribed and utilized, the system can help identify patterns of non-compliance with treatment protocols and track the emergence of drug-resistant strains, thereby informing strategies to optimize treatment approaches and combat these challenges effectively.

Ultimately, our solution not only addresses operational needs but also significantly contributes to strategic planning, improving transparency, fostering accountability, and enhancing public health research. By streamlining access to critical medication data, it empowers a wide array of stakeholders to effect meaningful improvements in public health management and policy, ensuring better health outcomes for the population.

Our solution establishes a monitoring and analysis system on medication access, aiming to democratize information and generate cross-sector recommendations. It is designed to be openly and freely accessed by researchers, healthcare professionals, patient societies, administrators at various managerial levels, and other interested parties.

Decision-makers can utilize the generated reports and recommendations to make informed decisions regarding medication procurement and distribution. This enables better planning and resource allocation, ensuring essential medications are available when and where needed.

For researchers and academic institutions, our solution provides open and free access to detailed reports and analyses of medication consumption trends. This supports research efforts and the development of new strategies for healthcare delivery and policy improvement.

Patient societies and advocates also benefit from the solution by gaining access to information on medication supply. This empowers them to better understand the challenges in medication access and advocate for improved healthcare services, fostering a more informed public discourse on healthcare rights and needs.

The solution's focus on users of public health services, including both those with social security and those without, aims to gradually promote improvements in access to medication at a national level.

The Observatory for Access to Medicines and Health Supplies (OCAMIS) is supported and advised by two of the country's leading public universities: the National Autonomous University of Mexico and the University of Guadalajara. Additionally, it receives guidance from the Public Health Society of Mexico and the College of Mexico, organizations recognized for their capacity and expertise in the fields of public health, public policy, and evaluation.

Furthermore, OCAMIS has an Interinstitutional Commission composed of representatives and guests cross-sectorial (civil society, patient societies, healthcare professional organizations, academies, governmental institutions, and the pharmaceutical industry). The support of these institutions and the extensive network of collaborators provides us with credibility and ensures the quality and objectivity of the proposed solution.

The operational team of the observatory consists of specialists from various areas, including health management and policy, law, data science, public policy, and public health. The team has been involved in medication supply issues for over five years at various managerial levels, we possess extensive experience and comprehensive knowledge of the system's operations, gained through our involvement in strategic sectors. This combination of specialized experience ensures a comprehensive understanding of the challenges and needs of the healthcare system. 

Additionally, we represent the population as we are part of the healthcare personnel, patients, and public officials. This diversity of roles allows us to fully understand the needs and challenges faced by the population in accessing medicines and health supplies, and the pressing need to implement the use of technology for monitoring, planning, and evaluation of a healthcare system.

We've developed a digital platform that enables seamless integration of prescription data gathered from public healthcare institutions. This platform empowers us to analyze and categorize information efficiently. At present, our dataset comprises a staggering 3,000,000,000 prescriptions. Moreover, we've curated a concise list of 12 medications, allowing for comparative analysis across various social security institutions through graphical representations.

We have reached a level of maturity and readiness that allows us to move forward with scaling the project. We are prepared to expand the scope of our platform and increase the number of monitored medications in the major public health institutions. Additionally, we are in the final stages of planning for the implementation of strategic indicators that will enable a more precise and efficient evaluation of the healthcare system's performance. This progress firmly positions us to carry out a successful implementation and ensure the positive and sustainable impact of OCAMIS on healthcare improvement in Mexico.

We are applying to the MIT Solve initiative to leverage its prestigious platform for enhancing our project’s visibility and impact on a global scale. The recognition and endorsement by MIT Solve would not only confer significant prestige, but also strategically position our observatory as a cutting-edge, technologically driven solution designed to tackle global challenges through a lens of social justice and human rights.

MIT Solve’s unique ecosystem offers unparalleled access to high-level managerial decision-makers, which would substantially enhance our ability to influence and engage with key stakeholders. The opportunity to be part of this network is invaluable, as it allows us to enrich our project with diverse perspectives and experiences. This interaction is crucial for broadening our understanding and approach, ensuring that our strategies are well-rounded and inclusive.

Moreover, the collaboration with Solve would provide essential resources for strengthening our team’s capabilities in leadership, negotiation, managerial training, impact assessment, and public relations. These areas are critical for the sustained growth and effectiveness of our project, ensuring that we are equipped to manage and expand our initiatives efficiently.

The financial support from MIT Solve is critical to consolidating the next phases of our project. It will enable us to proceed with confidence and determination towards achieving our goals, ensuring that we have the necessary resources to implement and scale our solutions effectively.

Additionally, the methodological support from Solve will be instrumental in refining our approach, enhancing the robustness of our data analysis and overall project methodologies. This improvement will fortify stakeholder confidence in the reliability and effectiveness of our work, thereby attracting more partners and collaborators to our strategy. The broader engagement facilitated by this trust will amplify our impact and accelerate progress towards our objectives.

By participating in MIT Solve, we anticipate not only advancing our project, but also contributing to a shared vision of solving some of the world’s most pressing challenges through innovation and collaboration. This partnership represents a vital step towards creating a more equitable and sustainable future.

OCAMIS, our developed system for monitoring and analyzing medication access in Mexico, is a pioneering advancement in healthcare technology. It stands out as a novel solution that bridges a significant gap within the Mexican healthcare system by providing a unified data system to monitor access to medicines and health supplies.

A key innovation of OCAMIS is its focus on the effective delivery of medications to patients. This shift from traditional models that primarily measured purchases or warehouse availability to a system that ensures medications reach those who need them, marks a significant advancement. OCAMIS employs a citizen-driven, open, and public monitoring approach, leveraging technology and data to enhance accountability and facilitate greater citizen participation in healthcare.

Furthermore, OCAMIS is a public and open system designed not only to support the public healthcare system but also to represent the voices of all sectors involved. By democratizing information and facilitating cross-sector recommendations, OCAMIS not only enhances information accessibility but also sparks a more robust interest in research and strategic improvements.

As the first system of its kind in Mexico, OCAMIS embodies innovation and progress. It serves as a testament to our commitment to enhancing healthcare outcomes for all citizens, paving the way for a healthier and more equitable society.

The accessibility and transparency of the data provided by OCAMIS encourage the involvement of multiple stakeholders, including researchers, policymakers, and healthcare managers. This broad engagement helps to ensure that improvements in healthcare access are comprehensive and informed by a variety of perspectives. By making information easy to access and understand, OCAMIS facilitates a multifaceted approach to enhancing healthcare, addressing needs from various fronts such as research, management, and policy-making.

Additionally, the tool poses no risk to the population, as the data obtained through the National System of Transparency and Access to Public Information does not contain personal information that could compromise individual confidentiality.

There is no homogeneous source of information, each institution, and even each medical unit, has its own control system, which can range from a physical record to more complex digital systems. Furthermore, the absence of structured and continuous evaluation of the system's performance prevents planning, procurement, and distribution of medication from meeting the real needs of the population and the country's epidemiological profile, further exacerbating the population's health.

The lack of technology implementation is generating inefficiencies and deficiencies in resource management, which has negatively impacted the access and availability of medication for the most vulnerable population. Besides, accessing public information entails a lengthy and cumbersome process, which serves as a disincentive for research and discourages cross-sector participation.

Ultimately, our solution not only addresses operational needs but also significantly contributes to strategic planning, improving transparency, fostering accountability, and enhancing public health research. By streamlining access to critical medication data, it empowers a wide array of stakeholders to effect meaningful improvements in public health management and policy, ensuring better health outcomes for the population.

1. Expanding the analysis of prescriptions, with priority given to those medications necessary to address the epidemiological and demographic profile of the Mexican population.

2. Consolidating the measurement of effective access indicators and applying them in Mexico's three main public health institutions: IMSS, ISSSTE, and IMSS Bienestar OPD.

3. Promoting research, empowerment, and collaboration across various sectors by providing comprehensive access to quality data and information. This will be assessed through visits to the platform, queries to open data, and specific information requests.

4. Positioning the observatory as an intersectoral ally, aiming to improve public health services and achieve equity in access to quality services through the use of technology. This achievement will be measured by the frequency and quality of recommendations provided to healthcare providers and policymakers. (Feedback from all our stakeholders)

The core in the Observatory is the data. Our source is a vast volume and heterogeneous formats to display the info between and inside the 60 public health institutions, who give us files in incomprehensive formats and with a bad quality and low operability, 

We have the challenge of sorting and cleaning that data and developing complex methods and dashboards to consolidate and verify the data consistency.

The technology is key in all the process to the data, from ask, collect, until display and build the indicators of the accessibility. We develop an ETL complex platform with distributed computing, big data solutions and data analysis. And give us the chance to share the findings and the consolidated databases between the community of researchers and civil society.

Also, many institutions give us data without official catalogs, so we applied machine learning technologies to merge and sort the non standardized data

At OCAMIS we have 7 people working. 3 full-time, 2 part-time and 1 permanent advisor.

We have been working on this solution since 2021, but we all have extensive experience in the field for years.

At the Observatory, we recognize diversity as an invaluable asset that drives innovation and creativity. We collaborate harmoniously with 5 women and 2 men with diverse perspectives and experiences that enrich our work. To ensure that our team is diverse and that all voices are valued and respected. 

We actively promote diversity in our hiring and promotion policies, seeking candidates from different backgrounds, experiences, and perspectives. This allows us to build a team with a wide range of skills, knowledge, and viewpoints.

Also, we offer flexibility in work schedules and reasonable accommodations to ensure that all team members can reach their full potential and continue their development in other aspects of their lives.

We always foster openness and mutual respect among all team members, promoting a culture of constructive feedback and openness to new ideas.

These actions not only benefit our employees individually, but also strengthen our team and help us achieve our organizational goals. We are committed to creating a welcoming and inclusive environment where every team member can thrive and contribute fully.

Our initiative operates on a non-profit basis and is primarily supported through various grants and donations. These funds are crucial for the development of our operating system, platform interface, and for acquiring virtual space needed for data management. Our system features dynamic dashboards that offer strategic information and data access at no cost to the users.

In addition to providing free access to our dashboards, we generate automated periodic reports for decision-makers and other stakeholders. These reports are designed to influence policy and practice, achieving scalable impact.

We are hosted by the Universidad Nacional Autónoma de México (UNAM), which supports our initiative by providing office space and servers. This partnership not only helps in reducing our operational costs but also strengthens our capability to handle large datasets securely and efficiently.

We value the creative freedom our donors provide, yet we remain committed to maintaining high standards of transparency. We ensure the appropriate use of resources through detailed reporting and efficient operation of our observatory, fostering trust and accountability with our supporters and the communities we serve.

In addition, from conversations we have had with industry players, we know that they are interested in having access to our data. We believe that this opens up an opportunity to generate a business model for OCAMIS, which will allow us not to have such a high dependence on donors.

To ensure the financial sustainability of our platform, we have implemented a dual revenue model. While strategic indicators and data on priority medications are freely accessible through our open platform to public universities and members of the intersectoral committee, we also offer specialized services that generate revenue.

Our revenue-generating services include providing customized data analysis and detailed reports tailored to the specific needs of various clients. These clients range from private healthcare providers to pharmaceutical companies and international health organizations. By offering these premium services, we not only cater to a niche market that requires more detailed and specific information but also generate the necessary resources to cover our operational expenses and ensure the continuation of quality service.

Evidence of the success of this model is seen in our growing client base and the steady stream of revenue from these customized services. This approach not only supports our financial health but also allows us to maintain the free access component of our platform, thereby upholding our commitment to open data and broad accessibility.

Additionally, the support we receive in terms of infrastructure and resources from reputable institutions like UNAM, which provides us with office space and server capacity, has significantly reduced our overhead costs. This collaboration allows us to reinvest more resources back into improving the platform and expanding our services.

By diversifying our income sources and leveraging strategic partnerships, we are on a clear path to achieving long-term financial sustainability while continuing to fulfill our mission of improving healthcare access and transparency.