MicroClinic Technologies - Blue Angel Network

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MicroClinic Technologies - Blue Angel Network: Scaling last mile access to Health IT powered by youth

Nairobi, KenyaKisumu, Kenya
Year Founded:
2012
Organization type: 
for profit
Project Stage:
Established
Budget: 
$500,000 - $1 million
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

ZiDi™ is a software developed for point-of-care (POC) tracking of commodities in clinics serving rural and peri-urban communities in Kenya. We are scaling a network of trained youth, Blue Angels, to promote ZiDi™ and improve availability, accessibility, quality and affordability medicines.

WHAT IF - Inspiration: Write one sentence that describes a way that your project dares to ask, "WHAT IF?"

What if we could supply medicines through the Blue Angel Network to clinics at wholesale prices and yield 30-60% in savings for over 2.5 million patients annually?
About Project

Problem: What problem is this project trying to address?

Patients living in low-income peri-urban or rural communities are forced to travel long distances to access care, which costs them time and money - the poverty penalty. In response, private owner-operated clinics serving the last mile are becoming commonplace. However these emerging clinics, which rely on sales of medicines to be sustainable, report frequent stock-outs of medicines. The poor computer skills make stock management a challenge.

Solution: What is the proposed solution? Please be specific!

To bridge this gap, we are developing a 250-strong network of trained youth, branded the Blue Angel Network, to support the uptake of ZiDi™, a health management information system developed to facilitate POC tracking of commodities and stock management in clinics. Blue Angels train HCPs to appreciate and accept the benefits of health IT, notably for real-time tracking of inventory to reduce losses and stock-outs, and maximize returns from their inventory; Blue Angels will train HCPs to validate the authenticity of medicines and curb the exposure of patients to counterfeit medicines; Blue Angels will assist clinics with forecasting to optimally stock their clinics with the necessary variety of drugs and improve availability of medicines.

Awards

2013 GSK and Save the Children Healthcare Innovation Award; 2014 Financial Times - International Finance Corporation Sustainable Technologies in Healthcare Finalist; 2014 Frost & Sullivan Customer Service Leadership Award; 2015 Social Innovation Leadershi
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Dr. Odongo is a medical doctor who owns Alpha Medical Centre in Vihiga, located in rural western Kenya. His desire is to improve the quality of health care for his community through quality services and access to quality affordable drugs. He insists on offering his patients drugs that are different from the ones in the open market. However, these items are expensive and easily stolen from his pharmacy. Dr. Ondongo subscribed to ZiDi™ to help him manage his facility and track his stock movement, yet was not computer savvy to fully utilize ZiDi™. Upon realizing this challenge we assigned 23-year old Blue Angel, Bernard Onyango to his facility. Inventory & Revenue increase was 40% in 2 months. Data from ZiDi™ attracts wholesalers to him.

Impact: What is the impact of the work to date? Also describe the projected future impact for the coming years.

The Blue Angels Network in Kenya is presently a 6-member strong team covering two target markets in central and western Kenya. The Blue Angels have recruited 10 private clinics to date that serve approximately 30 patients per day and have trained approximately 50 HCP in total. Blue Angels enable clinics to achieve 70% reductions in the frequency of stock-outs, eliminate counterfeit drugs at the POC, and coordinate data capture and reporting on consumption rates of medicines, which we anticipate will eventually attract wholesalers of high quality affordable medicines to deal directly with the clinics via an e-commerce site for the Blue Angel Network. Six of ten clinics are reporting 40%-70% increase in revenue attributable to improved POC stock management. The clinics are stocking more drugs supplied by wholesalers. Patient satisfaction is also improving. Insurance coverage is up 15%.

Spread Strategies: Moving forward, what are the main strategies for scaling impact?

Our goal is to recruit and train 250 youths in 2016 to enable us scale to 250 clinics by Dec 2016 in five key target regions in Kenya. With combined volumes of approximately 7,500 patients/day, and with increased purchasing power of the clinics, we plan to partner with pharmaceutical companies to offer a differential pricing scheme or coupons that target owner-operated clinics, thus improving the safety, variety and affordability of medicines for the poor. This integrated business model will enable us better compensate the Blue Angels and offer drug-surveillance jobs for the youth.
Sustainability

Financial Sustainability Plan: What is this solution’s plan to ensure financial sustainability?

ZiDi™ is provided to clinics as a pre-paid subscription program. The clinics purchase patient points at 25-50 cents per patient, from which we pay the Blue Angels a 4-5% commission. Hence the Blue Angels are incentivized by the productivity of the clinics they serve and earn more as the number of clinics they serve grows. We plan to add performance premiums to their commissions based on how well the clinics achieve the four impact indicators.

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

We are not aware of another organization that is focused on training clinics in health IT coupled with capacity building to enhance dispensing of safe affordable drugs. However, there are a variety of program in Africa and India that have demonstrated the impact of inclusive business models on access to high quality drugs. For example, Square Pharmaceuticals, Bangladesh, delivers drugs directly to dispensing outlets to minimize mark-ups from middlemen. VillageReach, Mozambique, couples vaccine delivery to gas delivery. Arogya Parivar & Riders for Health use community networks to scale.
Team

Founding Story

After spending three years developing ZiDi™ into a leading one-stop-shop solution tailored to track revenue, inventory, utilization and productivity in clinics in the Africa market, we observed a slow adoption of ZiDi™ by the clinics. More disappointing was the limited use of ZiDi™ for inventory management, a key driver of the owner’s decision to purchase a health IT solution. Interviews with HCP revealed computer literacy was low in the clinics. We also realized that owners of clinics lacked a basic decision-support framework to guide dispensing practices. These findings indicated a deeper need for training. The result was the birth of The Blue Angel Network. Clinics love Blue Angels.

Team

The Blue Angel Network is presently comprised of 6 fulltime youth, 5 males and 1 female. All were university graduates with degrees in business administration or information technology, and were under-employed prior to becoming Blue Angels. They were recruited from a pool of applicants based on their sense of empathy, a desire to serve the last mile, a mechanical or technical inclination, and strong sense of community connectedness – they had traits of changemakers in their own right. They received extensive training on the features and functions of ZiDi™, and mastered how to motivate clinics to adopt health IT and go digital, against the odds of power shortage, zero connectivity and the lack of computers in their facilities. The Blue Angel Network is presently coordinated by the sales manager of MicroClinic Technologies, and they report through to the chief operating officer. We intend to recruit a Blue Angel coordinator to oversee the recruitment and training of an additional 250 Blue Angels over the next 12 months.
CO-CREATION IDEA: Please offer a brief description of how you imagine a win-win partnership with Boehringer Ingelheim to better serve unmet needs in health. (Hint: Please mention the underlying business model envisioned that would make such a partnership sustainable.)

We would appreciate the opportunity to work with staff from Boehringer Ingelheim to co-create a differential drug-pricing, loyalty program or coupon program in a manner that will encourage private owner-operated clinics serving the last-mile in Kenya to adopt health IT to enhance POC dispensing and management of stock. Patients will receive a manufacturer's coupon for which they get a discount. We in turn swap that saving with a discount to the clinics. Offering coupons to patients served in the clinics using ZiDi™ will spur an increase in patient volumes, which will enable clinics to purchase the pre-paid points they need to operate ZiDi™. An increased use of ZiDi™ will in turn enable us to better support and compensate the Blue Angels.

NEEDS: Based on you response above, please specify which of the following resources, operations or expertise by Boehringer Ingelheim you imagine leveraging to actualize the proposed co-creation opportunity. Please check all that apply. (Hint: while financing is often critical to scale, we are also interested in understanding what other assets or expertise could be leveraged).

Distribution Channels, Research and Development, Relationships/New Contacts, Marketing/Communications Support, Legal Support, Access to Capital.

EXPLANATION OF NEEDS: Please explain your choices in more detail.

We envisage that once we achieve a target of 250 clinics, we could also offer the opportunity to pool purchasing of drugs by the clinics via a dedicated e-commerce portal. The Blue Angel role could then be expanded to increase to include logistics, distribution and delivery of drugs. We would therefore need the support of Boehringer Ingelheim staff to co-create an e-commerce model for the Blue Angel Network through which clinics can connect with wholesale suppliers. Blue Angels will need training to discern and validate the authenticity of medicines being supplied to the clinics.

OFFER: What are the main assets you may contribute in a co-creation partnership with Boehringer Ingelheim that would better serve unmet needs in health?

Deep understanding of an unmet need in a specific market/context, Access to and established trust with customers/beneficiaries, Insights into pricing and financing of health products/services, Insights into marketing.

FOCUS AREAS: Which of the following best describes the main focus of your project? (select all that apply)

Improving the affordability of healthcare (e.g., microinsurance, reducing the economic cost of care), Packaging of health products and services to address needs currently unmet.

SECONDARY ENTRY FORM
Please share what your organisation and Boehringer Ingelheim will Co-Create together

MicroClinic Technologies is eager co-create with Boehringer Ingelheim (BI) to improve last mile diagnosis and treatment of cardiovascular disease (CVD) and stroke in five underserved regions in Kenya. ONE HUNDRED Private clinics serving densely populated peri-urban dwellings will be trained on a cardiovascular disease (CVD) screening protocol, which would be co-designed with BI and embedded in the MicroClinic’s existing ZiDi™ health management software. The screening protocol will be reinforced by a coupon/loyalty program, where clinics earn points for adhering to the CVD protocol that can then be converted into coupons for the purchase of electro cardiogram devices to better serve patients.

Please specify what your Co-Creation will result in:

a new market/customer group.

If you selected "other" above, please explain:
Please provide a 1-2 sentence summary of your Co-Creation idea

A cardiovascular disease screening program reinforced by a loyalty point program will strengthen and incentivize last mile early detection and treatment of CVDs, notably, in peri-urban dwellings of Kenya. This project will serve as a model to improve and scale point-of-care diagnoses and treatment of chronic diseases in resource-limited, nurse operated settings. It will spur sector-wide surveillance of CVD and enable adoption of electronic medical records in Kenya.

How does this project link to the core mission of your organisation?

MicroClinic Technologies seeks to transform healthcare at the last mile by improving access to affordable diagnostics and medicines at the Point-of-care using ZiDi™. ZiDi™ helps health workers, most of whom are nurses, to better diagnose disease. This co-creation would help MicroClinic to build out its existing ZiDi™ platform to include CVD protocols and to expand its loyalty program to track adherence. The loyalty program is a technology-powered solution that is scalable across Africa.

Beyond social impact, how does this project link to Boehringer Ingelheim’s core business?

Stroke care is a core strategic area of focus for BI. Also, Kenya is one of BI’s priority markets on the African continent. This proposal touches on both; this co-creation would provide BI with an opportunity to play a role in building out stroke care (education, detection and treatment) in communities where there is a large unmet need in Africa.

What are the specific inputs and actions that each side will contribute to this Co-Creation idea based on each of your unique competencies and experiences?

My organization will contribute:
MicroClinic will provide access to ZiDi™ in a target 100 clinics, thanks to a grant received from KfW-DEG (a program of GIZ) to expand access to ZiDi™ in private high-volume clinics serving peri-urban and rural regions in Kenya. We will sync the CVD screening protocols with the loyalty point system in ZiDi™.

Clinics will earn loyalty points based on adherence to the protocol. We will distribute the relevant devices like ECGs to clinics that achieve their target number of loyalty points.

Boehringer Ingelheim will contribute:
Boehringer Ingelheim will help us develop an effective and easy-to-use CVD screening protocol to facilitate early detection and treatment of stroke or other related diseases in clinics using ZiDi™ or any other health records management system. BI can help develop training videos or visual aids on the screening protocol which the health workers can access through ZiDi™ in the target facilities. BI (potentially with another partner) will donate the coupons which clinics can claim upon achieving the requisite loyalty points.

Please describe the potential revenue model for this Co-Creation idea.

We anticipate a win-win-win for the clinic, MicroClinic and BI. Clinics on ZiDi™ auto-generate claims and achieve better compliance with the multiple private insurers they work with and get reimbursed at better rates by the insurers thus improving their revenue. MicroClinic charges clinics a fee of 25-50 cents per patient, and will benefit with more uptake of ZiDi™ in clinics. The program will favour a needs-based demand for medicines to treat CVD in a chronically underserved market, which is good for BI’s social commitments and sustainable business imperatives.

What possible risks or challenges do you foresee?

TIME SPENT PER CASE: Health workers tend to resist protocols that add to the duration of the patient visit. Adding a CVD protocol would extend the duration of patient visits in an already resource constrained setting.

TRAINING: On-going technical support would be needed to enhance the skills of health workers vis-à-vis the management of ‘uncovered” chronic diseases like stroke.

APPEARANCE OF CONFLICT: Given that ZiDi™ collects patient data, this program will have to establish a firewall between patient level data and BI involvement.

Is there anything else you would like to share about your Co-Creation idea?

This idea is about achieving a much needed transformational change in health service delivery. Besides achieving sector-wide skills development of health workers and improving last mile access to care and treatment for CVDs in 100 clinics, this program will have the incremental benefit of improving quality of care for ~1 million patients per year, as well as create 100 rural health IT jobs for youth. MicroClinic Technologies will recruit, train and support 100 youth to maintain ZiDi™ and the equipment placed in the facilities. Demonstrating early impact will attract other ecosystem players into the coupon program to scale.

How much input do you hope to receive from Boehringer Ingelheim?

I’d like to implement together.

If you selected "other" above, please explain:

▢ I’d like to implement together

Besides Boehringer Ingelheim, what other types of partners might be valuable to carrying out your Co-Creation idea, and why?

Riders for Health – we intend to engage Riders to facilitate last mile logistics for our technical support staff. Technical staff can rent bikes from Riders to facilitate access to the facilities.

Insurance companies – low-cost diagnosis and treatment of chronic diseases could be attractive to insurances providers, like Changamka. They may offer our clinics preferential rates coupled with real-time adjudication of claims.

SAP – We are partnering with SAP to optimize the analytic capabilities of ZiDi™ to better serve the clinics.

Distributors of drugs – We will link clinics to wholesalers via our web-portal to facilitate orders for safe medicines at affordable rates.