I had a chance to speak with Tania Shahid, one of the core team members of Click Diagnostics in Boston, about their exciting venture. It was interesting to find out how the idea emerged from a Development Entrepreneurship course in MIT from four people with completely different backgrounds but the same common aspirations. They all wanted to do something in South Asia. They all wanted to do something in healthcare. They all wanted to leverage the latest technologies in mobile applications. Bringing all of these different components together gave birth to an idea that quickly gained appreciation and momentum in weeks.
At the end of the semester, they were: a team of 6, a secured start-off grant from the Legatum Center, an MIT 100k competition winner in the development track, and equipped with free legal advisers to help them setup their official company structure. Not bad for an idea that was conceived in a class. These awards and grants helped provide the team psychological benefits through validations and social proof – this is what kept them going, and today they are on the way to making it happen.
With the drive to bring about a change, they created a business model to ensure scalability, quick growth, self-sustainability and which was incentive-driven. In some ways, they’ve planned these different elements up in a mature way – acknowledging the fact that every stakeholder will eventually need to have business motives and incentives to keep this system rolling. It’s a for-profit business designed to become self-sustainable in the quickest time possible.
The goal is to provide health-care facilities to people in South Asia who cannot get to it themselves. Initially they will begin with diagnostics in dermatology and ophthalmology, but they are not confining themselves to these fields, and will let the diagnostic services expand with time. Technology is the real enabler in this business, so the idea would be to make it as user-friendly as possible.
Their core value will be the technology that they are currently building. They have recently secured development funds from the GSMA (UK) to build the mobile application of the service. Their development is underway and is expected to be ready by September for a pilot test. The pilot test will be done in a neutral ground in Egypt using Orascom’s mobile operator Mobinil (this works for them because they’re already partnering up with Mobilink to provide the service in Pakistan. They may however also partner with other telecos later on). They’ll also be engaging a global community of dermatology specialists called Telederm for the pilot program. The idea is to spend the next few months completing the application and testing it before officially moving on to raising capital to launch on a larger scale in South Asia.
Since the application will run on mobile devices, some partnerships will soon brew up with cell-phone manufacturers. They are already working with Nokia’s high-end phones for their initial prototype development. Eventually, however, it makes sense for them to want to work with more economical camera phones. Their application will be easily downloadable from the internet onto the phones.
Recruiting the right Health Workers is one of the most important determinants of the success of this venture. Tania mentioned that they are planning on sourcing Health Workers from organizations that already have a presence in the market; including NGOs, Government Health Workers (100k+ health workers currently employed by the government in Pakistan) and other organizations. Click Diagnostics will add the components of a scalable technology and incentive structure to avail their services.
The application will be made in a way that does not require the Health Worker to be from a nursing background – anyone with a middle (class 8 ) or matriculation degree can become a Health Worker. The Health Workers have to belong to the villages so that they understand the village dynamics and people well. After a weeks training on the application, working model and steps; they will be ready to go and report cases. Each case worked on will automatically be traceable by the Click Diagnostics system. Their initial estimates require one Health Worker to do an average of 3 to 4 visits per day in the radius of her immediate locality.
They will enable the micro-entrepreneurship model of Grameen and every stakeholder in their service chain will get a cut from each completed case. Their research shows that a lot of these patients go to local area pharmacists (if available) or self-proclaimed healers and pay them for medications. These pharmacists most often don’t have the right skill-sets to diagnose and prescribe the right treatments. Click Diagnostics will enable such patients to get this service from actual doctors through the Health Workers at a low cost. The revenue will be divided by the health-workers, the medical specialists and Click Diagnostics. After the payment is received initially by the Health Worker, it will be transferred as mobile currency via the mobile carrier networks.
The application will use language-free image based ways of capturing information and pictures of the patient cases. It will work in a questionnaire type of way of gathering information about symptoms, history and conditions. Each case will have a unique patient identifier, possibly in the form of a picture and name pronounced in a voice recording. The application will also be able to give follow-up reminders to the Health Workers to check up on certain cases.
The only thing that will probably be a significant barrier for them is building trust in these rural areas. People aren’t open to new ideas and are often resistant to change. Click Diagnostics are aware of this barrier and acknowledge the fact that they may take time to build their trust. They may initially have to offer the service for free in some areas to establish credibility. The Health Workers will ideally be people that the villagers know and trust. The Health Workers will be made to look the part as well (with white overalls). And, possible, they may even record video diagnosis from the specialists to show to the patients. All of these things are meant to gradually build trust amongst the masses – and once they see social proof of cases being diagnosed and getting better, they may feel more at ease and open to discussing their issues.
Eventually it will be good if this scales into providing treatments as well. Tania mentioned that they may provide logistical facilities for serious cases to be able to meet with the nearest specialists. But all of that is still in the air yet. Diagnosis is just the first step, however milder and easier problems can certainly be treated simply with proper medications if caught in time.
My other concern was that a simple one step process may not always be enough to diagnose a disease. As an example, benign lesions can be mistaken for skin cancers, if not diagnosed properly. Will images and a set of questions be enough for the specialist? The answer so far is that most dermatology cases in these areas are simple dermatitis or infections that can easily be identified and diagnosed. Special cases are rare, and if needed, the data gathering process can go back and forth until they have the right set of info.
If you believe in their cause, or can help in any way, join their Facebook group here.
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