Himalayan Cataract Project has treated ~1 Million patients in 20 years.
LOW point - Day 1: We came in with perception that we really understood problem - but turns out we didn’t understand it fully. Understood deeply about end user experience whereas didnt have understand of business perspective We learned that making global health solutions solutions require alternative/creative scaling strategies that aren’t used frequently in the industry
We used to think that the solution itself was the value we are providing. But we learned that The solution isn’t the value -- it’s the impact or outcome of the solution is the value. We learned to ask, what is the improved outcome we provide to organizations on the ground? This helped us uncover some of these scaling strategies to explore . -- CRAIG, STEVE W., PETE
Before this class, we had been getting out of the building a lot! Partnering with HCW in Ghana for several months, we thought that addressing end-user’s needs was good enough validation that our product was valuable. But after this week, we learned that it is important to reach out to the vast array of other stakeholders in the field to assess what exactly is valuable about our product. For ex - Dr Burgos. This week We validated that our solution is both desirable and feasible to OTHER players in the field beyond our initial partnership with HCP, and that we should keep working towards making this solution scalable and sustainable.
Working towards sustainability of this global health solution, we interviewed some potential customer segments who were PRETTY hard to get a hold of -- Hyp 1 - sell to NGOs to implement this.NGO prob cant pay us; result: more likely funded from philanthropic org or impact investing Hyp 2- was having govts as customer segments since they are implementers -- realized B2B2G - is more feasible [ex: Salauno govt tenders, HCP] in terms of access to funding, more flexibility in operations, quicker pilot testing, etc. But how to fund b2b? HYP 3 - was selling aggregate data to research institutions. Result of interview Perception -- make sure there is a closed loop of impact if you are selling the data - Luby + RC + IHME. Better to look at institutions directly influencing field of global health rather than disconnected people.
Eye-Dentify H4R Stanford 2020
An off-the-grid, tech-enabled way to
make patient tracking & data collection more accurate and efficient in order to optimize patient care in medical outreach settings. Total Interviews Conducted: 70 Interviews Conducted & Meetings During H4R: 25 Eye-Dentify
THE TEAM Radw aBSc. Computer
Engineering & Electronics Engineering MEng. Product/Service Design and Management for Impact 3+ Years Experience in Data Infrastructure & Machine Learning Hacker, Hustler & Designer Aish BSc. in Physics PhD Bioengineering Research on Nanophotonics, Drug-delivery & microfluidics Hacker, Hustler & Picker Manali BA Global Health MS Community Health and Prevention Research UX Design, Mixed-Methods Public Health Research Hustler, Designer & Picker
Problem Blindness exacerbates the effects
of poverty and the likelihood of perpetuating intergenerational poverty Out of the 7 Million Blind People in Africa 50% Suffer from Curable Cataract Leading Organization: Aravind (130K surgeries/year) will cover the backlog in 500years New cases of cataract occurring in the indigent populations are ~1.5 M annually
High Volume Cataract Outreach Campaigns
are working to treat the backlog of curable blindness as fast as possible. But, in high volume settings like this, these papers are often damaged, lost, or difficult to read adding the burden of either recollecting or the loss of the data. “You’re wasting time to make sure you don’t work on the wrong patient all the time.” “So Sometimes the only thing we have to identify a patient is that they have an eye problem” And when a healthcare worker can’t read the form, they cannot provide the best/right eye care for the hopeful patients. A healthcare worker would spend an estimated 1 hour per patient noting down their information during a high volume cataract outreach campaign. 1 cataract surgery = 10 mins
EYE-DENTIFY CONNECTS (1) A $5-$12
tech enabled patient bracelet that automatically identifies and tracks patients during outreach campaigns and locally stores and moves patient data from one station to the other with (2) A simple, digitized patient health record that works off-the-grid on a handheld portable device. Eye-dentify leverages... Ubiquitous technologyPatient wearables & the power of dedicated healthcare workers
Revenue Streams B2B/B2G Hardware sales
and set-up [Hardware Leasing Fees - Service Setup Fee - Data Storage Subscription] Healthcare outcomes data Key Partners Hospitals EMR companies Healthcare NGOS Universities & researchers Key Activities Key Resources Engineers, product designers, community health specialists, medical specialists, business experts Financial Resources: Grants and stipend Value Proposition Enabling more efficient nursing via: - Digitizing global eyecare patient identification & tracking in rural areas to -Seamlessness & Automation of healthcare data aggregation -More streamlined patient flow Access to more complete and accurate data to enable improved patient outcomes and improved quality of care, leading to improved livelihood of patients via cured blindness. Customer Relationship Healthcare Workers (direct users) International Healthcare Organizations (Customer)[User access/Promotional services/ Provide training/ mutually owned service.] Patients (indirect users/wearers) Fixed Costs [Software Design - Hardware Design] Variable Costs [Wearable Unit Purchase - Wearable Unit Customization - Scanning Devices / Data Insertion Devices - Intranet Hardware devices - Software Scaling and Cloud Data Storage - Salaries & Stipend - User Training Cost - Shipping & Distribution] Cost Reduction Strategies [Recycling wearable hardware / outreach - Purchasing from local vendors & manufacturers - Establishing a local Training of Trainers System ] Customer Segments End users: Health care workers & Patients at crowded medical camps. Decision Makers and Economic Buyer: health- care outreach organizers like Unite for Sight, HCP, Swiss Red Cross administrators (program managers/ directors) & in-country High volume campaign coordinators (members of Ministry of Health eg: Ghana), Organizations involved in vaccination camps, healthcare in refugee camps, eye-care outreach like Aravind eye care, HCP Awareness: International healthcare NGOS like Red Cross, Doctors without Borders that organize outreach camps Evaluation: feedback from healthcare workers, patients, biostatisticians Lifetime support: measure device success alongside camp progress/success metrics, get feedback from healthcare workers and patients and biostatisticians Networking: Establishing partner relation, connection with med-tech companies and eye-care organization Solution testing: High- fidelity and low-fidelity prototyping, concept testing on ground Delivery: Training, marketing, website/app communication
One Big Initial Insight Empat
hize Define Ideate Prototy pe Test The Design Process The Business Development Process Desirability Usabilit y Viability SustainabilityFeasibility The two processes are complementary and essential for the success of any project. We learned that making global health solutions sustainable require alternative/creative scaling strategies that aren’t used frequently in the industry Scalability
What did we learn about
our value proposition? “Who is winning & by how much ?” ~Craig Seidel “The smarter you are, the harder it is to consider that perhaps you can’t precompute problem + solution” ~Steve Blank “Talk to other NGOs that work with governments-- considering B2B2G model?” ~Rekha Pai “Think about saboteurs; what are your countermeasures?” ~Tom Bedecarre “most effective way to touch people is to tell a story to get them to take action” ~Robert Locke “Customer Acquisition Cost -- how much time are you losing/wasting engaging with wrong patients and what’s opportunity cost to you?” ~Pete Newell “How much data do you need to have before it is valuable?” ~Steve Weinstein
What did we learn about
our value proposition? “How can you advance the ecosystem and affect the patient?” ~Craig Seidel “Let’s say that you get this working well enough and 5% more people get cataract than what otherwise would have happened. That seems to me to be pretty good and that is well worth your effort” ~Steve Luby “Both will work; make sure to test for extensibility & interoperability” ~Jon Peha “Apple has Data collection and data analysis very separated, keeping the aggregated data anonymized so its not personally identifiable ” ~Margaret Cummings “If you develop this tech we’d like to use it. I haven’t heard of wearable to syncing data across clinic flow. Would love to collaborate and pilot with you” ~Jose Luis Burgos
What did we learn about
our Customer Segments/Revenue Model? Considering different revenue models beyond direct sales of product [ex: 2- sided business] B2B2G Model rather than direct B2G -- partner with NGOs who work with gov health systems Perception matters when seeking funding in global health/international development
Customer Segments Revenue Streams Key
Partners & Suppliers Key Activities Key Resources Buy-in Support Cost Structure Beneficiaries Value Proposition Value Proposition CS 1&2 - Increased number of patients treated during outreach campaign [increased cost effectiveness] CS 1&2 - Better-informed program budget and operation decisions for future healthcare service delivery CS 3 - Access to large aggregate population eye health datasets CS 2 - Decision Makers/Economic Buyer: Philanthropic Foundations who fund global health NGOs Pilot testing in COVID- adapted outreach settings Implementers: Health Ministries / Governing Bodies Suppliers: Product manufacturing/ supplier Implementers/Users: Local Hospitals & Healthcare staff Software Dev.→ MVP Electronic devices/ hardware Supply chain management and distribution Training resources for implementation Customized EMR software Get - CS 1&2: email marketing, articles, webinars // guest articles, research conferences & publications CS 3 - Economic Buyer: Health research groups [IHME, WHO] Fixed costs: Software & Hardware Design Cost Reduction Strategies: * Recycling hardware * Establishing training of trainer program * Local vendor purchasing Variable costs: * unit purchase / customization * software customization * training resources B2B2G Models Hardware sales and set-up [Hardware Leasing Fees - Service Setup Fee - Data Storage Subscription] Healthcare outcomes dataSelling aggregated outcomes data to research institutions Channels CS 1 - 2-step distribution Training Healthcare Workers Get - CS 3: email marketing, SEM // research conferences & publications CS 3 - Dedicated E- commerce or Aggregator CS 1- Decision Makers/Economic Buyer: Global Health NGOs who fund and operate outreach health services [via universities, non- profits, etc.]
Hypotheses We want to Test
Next ● What is/are the best revenue stream(s) to ensure sustainability of this global health solution? A) Leveraging population health data B) 2-sided business C) Intrapreneurship ● How can we extend the value proposition? A) beyond eye surgeries to other medical outreaches? B) beyond the current set of data collected to more a more valuable data set? C) exploring multiple uses of patient wristband for personal health data storage? ● How can we pilot test the solution to verify the value proposition is valid under constraints of COVID? Upcoming Interviews ● Stanford - Global Biodesign Director ● Verily - Partnerships and Outreach ● IHME - Global Burden of Disease Research Analyst ● Quantum Insights - CEO & CSO ● 2 Public Health Data Centers ● Silicon Valley Social Venture Fund ● & More!