Sehat Kahani

What makes your solution innovative?

Led by a team of mostly females, Sehat Kahani competes against gender based socio-cultural to deliver authentic and reliable healthcare services. Sehat Kahani has the first mover’s advantage of being in the field for more than 3 years, piloting and iterating revenue streams, and treating actual paying customers. We are the data aggregators striving to streamline true health data that has been underreported or misreported in Pakistan. We have made revenue from over the net, created key collaborations and partnerships across all service lines and won national and international recognition for our work. We have a wide market reach and a potential to scale our solution to 76 million Internet users and 165 million cellular users. We pride ourselves for rebuilding the human health resource of Pakistan by creating an extensive network of female doctors, specialists and nurses who have been unemployed. In addition, our solution is designed to give doctors a greater ability to reach and effect positive changes for their patients, while saving valuable clinical time. For any health care situation, patients and providers can collaborate on an "action plan" to drive greater engagement and adherence – from anywhere.

 Sehat Kahani technology utilizes Web standards and features HIPAA-compliant privacy controls and sharing preferences for each user. Powered by the convenience, ease, and affordability of Sehat Kahani telehealth mechanism, providers and patients alike could no longer be burdened by the longstanding paradigm that patients bear the responsibility of physically traveling to the care they require. Due to its remote access, we have the competitive advantage to remain operational during the current pandemic where OPDs and many hospitals are shut down due to risk of exposure to COVID. Sehat Kahani web and mobile health solution promises improved outcomes, significant cost and time savings and the agility to compete profitably moving forward.

What are your impact goals for the next year and the next five years, and how will you achieve them?

Telemedicine is a growing market globally that is expected to grow and become a 202 Billion USD market by 2025. Sehat Kahani; like all the other Global Players in the telemedicine market, intends to grow its current business by expanding its Telemedicine Platform in Pakistan and markets with similiar challenges such as Nepal, Bangladesh, etc. With the current COVID scenario; the inertia towards telemedicine has already been broken and the acceptability of seeking a doctor’s opinion over a video call through a smartphone has grown tremendously. We raised our Pre-Series A round of investment of 1 million USD in March this year and we aim to move towards a Series A of around 8 Million USD in the next 18 months to facilitate the growth. Sehat Kahani has already built a strong network of corporates and industry magnets (Including Banks, Telecoms, and Pharmaceuticals as the key giant players) as early adopters to champion Sehat Kahani’s vision and impact. In the next 5 years, we aim to be able to lock over 10 million active users availing e-health services through the E-Health application, shifting the trend from physical health towards virtual OPD consultations and other digital diagnostic services. Sehat Kahani is also in the process of creating strong Public-Private Partnerships ensuring Primary Healthcare access is taken up by the government and creating potential impact by creating more than 100 nurse-led E-Clinics across Pakistan. By 2027, Sehat Kahani envisions scaling up the E-Health Application both within Pakistan as well as Globally and becoming a leading global brand in the arena of telemedicine. Our long-term sustainability plan includes not only enhancing the services in the current mobile application to enhance the overall user experience but also being able to integrate modules such as chatbots, integrated modules as well as AI enabling to scale the current Mobile Application operations.

How are you measuring your progress toward your impact goals?

E-Clinics:

a)Number of patients reached via general physical consultations/ specialist consultations, VAS services, Laboratory services, Ultrasound services and tertiary care referrals monthly, quarterly and yearly in next 5 years b) Number of follow up patients monthly, quarterly and yearly in next 5 years c) Number of doctors/CHWs/Nurses engaged/working actively within the network yearly d) Number of beneficiaries mobilized monthly, quarterly and yearly in the next 5 years e)  % of patient conversion after mobilization monthly, quarterly and yearly in the next 5 years f) % of patient satisfaction after using the clinical services  g) % of employee social and financial upgradation yearly h) % sustainability and growth achieved per vertical yearly 

Health Education and Preventive Campaigns:

a)Number of beneficiaries impacted per campaign b) Number of doctors, Nurses, and community health workers engaged in each preventive care campaign c) % decline in targeted health burden of the community after campaign d) % of percentage of patient sent for tertiary care referral after campaign e) %Enhanced knowledge of the community members After campaign f) % sustainability and growth achieved per vertical yearly 

Mobile Health Application:

a)% of corporates/ Third parties bank, insurers engaged for the concierge model  b) Number of beneficiaries covered under the corporate concierge model monthly, quarterly and yearly c) % of new and follow up patient consulted under the model monthly, quarterly and yearly d) % of patient satisfaction after using the corporate concierge model monthly, quarterly, yearly e) % of employee retention and social/financial up-gradation yearly f) % sustainability and growth achieved per vertical yearly

What is your theory of change?

Our theory of change is as follows:

Input:

• IT infrastructure: equipment and network infrastructure for strong connectivity

• Manpower: Service providers and patients- Create job opportunities by hiring female doctors and specialists and community health workers for adoption of our solution in their practices. 

• Develop skills & Knowledge of at least 5000 more female health workforce 

• Funding (Internal and External)- 8M USD funding is required to have envisioned scale-up is next 18 months; 1.2 M funding has been raised through pre series round A in 2021

Activities:

• Mobile based application development and troubleshooting on 1000 users with upgradations

• Provide access to video-conferencing and value added services to more than 350,000 beneficiaries through our e-health clinic model and more than 300,000 beneficiaries through our mobile health application in next one year

• Build partnerships with at least 50 corporations and organizations for scaleup and adoption of our solution.

• Integration of AI, machine learning and predictive algorithms in existing solution in next six months 

• Interface for e-labs, e-pharmacy, e-referrals and e-monitoring (for home isolation for suspected COVID cases) in existing technology

• Increase efficiency of our 24/7 helpline to screen suspected COVID Cases

• Training and education of at least 5000 healthcare professionals to implement our solution

Outputs:

• Improved accessibility and affordability to health services to 1 million beneficiaries collectively in next one year

• Better professional communication among 5000 female health professionals network build to adopt our solution

• Enlarged catchment area by reaching out to 500,000 beneficiaries who are smartphone users and can adapt out innovation in order to avail services in the next one year

Desired Outcome:

• Improved quality of care

• Enhanced efficiency

• Patient satisfaction

• Provider satisfaction

• Improved quality

• Improved cost

Impact:

• Improved accessibility to health services

• Increased avenues for screening and referral of suspected cases

• Treatment management for primary health ailments including mild COVID cases 

• Continuity of e-monitoring and following for suspected COVID patients in home isolation

• Improved health related quality of life

• Improved awareness of primary health as well as for COVID and its complications 

• Increased employment opportunities for provider to utilize remote solution to reach their patients

Describe the core technology that powers your solution.

Our technology:

(a) Software for e-health clinic model: The first constitutes licensed software provided by our technical partner named Digital Care and Virtual Healthcare Professional to facilitate tele-consultation through the access vertical. This software is a complete end to end solution for the telemedicine module being operated at the Sehat Kahani E-Health Clinics. A few features of this software include:1)Doctor’s profile with appointment slots booking2) Complete Patient EMR system 3)Complete patient history and patient's record created by clinical assistant (nurse) and then updated by the online physician 4)Tele-consultation with the physician 5)Online E-Prescriptions 6) Complete doctor’s notes and final case summary 7)Other features include possibility of uploading lab reports, x-ray reports and linking it with the patient’s file 8)Monthly data collection through an internal dashboard 9)Data Analytics providing monthly summary of the disease patterns, service utilization etc. A typical tele-consultation process entails that as the patient enters the clinic, he/she is registered on the system with all relevant demographic details. Once registered, this patient is given an appointment for consultation. This is also reflected at the doctors’ end. The doctor then starts video consultation with the patient. This process is mediated by the nurse at the patient’s end, who collects vitals and records them along with any other important information (history, examination) into the patient's profile. The doctor also adds any relevant information obtained during the consultation into the patient file and saves the file in her record. Once she has completed the entire procedure, consultation is ended. The summary of consultation and drug prescription is shared by the provider with the patient to initiate the treatment. The data of this software is recorded on the cloud with an access only available with the admin of the portal which is under Sehat Kahani. To increase the efficiency and utility of the software both the doctors and providers are given training and refreshers every quarter.

(b) Software for mobile health application: 1)A complete web based platform which can be operated through an android and IOS app as well 2) Patient’s Login 3) Patient’s Medical History form 4)Features to either book appointment with the respective doctor or conduct instant consultation 5) Tele-consultation through video or audio call with the physician 6)E-Prescription from the doctor with complete doctor’s notes. (7) A free forum with chat option with the physicians This software has a web portal as well as application (IOS and Android) Keeping in view the sensitivity of the data stored on this system, two databases are used to store data on. This will allow complete security as well as ability to lease the software to other providers as well.

Which of the following categories best describes your solution?

A new business model or process that relies on technology to be successful

Please select the technologies currently used in your solution:

• Artificial Intelligence / Machine Learning
• Software and Mobile Applications

https://sehatkahani.com/

Which of the UN Sustainable Development Goals does your solution address?

• 3. Good Health and Well-being
• 5. Gender Equality
• 8. Decent Work and Economic Growth
• 9. Industry, Innovation, and Infrastructure
• 10. Reduced Inequalities
• 17. Partnerships for the Goals

In which countries do you currently operate?

• Pakistan

In which countries will you be operating within the next year?

• Bangladesh
• Pakistan

What type of organization is your solution team?

For-profit, including B-Corp or similar models

How many people work on your solution team?

125 full time workers; 40 part time workers/ contractual staff

How long have you been working on your solution?

5

What is your approach to incorporating diversity, equity, and inclusivity into your work?

To ensure that we incorporate the perspective of our target population and encourage women leadership; women occupy roles in every level of Sehat Kahani resulting in 90% of senior leadership and 75% of the core team comprising women. While designing or expanding the scope of our implementation design, we assure that women providers, patients and advocates participate in the design and implementation of telemedicine tools. We also aspire to utilize new data gathering tools and assure gender parity in collection. We realize that when girls and women have better access to information, they also have better health outcomes. Through extensive advocacy and awareness building in the community we are creating early adopters for telemedicine innovation and empowering women to realize their right to access physical and mental health services. On the other hand, we are collaborating with women experts in technology and healthcare to design, implement and lead programs and services that best meet the needs of our end users. We are actively creating training programs that address the problem of unconscious gender bias for healthcare providers and its consequences. We are also conducting research focused on women’s health outcomes and raising awareness of the gap. While creating partnership linkages, we ensure that we are working with companies, academic and intergovernmental institutions that use their resources and influence to accelerate women’s leadership and participation in healthtech. By creating the right ecosystem, networks, and incentives, we can begin to unpick the entrenched biases which have created the inequities, and start to close the gaps in health access for women around the world.

When we implement telemedicine services in the targeted communities we conduct pilot testing and focused group discussions to gather evidence. Direct communication with our potential beneficiaries enables us to identify pain points and breakdowns in the telehealth video visit experience for patients, providers, and staff. We also learn about patient, provider, and staff perceptions of telehealth, including what makes users more or less likely to continue using telehealth. Collaborating with community partners and women influencers in the communities helps us to identify the barriers they face in accessing telemedicine services within their vicinity. Using insights from this feedback helps us to design and implement improvements in telehealth visits. We generate customer reports that comprises end-user requirements and formal assessment across technical, clinical, usability, and cost domains of all vertices of our solution. In addition, when we think of users in the telemedicine space, we realize that our mental health and healthcare professionals might not necessarily be trained in technology solutions. For this purpose, we build design capacity into our teams through training, professional development, and partnerships. We periodically conduct user validation for our human health resource by engaging them in on-going feedback sessions regarding any modification of our technological solution to improve its interface or effectiveness. We also conduct in-depth interviews to understand any challenges they might face while using our solution. Having diverse teams - in terms of gender, ethnicity, training and background - is therefore critical for our organization as unconscious biases will be recognised and addressed. This will in-turn improve the impartiality of the data upon which care decisions are based resulting in increased uptake of our services by our end-users thereby contributing to the success of achieving the desired vision of our organization.

Sehat Kahani on the supply end caters to women needs by providing a platform of employment to female health care providers who lack the facility to out-stand social taboos and join the healthcare workforce. It provides a means of earning to females who are marginalized and are considered an insignificant role in the economy of the country thereby allowing them to sustain themselves and obtain equal rights in the male dominated society. On the demand end, the organization also sustains the need for females to have access to quality and affordable healthcare particularly in terms of reproductive health and wellbeing by providing such healthcare facilities through the use of technology. This enables women to learn how to incorporate technology and build their confidence and skills so as identify and self-sustain their rights. In addition, Sehat Kahani is also actively working in improving health access for refugee women and children in disaster prone areas of Pakistan. Many women who are refugees or IDPs face unwanted, unplanned, and poorly spaced pregnancies, due to a lack of access to contraceptive services and supplies, overburdened providers with little time to educate or counsel clients, pressure from husbands or other family members to “rebuild” the population, and increases in rape and prostitution. Through our services women in stable refugee settings are now able to receive comprehensive care through telemedicine health services including services such as risk screening, early detection, and management of complications; and providing health education and preventive medication establishing 24- hour referral and early/ subsidized referrals to emergency facilities when needed. In addition, we are also integrating mental health services to deal with the psychosocial trauma these women and minorities face due to displacement.

What is your business model?

Sehat Kahani has a sustainable revenue sharing model that offers services focused on all market segments via: (a) E-Health Hubs and Health Education: At Sehat Kahani E- Health Hubs a front line worker is trained to act as an intermediary for our beneficiaries who are charged $0.5 to $3 to connect with qualified home based female physicians or a specialists virtually. Sehat Kahani also conducts preventive health care drives to bring out a long term behavioural change in communities capped at 20% net revenue profit. (b) Mobile health Application: Through this application, users can obtain quick consultations with general and specialist female doctors along with keeping track of their health history and obtaining digital prescriptions. Our target users include: (i) B2B solutions enable corporate businesses to use this app as a tool to meet the primary health needs of their employees.  (ii) B2B2C solution is for corporations with a larger consumer base, such as banks, insurance companies and telecom firms who are able to provide app services to their clients. For our corporate models we charge a per user annual subscription fee of $5-$20 for GP only, $10-$30 for GP+specialist and $15-$50 for GP+specialist+mental health expert (iii) B2C solution is for retail users targeting more than 74 Million of smartphone users with subscription charges $10/user/year or per consultation charges ranging from $2-$15 per user. 

Do you primarily provide products or services directly to individuals, to other organizations, or to the government?

What is your plan for becoming financially sustainable?

Sehat Kahani will come as an implementation partner to operate and manage telehealth units in northwest regions of Pakistan whereafter initial establishment costs, annual costing will be managed by Sehat Kahani teams deployed in these communities. This cost will be maintained through a sustainable business model and consumer traction that will enable these units to break even and sustain Economies of Scale are defined as when more units of a good or service are produced on a larger scale, yet with (on average) fewer input costs. As Sehat Kahani Grows and production units increase, we will have a better chance to decrease the costs. According to this theory, economic growth may be achieved when economies of scale are realized. Referrals will be created at the telehealth units to resource centers which will result in a reduced patient burden at the unit level. We will partner with local organizations and the government to expand our scope of mobile health applications to increase user traction and utilization rates. More and more specialized patients will then be consulted at the primary health care level within their vicinities resulting in a more focused approach to primary healthcare patients within these units resulting in enhanced patient quality of primary healthcare services at these units. The cost will also be maintained through this prospective partnership and referral. At a social level, we benefit our doctors by being able to practice medicine remotely from the comfort of their homes. The inclusion of these unemployed human health resources plays a major role in managing the healthcare sector challenges while mitigating cultural and social sensitivities. Additionally, these doctors and frontline health workers gain financial inclusion, access to virtual continuing medical education sessions, recognition on social media, a chance to attain additional certifications, and most importantly, a whistle-blower initiating behavioral change for telemedicine in Pakistan. In Sehat Kahani’s e-clinic model, each E-Clinic is leveled at sustaining themselves over a period of 12 months post establishment which helps them in achieving a target of 450 clients which helps them in generating enough revenues which are cash flow positive. This allows them to sustain the E-Hub clinics themselves in the upcoming years as well as help fund other scaling projects across the country.

For our long term sustainability plan, Sehat Kahani in the next five years envisions establishing 101 E-Health Clinics Nationwide and aims to train a Network of 5000 doctors, health providers and mobilizers developing independent micro entrepreneurs or consultants on the Sehat Kahani Panel. This would result in a cumulative impact of approx. 15 million lives both directly as well as indirectly through the E-Health Clinic and Health Education services which Sehat Kahani provides creating a Gross Revenue of around 8.8 Million USD with an anticipated Net Revenue of around 2.7 Million USD. Additionally Sehat Kahani through its E-Health application, will be able to lock over 30 million active users availing e-health services through the E-Health application, shifting the trend from physical towards virtual OPD consultations and other digital diagnostic services in Pakistan.

Share some examples of how your plan to achieve financial sustainability has been successful so far.

Some of the examples of our funding includes:

• SPRING Accelerator provided a grant of $83,000 in Feb 2017

• Cartier provided a grant of $30,000 in 2017

• GSMA Fund provided a grant of $169,793 in March 2018

• Raised equity from Elahi group of companies for $100,000 in Feb 2018

• Frontier Innovators provided a grant of $75,000 in March 2018

• Amplify Grant provided a grant of $100,000 in July 2018

• Raised equity from Zeehan Ahmed of $100,000 in Dec 2018

• USAID provided a grant of $18,460 in Feb 2019

• Rolex provided a grant of $75,000 in August 2019

• Acumen provided  a grant of $48,194 in May 2020

• Microsoft provided $5,000 worth of cloud support.