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Praanno: COVID+ Patient Management Tool

The Praanno software tool will facilitate symptom management for COVID+ / suspected COVID+ patients not requiring hospitalization.

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Praava Health, an integrated healthcare system in Bangladesh, plans to develop a software tool that will help people who have confirmed or suspected COVID-19 manage their symptoms effectively from home.

Praanno will:

  • Prevent clogging of healthcare system for patients who do not require hospitalization by preventing unnecessary healthcare visits that spread disease among patients and health workers alike.
    • As COVID-19 spreads in a community, hospitals become sources of cross infections. COVID-19+ patients end up infecting healthcare workers and other patients. 
    • To date, ~12-15% of reported COVID+ cases in Bangladesh are health workers.
  • Provide ongoing medical advice to quarantined patients and family members, including clear directions as symptoms evolve over time regarding if and when to seek hospital care.
  • Support family members with guidance and resources to help to manage their loved ones who may be COVID+.
  • Ensure clear standards of care for medical professionals treating COVID+ patients, especially as scientific understanding of the virus is constantly evolving.

Audience for the Praanno Tool: 

Inspired by the basic public health concept of active and passive surveillance, the audience for the tool should be: 

  1. COVID+ patients
  2. Suspected COVID+ patients
  3. High risk populations
  4. Family members for people falling into categories 1, 2, and 3. 
  5. Medical professionals treating patients in categories 1, 2, and 3.


Only COVID+ patients with severe and critical symptoms are hospitalized for treatment, whereas those with mild and moderate symptoms (~80% of all COVID+ patients, estimated 70M in Bangladesh) are recommended home management, currently with limited guidance on both how to manage their health while at home or at what stage to seek doctor’s help again/ get hospitalized. 

 

The Praanno tool incorporates the following features: 

  1. Dynamic tool for reporting biometrics. 
    1. Frequency and nature of biometrics reporting is based on risk assessment for each patient, such as those suggested by British Journal of Medicine, based upon the latest guidance and clinical recommendations from WHO, Centers for Disease Control (US), and National Institutes of Clinical Excellence (UK), among others. Praava Health has identified and developed pathways for 5 different risk categories. 
      1. Very High Clinical Risk - Confirmed COVID-19+ AND age > 65 OR Co-morbidity
      2. High Clinical Risk - Confirmed COVID+ OR Suspected case with at least one core symptom AND age > 65+ OR Co-morbidity
      3. Low Clinical Risk  - Suspected case with associated symptoms OR One Core Symptom age < 65 and no comorbidities
      4. Asymptomatic and High Clinical Risk - Positive Travel / Contact History + age > 65 OR Comorbidities
      5. Asymptomatic and Low Clinical Risk - Positive Travel / Contact History + age < 65 + no co-morbidities
    2. Based on risk group, patient and family member will:
      1. Report biometrics/other necessary information over time.
      2. Receive push notifications on self management tips.
      3. Receive recurring follow-up calls and recommendations from Praava doctor.
      4. Be advised on if and when they need to seek hospital care.
    3. Praanno will push data shared by patients and family members back to care team,  which will reach out for follow ups as required. 
  2. Educational content, including awareness videos and other tools. 
  3. Latest evidence-based guidelines, pathways, and algorithms for COVID 19 for medical professionals, from sources including WHO and CDC, to guide consistent decision-making, especially critical when knowledge on the virus is evolving so quickly.

What is the need are you focusing on?

An unchecked COVID-19 pandemic in Bangladesh could lead to extreme mortality and contagion due to higher rates of poverty and insufficient supply of quality healthcare- especially in the dense urban setting of Dhaka, a city of 18 million with a high risk of community transmission. Decades of progress toward poverty reduction and health could be undone in months. As of April 30, Bangladesh has recorded 7,103 cases of COVID-19 and 163 mortalities, but due to lack of testing infrastructure, the actual infection rate is unknown. 

In Bangladesh, most people go to a hospital when they are sick and there is very little emphasis on prevention. When there’s not a health crisis, fewer than 20% of people can access critical care, which means a spike in COVID-19 cases can quickly overwhelm the health system. There is an urgent need for solutions that keep people out of the hospital and help maintain health to prevent escalation of mild COVID-19 cases or non-COVID illnesses.

Which type of submission are you sharing?

  • Identifying a gap that needs to be addressed
  • Sharing an actual pivot your organization has already made

Describe the business pivot or adaptation in 3-4 sentences.

During the COVID-19 crisis, we are accelerating the offline to online channel development, and are building Praava’s brand further beyond its existing community and accelerating investments in online to offline and telemedicine channels across Dhaka city and indeed the entire country. Through the COVID-19+ Patient Management product, Praava will develop protocols and technology solutions to improve communications between patients, doctors, and families as symptoms evolve over time; to help families care for COVID-positive patients; to help patients to determine if and when they need to access hospital care. This will prevent clogging of the healthcare system with patients who do not require attention from a hospital and prevent further spread of infection by helping patients safely manage their symptoms at home.

Do you plan to implement this solution?

  • Yes

Describe the impact that this solution will create in the world.

According to the CDC, 80% of COVID-19+ cases can manage care at home without requiring hospitalization. In Bangladesh, where healthcare is already overly hospital centric, there is a substantial risk that patients who do not require hospitalization will flood the hospital system. A leaked UN memo projects the COVID-19 pandemic might result in up to 2 million deaths in Bangladesh, and that patients will be left untreated because of “a complete saturation of the health system early in the epidemic.” Bangladesh could see years of social and economic progress wiped out by COVID-19. A BRAC University paper projects that Bangladesh will have 89 million symptomatic COVID-19+; of these cases, an estimated 71 million (80%) do not require hospitalization. Praanno will help these patients assess if and when they need to access hospital care, help families care for COVID-positive patients, and improve communications between patients, doctors, and families as symptoms evolve over time.

What is the name of your business or organization?

Praava Health

What does your business/company do? Whose needs does your business/company address? Who do you serve?

Praava Health is delivering a better patient experience and international quality care for Bangladesh’s middle class. Praava offers a wide range of outpatient services, world-class laboratory and imaging diagnostics, and pharmacy, all under one roof. Our services include: -Family Health Professionals (8 specialties) -Visiting Specialists (10 additional specialties) -Bangladesh's first molecular cancer diagnostics lab -Full range of imaging services -In-house pharmacy -Telemedicine, including teleconsults and videoconsults and case reviews with local and foreign doctors -Bangladesh’s first fully integrated Hospital Information System, including Electronic Health Records and featuring the country’s first Patient Portal

What is your profession?

Founder & CEO

Where are you located (country)?

Bangladesh

Where are you located (region)?

  • Southern Asia

What industry is your business/company in?

  • Healthcare/Medical

How many people does your business/company employ?

  • 50-249

How old is your business/company?

  • 2-5 years old

Which classification describes your organization/business?

  • Business

What kind of stakeholders and partnerships are needed to pursue this solution?

  • Funding- Grants
  • Funding- Investment
  • Stakeholders/Partnerships- NGOs
  • Stakeholders/Partnerships- Private Sector
  • Stakeholders/Partnerships- Government
  • Stakeholders/Partnerships- Civil Society Groups
  • Stakeholders/Partnerships- Grassroots/Community Groups

Do you need help building partnerships and finding partners?

  • Yes

If Yes to the above, please share 1-2 sentences describing the specific help you desire.

[Tech] Launching Praanno on an accelerated timeline requires a level of development / data architecture expertise that we currently do not have in-house. We would benefit from a partnership with developers who would be able to help build and scale Praanno. [Scale] Praanno can be rolled out to an extensive patient community through partnerships with NGOs, hospitals and government-run health facilities. Through these partnerships, we can deliver care to at-risk patients in these agencies.

What do you think are the main barriers to implementing this solution?

-Integrating with as many customer facing messenger platforms (eg. Imo, whatsapp, Facebook messenger etc) -Health Data layer interoperability - using new standards like FHR will be a challenge due to the lack of specific skill sets related to this. -Making the platform agile for changing clinical protocols and interventions -Creating solutions that are useful and easy to use for medical professionals as well as patients and family -members of all ages

If you are currently working on a pivot, what have you learned so far?

Pivoting from pre-Covid operations into telemedicine, we have faced an array of issues that we had to quickly resolve to ensure seamless patient journeys as Praava promises. -We realize tech literacy is low on both service provider and patient side, which meant slow uptake on telemedicine services and long hours of training for the doctors. -As we aim to serve patients from all kinds of demographics, we have had to build solutions and processes that work on all kinds of devices, internet connectivity and coverage -Sudden surge in technology resources including hardware, third party integrations and human resources has required significant investment -The telemedicine system in place is not at a point right now where it can provide the end-to-end healthcare process including test referrals and follow ups, which we offer to patients when service is provided in person.

Are you aware of any open source efforts, hackathons or other collaborative efforts related to your solution? Are you participating in these efforts?

ACT COVID19: NATIONAL CALL is a national hackathon powered by the ICT ministry of Bangladesh, which is calling upon all entrepreneurs and software developers and scientists to submit their solutions to COVID-19 under several clinical and business themes. Praava Health is participating in the hackathon presenting Praanno made according to current international benchmark and standards under the Healthcare Equipment and Treatment theme.

Website URL

https://praavahealth.com/

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