Since our last post on the Kenya-based MicroClinic Technologies’ Zidi software, the program has seen many encouraging changes. Below, read news of the organization’s improvements and lessons learned in the field, as well as our original reporting on the health program.
After a successful 12 month pilot of Zidi software in Kisumu county, Microclinics has received approval from Kenya’s Ministry of Health to implement their technology in up to 4,000 public facilities. While the logistics of this roll out are still underway, MicroClinics has turned its attention to registering additional service providers in both the public and private sector. They are currently working with three facilities that include:
- Gatundu District Hospital, which is a level 2 public health facility and MicroClinic’s first Zidi client serves large volumes of patients and includes a fully equipped maternity ward, but no on-site surgery center. The reporting and inventory management were the features of the software that were of most interest to the hospital. The software streamlines registration and tracking of patient records as well as drug inventory, which aligns hospital reports to the standard reporting template used by the Ministry of Health.
- Marura Hospita, also a level 2 hospital but is a private facility. Similarly, the adoption of the Zidi technology has allowed them to save on reporting costs and other redundancies they had discovered in their system of operation that slowed how care was delivered. This was especialy critical to them as they saw upwards of 80 patients per day, so they couldn’t affort to delay delivery of care.
- Mart Meg clinic, is a private health facility that serves a volume of 5-10 patients daily, acting as one of the smaller providers to have implemented the Zidi software. They weren't seeing as many gains from the software such as streamlined reporting and significant operations efficiencies due to other challenges such as blackouts, patient volume, staff turnover etc. Nonetheless, the software proved invaluable as it allowed the clinics to have a central database for patient records and inventory and it generated the required government reports.
Original post, by Lane Goodman with Trevor Lewis and Heather Vincent
After winning “most promising innovation” in CHMI East Africa’s innovation awards in March 2014, ZiDi™, a Kenya-developed software designed by MicroClinic Technologies to give owners of clinics in Africa full management control of personnel, patients, inventory and fees collected in real-time has gone on to attract considerable attention from the social innovation space. Continuing on this wave of success, in November 2014, MicroClinic Technologies was selected as a grantee in the CHMI Learning Exchange, an initiative designed to support the scale and improvement of programs profiled in the CHMI database by allowing programs to engage in a strategic learning activity with a pre-defined partner. Microclinics applied for the Learning Exchange to partner with GSK (Kenya) and Spartan (South Africa) to learn from their experiences in increasing adoption of innovative technologies in the markets they operate in. They sought to improve business and health outcomes through the implementation of a sustainable sales and business development program for youth agends.
According to MicroClinic Technologies founder Dr. Moka Lantum, “CHMI was the first Health organization to recognize the power of our innovation and business model. Since being recognized by CHMI at the East Africa Health Federation Conference in Nairobi Kenya and participating in the CHMI Learning Exchange, ZiDi™ has received numerous interests from local and regional entities seeking to better understand and support our value proposition and disruptive approach to increase access to safe affordable drugs for the underserved. Private clinics are also adopting our service, and the satisfaction from the customer base is what we strive for every day.”
The Challenge of Medical Record and Inventory Management
Despite a successful and consistent downward trend in the childhood mortality rate in Kenya, the mortality rate of 71 per 1,000 live births is still alarmingly high. Without effective systems to manage inventory and order new medicines and assure their procurement from a trusted source, rural clinics face constant stock-outs of medicines and stand the risk of distributing dangerous counterfeit medicines. Rural clinics provide over 80% of care in Kenya, but these stock-outs and fake drugs contribute to the high rate of childhood mortality.
MicroClinic Technologies’ innovative health enterprise management service, ZiDi™, addresses many of these issues in rural clinics through an automated electronic medical records system and real-time drug dispensing tracking feature. With ZiDi™ facilities have the power to forecast demand for services and supplies. This inventory tracking feature connects with its second service offering, Chama-Rx, which is expected to launch in early 2015. When facilities subscribe to Chama-Rx, they participate in a pooled purchasing program that allows them to order supplies weekly at the quantities they need and at close to wholesale prices.
ZiDi™: More Than Just Electronic Medical Records
ZiDi™ is an application that seeks to eliminate guesswork from the practice of medicine in Africa. Everyday, providers in Africa, especially those serving the bottom of the pyramid, are faced with a myriad of issues that require data for good decision-making. For example, most clinics don’t know how many patients will be coming in each day; most clinics operate at 25% capacity or less with little knowledge of the performance gaps. The clinics lack diagnostic equipment so the providers rely on intuitive thinking to discern the diagnosis and treatment plans; 40% per cent of patients are misdiagnosed. Many providers seeking to prescribe a given drug are unaware of whether or not the drug is in stock or in a nearby chemist; 64% percent of clinics report stock out for basic antibiotics. And when available, these drugs are either too expensive or are counterfeit; one in four of patients are priced out of a prescribed drug and 30-40% of the drugs available in the market are counterfeit. Hence, providers are trapped in a constant guessing game on patient volume, diagnosis, cost-effective treatment options and safety of prescriptions.
The data is collected in ZiDi™ seeks to reduce the administrative reporting and clinical decision burdens placed on owners or administrators of clinics in the Africa health setting. The need for data is further compounded by the need for public health disease surveillance by the Ministries of Health and donor programs.
Heather emphasized that ZiDi™ is more than just a piece of software – it is a highly customizable service that offers clinics an end-to-end solution. The company further provides value for its users by offering ZiDi™ as a one-stop-shop utility service inclusive of tech support, hardware, training and installation costs.
The innovative payment model offered by MicroClinic Technologies also makes ZiDi™ affordable for all levels of care. Rather than the fixed one-time huge upfront cost required by most software vendors, MicroClinic offers ZiDi™ as a pay-as-you-go service charged at a per patient fee. Facilities are thus able to pay a fee that ranges from $0.50 - $1.60, depending on patient volume. Similar to purchasing airtime, facilities purchase ZiDi™ with patient points, allowing them the flexibility of paying according to their working capital needs.
Impact Targets: Reaching the Last Mile
ZiDi™ improves patient care by standardizing the clinical encounter to ensure rural citizens are offered the same level of attention as those seen in higher levels of care. For ZiDi™ to reach the last mile, MicroClinic Technologies is recruiting youth from local communities to serves as independent sales agents. The “Blue Angels” youth agents are trained and equipped with information to enroll clinics within a given target territory. MicroClinic expects to create one youth IT job for every five clinics enrolled, with a potential to create jobs for over 1,000 youth in the Kenya private sector alone. “Once clinics have satisfied patients, access to health financing and drugs, and access to local labor for maintenance, there is no reason why any clinic regardless of location should not be profitable and sustainable, thus minimize the rural-to-urban flight of clinicians in Africa,” writes Heather Vincent.
MicroClinic Technologies continues to receive interest and accolades from organizations including GIZ-Kenya, PSKenya, IPIHD, and Ashoka, was a finalist for the 2014 Financial Times/International Finance Corporation Award for Achievements in Health IT, and received the 2014 Frost & Sullivan Customer Value Leadership Award in Africa. These awards recognize the disruptive approach that ZiDi™ heralds: the promise of e-health in the African market.
Photo top: Moka Lantum, founder of MicroClinic Technologies, with clinic officer
Photo above: © GSK c/o MicroClinic Technologies