We work independently and with world-class partners to provide complete project execution capability from advanced R&D, development, deployment, and impact measurement on the ground.
IPRD works as a catalytic organization by first developing technologies and demonstrating impact in smaller deployments, thus providing technologies, processes, and know-how to larger organizations to achieve disruptive impact on a global scale.
We strive to understand the unique challenges of building solutions that serve patients at scale.
Our Team works closely with both patients and healthcare workers in both the public and private sectors to innovate disruptive solutions now enabled by the mass commoditization of powerful digital hardware and software capabilities.
We have built innovation centers located strategically close to users, enabling the development of highly-localized solutions, rapid problem solving, and direct feedback, while at the same time leveraging core technological capabilities we are developing that are designed for scalable deployment anywhere.
We are headquartered in New York. Our innovation centers are located in Bangalore and Johannesburg with projects distributed across all 3 locations.
OUR WORK
COVID-19 has exposed the strengths and weaknesses of healthcare systems throughout the world.
IPRD has applied its significant experience and technical capabilities to where it can help most.
IPRD has worked on advising on bluetooth contact-tracing standards, MITRE’s nationally-available monitoring, reporting and analysis platform, developing vaccination certificate standards, and has adapted its SmartHealth platform capabilities to develop SmartHealth RECOVERS (Rapidly-deployable and Extensible COvid-19 Vaccination opERational Solution) to manage mass patient vaccination in pop-up vaccination centers in LMI countries.
Knowing the identity of a patient is critical to monitoring their health history over time. This capability is particularly important for early detection of disease by comparing current information to a baseline, for treatment of chronic diseases like HIV & TB, as well as for reducing loss-to-follow up and to avoid expensive re-testing. However, in many LMI countries in particular, identifiers do not exist, are not unique, or are linked to national registries that have nothing to do with healthcare. This can generate perceived and real concerns within a country’s population related to issues such as lack of inclusiveness, for migratory populations near borders for example, and the potential for Government overreach and misuse of identifiers.
We have developed a decentralized approach to identification that focuses on patient matching and that does not depend on coordination or linkage to centralized systems or national registries although they can be used if available. At the same time, the approach enables independent clinics or even patients themselves to provide others access to their matching information, with the patient’s permission, to enable patient matching in diverse and disconnected environments.
In addition, we have developed an approach called Federated Biometrics that eliminates the aggregation of large numbers of biometrics held by a single custodian, and reduces or even eliminates GDPR compliance and other regulations, both of which have been real and perceived barriers to the deployment of biometrics to address important use cases in global health at scale.
PLATFORMS
A platform approach to a digital health solution enables a high degree of configurability without the need to redevelop core functional modules. A single platform can support diverse health verticals, such as maternal health, HIV, family planning, and malaria, while sharing common information such as identity or family survey information. This enables digital health solutions to scale while maintaining quality of care and reducing cost.
At the same time, platform solutions are often developed organically with a focus on a particular geography or health vertical, and in addition, training and other processes may have already been developed to use them. The key then is to enable different platforms to leverage each other’s capabilities and to easily share data and results to maximize impact and avoid duplication.
IPRD is working with the World Health Organization (WHO) and a global software platform company to build tools and standards to allow Government-sponsored or donor-sponsored system integrators to choose platforms interchangeably based on particular needs and preferences in a local geography. For example, such tools will allow providers to ingest the latest WHO guidelines in a machine-readable format, and to share data between platforms using rapidly-emerging FHIR protocols, and will drive different platform solutions to consistency of performance and interchangeability.
A digital campaign may be as simple as the distribution of family planning information, or as complex as a multi-dose vaccination program. Generally, a well-organized campaign may comprise a modeling and campaign control component, shown to the right in the block diagram, an intervention component, shown on the bottom, and a reporting component, shown to the left, which may include existing outcomes or reports from Government agencies.
A digital campaign can increase the quality and magnitude of the data flowing between these components as well as increase the precision of data, such as including anonymized outcomes at the individual level as well as increasing the temporal and geographical resolution of the data.
Digital Campaigns can be seen from the perspective of patients, health workers and administrative staff who may be part of a campaign, as well as from the perspective of Governmental agencies, donors, and research groups that either fund or depend on the results of a campaign to measure success or plan interventions.
Digital Campaigns can also be seen from the perspective of previous or future Digital Campaigns so that data and interventions from previous campaigns can be built upon and leveraged at the individual patient level, regardless of whether the campaigns were in the same or different health verticals.
As an example of a Digital Campaign, we have added SmartDocuments to our SmartHealth platform to provide a total operational solution called SmartHealth RECOVERS for enabling effective COVID-19 vaccination programs throughout lower-to-middle (LMI) countries and that generates DIVOC-standard vaccination certificates.
Leading organizations such as the Pew Charitable Trusts, working with IPRD Solutions,
have shown in a report on Enhanced Patient Matching that both patients and healthcare practitioners everywhere want to access and share personal health records (PHRs) securely and accurately so healthcare practitioners can be better informed and provide better care, anywhere the patient visits. However, in lower-middle-income (LMI) countries and elsewhere, PHRs often don’t exist or are so narrowly-designed that they require custom and therefore non-scalable integration for use in other health verticals or use cases.
We have developed a unifying approach for PHRs that considers records stored by the patient, point-of-care clinics, or centralized national laboratory databases as a continuum, with patient-centric permissions and access control capabilities that make record sharing inherently simple. We follow this unification strategy for other parameters relevant for PHRs, which brings some surprising and powerful capabilities not possible with traditional PHRs.
IPRD, working closely with the Hacey Health Initiative in Nigeria, has adapted and deployed a proven and scalable mobile/web based digital system for documenting and monitoring pregnancy related visits to Primary Health Centers (PHCs) and Community centers. Our initial deployment has received universal approval from health workers and the team at the Department of Health at the State of Oyo in Nigeria. Our teams are working to expand this access to the majority of the Primary Health Centers across the state of Oyo.
Low-cost HIV testing is a major capability contributing to the “Know your HIV Status” component of WHO’s overall 90/90/90 strategic goal. However, testing supplies such as RDTs are not as widely available in rural communities like KZN in South Africa. In addition, WHO protocol in any case requires a second supervised test before a positive HIV status is confirmed. IPRD and our partners at WITS RHI, South Africa, are testing a machine-guided risk assessment process run on widely-available mobile phones in order to supplement RDT testing capabilities and to complete the last mile of WHO’s 90/90/90 goal.
We have developed an HIV Risk Assessment capability to better understand the risk level of an individual to contract HIV. We are working with WITS RHI, South Africa for the trials and validations of the science. The first stage of clinical trials to ascertain feasibility was completed in Feb 2020 with over 1000 participants. Data analysis showed that the participant’s Demographics, Sexual Behavior & History, Personal Behavior & Lifestyle had the strongest correlations to HIV status. The second stage of the clinical trial is currently underway in multiple locations across South Africa.
Our work on malaria has focused on the collection and analysis of real-time data streams that can generate insights for course corrections, as well as customized control and elimination strategies for malaria that are adapted to the needs of specific populations in specific environmental settings [Mundel & Suzman].
Our goal is to achieve disruptive impact by developing and deploying digital platform-based systems that enable real-time, targeted malaria modeling, diagnosis and intervention for every village and nation in sub-Saharan Africa and South Asia.
For example, machine-guided healthcare enabled by smartphones and machine learning can use geographical and temporal context, including diagnoses from nearby patients and villages, to improve diagnoses locally. At the same time real-time data streams can update and improve highly sophisticated and longer-term models developed over decades by major scientific modeling organizations such as Imperial College, London.
To evaluate feasibility, an innovative, incremental machine-learning approach was developed and applied to symptom and RDT information collected in Nigeria and played back longitudinally to simulate daily updating of classifiers. A comparison of an expert community health worker / logic-driven malaria diagnosis with 450 patients over 3 months in 5 clinics near Kano, Nigeria, versus an incremental machine-learning and context-based diagnostic approach showed an approximately 20% improvement in diagnostic accuracy as measured by F1 score.
Objective measures such as heart rate or a Rapid Diagnostic Test (RDT) result can dramatically aid assessment or diagnosis. However, obtaining such measures may require specialized equipment and training, and the results are often lost to paper records. Moreover, they are not particularly useful for real-time surveillance - monitoring for outbreaks, and effectively allocating aid.
We deliver simple mobile phone-based tools to obtain objective measures without the need for special training and minimizing or eliminating the need for equipment. We are defining and using FHIR-based standards which provides a template for medical device manufacturers or software developers to also provide their own objective measures, and also makes it possible to access data in real time, enabling surveillance and record storage even in the most remote environments.
Our vision includes enabling high-value, health-based data services, such as patient identity, machine-guided-diagnosis, and secure health-record storage for underserved communities primarily in LMI countries.
The vision can be realized by empowering local integrators to develop healthcare solutions at scale, by selecting and combining existing software and hardware modules without the need or capability to develop the modules themselves. We believe that the explosive adoption of digital networks, mobile phone and computing technologies has put this vision within reach even in the most underserved communities.
A core step in achieving this is the specification and adoption of APIs and data standards that enable interoperability or communication between data services from different vendors or that perform different functions. We believe that existing standards such as OpenHIE and DHIS2 can be supplemented with newly-developed FHIR©-based standards to provide enabling capabilities for use cases unique to underserved communities in LMI countries, resulting in solutions that are best suited for the bandwidth and reliability limitations of mobile phone networks in such locations.
IPRD is working with Google on an SDK for Android FHIR support. IPRD has also developed APIs and data standards to enable different objective measurement capabilities (such as temperature, blood pressure, RDT results) to communicate and integrate in the same way with machine-guided diagnostic workflows.
