Updated Apr 05, 2018

The Maternal Episode of Care Prototype (Liberia)

Our tool assists governments in engaging private health providers for maternal care by using NFC and decision support technologies to link quality care to e-payments -- streamlining and automating patient, provider and payer transactions.

opendevelopment.co
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Ilyse Stempler

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Snapshot

Stage 2: Research & Development

In close collaboration with Liberian stakeholders, we have co-designed, refined and user-tested a working prototype. We plan to pilot the system in 2018 with private facilities and 500+ pregnant women.

Focus Areas:

Urbanization and Maternal Newborn and Child Health

Urbanization and Maternal Newborn and Child HealthSEE LESS

Implemented In:

Liberia

LiberiaSEE LESS

1
Country Implemented In
$250,000
Funds Raised to Date
Verified Funding

Problem

The increased demand for maternal health services has outpaced the ability of many public health systems to provide adequate, high quality and respectful care. Resources invested in public facilities often are without commensurate accountability mechanisms to empower communities. Engaging the private sector is critical for achieving reductions in maternal and newborn mortality because it fosters competition and improves the resilience of the health system overall.

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Solution

Our tool is designed to improve quality care by: providing the financing to empower women with more choice in where to seek care, providing healthcare workers with e-decision support based on a country’s own clinical guidelines and patient data, and by tying prompt payment to quality measures. At the same time, it streamlines and automates the operational functions required in a health insurance scheme, like coding care and submitting a claim.

Mission and Vision

We think this approach will empower national and local authorities to overcome many of the key operational challenges for engaging the private sector in UHC. We believe that by re-imagining “why, what, when, how and by whom” data is captured, analyzed and used, we can reduce the financial barriers for poor women who want to access quality care from the private sector, without requiring payers and providers to invest in complex, time consuming and costly administrative systems.

Innovation Description

Our approach was designed to improve access to quality maternal and newborn care across the maternal and newborn episode of care (EOC) by: (1) giving women greater control of where to seek care and over their own birth record, through the use of near field communication (NFC) technology, (2) providing healthcare workers with e-decision support based on the country’s own clinical guidelines and the patient’s condition, and (3) tying a provider’s prompt e-payment to quality (as defined by adherence to clinical guidelines). The tool also streamlines and automates many of the key operational functions needed to support public private partnership in the health sector (e.g., claims submission, payment adjudication, auditing and reporting).

How it works? An enrolled woman is given a token equipped with a read/writable near field communication (NFC) chip. When she goes to an accredited private facility, the provider use will their NFC-enabled smart phone to ‘scan’ the chip to verify her eligibility and gain access to her birth record. As the healthcare worker navigates the e-decision support, entering in the results of his/her questions and observations, test results, and services/drugs provided, this data is recorded for the patient, the provider, and the payer. Once the provider has connectivity and data is synced, it triggers an automatic payment based on adherence to clinical care guidelines and pre-negotiated terms.

Competitive Advantage

There is no need for cumbersome claims processing, and because the solution automatically collects robust utilization data, including time spent with the patient and trends in health conditions, it can generate HMIS reports to the government, signal the need for an audit, and lay the foundation for value- or performance-based episodic payment schemes in the future.

Planned Goals and Milestones

As the prototype has already undergone extensive co-design, testing and refinement in Montserrado County, the pilot will be ready to proceed in mid-2018, pending financial support from donors and investors. The two-year pilot budget of USD $1.5 million would enroll approximately 850 pregnant women, providing them with access to quality care at an accredited facility throughout the maternal and newborn EOC.

Funding Goal1,500,000

Milestones

Apr 2018
Recognition
Applicant
ORGANIZATIONUnited Nations
Mar 2018
Dec 2017
Nov 2016
Jan 2017
Launched
Date Unknown
New Country
Liberia