5 Rules nonprofits can follow in their digital health procurement

Nonprofits can save their dollars by relooking their procurement strategies for digital health. Procurement for digital technologies need not be the same as procuring physical services and supplies.        

Recently, I reached out to about 250 nonprofits across India to find out their reach and the healthcare activities they have undertaken so far. Of the 33 out of 250 nonprofits who responded, the majority (91 percent) are creating health awareness. Some 49 percent of nonprofits are supplying medicines and consumables. A 43 percent of respondents are delivering healthcare through doctor consultations. And 30 percent of nonprofits are also running clinics.

Embracing Digital Healthcare

Like many things, COVID-19 forced most nonprofits to actively scout for digital health technologies. The shift came almost overnight. More than ever, nonprofits are exploring digital health tools and technologies.

Education and Awareness

Not surprisingly, most nonprofits are going big in procuring Apps for spreading health education and awareness. In this segment, nonprofits tend to ask for a mobile App (more specifically, the Android App) to run educational content mostly packaged as short videos through a cadre of public community health workers (such as ANMs, ASHAs, and Anganwadi Workers) to the communities. In a few cases, nonprofits wanted to use AI chatbots in local languages.

Without exceptions, nonprofits intended to develop these Apps and the content from scratch and also own the rights to the source code. The procurement policies encourage the software development agencies to quote for maintenance and server cost. A very few contents developed as part of these projects are available publicly, such as on YouTube for reuse and repurpose.

Doctor Consultation and Telehealth

In this category, there are fewer NGOs to procure prescribing and telehealth Apps. Those who procured during the COVID-19 period attempted to own the source code and licenses. Some nonprofits with significant budgets automated both in-clinic consultations and point-of-care diagnostics. In most of these cases, nonprofits procured software and hardware through grants they received either from international donors or through corporate social responsibility.

Supply Chain and Commerce

Compared to the activities above, most nonprofits are yet to use digital health (such as an eCommerce App) for their sale and distribution of medicines and consumables. One plausible reason is that the scale and diversity of the product bucket are quite minimal. Most nonprofits focus on supplies related to reproductive and menstrual health. They are yet to venture into prescription drugs, covered well by the private shops.

Common Thread

In my analysis of nonprofit procurement, some common threads are emerging:

1. By default, nonprofits tend to develop the Apps from scratch. There is a limited attempt to analyze the reusability of the existing Apps being used in other projects.
2. Some have included the catchphrases like AI/ML in their procurement announcements, without detailing their relevance, applicability, accuracy, and development.
3. Procurement policies didn't specifically seek interoperability and integration with their existing Apps or Apps brought by the state or central health administrations, for example.

What Should We Do

Here are the 5 rules that nonprofits may apply while making their next procurement:

1. If most of the functions are available in a SaaS App or framework, chances are the agency can configure the SaaS App to meet most of your requirements. Because most projects get funded for 2 to 3 years, nonprofits don't need a license to own the source code. Nonprofits should make sure the SaaS provider has stringent data security and privacy in place.
2. Make sure the App is interoperable and integrated with your existing systems as much as possible. The list of integration and interoperation with your existing systems would include a single login, unified master data, content, to name a few.
3. Develop an empanelment of digital health agencies with strength in their specific digital health areas to speed up your procurement process. You may revisit the enameled providers every two years.
4. In the impact space, nonprofits always need to measure cost-effectiveness. In any procurement process, make sure you mention the number of users (login users) and end-users of the App. The agency would be in a better position to justify its budget per user.
5. Wherever possible provide a realistic and performant technology stack that follows open-source principles. There are many volunteers who can suggest a technology stack. A survey among the digital health agencies would also help the nonprofits to finetune the technology stack and architecture before they can initiate a formal procurement process.