The Saathealth Story: From Access to Empowerment

At Saathealth, our central thesis is that the demand for healthcare will continue to rise significantly, as improvements in diagnostics mean we live longer with prolonged chronic conditions. Most countries are starved of adequate health workers and while we need smart supply side innovations, we also need to reach, engage and guide health consumers towards preventive health interventions.?

Saathealth specialises in mapping the users’ journey, speaking to them in a language they understand, raising awareness and health seeking behaviours and guiding consumers towards products and services that best serve their health needs- using the right message to the right user at the right time!

We decided to reflect on our journey, using the lens of the papers we have contributed to publishing over the last 10 years. It was a privilege to work with experts across healthcare, human centred design, technology and behaviour change content for these papers, so we cannot claim sole credit for this work. However, these papers are a summary of the exciting influences on our own approach to the application of digital health to improve health systems globally.

Early Discoveries: Access to Information and Design Challenges

Our first paper in 2011 found that despite several efforts, patients have limited access to authentic information. Some have the facts and know about procedures, but lack conceptual understanding of the disease. Challenges include low education, no access to technology, lack of socialisation, less time with doctors and counsellors, high power-distance between patients and doctors and counsellors, and information overload. Many of these challenges persist even today. Information solutions based on mobile phones can lead to better communication and improve treatment adherence and effectiveness

Our work with emerging digital users highlighted 4 main design aspects that mobile based health interventions must consider to overcome barriers to digital adoption .

• Cost is no longer the biggest barrier..?
• Infrastructure investments will overcome any remaining cost barriers
• Digital experiences need to be designed for low-income populations.
• There is a lack of trust in health-related digital information. Since this paper, we have seen that there is an increasing trust in digital health information, especially amongst the low income consumers.

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Leveraging Technology for Health System Advancements

Our next paper highlighted that the increasing use of technology by health systems, provides an opportunity to use the data exhaust and meta-data generated from digital tools as an additional data source, increasing the ability to move toward real-world evidence in the evaluation of digital health interventions and health interventions.

Our ongoing focus on ethnography in this paper, highlighted the need to engage with the broader ecosystem of the patient, helping users resolve contradictions and make practical choices confidently. It identified the need and the opportunity to go beyond only broadcasting information, adding options to repeat information and allow for interactivity. ?This paper captures our ongoing implementation experiences that provided early and robust evidence that tailored mobile based messaging can significantly improve health practices and knowledge that can positively impact children’s health.

The Data Revolution and User-Centric Approach

A related implementation paper provided evidence that mobile based messaging providing tailored and timed information can positively impact maternal health care practices proven to improve maternal health outcomes.

The data revolution allowed us to explore the combination of incentives, carefully designed behavioural nudges and storytelling combined with a gamified journey, to nudge parents towards better health and nutrition choices for their children. (published paper available on request)

Advanced Predictive Modelling for Greater Uptake of Health Content

Our learnings from the use of a data-driven approach to interface design, and a contextualized understanding of the end-users, were shared and published in our first ACM Compass paper. We shared how the ubiquity of data enabled phones and increasing use of artificial intelligence powered technologies unlock unprecedented opportunities to reach and serve the billions of new underserved consumers with transformative health, nutrition and early learning information.

Our follow-up ACM Compass paper showed how machine learning-driven health recommender systems may be effective tools to sustain user engagement with health content data from our user base allowed us to build scalable, predictive models that we published in the Frontiers in Artificial Intelligence. We learnt that ML algorithms can optimize the effectiveness of digital interventions by augmenting personalized experiences and directing limited health resources toward populations that are most resistant to digital first interventions.

Our work in sub-segmenting digital behaviors for targeted interventions led us to our work in digital phenotyping, presented at the Harvard’s Health Data Sciences Symposium. The potential of digital phenotyping perhaps demonstrates the greatest potential for precision digital health interventions.

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Digital Phenotyping for Precision Health Interventions

Assigning a digital phenotype can help build predictive models around user behaviour, providing insights into their engagement levels and the means to optimize the efficacy of digital health interventions. This method of user segmentation offers further opportunities to enhance diagnosis, risk prediction, treatment effectiveness, and patient monitoring. Our follow up digital phenotyping scoping review mapped the published research on digital phenotyping and provided foundational as well as application-oriented approaches toward digital phenotyping in health. The review confirmed the need to focus on more prospective, longitudinal studies that include larger data sets from diverse populations and build “digital phenotypes” to personalize digital health interventions and treatment plans.

Multi-Pronged Strategies for Health Education and Behavior Change

Our latest publication summarizes Saathealth’s approach to improve knowledge levels on various health topics, nudge positive behaviour changes, and drive improved health outcomes. We share our learnings from using a multi-pronged approach: (1) ensuring localization and cultural relevance of the health content delivered through user research; (2) disseminating content using omni-channel approaches (3) using iterative product features such as gamification and artificial intelligence-based (AI-based) predictive models; (4) using real-time analytics to adapt the user's digital experience by using interactive content to drive them towards products and services and (5) experiments with sustainability models to yield successes. We published our learnings in the hope that these strategies will help guide the sustainable and impactful scaling of mobile health interventions in other resource-limited settings.

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Saathealth’s? upcoming publications will share our learnings from health spends in Indian consumers, especially in the aftermath of the COVID19 pandemic and our systems approach to deploying digital health interventions to serve the needs of adolescent mental health.?

Our publication journey provides a glimpse into our evolving understanding of the opportunities that digital tools enable in expanding the reach and impact of health interventions to underserved health consumers. They sharpen our thesis for creating health impact, challenge our assumptions and help us focus our energies to driving real change where it matters most – with the end consumers!