Tech for Good sits down with the founders of Ghanaian digital healthcare startup Redbird to find out how they are fighting chronic illnesses and advocating for a more decentralised healthcare model in the country
It all started with a hackathon, and ended with a healthcare startup in Ghana. Patrick Beattie, a founding scientist at a medical diagnostics startup in Boston, and Andrew Quao, a trained pharmacist, met in a hackathon in Accra, where they found out their shared interest in improving access to medical testing in Ghana, a country where a centralised and oversaturated healthcare system has turned pharmacies into the primary healthcare point. Soon after they brought in software engineer Edward Grandstaff, and started to develop the tech for a project that would provide a solution to this situation: Redbird. Redbird is a Ghanaian healthtech startup that allows easy access to convenient testing for chronic diseases and ensures that doctors and patients can view the details of those test results at any time. The company has recently raised $1.5 million from investors including the Johnson & Johnson Foundation to create a decentralised model that will support Ghanaian pharmacies and give people back control of their own health. We sat down with Redbird’s three founders to talk about the company’s mission, and the future of healthcare in Africa.
TFG: Before we go into what Redbird does, can you give me some context about why there was a need for a company like yours in Ghana?
Beattie: “There's a couple of important things to know about the current state of healthcare in Ghana. The first thing is that chronic disease is exploding across the continent. When people outside of Africa think of Africa, they tend to think of things like malaria, tuberculosis, HIV; infectious diseases. But the reality is that one of the biggest health crises here right now is just the explosion of chronic diseases; things like diabetes, hypertension and high cholesterol. “When you look to the future, this is becoming a bigger and bigger health burden. And it is important because, from a testing standpoint, someone who has an acute disease hopefully gets tested once and then is diagnosed and treated immediately so that they can move on. Whereas with a chronic disease, the way you stay healthy is getting tested repeatedly. You monitor your health for the rest of your life; and that's very different. So your testing needs become much more frequent.
“The other thing to note is that the health systems here were set up to care for acute diseases, but in no way ready for chronic diseases. It’s very centralised and there are long waiting times. But if you need to be monitored frequently, daily or even more often than daily, you can't imagine going into a health facility and waiting for the whole day just to do that.”
TFG: What is Redbird’s mission?
Beattie: “Our goal is to make healthcare much more convenient. Convenience can be the difference between life and death; maybe not today but down the line. We look for ways to make healthcare more convenient for patients so that they can manage their health. “When we looked at it, people were already going to pharmacies often as their primary care because it was much more convenient. They were even doing some degree of testing in pharmacies like malaria tests. What we do is we help pharmacies offer not just malaria testing, but now instant or rapid diagnostic testing services for 10 different disease areas. Some of those are acute areas like malaria or typhoid, but a lot of them are more chronic diseases, things like blood sugar testing for diabetics, cholesterol testing and anaemia testing. “Every pharmacy that partners with us can now offer these 10 different diagnostic tests. They are existing already approved diagnostic tests, we're not developing the tests themselves. What we do make is the software, which is a place for patients to store their records, so that when they do go into a hospital to visit a clinician, they can show them their full health history.”
TFG: So how does the process work?
Grandstaff: “We supply the pharmacies with the tests, and we set up with a tablet device that connects to a local network. When patients come in to take a test, we get them registered on the tablet. We do it by phone number so that we can uniquely identify people because we have found that, even though smartphone penetration is growing fast, it's still not fully there. “We very purposely take the approach of different levels of tech sophistication of our users. For those that do have a smartphone, we do have a patient's application that gives you all the insights right there, but we also allow the option of not having to interact with the tech at all, it’s the pharmacist who does that. We think that's important because, if you only serve the top layer and expect your patients to learn how to use the software, you’re keeping a lot of people from having access to healthcare. “When a diagnostic test is taken, it immediately gives feedback in terms of World Health Organization metrics, explaining whether the blood pressure is high, or the blood sugar is within “normal” range. So that's an instant feedback that the pharmacy can provide a patient. But the key thing is that that result is remembered over time so that when the patient comes back, there's no need for any registration process, they're already connected to that particular pharmacy. And now you're building a trend, not just a single data point.”
TFG: What has been the most challenging part of the process?
Beattie: “The main difficulty is understanding the needs of the patients. Because we obviously look at the tech and see everything that you could do with it, but that doesn’t always align with what our patients want, so it’s important that we respect that. So a lot of our learning has been around understanding what actually does create value for these groups.”
Quao: “The challenge is not the tech; it’s using the tech, and getting people to switch and amend the workflow to incorporate that tech seamlessly. We train partner pharmacies and we expect that when people come to get tested, they see the need to ensure that they're no longer writing the results on paper, and use the software. But we don't get 100% usage of that, which is the challenge and it's something that we are working on to fix.” Grandstaff: “The real trick is coming in at the level that makes it convenient enough to use again; that the technology works in the framework of the pharmacy, and allows them to still develop a connection with their patients. Because, when patients have a health problem, they’re not wanting to go to the hospital, they go to the pharmacy first. I think that's also one of the things I really like about what we're doing, because we aren't trying to solve this problem from the top down. We're where people go to get healthcare and we're partnering with the facilities that provide it.”
TFG: How does the business model work?
Quao: “We are not a software-as-a-service provider. The pharmacies buy the rapid diagnostic tests from us, and while they continue to do that we provide the tablet, the software and the training for free. So what’s how we have set it up, to make money on the tests that are used. We wanted to avoid asking people to pay for a software even when they don’t use it for a month.”
TFG: Redbird has participated in accelerator projects including Founders Factory Africa and the Alchemist Accelerator. What have you gained from these experiences?
Beattie: “The Alchemist Accelerator was really the beginning of Redbird, because at the time, the three of us were not even now in the same location yet. But it was a great experience. It really helped kickstart us early on and create a network of investors that were not just in Africa, but also in the US, Europe, and India. At the time we were in just two pharmacies and we had 37 by the end of that year, so that really helped us get that early traction, which was really valuable. “Founders Factory was last year around this time. And obviously, we're at a different place now, but they are also a different type of accelerator there. It was more about how can we experiment and really find better ways of doing things? And that's really where Founders Factory excels in, bringing a lot of expertise that you don't have, and helping you go through that design thinking process. We've been incredibly happy with both programmes. They've offered different things, but each of them offered what we felt we needed at that time to get to that next level.”
TFG: You have also had a very successful funding round recently, so congratulations. What are your plans moving forward?
Beattie: “The first thing that we're so excited about is not just the funding, but who came in with it. These are great partners that we feel are really good and their expertise set us up for success straight away. The Johnson & Johnson Foundation is obviously a huge name and has a very broad healthcare expertise. And Newtown being a well known VC on the continent as well, we just think that they will really help us get to that next stage that we're looking to get to, as far as where we're looking to go.
“We want to continue to expand in numbers of pharmacies and also geographies. We are looking to replicate this model in similar markets. In addition, though, we're very focused on not straying too far from what has been a strength, which is getting to know our customers better so we can maximise the value we're providing them and therefore, really build the strongest relationship. So a lot of our focus now is just understanding how we can improve our relationship with the pharmacies and patients coming in so that we can offer the most value to them. “We recognise pharmacies are a very convenient and widely used point of healthcare. But they're not the only one. We want to make sure that we're helping these patients benefit from everything we do in a pharmacy but that when they go anywhere else in the healthcare system, they have convenient options for them as well.”
TFG: Where do you see the healthcare industry in Africa going in the future?
Beattie: “There is one thing, just because I think the more we talk about it, the more likely it's also to become true, which is the concept of leapfrog events on the continent. We strongly feel that decentralised digitally-enabled healthcare is that next leapfrog opportunity for Africa. The existing infrastructure is, you know, really struggling under the chronic diseases exploding everywhere, and you can’t rely on it, so you are forced to innovate. And that is why a lot of exciting innovation in the sector is happening here. “I think that you're going to have this situation where an ecosystem of players is going to create a healthcare model that's much more decentralised yet provides high-quality care, because it's also leveraging digital technologies. And countries all over the world are going to be looking towards the ecosystem here and say: ‘Oh, we need to replicate that’.”