DCCC Brick-and-Click Model Project Profile:
Project outline and goal:
According to WHO, primary care is the most efficient and effective strategy for improving health outcomes in low- and middle-income countries. A well-functioning primary care system can handle 90% of health conditions. Only 10% requires referral to higher levels of care.
The Brick-and-Click project is part of a collaborative effort which aims to enhance access and quality of primary healthcare for low-to-middle income households who are often unprotected by both public and private insurance schemes in emerging markets (also referred to as the ‘missing middle’ segment). The hybrid solution combines the best elements of in-person (‘brick’) care and virtual (‘click’) care.
The ‘brick’ portion of the solution refers to a physical point of care that can either be fixed or mobile and that is staffed with a health worker (such as a nurse, paramedic, or community health worker) who performs primary care consultations and runs awareness campaigns. The ‘brick’ can also include simple diagnostics and can act as a lab collection point and a mini pharmacy where over the counter medicines can be dispensed and prescribed medicines delivered. The role of the ‘brick’ in the model is to create trust and empathy and to help stimulate better health-seeking behaviors amongst patients.
The brick is supported by the ‘click’ which acts as a digital health ecosystem utilized by the health worker who, can access a general practitioner or other medical specialists via telehealth to assist with consultations. The ‘click’ serves to ensure quality, good diagnosis, and the right referrals and is supported by other digital tools such as an e-pharmacy, artificial intelligence capable of reading lab results, and electronic medical records for the continuity of care.
Inclusive health insurance is embedded within the model to further reduce out-of-pocket expenses (both out-patient and in-patient) and reduce financial barriers to getting the right care at the right time. This includes basic coverage, which is free to members, as well as an option to upgrade to a more comprehensive coverage that generates revenue to ensure sustainability of the model.
Ecosystems players involved
Currently, five DCCC members – AXA, Orange/Enova.com, PharmAccess, Philips and Swiss Re Foundation form the team that is working on the Brick-and-Click model.
There are opportunities for other DCCC members to get involved and, for example, contribute toward the strategy, design, and implementation of the project. Especially bringing in existing elements of the Brick-and-click model that can be leveraged and collaborated with.
Anticipated outcomes and impact
Brick-and-click models such as the one proposed here can represent an innovative and helpful approach in addressing the access and quality challenges of primary healthcare and yet only a handful of such models exist, none of which at a large scale. DCCC’s investment in this project can meaningfully contribute to accelerate this progress and can add value by:
- Simultaneously focusing on quality primary care and its financing as well as business model innovation to serve low-to-middle income households in a sustainable manner.
- Leveraging the collaborative power of DCCC members in terms of experience, solutions, and funding for demonstration cases as well as identifying areas where local and global teams of DCCC member companies can work together.
- Being patient enough to build foundations that can scale.
- Aiming at creating a demonstration case and creating bridges for specific governments and their universal health care (UHC) strategies.
- Demonstrating a quality improvement model that serves both brick and click modalities.
Potential for scalability/ next steps
The project is its initiation phase, collecting and assessing input of organisations that can provide elements of the Brick-and-click model.
Next steps include short-listing up to five potential demonstration projects by the end of June 2023, completing feasibility studies by the end of October, and clarifying the actual demonstration at scale by the end of 2023.
In 2024, demonstration will take place at various locations. In 2025, the team is aiming to further expand and replicate.
Opportunities for other organizations in the project
The project team believes that within the DCCC member base and outside there are relevant tools/devices/solutions/services ready for deployment to consider becoming part of the Brick-and-Click model. Therefore, it is opening a ‘Call for Input’ to outline what tools /devices /solution/services DCCC members can deliver to get low cost brick and click to work more effectively and affordably.
Below overview outlines the categories we are looking for your input.
- Back-end automation of tasks -e.g.
- Document management
- Labs management
- Prescription management
- Supply chain management
- Data management and coding
- Data recording
- Clinical decision making
2. Helping clinicians make the right diagnosis – e.g.
- Symptom checkers
- Devices that aid diagnosis -point of care testing
3. Making space and care replicable e.g.
- Cookie cutter low-cost clinics
- Safety and risk management
4. Therapeutic interventions digital /low cost e.g.
- CDM therapeutics
- Prescribing -e-pharmacy
- Wellness interventions
Please email michal.matul@axa.com with the tools/devices/solutions/services that your organization could deploy. Please indicate the category it belongs to and share materials with more information.
