For our fourth installment of the Inclusive Innovation Exchange, Resonance and the MIT Legatum Center for Development and Entrepreneurship hosted two digital health innovators—Dr. Anatole Menon-Johansson of SXT and Amir Barsoum of Vezeeta—to discuss how technology can expand patient access and improve health outcomes.
When Menon-Johansson founded SXT, the UK’s STI rates had taken an alarming turn for the worse. By 2019, gonorrhea infections in the country had reached an all-time high. Initially, SXT offered a digital “signpost” service, using its website to refer patients to the right care provider based on their answers to a brief questionnaire.
Over time, SXT sought to solve a much harder problem: how to get someone with an STI to feel comfortable communicating that information to their previous sexual partners. They developed an anonymous text message system to alert people that a sexual partner had an STI and refer them to appropriate care. The system upended traditional STI prevention methods and helped empower patients with the information they needed to stop the spread of infections. SXT has since expanded to the U.S. and Australia and hopes to serve sub-Saharan Africa soon.
“We didn’t start off with a market, but with solving a problem,” Menon-Johansson said.
Vezeeta’s Barsoum echoes the sentiment. His company seeks to give patients more agency and options in making healthcare decisions (Barsoum calls patients “consumers”). “Healthcare is the place where every time you step into it, you have no decisions,” he said. “I go to a restaurant, I get a menu; I choose. I go to a clinic, and I’m not a consumer; I’m a patient. I’m decision-less and information-less.” His company seeks to transform patients into consumers by giving them the data and decision points they need to improve their health care. He points out that even in the U.S. and Europe, most digital innovations have served providers and payers rather than patients.
“We’ve surrendered to patients not having control,” he said. “I think there’s a huge opportunity to change that.”
When done right, digital health can empower patients by unlocking and making accessible more information, more tools, and more options.
As we’ve explored in previous episodes of the Inclusive Innovation Exchange, there are downsides to the fragmentation of the global health landscape. It makes it more difficult—and less likely—that different companies and industries will work together toward better solutions. It also, as Menon-Johansson noted, makes data collection vastly more challenging—especially in light of regional and international variation. “We went live in New Zealand, and the way they capture demographics is different; the way they provide support is different,” he said. “It gets easier as you get more experience, but it is a challenge.”
Yet Barsoum also sees potential. “We usually talk about [healthcare ecosystem fragmentation] as a problem, but it’s not always,” he said. “When providers are consolidated, the probability of them accepting third-party health technology vanishes. Ecosystem fragmentation actually enables innovation.” In other words, the absence of a unified approach in the global health context can create opportunity (as well as headaches). In a field lacking in coordination and consolidation, there is room for innovators to get creative, be scrappy, and solve old problems in new ways.
While fragmentation may drive innovation within specific geographies, it makes it harder for companies to scale across countries and continents. The services, data collection, and delivery methods that work for one population may not work for others. Barsoum noted that a country’s regulatory policies around health,digital technology, and data are another area where distinctions matter. “If there’s no policy at all, I’m good with that,” he said. “If you have one, I know my rules—but in the middle is very painful.” Just as important are a country’s policies around communication between health and technology providers.
Barsoum reflected on his team’s process for scaling across the Middle East and North Africa. “Markets with the largest populations are the ones you need to start with,” he said. “It’s very difficult to think of a small market that would be the telehealth leader and then, say, dominate Nigeria.” He argued that the difficulties you encounter in a diverse, complex city help you gain the metrics and build capacity to approach smaller markets.
SXT has also expanded into large cities but is considering expansion into the areas of greatest need—for instance, Sub-Saharan Africa—by partnering with USAID or other international donors. Menon-Johansson plans to establish pilots in locations across the continent to demonstrate proof of concept, in the hopes of attracting a donor partner to help offset the increased cost of reaching lower-income markets.
Global health innovators like Barsoum and Menon-Johansson may employ different approaches, but they are increasingly tapping digital health solutions to reach more patients, provide those patients with a greater range of options, and improve health outcomes. As the digital health field grows, so will the range of solutions and approaches that can meet the needs of patients—or, as Barsoum would say, consumers.