CASE STUDY: 04-25 OCT, 2014

Global Innovation Fellows Partner with Project Hope to Assess Healthcare Needs

Quang Tri Province of Vietnam

Global Innovation Fellows Vietnam

Global Innovation Fellows is a program of Medtronic Philanthropy that matches teams of diverse Medtronic employees with social impact organizations in skilled-service projects that aim to solve problems related to healthcare access in remote regions around the world.

Project Overview
A recent project involved a partnership with Project Hope, a non-government organization (NGO) that delivers essential medicines and supplies, health expertise and medical training to prevent disease, promote wellness and save lives around the globe. Together, Project HOPE and five Medtronic Philanthropy Global Innovation Fellows conducted a healthcare assessment in the Quang Tri Province of Vietnam. The Fellows included: Alejandra Caceres, Coronary; Fabian Immink, Corporate, Laura Glebe, Surgical Technologies; Murtaza Lakdawala, Neuromodulation; Maureen McGuire, Corporate.

Healthcare in Quang Tri

Across Quang Tri, approximately 140 Commune Health Stations (CHS) are in place to serve residents in the Province with primary healthcare and prevention, with the expectation that District and Provincial Hospitals are reserved for referrals and more specialized care. The vast majority of Vietnam has undergone significant economic revitalization during the last 20 years resulting in a more stable economy and significant improvements in healthcare. Quang Tri Province, located in the northern central part of Vietnam near what was once the demilitarization zone (DMZ) demarking the North from the South during the US - Vietnam Conflict, has not enjoyed the same economic growth.

Methodology

The goal of this partnership was to identify solutions that would improve healthcare access and quality in the primary healthcare setting and take the burden off the higher-level medical infrastructure. To better understand the current healthcare situation in Quang Tri, the Medtronic/Project HOPE team conducted approximately 20 meetings with more than 90 stakeholders over the course of three weeks. The team met with individuals from all levels of the healthcare system including medical officials, doctors, nurses, midwives, and pharmacists at the Provincial, District and CHS levels. CHSs were visited near urban areas, in the lowlands, near the coast and in the highland/mountainous regions.

Results

The assessment revealed that over the last decade, the CHSs in Quang Tri have suffered as more privately-insured patients hold the perception that higher quality care exists at District and Provincial Hospitals. Patients sometimes wait for hours to see a Provincial Hospital doctor for treatment of an ear infection or strep throat – conditions that should be diagnosed easily and treated at the CHS. This places primary healthcare access and quality as a priority of local officials.

Recommendations

To address these issues, the team developed a comprehensive, multi-dimensional solution that has the opportunity to make a sustainable, long-term difference in the Quang Tri Province:

To improve the patient experience and increase trust in the care offered in Quang Tri Commune Health Stations, a "Government Social Franchise Model" should be implemented as a means to drive quality and consistency across CHSs.

Social franchising is a creative attempt to use conventional commercial franchising methods focused on standardization and quality to achieve social rather than financial goals. Non-profit organizations are applying franchising strategies to improve health in developing countries and social franchising unites healthcare facilities in a network under a common brand, strict quality standards, and clear health services at affordable prices. If implemented and managed well, government social franchises can provide:

  • Greater access to quality, affordable health services;
  • Relief to an overburdened public health system;
  • Increased trust in healthcare workers to deliver primary care;
  • Increased incentives for health providers to deliver high quality care;
  • Improved professional development opportunities for healthcare professionals; and
  • Improved access to health financing mechanisms for equipment and supplies for the public sector health system.

The team's recommendation entails conducting an initial pilot with two to three Quang Tri Province CHSs leveraging the Government Social Franchise Model. The goal of this pilot is to systemically improve the quality of primary care at the CHSs. This proposal takes a holistic approach and addresses three pillars for success:

  1. Infrastructure improvements
  2. Equipment improvements; and
  3. Effective staff training

This recommendation would require close management oversight and a unified brand – all aimed at providing a superior, high quality patient experience.

Finally, an innovative aspect to this solution is the introduction of a full-service in-clinic pharmacy in the CHS as a method of increasing patient traffic and generating revenue. This component is important to driving a self-sustaining model that can be maintained long after the pilot project is complete.

This year more than 25 Fellows were selected to participate in team immersion projects and put their skills and expertise together to solve important heath access problems around the world. Trips to three locations took place in October 2014 (Bangladesh, Rwanda and Vietnam), and three more cohorts will be deployed in March 2015.

Visit globalinnovationfellows.medtronic.com to learn more about the program and how you can get involved.