Project CATCH

[COVID Aid via Tele Channel at Home]

Context
The pandemic COVID-19 infection has been growing at the rate of doubling every 5-7 days in most parts of the
world, despite some very stringent social distancing and stay-at-home orders. In India, the known cases are
doubling every 4-5 days and this is despite very selective testing and overall less than 100K tests being done to
date. If one sees this from an exponential angle, any metric that keeps doubling at a set frequency grows into a
very large number. If we assume the rate of growth at doubling every week, we will hit an unmanageable
number of 50 Million in 4 months. If most of the social distancing measures manage to flatten the curve, we
are still likely to hit 5-10 Million cases in just 5 months which is still way too many and will put an unbearable
burden on the entire healthcare system of the country.

As the number of cases grows, panic will set in and many people will seek early medical intervention. If even
10% of these cases end up at the hospitals, hospitals will have no choice but to turn many of these people back
leading to widespread disappointment as well as a further increase in infection during transit to and back from
the hospital. This situation is untenable and we need to find an alternate solution for this.

Since there is no approved therapy for COVID-19, even hospitals have to treat patients with simple flu
management protocol except severe cases that require supplemental oxygen or ventilation support. To
prepare for vastly increased numbers that are likely to hit us in the coming months, we need to set-up a
nationwide telemedicine system that can handle millions of patients and guide them through testing,
quarantine and flu management protocols at home. This approach has 5 major benefits:

1. We can treat a large number of patients at home and reserving the hospital capacity for only those in
critical condition
2. This will limit the risk for the doctors. If a doctor is seeing COVID patients, chances of infection are
very high for the doctor.
3. We can onboard doctors from all parts of the country and can do much better demand-supply match
than the local physical infrastructure
4. Centralized effort can ensure that all doctors are using the same standard protocol which can be
updated through real-time analytics as we learn more about the disease.
5. All doctors and even the semi-healthy professionals can be remotely trained to further increase the
supply of medical professionals to manage the disease at scale.

This entire effort will be non-commercial in nature and will be funded completely by individuals, government
and charity organizations.

Objective:
Build a platform that will eventually manage 100M cumulative patients, 5M active cases at peak and network
of over 100,000 doctors. This platform needs to be live in a maximum of 12 weeks.
Why will this work?
This platform will leverage the best of Indian tech and health ecosystem. We will have the top caliber product
and tech talent that understand how to build systems for scaling to millions of transactions, top supply-chain
experts who know how to build large scale operations with efficiency and top health-care experts who can
ensure highest quality medical care.

Moreover, the entire system will be designed with no commercial intent, completely transparent agenda and
process and intent of collaboration across all like-minded individuals and organizations in the country.

Approach
There are 4 major aspects of going about building a large scale nation-wide telemedicine platform at record
speed.

1. Platform
We will build a platform that can manage the orchestration of testing, case management,
telemedicine, and hospital handover. This platform will be built by a volunteer team of 50 engineers,
architects and product managers who will join this project full time for 6 months from across the tech
companies. We will not start from scratch but rather use the technology from all telemedicine
platforms in India and then further customize this for COVID use cases and scale.

2. User App
This will be a customer-facing app that makes the doctor interaction and the COVID case
management extremely simple for the end-user. This app will be available in all regional languages
and will enable the user to track the disease day by day and get timely consultations and data via both
text and telemedicine from the same doctor to the extent possible

3. Marketplace of Doctors
We will build a BD & Training team of 50 people whose job will be to reach out to doctors and build a
network of doctors to onboard and train on the COVID protocol. The team will run large scale
marketplace operations to call, train and onboard doctors and then do ongoing quality management
to ensure engagement and quality of care.

4. Standardized Protocols
Team catch will have a governing council composed of top medical experts in the country who will
keep updating the protocol taking ICMR and WHO guidelines in regular consultation with health
officials. These protocols will be updated weekly and will be disseminated to the entire doctor
network through webinars and online training.

Funding Mechanism
We will come up with standardized pricing per consultation per case [which may need 3-4 consults] that will
constitute the refund mechanism for the doctors. The entire effort will be funded in the following manner:

1. Customer pays
We will encourage the customers to pay if they can afford to, but those who cannot afford to pay,
can skip this and avail the entire service for free. We will also encourage customers to pay-forward
where the affluent customers can pay for 1, 10 or even 100 customers which funds the cost of
treatment for other customers

2. Government Tie-ups
 We will reach out and partner with PM Cares fund and state funds who can underwrite a fixed
number of consults or cases

3. NGO Tie-ups
Many NGOs are raising a large amount of money for COVID and they can assign funds for a fixed
number of Consults.

4. Private Funding
Any organization can fund a fixed number of consults for their employees/user base and give them a
unique account to avail the service which is already prepaid.

5. Debt
If the demand exceeds available funds, we will also procure debt that can be paid by consumers over
a long period.

The motto of the whole effort will be to ensure that no one is denied services, that doctors are compensated
fairly and that everyone is provided the same quality of service despite their economic and social strata.

Medical Partnerships
Project ACT will require many partnerships to be put in place so that entire community resources are
leveraged intelligently and equitably. Many of these partnerships will require technical integration that will be
governed by the DHRS system described in a separate architecture document. Following are some of the major
partnerships required:

1. Testing Labs: We will support testing through all major labs in the country and as and when the
doctor prescribes the test, the request will be passed on the to nearest lab/available supply based on
the round-robin algorithm. This will be fully pass-through pricing with zero commission.

2. Pharma Delivery: We will integrate with all major online pharma companies and if the customer
chooses, any prescription will be routed to the closest pharma company.

3. Hospital Integration: We will integrate with all major private and government hospitals where
patients can be referred and safe ambulance transfer can be managed. We will also build capabilities
so that family members can track progress online instead of going to hospital risking further
contagion.

Governance Framework
The entire effort will be managed through multiple councils, each comprising of 3-5 leaders with deep
experience in relevant areas. The key councils are:

1. Core Governance Team

This will be the central leadership team orchestrating all strategic decision making and ensuring
smooth collaboration across all teams, streamlining communication and ensuring adequate resources
are available for all streams.

2. Platform Team
This team will have technology and product leaders who will oversee the choice of architecture,
integration approach, using open source components and guiding the entire tech team to get the
whole platform built in record speed, guaranteeing scale, quality, and privacy.
 3. Doctor Outreach Team
This team will manage the marketplace and operations side of things, recruiting doctors, running
training and daily marketplace operations at scale

4. Medical Panel
This is the team of health experts responsible for certifying the protocols and keeping these updated
regularly that can be disseminated to all health care workers efficiently.

5. Healthcare ecosystem
This team will reach out to all major players across Diagnostics, Pharma, and Hospitals and integrate
their respective services with the CATCH platform.

6. Fundraise team
This team’s job will be to procure funding for doctor reimbursement across government funds,
Charities, and private organizations.

Governing Principles
Following are the guiding principles;

1. This is a purely non-commercial project and all the participants will sign a pledge to not use this effort
for commercial exploitation. For all service provider on the platform, there will be pass-through &
transparent pricing

2. The entire platform will be built on an open-source basis and the complete source code will be made
available to be used via open-source platforms. This includes technology that may be contributed by
any health platform.

3. There will be the strictest of guidelines around health data. Only the user will be the owner of his/her
data and can choose to get the data deleted after the case has been completed. After the crisis is
over, either the data will be destroyed or handed over to an entity that is overseen with medical
authorities in India

4. There will be no branding or promotion for any commercial entity in the entire platform. Service
providers will be listed by name and agreed upon pricing will be transparently disclosed

5. There will be an audit committee that will audit the funds flowing through the platform and publish a
monthly report to ensure there is no leakage in the system

Managing Therapy & Vaccines

There is a high likelihood that we will see some therapies emerge in the next 3-6 months and vaccines in the
next 6-12 months. As and when the therapies and vaccines start to be approved, we can use the same
platform for people to book and avail of these services. Once a person is prescribed therapy for an active
COVID case or signs-up for Vaccination as a preventive measure, the ticket can be routed to the 3rd party
provider of these services. This can again be self-pay or funded by another organization.

The same platform can generate Aadhar linked digital certificates that people can use to gain access to any
public location of the congregation.
Team Structure
The tech and operations teams will be structured along the following lines:

Technology Team
1. Architecture team[3-4]
Responsible for the design and architecture of the entire system.

2. Platform [15]
All back-end systems to drive the orchestration across various participants on the platform, Building
the API layer for easy integration.

3. Consumer App[15]
This is a consumer app that supports telemedicine and case management use cases, available in
English, Hindi and all regional languages of India. Eventually, the consumer app should also have a
voice-based as well as an AI doctor interface to drive further scale.

4. Case Management[5]
Workflow layer for managing the entire case duration across every stage and adequate escalation and
alarm mechanisms

5. Protocols Automation[5]
This team builds the layer that can be used by health experts to update the protocols regularly. This
will also have ML elements that will suggest protocol improvements based on historical data.

6. Integration Layer[10]
This layer will expose the API and integration protocols for all Diagnostic, Pharma and Hospitals
network to integrate with

7. Analytics[5]
This team will build out all required reports, dashboards and analytics to generate insights and trends
about the cases.

8. Data Privacy & Security[5]

This team will build security protocols to ensure that the system is hacking proof and has a very high
degree of data protection.

9. Support Systems[15]
This team will build all the back-end systems that the marketplace teams will need for ongoing
management of doctor-patient interaction.

Marketplace Team
This group will have the following teams:

1. Doctor Recruitment [20]

This team’s job will be to reach out and recruit a large number of doctors, explaining the program
intent and how the commercials work for the doctors

2. Doctor Onboarding/Training[20]
This team will be responsible for training the doctors on digital systems and COVID protocols

3. Doctor Management[10]
 This team will do the ongoing account management for the doctors, ensuring they stay engaged and
their queries are solved in an expedited manner.

4. Healthcare partnerships[5]
This team will liaise with all health-care partners across diagnostics, pharmacy, and hospitals

5. Government partnerships[5]
This team will liaise with both central and state governments to coordinate about policy, protocols,
and funding

6. NGO/Corp partnerships[5]
This team will liaise with various NGOs, Charities, and Corporates to secure funding for doctor
reimbursements.

7. Quality control[10]
This team will monitor all patient metrics and audit logs to ensure SLAs are being met and customers
are properly handled.

8. Customer care[20]
Central team to answer all patient inquiries

9. Control Tower[10]
Monitoring everything end to end in real-time.

Timelines
1. Governing team set-up: Apr 8
2. Execution team kick-off: Apr 8
3. Pilot go-live: Apr 30
4. Beta go-live (1K doctors): May 15
5. Go live (5K Doctors): May 31
6. Scale to 25K Doctors: June 30

Platform Ownership
While this effort can play a very meaningful role in managing the COVID crises, it will also result in a very large
public good that can eventually become part of India's stack. Post crises, we will pursue one of the following
two routes:

1. Handover to appropriate health agency of GOI which can continue to use and enhance the system for
large scale health management, especially for those who do not have quality access

2. Form an industry non-profit consortium along the lines of UPI with equal investment from 20 or more
health ecosystem players with no more than 5% ownership each which will continue to improve the
protocols as a common industry resource.