Ram Lakshmanan and his team were onstage at the Clinton Global Initiative annual meeting in New York on Tuesday evening. They were finalists for the Hult Prize, which each year awards $1 million to the best plan for addressing global problems. They were making their pitch for a better healthcare plan that would include something they’re calling “Doc-in-a-Box.”

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This year’s prize challenge focused on proposals to improve life for the 250 million people living in slums and suffering from chronic diseases like diabetes, high blood pressure and heart disease. Slum dwellers often can’t afford medical care or live too far away to reach clinics. The care they can obtain often focuses on emergency services rather than long-term health.
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The winning project, called NanoHealth, proposes hiring and training community health workers, and equipping them with “Doc-in-a-Box,” a diagnostic tool the team designed that can measure basic indicators like blood sugar, blood pressure and blood lipids and create an electronic health record for the patient.

The health workers are called saathi [friend], and are hired from the community, trained and certified by the organization. They run screening camps to diagnose patients and refer them to partner healthcare organizations, and then follow up with the patients frequently to make sure they are taking their medicines or implementing lifestyle changes.

The team originally conceived a narrower project, simply to help slum dwellers with chronic diseases stick to their prescription plans. But the students quickly discovered that many patients didn’t know what medicines they were supposed to take — if they had even been diagnosed.

“Let’s get some doctors to verify their diagnosis,” Aditi Vaish, 35, remembers thinking. “But no doctors serve these slums. So let’s get a screening device.” Once they’d conceptualized the Doc-In-A-Box, they decided to set up “camps” in the slums to meet with the residents and get their medical information.

Of necessity, their project became more holistic. “One part was not enough,” says Ashish Bondia, 32. “For the urban slum dweller, the entire healthcare journey was missing.”

“In order to have an impact in chronic care, whether that is in an urban slum or for anyone, you need to treat all the pieces of the problem,” adds Vaish. “There’s underdiagnosis, poor treatment and poor compliance.”
http://www.npr.org/blogs/goatsandsoda/2014/09/26/351515298/and-the-million-dollar-hult-prize-goes-to-a-doc-in-a-box