Product Overview: MEDSINC

THINKMD is a healthcare innovation company whose mission is to globally advance healthcare equity
and equality by expanding healthcare capacity. Our focus is to develop simple, integrated point-of-care
solutions that empower minimally skilled users with the skills to dramatically increase healthcare
capacity and primary health care service delivery to everyone; everywhere the humanitarian need is
greatest. Specifically targeting community health workers (CHWs) these solutions are designed to be
affordable in resource poor countries as well as have the potential to provide local economic
opportunity that leads to long-term sustainability. THINKMD is a US based benefit corporation.

MEDSINC Overview:

MEDSINC is a simple-to-use, self-training, mobile, integrated clinical assessment software platform

that enables minimally skilled users to effectively assess how sick a child is and provide immediate
triage and treatment recommendations. Initially targeting pediatric populations from two months to five
years, MEDSINC guides users through an integrated clinical severity assessment for four critical
clinical conditions: respiratory distress, dehydration, infection risk (sepsis-SIRS), and malnutrition, as
well as eight common diagnoses. Completion of an assessment includes ~30-35 questions, takes 5-15
minutes, and once complete, MEDSINC generates clinical assessment, treatment and triage
recommendations that include:

Patient demographics, illness history, vital signs and physical examination data
Sickness severity scores for respiratory distress, dehydration, infection risk, and malnutrition
Screens for malaria, meningitis, anemia, skin infections, urinary tract infection, ear infections,
measles and dysentery
WHO-IMCI compliant assessment, treatment recommendations and follow-up instructions
Immediate triage recommendations

Demographics Clinical History Vital Signs Physical Exam Assessment/Treatment/Triage

Why MEDSINC is Different

While a number of mobile health (mHealth) child health assessment tools and protocols have been
developed in the last few years, MEDSINC is unique in many respects. Existing tools mainly utilize a
decision-tree approach incorporating IMCI guidelines or other disease specific algorithms onto a
mobile device. These tools are not integrated and have low usability and acceptability for minimally
skilled users or fail to gain widespread adoption due to their singular focus on a limited range of
disease.

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MEDSINC differentiates itself from other digital or mHealth tools in a number of different ways:

Unique Integrated Clinical Assessment: MEDSINC uniquely employs the same logic and
clinical approach used by physicians to complete an integrated clinical assessment of a child.
This assessment does not utilize a binary, skip logic decision tree approach, that allows the
user, through a series of basic questions and tasks, acquire key clinical data points, including
patient history, vital signs, and physical examination findings. Once acquired, MEDSINC
automatically compares these data points with age-specific normative and corrective databases
embedded in the software. Each data point is assigned a weight, then packaged and analyzed
by a very simple Bayesian artificial intelligence (AI) type rules engine to simultaneously
determine a clinical severity assessment for four key clinical states; respiratory distress,
dehydration, infection risk (sepsis-SIRS) and malnutrition. These data points are also used to
generate possible diagnosis for eight additional diseases.
Automatic Treatment, Triage and Follow-up Recommendations: Based on the generated
clinical assessments, MEDSINC provides age- and weight-specific triage, treatment, and
follow-up recommendations that comply with WHO, IMCI and ICCM guidelines and are
aligned with essential medicines such as ORS, zinc, Amoxicillin DT, and other proven
treatments.
Simple and Educational Interface: Our goal is to increase the capacity and enhance
performance of the individual user, not simply train them to fill out an online form. With expert
UX/UI designers, weve created a simple interface with limited text that is easy-to-use and
intuitive to operate. Our success is a result of our self-training tools, illustrations, and
instructional video clips built into the MEDSINC interface itself. These graphics do not slow
down an inexperienced user, but are seen during each assessment and serve to reinforce training
and re-training for users of all skill levels. With MEDSINC, we will not only increase
compliance with WHO-IMCI guidelines, but users will receive compliance training every time
they use the platform.
Surveillance and Public Health Data Analysis: MEDSINC acquires real-time, geo-tagged
public health data with each assessment. Once deployed in a region, aggregated and analyzed
data from MEDSINC can offer epidemiologic, outbreak surveillance, population health, and
predictive disease modeling that would provide valuable information to NGOs, health ministries
and international health agencies, helping to direct and ensure efficient and effective allocation
of limited resources to where they are most needed.
IMCI and ICCM Compliant: Using the MEDSINC platform to perform a child health
assessment obligates the user to comply with IMCI and ICCM guidelines eliminating the guess
work and complication when minimally skilled workers are expected to support IMCI and
ICCM at the primary health level.
Monitoring and evaluation data: MEDSINC saves the user data for each clinical assessment
performed and the location of the assessment. This data can be utilized for monitoring and
evaluation of the CHW performance and efficiency, which will provide management support for
strengthening the primary health care system via increased accountability.

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 Unique Technical Specification: MEDSINC platform is designed to be functional on any
mobile device (OS agnostic) with a touch screen, capable of downloading a web page. After it is
downloaded, it is completely functional with or without mobile or Internet connection

Simple Regional Configuration: MEDSINC is designed to be adaptable for regional

specificity (e.g. language; currently English, Spanish, French and Bengali; clinical diseases,
treatment, UI/UX) with the ability to quickly configure updates to reflect public health
priorities, revised national guidelines or questions/information related to a disease screening or
newly emerging diseases. The platform has been engineered to reflect contexts of different
locations and is easily modified to integrate new languages and / or images that more
adequately reflect cultural norms within a particular country or region. These adaptations can
be made in a matter of days, which enables rapid adaptation for identification of emerging
disease threats and provides early data to government and international organizations to
formulate a rapid, focused, early response.

Figure 1: Comparative Platform Content between MEDSINC, IMCI, iCCM, and ALMANACH

Assessment MEDSINC IMCI ICCM ALMANACH

General Danger signs
Anemia
Capillary Refill
Fever
Duration of Fever
Cough or Difficult Breathing
Chest In-Drawing or Stridor
Wheezing
Duration of Cough or Wheezing
Respiratory Rate
Heart Rate
Oxygen Saturation
Diarrhea
Blood in Stool
Vomiting
Infant Suck
Signs of Dehydration
Drinking and Breastfeeding
Tears when Crying
Last time Child Urinated
Skin Turgor
Acute Malnutrition: MUAC, Edema
Ear Prob lem
Swelling b ehind ear
Ear discharge
Ear pain
How is Child Sleeping
Measles
Mouth Ulcers

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 Clouding Cornea
Eye Pus
Skin Infection
Feb rile disease assessment-Malaria
Pain when Moving Neck
Vaccination/ Immunization History
HIV Status
TB Exposure/Screen

MEDSINC Validation

MEDSINCs simplicity of use and potential for dramatically increasing pediatric healthcare capacity
has received universal positive feedback
THINKMD has employed focused short-term Beta-testing and agile software development in
partnership with government, NGO, and academic partners in the US, Bangladesh, Peru, Ecuador, and
Burkina Faso. We have strategically coordinated with partners in alignment with our mission,
including:

MEDSINC has captured more than 14,000 data points on over 300 patient assessments by minimally
skilled workers using the MEDSINC platform following 30-120 minute training sessions. To date, in
each region tested, independent assessments by minimally skilled users using MEDSINC compared
with local and/or board certified pediatricians have consistently shown between 80% to above 95%
integrated clinical assessment correlation.

Figure 2: Validation results across multiple countries

Bangladesh (n=51) Peru (n=36) Ecuador (n=47) Burkina Faso (n=163)

Percent Correlation between CHWs

100
100
90 95 96 96 94 93 95
using MEDSINC and Health

92 90 93
90 88 88
80
83
80 82
70
Professionals

60
50
40
30
20
10
0
Dehydration Respiratory Distress Sepsis/SIRS Malnutrition

Clinical Severity Assessment

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USAID Innovation Award

THINKMD was recently selected as winner of the USAID-DAIs global 2016 Innovation into Action
Challenge. As part of this award, we will be testing with USAID-DAI the utility of the MEDSINC
platform as both a clinical severity assessment platform and an emerging disease platform at a site in
central or South America.

Moving to Scale

MEDSINC will be available for a limited commercial release in summer 2016. THINKMD is currently
in the final planning stages with multiple international NGOs with strong child health programming for
additional in country validation, utilization and impact analysis studies. Data analysis from continued
research will provide critical information in determining their deployment priorities for MEDSINC.

The validation and development experience for our current MEDSINC configuration puts us is a very
strong position to quickly develop new clinical platforms since we now have established frameworks
for future UI/UX, clinical assessment rules engine, and backend architecture for derivative MEDSINC
products. Future platform expansions will include:

Expansion of diseases
Maternal and newborn
Children (>5yrs), adolescents, and Adults
Emerging disease
Emergency medical / Humanitarian response
Electronic Health Record functionality

Integration of MEDSINC with mHealth biometric and diagnostic sensors

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