Interview with Initiative Participants: Team CHIIN

I4A talks to Feyisope Eweje from the COVID-19 Healthcare Information Integration Network (CHIIN). He completed his undergraduate degree in mechanical engineering at MIT and is currently pursuing his M.D. candidacy at the University of Pennsylvania. He has done a lot of work in the medical device and health technology innovation space, so now he is working on a variety of research and entrepreneurial projects. CHIIN is another kind of effort that he helped start in collaboration with some of his peers from various past exploits to try and make an impact on the COVID-19 response in African healthcare systems.

Interview conducted by I4A team member Saloni Wadhwa.

Saloni: Let’s talk about CHIIN - how was it founded and what is the major goal of the organization?

FE: Basically, CHIIN just started with my brother and I. My brother is also a medical student and we both wanted to think of a way to utilize our interests in providing technical tools in a lower resource healthcare context to try and make an impact on the COVID in response in Africa. At the time CHIIN was formed in May, there lack of resources and information distribution about the pandemic in many countries in Africa because they did not many cases. 

So, we wanted to think of a way that can potentially aid in the response to this and thus, we came together with a few people that we knew to do the hackathon at MIT that was focused on providing tools for the African COVID response. Our track was focused on information distribution and empowering the healthcare workforce so that they have adequate information. Hence, the idea of CHIIN was basically how can we bring types of knowledge that are often offered to health care providers in high resource context to people who are in rural healthcare, where they might not have stable Wi-Fi access but they still need to have a sense of not just what's going on with the pandemic at a national scale but also what is going on in the community regarding the number of cases and resource requirements.

CHIIN is an SMS-based platform to pull that locality specific information related to COVID-19 from our partners at state ministries and get that information distributed to a number of healthcare workers who are at the online via SMS messaging.

Saloni: What were your major challenges during the initial stages of conceptualization and how did you overcome them? Further, what are your current challenges as the landscape changes?

FE: There have been pivots in our overall strategy, but our initial idea was to partner with the Kaduna state Ministry of Health in Nigeria. We had a number of conversations with them but at the end of the day, talks just broke down and we had to reconsider our approach. That said, with any global health effort the importance of having an on-the-ground partner is paramount, it is the biggest aspect of the success of any project, I would say. 

One way we kind of got ahead of that is during the hackathon, we had people who are based in Nigeria with the aim of eventually deploying this solution in Nigeria as our first target. The main issue, however, was that while we had the input of local physicians, who are part of the health system, they are either refer COVID patients to different health settings or they aren't somehow involved in the overall response at the clinic level.So, we had difficulty engaging people there at government level which is where we need to really get that engagement to allow wider impact. 

Now, we've kind of now reconfigured our approach to less of the local specific, to the minute updates about COVID, but more so a generalized kind of health information resource for health care workers. We are thus looking to take a more general approach to the distribution of information regarding the management of various diseases including COVID specifically to providers who are in these rural, lesser resource settings.

Saloni: Considering CHIIN was a tailored response to COVID, how has this pandemic influenced your way of thinking and your outlook?

FE: I would say, in a general sense, speaking to my experience as a medical student, when we first got the news that we're not coming back for the semester and things are going to change for us, people's first response was, “What can I be doing?” A lot of medical students felt very powerless, while our preceptors and our teachers were at front lines. My spirit was along the lines of, what can I be doing in order to further the response and strengthen the healthcare system, as it's boggled down by this devastating disease. That’s where the motivation came for me. Further, I'd say for all the people who are members of the CHIIN team, the specific application to African healthcare systems really came from our own personal backgrounds as most of us are Nigerian and we wanted to do something for the people we cared about.

Saloni: Let’s now move on to the proposal, could you talk more about the proposal that you wrote for Ideas4Action? What was the writing process like and if you would have any advice to give to people who want to submit proposals, what would that be?

FE: For us, there are two main lines of thinking that we had to have. One was really nailing down what the problem is, and then the other is giving a very detailed and clear explanation of what our solution is and how we plan on implementing it. I would say the former is probably the most important for any proposal, because no matter what kind of fancy technology or interesting kind of approach you could take in a solution, if you don't really have like a clear problem that can be identified and acted upon then it's really pointless to describe whatever solution it is that you're coming up with.

For us, this really involved going through the literature and even having the opportunity to speak to some people on the ground, including the people who are on our team to really understand what the problems are as it relates to information distribution just within health care systems in general, and seeing how those problems had been amplified by the need to rapidly get information across to health care providers across the care.

Understanding that problem initially helped in the technical scoping of our solution, which was further assisted by the MIT hackathon, where we had the opportunity to work on making the initial product and demonstrating functionality.  So we were able to create a more detailed proposal when compared to someone who might not have already done their initial prototyping. 

Saloni: What was your experience like, competing in a social impact driven initiative like the MIT Hackathon?

FE: I would say it was a positive experience. There were a lot of very ambitious teams, that were also driven by the same determination to do something to help, whether they were engineers or clinical providers. Since everyone was trying to do something that could be useful in the world, it was a little bit different than the traditional hackathon. It wasn’t just a cool and flashy device, it would actually benefit somebody in this case. 

Saloni: Speaking to your background, you first started as an engineering student and now you're doing medicine, so you've seen two different fields. What do you think other barriers that exist in these departments?

FE: I think about this a lot. I think it's not necessarily about barriers but more so the realities of what it takes to become someone prominent in medicine or in engineering. For example, if you want to become a super prominent position in medicine, it involves residency, then a fellowship and another fellowship and some more specialization. On the other hand, to become a really experienced engineer who can take on a challenge involves practicing that problem-solving mindset. So, the ways of thinking are just so different that it's very difficult to successfully bridge those two modes of thinking. There are thus, so few people who are able to successfully understand both schools and craete a meaningful impact in both.

That said, I would say in my own experience, I've been able to find ways to connect my interest in engineering problem-solving and technology development to meaningful impacts in medical field. So, I would think there has been more collaboration than in past years. 

Saloni: How did your education at Penn and prior institutions help with your reflections and thinking? Additionally, in your opinion, what needs to be done to better prepare students to address real life problems?

FE: I think that what a lot of people could probably do or learn is that it's not necessarily about ‘how am I going to take this technology and make an impact on these people’ it's, ‘what do these people need or what does this problem need’ and ‘how can I go back and see what type of technologies can be applied.’ For example, I did mechanical engineering and a bunch of design things, but I also have software experience just because I knew that whatever problems I encounter in clinical practice is not always going to be some device or some piece of hardware. Similarly, it's not always going to be a piece of software or some fancy website system that's going to solve a problem. Hence, it's a combination of knowing the different types of technical solutions that are available and really understanding what the problem is 

Saloni: Could you comment on the importance of the creation of joint value and knowledge sharing of best practices and lessons learned?

FE: A major lesson I want to share, specifically in the area of social impact and global collaborative efforts, the best kind of way of mitigating issues is to try and engage with people, both early and often. If we have our complete solution we're ready to give it to whatever type of system and really start implementing it say, tomorrow, then if you have some sort of continuous engagement with someone, by the time you get to the stage that you actually need to have this implemented, you'll have that strength of connection that will allow them to act as your champion and really make sure it gets to the people who you're hoping to impact. I guess this piece of advice is tailored more towards the setting where everybody is doing everything remotely and we don't have the opportunity to travel abroad. But, I do think that this might be relevant for the foreseeable.

I'd also say that if you find a group of people or a type of problem that gets to whatever central core motivations you have, it's easier to find not just the time and effort to do it yourself, but also encourage other people to also find that time and effort and really drive something to completion and to the point where it actually can make an impact on people. I think that's the tricky thing with the social impact space: sometimes motivation just becomes murky and people lose interest. But, when you know the people who you're trying to impact that is, you either have direct connection to them or you can see the struggles, it can be really powerful and motivating to people to put all their effort into the cause.

Read more at: https://chiin.org/