Notice C

Promoting the collaborative development of proposals for investments in digital health global goods

Planwise - Optimizing Geospatial Network Coverage

Notice C Opportunity: 
Announcement C0: Global Good Software Development and Support
Application Status: 
Approved – Contingent on Funding

Executive Summary

What is Planwise? Planwise is an open source software tool that uses geospatial modeling and optimization techniques to make it simple for an organization to understand whom they are helping, and to maximize the efficiency impact of their services.  Specifically, it shows a user what the current coverage and capacity of the network is, and then produces scenarios for how to best enhance access to care; for the least amount of funding.

Millions of people use “big data” and complex optimization algorithms every day when they look up driving directions on their smartphone. Combining good design and fast algorithms can make an otherwise daunting task intuitive, transparent, and accessible. Planwise makes optimizing the coverage of a service network (e.g., health facilities or schools) as easy as getting driving directions on your phone. It can analyze and generate coverage or catchment maps for your program & then suggest the most impactful options to improve access or capacity. Planwise does this without needing external consultants, forcing users to difficult to use or proprietary datasets or hire a data scientist.

See a brief video: https://www.youtube.com/embed/eRbo7xTx_Xw     

Now, the Planwise community is seeking to mature, grow, and extend the community of implementers for increased impact. Specifically, we are seeking to:

  1. Formalize and grow the community of implementers
  2. Create and deploy a strategy for replication and scaled impact
  3. Extend Planwise functionality to fill priority community-identified gaps

Planwise Project Description

This concept note seeks to catalyze and respond to the current demand to mature the Planwise community and solution. By providing free to use, powerful planning tools, to augment the human insights to planners and managers, it is possible to achieve significant impact. The Planwise solution to date has the core components available for completing this process.  

In communities around the world, significant proportions of the population live outside the reach of critical, life-saving, health or other social services. Access to care is affected by the demand for services being greater than their capacity or that the distance an individual must travel is too far. Community and program leaders, planners, and managers are responsible for increasing access to these services but must do so without understanding the current geographic coverage area and how to optimize access to care efficiently.

Planwise solves this challenge by taking three categories of data and bringing them together in a coordinated way. The tool uses data on the current population, overlaying road and walking time calculations, and lastly locations of service networks or the health system. Each of these types of data is now available via open global services, see below for specific details. Together these data sets combined with the industry-leading best practice algorithms, and optimization techniques allow a ministry of health or NGO program manager to use Planwise to see three critical pieces of analysis:

  • The current coverage of the health system and quantified current capacity.
  • Identify areas where coverage is missing; Or with an overloaded network.
  • Receive suggested scenarios for how to best enhance the service delivery network for maximum impact.

In the future, we also plan to include other modifiers on service demand, such as disease epidemiology or the quality of services provided at a facility. This type of service is possible due to the existence of global services, including:

  1. WorldPop that provides an open-access archive of spatial demographic datasets for the developing world.
  2. Open Street Maps (OSM) that provides open road network data - while incomplete in some places, it represents the best scalable service for this data. Initiatives such as Missing Maps can also help to close these gaps for implementation partners.
  3. Google Earth Engine and the collaboration with the University of South Hampton have recently made friction surface data accessible, to allow for walking time calculations.
  4. Any geospatial dataset for a service network, including OpenHIE. Planwise allows for CSV uploads, and in the future, we plan to support common formats/standards of geospatial location data.

The application of Planwise began with maternal and child health and laboratory planning, but has expanded as more partners engage including more broadly:

  • Primary healthcare delivery, particularly for maternal and child health programs seeking to deploy new facilities, upgrade facilities, add ambulances, mobile clinics
  • Laboratory or referral networks, where facilities collect a sample or interact with a patient before further testing or treatment at a second location.
  • Staffing and training, to improve the capacity and quality of staff located within the network of locations.
  • Village or site-level interventions, disaster response where a team sets up for a period to offer emergency services or to support a public health campaign.
  • Radio tower placement and capacity for international development projects that provide educational programming and behavior change content.
  • Water well and school placement to maximize impact for investments in access and availability of critical services.

Past design and implementation partners include Concern Worldwide and the African Society of Laboratory Medicine (ALSM) - implementing in Niger, Kenya, and Ethiopia. Our partners plan to scale-up of these activities in the next 6 months. Other key partners have been identified across half a dozen other nonprofits and social impact organizations, and are working in many countries across Africa and Asia. Planwise is already operational in Afghanistan, Burkina Faso, Central Africa Republic, Ethiopia, Kenya, Nepal, Niger, Pakistan, Philippines, Tanzania, Thailand, and Uganda. Additional countries are actively being provided routinely through current program activities.

Open Source Repository: https://github.com/instedd/planwise via GPLv3

Technical Approach

InSTEDD, working with existing partners, has already developed and deployed a working and stable cloud-hosted instance of Planwise that is free to use. We want to build on this success to see Planwise implementations replicated and impact scaled. The following objectives are required to achieve our impact goals:

  1. Formalize and grow the community of implementers
  2. Strategy for replication and scaled impact
  3. Extend Planwise functionality to fill priority community-identified gaps

1: Formalize and Grow the Community of Implementers

A grassroots network of Planwise implementers has emerged through InSTEDD’s leadership and partner network.  Our first objective for this project is to formalize this engagement and create an open community and governance structure that collects and shares experience, knowledge, as well as informs the future development of Planwise.  This is critical to achieving NGO-driven replication of Planwise use and to facilitate transparent collaboration among partners. Activities include:

Activity 1.1: Design and Document a Governance Model - First, we propose to design and document, with key stakeholders, a governance model for the Planwise OSS solution that makes it clear how groups can contribute or collaborate, protect intellectual property, and prioritize the future development of Planwise. Protecting the intellectual property of experts is essential, specifically for the data science associated with geospatial modeling and optimization. The license for Planwise will continue to be open-source GPLv3.

Activity 1.2: Setup Digital Community Resources and Infrastructure - We propose to set-up online community tools and establish resources for Planwise implementers and partners. It should be simple and straightforward for contributors or implementers to connect with the community and learn the basics about how to use or contribute to Planwise.

Activity 1.3: Operationalize and Run the Community - Operationalize and Run the Community - Once the foundational pieces of an online community are in place, the task of operationalizing and managing the community can begin. This process necessitates a blend of providing routine value to others, as well as fostering organic community participation. To more explicitly engage implementers, we plan to document case studies from 3 implementers and empower them to share their experiences through the community.

Deliverables:

  1. Published governance and community model for Planwise;
  2. Operationalized community with participation from stakeholders using Planwise,
  3. With online resources and infrastructure ready. (e.g., wiki, chat-forums, and calendar of events) & Communication Tools - Simple website and onboarding materials
  4. 3 Planwise implementer case-studies.

2: Strategy for Replication and Scaled Impact

We believe the Planwise solution is ready for scale and replication to any program looking to make data-driven decisions for where investments are made to improve service. To achieve this, we are seeking to create and implement a strategy for replication and scale.  By designing such a strategy or model with scale and replication in mind, our team is seeking to find a sustainable pathway to achieve replication and increased impact; in addition to being able to maintain and extend Planwise functionality. Our experience from past open source initiatives is that quality technology alone can’t achieve the type of impact we are seeking.  That designing a strong program, engaging the right partners and executing on the model is just as critical to success. Activities include:

Activity 2.1: Bootstrap Implementation Support for Key Impact Partners - New partners may be interested in exploring the use of Planwise, but have difficulty facilitating it for existing programs. We would like to help these partners bootstrap Planwise into their organizations.  As part of the program, we propose to seed fund 3-5 organizations to explore Planwise utilization across their programs. Increasing the number of implementers are critical to many aspects of this project, but also for this program to have a direct and measurable impact.

Activity 2.2: Design and Test Models for Sustainability - Designing solutions that can have a scaled impact require a focus on developing and testing models that facilitate replication. We do not anticipate a single funder supporting Planwise directly, so instead, we plan to create a model of services and an associated program that helps partners easily replicate Planwise implementation.  While this makes it easier for partners to integrate Planwise into their programs, it also helps to make Planwise more sustainable. We would also like to explore the potential to identify other pathways for sustainability, such as private sector licensing. When our team has a first version of the model developed, we plan to test the model among partners; and using qualitative/quantitative analysis to evaluate what works and experimenting as we go.  Further, this includes seeking to formally collaborate with key actors such as WorldPop and other geospatial communities of practice.

Activity 2.3: Production of Support Materials - An organizations decision to begin using a solution like Planwise, necessitates some degree of disruption of their status-quo; as Planwise is genuinely a novel service that allows them to leapfrog several maturity steps. We would like to develop a simple set of community materials that assist in the onboarding of implementation partners and also helps them to quickly and independently begin using Planwise.  Facilitating easy use is critical, as Planwise often disrupts or is an entirely novel concept for some groups. We want to make it as easy as possible for groups to take advantage of Planwise.

Activity 2.4: Mobilize a Publication / Scientific Literature Committee that reviews best practice literature for geospatial modeling, creates a research plan with implementers/universities, develops abstracts and publications that are then submitting to journals and presented at conferences.  Participation by researchers is critical as Planwise can both contribute to, and benefit from a rapidly changing landscape of geospatial analytics and other data science techniques. By fostering a group of researchers who can grow the knowledge base, the quality of Planwise will results will improve, and we will attract more research-minded users.

Deliverables:
  1. 3-5 organizations using Planwise
  2. A tested model to support replication and scalability
  3. User support materials, to help users independently solve their issues and use the tool.
  4. Research committee, working towards publications with partner researchers and associated implementers

3: Extend Planwise Functionality to Fill Community-identified Gaps

As is the case with most open-source software projects; there are usability, interoperability, and critical aspects of functionality where dedicated investment could help foster additional scale and grow the community of implementers by removing barriers to their use. Any investment or enhancements made to the solution will use the roadmap created by implementers.  This feedback loop is critical because we want to ensure that Planwise maps to implementers needs, and is reactive to users. Also, as we begin new collaborations, we will learn more about how Planwise should work, and being able to have the flexibility to respond to those findings will be vital to staying relevant. Activities for this objective include:

Activity 3.1: Load additional country metadata for 50 countries (e.g., roads, friction surfaces, & population). We currently have 10 countries loaded as of September 2018 and expect to have approximately 15-20 by December 2018 - all of which have been funded by current implementers. Any implementer can use loaded metadata once it has been loaded for a country, amortizing the investment.  This is key so that countries can easily begin using Planwise in their priority countries that are not currently covered.

Activity 3.2: Enable additional planning scenarios and functionality - Planwise supports two forms of planning right now; 1) Referral scenarios (e.g., lab tests or transport for services) and 2) direct service access. There are other types of planning scenarios and dimensions of planning we have already identified from partners that would be useful to provide straightforward templates for Planwise use (e.g., Outbreak preparedness/response, capacity building, malaria eradication, etc.).  We would like to work with implementers to document their needs and collaboratively create a roadmap for enhancing Planwise. This will increase participation by partners, and build in a feedback loop to respond to users critical needs.

Activity 3.3: Ensure interoperability with partner systems by implementing standards that are common in the health and geospatial data domain. Typical standards include ones such as FHIR, mCSD, or other geospatial-based standards such as those supported by the Open Geospatial Community. Interoperability with services like DHIS2 or Healthsites.io is a priority. Planwise does support integrations with facility registry applications currently as well as providing a simple CSV import functionality as well for service location data. Making Planwise interoperable with common standards will help increase partners ability to import their service networks.

Activity 3.4: Interfaces to enable fine tuning and experiments by GIS experts. By enabling Planwise to act as a hub for research and improving geospatial optimization and planning techniques; not only with implementers and the platform be enhanced, but the state of knowledge around geospatial modeling.  Also, this functionality will target supporting the consultants and experts who often carry out these types of activities manually. Planwise can then act as a tool that enables experts to go further in their analysis and recommendations, focusing on more sophisticated issues and research questions.

Deliverables:
  1. 50 new countries with loaded metadata; where implementation will now be possible.
  2. Community-generated roadmap of enhancements; to support user prioritized functionality and planning scenario project templates.
  3. Enhanced Planwise deployed and shared as open source software (GPLv3)
  4. Interoperability with OpenHIE / geospatial information systems.
  5. GIS expert interface in Planwise, to enable research and customization of modeling algorithms.

Consortium Team

InSTEDD is a non-profit, human-centered design, and software development organization based in California, with innovation labs (iLabs) located in Southeast Asia and Latin America. InSTEDD has been working in the health and development space for the last decade, developing high quality, scalable, open source digital solutions. InSTEDD is committed to HCD, agile development, capacity building, open source, and ensuring that partners have more significant degrees of positive impact with technology. InSTEDD was founded in 2006.  

Examples of related work include:

  • Africa Laboratory Mapping Project, with ASLM.  Seeking to map and improve laboratory networks across the continent.
  • Founding member and community lead for OpenHIE - focusing on facility registries and geospatial services and interoperability.
  • Cepheid GeneXpert remote telemetry and connectivity solution for diagnostic tests.

We plan to manage the development and community efforts centrally from the InSTEDD team. Our team will engage stakeholders with concrete implementations, who are currently, or planning to, use Planwise. Core to our team are:

  • Scott Teesdale: Program Lead and Design Researcher
  • Nico di Tada: Architect and Director of Platform Engineering
  • Backed up by the InSTEDD platform, iLab and other core team members as needed.

Other groups who are key stakeholders include the following implementers that are interested in implementing Planwise for their programs:

  • Catholic Relief Services to integrate Planwise across their programs and improve the quality of service delivery, particularly related to walking times to healthcare focusing on program work Sub-Saharan Africa.
  • Equal Access is exploring the applicability of Planwise to measure the impact of health programs transmitted via FM & AM radio and optimize their reach by calculating and optimizing locations and characteristics of transmitters. Many of these programs are located in the Sahel region of Africa and the Middle-east / Asia.
  • ASLM: Working on a funded program that is implementing Planwise in 2018 for diagnostic device placement and sample referral optimization in 12 countries - Niger, Ethiopia, Zambia, Zimbabwe, Malawi, Congo, Brazzaville, Cameroon, CAR, DRC, Gabon, Chad, & Sao Tome
  • Concern Worldwide was the first implementer of Planwise for Maternal Child Health, and their collaborators and funders (including the Xerox Foundation, and with special acknowledgment of Kelly Roberson who first pioneered with InSTEDD the work on productizing, at scale, the mathematical models validated in Kilifi, Kenya). Concern now focuses programs on the most challenging humanitarian environments.
  • Tupaia is an HMIS system being deployed in the Asia-Pacific region and are interested in using Planwise for both planning and disaster response purposes.
  • UCSF and Akros are implementing malaria control programs, and are interested in using Planwise to improve malaria eradication programs.
  • PCI-India: To improve and maximize the impact of their vaccination and infectious disease work in Bihar, India.

Technical collaborators include:

  • WorldPop, the open population and movement dataset effort that provides open access archive of spatial demographic datasets as a data commons, maintained by the University of Southampton. Additionally, Southampton researchers and grant writers are exploring further implementations of Planwise.
  • OpenStreetMap as a provider of road networks and in some cases drive time data.
  • Google Earth Engine as a source of elevation data, and as a close ally of Planwise that has worked with the University of Oxford to create unique data derivatives and friction surface maps corresponding to walking times, which Planwise can help operationalize in the field.

We plan to continue to grow the list of interested stakeholders and invite them into the community of users.

Digital Health Technologies

Planwise is its own stand-alone open source software solution, that is hosted free to use in the cloud. Partners who wish to deploy their own local version are free to do this, although we don’t recommend this unless the hosting infrastructure is proven and ready. Further, geospatial data on service location doesn’t have any of the typical limitations of medical records that have PII, so there are many financial and logistical benefits of using the cloud.

Work Plan, Project Deliverables & Timeline 

The work plan for the Planwise concept can be found here: Link to spreadsheet

Community Feedback & Ecosystem

Planwise organically attracted a living ecosystem of public and private sector data providers, algorithm experts, and country implementers, connected by common interest rather than by MOUs and competitive contracts.

Planwise commits to act as a genuinely open initiative allowing for a multitude of partners and collaborators to engage and not driven by a single consortium or set of partners. To grow the community organically, we plan to focus on empowering groups and providing value, which aligns with the community by supporting their goals. Specifically, we will:
  • Hold routine (monthly) web-based community meetings where participants can share best practices, case studies, challenges, explore collaborations, and share updates.
  • Conduct surveys and polls to gather feedback on community meetings, Planwise enhancements, guidance needs, and support material requirements, etc.
  • Create and maintain an open digital repository of guidance, likely a wiki or simple website, to share information and details.
  • Provide a simple mechanism to share and review concepts or proposals, and find collaborators.
  • Depending on community preferences, we may also create a chatroom environment (e.g., slack) or google groups for asynchronous communication.
  • Engage other communities such as OpenHIE
Planwise is a powerful example of how catalyst funds could both support current implementation and accelerate the growth of a network and technology that has the vision of being self-sustainable in the long run. Thank you for considering our concept, let us know if you have any questions.

Scenarios

  • Maternal and Child Health
  • Disease Surveillance and outbreak response
  • Laboratory management and referral pathways
  • Radio Towers
  • Water points
  • Schools
  • Primary Healthcare

Use Cases

Use cases for Planwise, include:
  • A program manager or planner uses Planwise to load their list of sites and review the coverage or catchment of the network, by their preferred mode of transportation (e.g., walking, driving, etc.) and the preferred amount of time.
  • A program manager or planner uses Planwise to identify areas that are outside of the current catchment area; to find locations to send mobile clinics or send community health workers.
  • A program manager or planner uses the catchment calculations in Planwise to find the best locations to enhance or grow the network of locations. These improvements may be through new locations or upgrading existing locations. The best options being the cheapest ones, that would help the most people.
  • A program manager or planner takes the findings from Planwise, and can easily customize recommendation scenarios based on his/her contextual knowledge. The tool then recalculates the findings.

User Stories

User stories for Planwise, include:
  • As a program manager, I am preparing to deploy an intervention, and I would like to know where to select my intervention site(s), to reduce walking times for those who are most vulnerable.
  • As a public health manager, I want to understand the exact catchment of who can access a service my program is providing - via both driving and walking times.
  • As a program manager, when I am designing an intervention; I want to form a strategy, with specific coverage targets, to achieve my proposed goals.
  • As a laboratory manager, I want to understand the gaps and bottlenecks in sample or patient referrals, so I can increase capacity or adapt referral patterns to maximize efficiency and decrease the time required to have a test result delivered to a patient or provider.
  • As an analyst, I want to identify communities that have limited or no access to a service, to better articulate risk for poor health outcomes, outbreaks of disease, etc.
  • As a program manager, I want to compare different scenarios for how best to increase the scope or capacity of the health system, so that I can make an informed decision about the approach we will take - such as to add more ambulances, build new facilities, increase capacity at existing facilities, send mobile clinics, etc...
  • As a GIS analyst, I want to pull the base layers of demand and capacity data into another GIS or data visualization platform, to quickly create custom reports and create compelling stories of impact and continuing need.
  • As a funder/fundraiser, I want to know how much our network or system needs to grow to support X% of the population so that I can pursue the right amount of funding or advocate for universal access to care.

Planwise Global Good Maturity Model

The self-assessment of the global good maturity model for Planwise can be found here: Link

2 Sentence Summary

What is Planwise? Planwise is an open source software tool that uses geospatial modeling and optimization techniques to make it simple for an organization to understand whom they are helping, and to maximize the efficiency impact of their services.  Specifically, it shows a user what the current coverage and capacity of the network is, and then produces scenarios for how to best enhance access to care; for the least amount of funding.

What is our proposal? Our proposal seeks to create an open community of implementers and a process to scale the use and impact of Planwise for healthcare and other social-impact related programs.  Specifically, we are seeking to:

  1. Formalize and grow the community of implementers
  2. Create and deploy a strategy for replication and scaled impact
  3. Extend Planwise functionality to fill priority community-identified gaps

Tags

Human Centered Design, Open Data, Open Source, Planning, Optimization, Catchment Analysis, Access to Care, Service Delivery Coverage, Efficiency, Cost Effectiveness, Geographic Accessibility, Demand for Services, Population Information, Census, Interoperability, Emergency Response, Facility Registry, Health Finance, Human Resources, Public Health and Disease Surveillance, Laboratory and Diagnostics Information System, Logistics Management Information System

Comments

Thanks for your submission and looking forward to your full proposal.

It would be great to add some details about the long-term strategy for self-sustainability. Additionally, regarding some of the integrations mentioned, will any digital health / information exchange standards be used?

Hi Nils, Thanks for the comment. 

We are seeking to develop both a governance model and a model for scale as part of the funding we would receive from Digital Square.  Would love to hear any thoughts you have on the topic, right now we are mostly in an exploratory state. 

Re: integrations, we want to be implementation driven for such things, as they tend to be expensive and time-consuming.  We currently support integration with an OpenHIE facility registry (via Resource Map) and also have a direct .csv import function already deployed for service location.  We are eager to explore other potential needs around integration too, whether those be FHIR based or mCSD or whatever it might be.