Five learnings from the Peruvian healthcare ecosystem, where AI is ready to assist
A blog by Michael Wilkinson, PhD, from Inavya, a Frontier Tech implementing Partner
Pilot: EmpatIA - AI to enhance healthcare in remote areas of Peru
Project EmpatIA is an 18-month initiative supported by UKaid that uses Avatr AI technology to improve healthcare access for at-risk patients in the Peruvian healthcare ecosystem. The project is delivered by Inavya in partnership with the British Embassy in Lima.
This blog is part of a series of publications that share the main findings of the project. The first publication on the Generative AI learnings is available here. The full ecosystem report referenced in this blog is available here.
Study Implementation
As detailed in the previous Sprint 5 blog, Detecta Clinic in Lima was identified as the pathfinder for Project EmpatIAI. After that, the Cayetano Heredia University Ethics Committee granted ethics approval for a clinical study, and the technology set-up was conducted. Below, we discuss what happened during the implementation of the Clinical Study at Detecta Clinic.
1. Study Overview
The design of the EmpatIA study aimed to assess the benefits of the Avatr application for post-surgery breast cancer patients at Detecta Clinic. In the study's design, two groups of patients were randomly assigned to either a Control Group or an Experimental Group. Patients in the Control Group received the usual post-operative service from Detecta Clinic; in contrast, patients in the Experimental Group received the usual post-operative service plus the Avatr app from Detecta Clinic.
A total of 51 patients were invited to join the Study, of which 10 declined to participate. Of the 41 patients who chose to participate, 23 patients (56%) were randomly assigned to the Control Group and did not receive the Avatr EmpatIA application; 18 patients (44%) were randomly assigned to the Intervention Group and received the Avatr EmpatIA application.
In the Control Group of 23 patients, 15 (65%) were from Lima, and 8 (35%) were from outside Lima living in the Highlands or Coast. In the Novel Group of 18 patients, 10 (56%) were from Lima, and 8 (44%) were from outside Lima living in the Highlands or Coast.
2. Key Findings
The research team used a standardised questionnaire called EQ-5D-5L as part of the study. The EQ-5D-5L is a self-assessed, health-related ‘quality of life’ questionnaire. The scale measures the quality of life on a 5-component scale, including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
The evidence revealed five areas of particular importance:
Pain Management
In the Novel Group, 17 patients (94%) reported that they experienced pain before surgery. Four days following surgery and while at home, 15 patients (83%) reported that they experienced pain but with an overall decrease in pain levels post-surgery. Given that the clinical aim is to ensure no pain by the second day after surgery, pain management after hospital discharge is an area for improvement.Anxiety
In the Novel Group, 16 patients (89%) reported anxiety before surgery. Four days following surgery and while at home, 17 patients (94%) reported that the intensity of their anxiety increased. This increase in anxiety levels post-surgery was associated with concern regarding potential future complications, further treatment protocols, trauma associated with breast tissue removal, and treatment costs. Anxiety has a significant impact on patients’ quality-of-life; therefore, this is an area for improvement.Comorbidities
In the Novel Group, 4 of 8 patients (50%) from outside Lima reported having comorbidities, compared to 2 of 10 patients (20%) from Lima. Patients from outside Lima were more likely to have complex health challenges that were exacerbated by healthcare access challenges. Avatr can help bridge the access gap for patients living in remote areas. Given the ever-increasing prevalence of comorbidities, further development of AI-enabled personalised healthcare is an area for improvement.Agency
In the Novel Group, 16 patients (89%) reported that the Avatr digital health application was useful for reminding them to take medications. Given the importance of medication adherence to patient health, this result is encouraging, and Avatr should continue. However, interviews with patients outside Lima revealed that other languages are often spoken at home; therefore, the Avatr system should cater to this non-spanish speaking population and incorporate other local languages for there to be full agency for those patients.Access
The study provides invaluable insight that can be explored comprehensively in a larger study. For example, feedback provided by participating patients suggested that the Avatr app can improve access to information on medication and personal records, especially for patients who live outside of Lima. Patients also suggested there could be opportunities to further improve access to personalised information and user experience through specific features such as appointment and medication reminders.
Ecosystem Report
The term "ecosystem" is commonly used in the global healthcare sector to refer to a network of patients, doctors, and other stakeholders involved in healthcare. These ecosystems are typically informal and include various entities such as healthcare providers, hospitals, universities, pharmacies, pharmaceutical companies, insurance companies, medical technology companies, investors, and government policy-makers.
The current Peruvian healthcare ecosystem is characterised as a complex network of institutions and caregivers that strive to deliver quality healthcare to patients across diverse regions. From pharmacists to surgeons, various professionals provide services to enhance patient outcomes and elevate care quality.
Given this complex network, there are significant opportunities to explore the use of health technology and AI to transform healthcare delivery, making it more efficient, effective, and patient-centred. Such a transformation benefits from the widespread adoption of smartphone technologies across Peru.
From January to March 2024, the project produced a report to profile the health ecosystem in Peru, which considered current unmet needs and opportunities to introduce AI technology to support transformation in Peru. The findings are presented in the ecosystem report which can be accessed here.
Embassy Event
In March 2024, the British Embassy in Lima hosted an event to share the main learnings from the Project EmpatIA pilot with key stakeholders from the Peru health ecosystem. The results of the study were presented alongside developments in the technology through GenAI. The event generated strong interest in the ongoing development of Project EmpatIA to support more clinical areas and partners from across the health ecosystem, including the Government of Peru Technology Agency, public healthcare providers from EsSalud and the Ministry of Health, private clinics, and universities.
Stakeholders expressed interest in future collaboration on education, research and development, and healthcare using GenAI. Some questions were raised about strategies to maintain data privacy, and our AI data safety roadmap, a working document, was shared in response.
The future
With Detecta Clinic serving as a pathfinder, a wide range of public and private healthcare providers, pharmaceutical companies, insurance providers, and others have expressed strong interest in participating in the further development of AI for healthcare in Peru. In addition, key health ecosystem stakeholders from other markets in Latin America expressed a desire to learn from the Peru experience and to extend Project EmpatIA across Latin America.
As Project EmpatIA in Peru concludes its transformative 18-month journey, we extend a heartfelt invitation to innovators and visionaries considering similar solutions or embarking on parallel paths. Project EmpatIA has demonstrated the profound impact of integrating AI technologies in addressing socio-economic challenges, fostering inclusive growth, and enhancing community well-being. We believe that the lessons learned and the successes achieved here can serve as a beacon for similar initiatives across Latin America.
We invite you to join us in celebrating this milestone and contributing your expertise, creativity, and passion to Project EmpatIA's ongoing mission. Working together can amplify our efforts to create sustainable, impactful solutions that benefit the entire region.
As we look to the future, we pose some questions for further research and thought: How can we enhance the scalability of GenAI technologies in diverse socio-cultural contexts? What partnerships are essential for driving systemic change across health ecosystems in Latin America? How can we ensure that the benefits of these technologies are accessible to the most marginalised communities?
Your participation and support are crucial as we strive to spread Project EmpatIA's benefits across Latin America. Together, let's create a brighter, more inclusive future for all.
Join us in this exciting endeavour - let’s make a lasting difference!
info@inavya.com
If you’d like to dig in further…
🚀 Explore this pilot’s profile page
📚 Read about the pilot’s first Sprint and their three key phases — “Project EmpatIA Starts”
📚 Learn about the pilot’s local impact and global reach — “Project EmpatIA: Local Impact, Global Reach”
📚 Explore learnings from the pilot’s third Sprint — “Project EmpatIA: Innovating within the Peru Ecosystem”
📚 Read the fourth sprint findings on engaging healthcare providers — “Project EmpatIA: Engaging with Healthcare Providers & Patients in Peru”
📚 Read the final learnings from the pilot here — “Project EmpatIA: Enabling Healthcare Transformation in Peru”
📚 Find out how the pilot uses generative AI here — “Avatr generative AI learnings in Project EmpatIA”
