 Very good morning to you. Thank you for keeping us company here at Y2540 VINKISS. You're just getting to join us. This is Y in the morning. Hashtag fasty vibes where we get to give you good music, good conversations and of course we get to do the spot on tech which is coming up right away. And this week's episode of spot on tech, we get to feature Cresswave Limited, which is an innovation driven company that undertakes software development project. And with me in studio are the directors, Felix Oredo-Gem and Max Wilger Komegidine, she let the conversation roll. Thank you for making time. Probably because I have really highlighted your name and someone might be wondering who's Max Wil, who's Felix, you can probably do an introduction. True, I'm Felix Oredo. I am one of the directors of Cresswave Limited and also a co-founder. Yeah, I'm Max Wil, I come back with NG and I'm also a co-founder and directed Cresswave Limited and I'm also a software engineer by profession. Okay, nice. So I think we start from what's Cresswave? Of course I have read a shortened version of a description of Cresswave, probably could give us an in-depth description of what Cresswave does. Okay, maybe I can start from how we started. Okay, Felix, my colleague here was a campusmate. We studied together at Moe University and back then we used to do some projects, small, small projects at high school for purposes of studying. Then we realized, oh, we can do something. We started by doing some competitions like the Pivotist for development. We participated in Pivotist, then we got to second runners up. We participated in Safari Come Up, which position did we imagine? I think we were in our category number three, we were in the category of business applications where we developed an application called Maiduka. Yeah, then we did another one, the final one, which was called Kulima, which became number one in the Origin Developer Challenge. And then we sat down, after now we won that one and we thought, why can't we make this thing to be something of the future? Instead of now just doing projects, doing one project, then moving on to another one. So we sat down back in campus and decided, oh, we can come up with something. And then we started by now doing our first project together as a commercial project, which was called E-Parent. And by then we had not incorporated the company. So we started by doing that E-Parent, then we started pushing it to the market. We realized, no, it's not working. So we decided now, let's look, let's go and do a market research, which is a gap in the market in terms of software. So that's how we sat down, did an evaluation, we checked it to the financial sector. That one was highly digitized by then, that is back in 2016. So we checked it to the healthcare sector, then we realized, oh, there is a gap there. Then we decided to incorporate the company CrestWeb Limited. Now from that small startup that we had, which was not official. And then that's how CrestWeb came into being. That is in 2017, we incorporated it in November. And now we started doing healthcare solutions from then up to now. What are some of the projects you've done? There's the one which we started with, the one called E-Parent. Then as we entered into the field, I think I can also capture something before going to the project. So in 2017, still we were still sort of employed, but there's this great man, we met Dr. Gacombe, who is the CEO of Metropolitan Hospital. So he was also a mentor at that time, and he advised us that you have to choose one path. If you go with two, one of them will fail. So because initially we were doing E-Parent, we now started interacting more in the healthcare sector. So one of our core projects is now that E-Care HMIS, which is a healthcare system for clinics and hospitals. And on top of that, E-Care HMIS, we have built some other modules on top of it, like there's a food ordering app for patients, but largely mostly on the healthcare sector. Also we have an app for patients such that patients are able to let's say view their results at home after you have gone to the hospital, pay your bills from the comfort of your phone instead of having to go to the cashier and stuff. So largely everything you have done is surrounding the healthcare sector. Yeah, with our core product being the E-Care HMIS. Before we talk about E-Care, of course, which was showcasing before we started the interview, is there a particular reason why you chose healthcare to be like, is there a particular reason? Yeah, maybe I can start as Felix has said, as we are doing the research, there was Dr. Gacombe, who has also been our mentor up to now. And while we were doing the research, we identified that healthcare was like 20% digitized, as compared to the financial sector, which is very highly digitized. If you go to banks, they're very highly digital. And so we identified that there is a gap in the healthcare sector. And that gap was affecting the provision of healthcare to quality healthcare to the people. So one of the reasons that we chose healthcare, it was to minimize that gap. Number two, we had a mentor who has been the healthcare sector for 25 years. So he could be able to tell us, this is the way to go. These are the gaps to address, which now we have been addressing using our solutions. And through that, we have been able to identify those gaps, close them through an ecosystem of applications that Felix was just mentioning. So our key thing for going into healthcare is to address the big gap that was there. Someone might have walked in on E-Care, you know, or they're just getting to tune into the conversation. Will you mind taking us through what is E-Care, what does it do? So E-Care, yeah, maybe even from the name, it's an e-health system. So E-Care is a hospital management information system. And other people call them EMRs. But because for us, it covers all aspects of a hospital, from management of a hospital, from entry, from patient management to hospital operations in terms of purchases. It manages all aspects of a hospital. So maybe to start is a concern by saying the patient management, that is a key focus. That was a first key focus. So patient management, it means once you get into a hospital, all your records are captured through the system. So from the reception, you are registered, your bio-data is captured, and then you are sent to the nurse, your information is also captured. You are sent to the doctor, the doctor also uses the system to capture your information, to request the lab tests, everything, to go to pharmacy, the drugs, they're done on that software, so that all your records are captured in one central place. So that is the aspect of the patient management. The other aspect is the hospital operation in terms of purchases. If the hospital is buying drugs, then you're able to do the purchases from there, and you're able to make the controls that there are no leakages in terms of, you don't lose any revenue through shoddy deals, underhand deals, where drugs are stolen from the stores. So you're able to manage from purchasing to dispensing, and you can tell every drug that was purchased, it was issued to this patient. You can be able to do an audit of all your drugs. So the same case for other items, other medical items like the clothes and everything, you're able to capture and track all the items that you have been able to purchase, and they have been utilized to serve the patients. So that is the other aspect of the HMIS, of the ICA. The other aspect is the self-management of the patient themselves, which my colleague had mentioned about the patient app. So one of the things we realized is that patients, if you move from one place, if today I'm treated at a certain facility A, if I move to facility B, then my records remain at facility A. So I'm not able to move with my records to the other facility. So that is how we came up now to, apart from now managing the hospitals, is also the patient to manage their records, such that you're able to move with your records from hospital A to hospital B, such that the other doctor does not start treating you from zero. They have your records. They know your history. So that is the other aspect of our ICA, whereby we capture, we keep the patient at the center, whereby they're able to access their records, able to access the hospital facility, able to access also the doctors and also be able to interact with their doctors. So the other aspect is about health institutions, some of them are business, even for the government ones. They also do some aspect of accounting and billing. So we ensure that we have those controls. The patient is able to be billed and the management is able to track all aspects of billing, what has been billed, what was issued, and those accounting reports are also available on our system. So I think, Felix... Yeah, I think just to add on what you're saying, one of the core things we realize in a hospital, most people don't understand that there are also businesses. So ICA also enables substance removal to track their, let's say, profit and loss, their margins and stuff. Also, in terms of reporting, we also provide the Ministry of Health reports, which are usually required by hospitals to submit to the government. So ICA automatically does that for you. Also, in terms of the patient management, there is something which we also do for people with non-communicable diseases like diabetes. This patient is required to be monitored remotely. So ICA also provides that platform whereby a patient is able to send their vitals through the application, and the doctor from wherever he is, he's able to consult with the patient without the patient having to travel to the clinic or hospital. Yeah, I think largely that's what ICA is about. Yeah, you had mentioned something about patients moving with their information from one hospital to the other. This app, is it interchangeable between hospitals assuming that I was probably being treated at a local hospital within my area, and now there is need that I be referred to a bigger facility, maybe a referral hospital at level 5, you know. So is it my responsibility as a patient, or the responsibility of the hospital to transfer the information, or is it just an automatic system that once I log in that I was here, the hospital needs to just send the same information to another hospital? Yeah, okay, thank you for the question. Okay, the first thing that we are doing is the patient, the data belongs to the patient. So the patient is the one to share the data with the other hospital. They have to authorize for their data to be accessed by the other facility. So what we have done on our end, we have come up with a portal whereby if you authorize your data to be sent by the other hospital, the other hospital can be able to log into that portal and access your data. Then if the doctor is using our app, there is an app we have called MDoc, which if the doctor now, the other doctor is on that platform, if you as a patient you share your data, then the doctor will be able to access your data through that app called MDoc. But generally the patient, because the data belongs to the patient, the patient has to authorize that data to be shared with either the other facility or the doctor who is seeing that patient. So how many people does it require to run Ikea? So for it to run, it depends because Ikea is able to run on a very small facility from a consultant clinic up to a big hospital, a level 5 hospital. So the number of users required also depends largely on the type of facility and the size. Because all the modules, if for instance it's a facility, a consultant clinic, usually there is a reception and the consultant. So those are two users. If you go to a level 3, you find there is a lab, there is a pharmacy, there is probably a radiology department. So you find each of those departments has a user. So the number depends on the size but it can range from one user up to a hundred or even more depending on the size of the facility. Amongst the features that Ikea has, or other advantages that I was going through with the presentation is that Ikea reduces costs. How would you define that? How would you explain that? Okay, I think I can start with the basic one. Like in terms of being paperless obviously you are able to reduce costs in terms of no printing and stuff. Then the other major one is sealing of loopholes, like especially areas like pharmacy, where you find like maybe someone might dispense a drug without maybe payment or something or there might be some fraud related there. And also you have some controls whereby before let's say someone goes to purchase something, they create a purchase order which has to be approved by management. So you find in those kind of areas you see some loopholes. Also we have done some integrations to M-Pesa and also banks such that payments are automatic. Like we find in some hospitals they are completely cashless. So that completely eliminates the cases of fraud and those kinds of stuff. And maybe to top on that, how the cost now drills down back to the patient is if our key focus is to ensure that there is a seamless flow of things within a hospital. So if they turn around time for a patient, initially it was one hour, then we are able to reduce it to maybe to 30 minutes. What that means? One, the patient is able to be seen in a very short period of time. The hospital is able to see more patients. The doctor is able to see more patients than before because early on you would find that you have to go with the paper at every point. You go to lab, you are written a paper, you go to pharmacy, you are written another paper. So once now we are able to streamline that process, what it means, the hospital can be able now to have to serve more patients and they can be able to reduce the cost in terms of the cost of offering that care because if for instance they are able to see 100 patients in a day and initially they are able to see 50 or 80, then it means they can be able to reduce the cost for the patient because they are able to see more patients and that now they can be able to charge less. Even like the consultation fees you find that they are able now to reduce because the turnaround time is less and also the number of staff required to move the patients is also limited so that cost can be passed now back to the patient. The other thing as Felix has mentioned is the controls. You find in most places that we have installed our system you find that patients were losing, the hospitals were losing drugs so the cost of operations becomes very high meaning they have to pass that cost back to the patient. So now once we are able to streamline that then that cost is now able to be passed back to the patient. I think just to add on it something I had forgotten. Also on the patient side like the diabetes app I was telling you about the remote monitoring were reducing the cost for patients here in that aspect that they don't have now to travel to and forth just with the app and internet they are able to be monitored and also the same also has telemedicine so a doctor is able to consult patients of any other type of illnesses in a short time let's say 20 minutes even at home on their free time. This is a method you have tried and tested and of course during the inception of an idea not so many people believe in an idea how difficult was it to sell the idea to the first client you had? I think maybe I can start with a bit of some history a bit of it so once we as my colleague has just mentioned about our mentor told us that we have to choose one either employment because of employment or because initially we are working like working on it and then part time working on the project so we had to make the decision that we have to leave our jobs to work on this full time and once we left our employment our first client was a dentist who is called Dr. Morioki and he comes from our village so it was basically a referral to somebody you know so that was the first client and he gave us I need my dental clinic to be working like this so that is the first project that we did into healthcare so we landed somehow into direct into a project so after now doing that project for him then from there he was able to refer us to some other clients and it was very easy to convince because for them once you could be able to go to his clinic is called Riverside Dental Clinic so go to Riverside Dental Clinic and you can be able to see our system there so from there we have been able to convince people like this is the way it is and then it has been now designed by like the dental line designed by a dentist for dentists so if you go to this other E-care our mentor has been to healthcare for 25 years experience so he is able to tell us this can work this cannot work so essentially that is what has been we have been using referrals has been the major convincing factor to our clients so they buy the idea because one it is they can be able to see it is in use number two it is highly innovative it has other is an ecosystem compared to whatever is available we are an ecosystem we have the patient up, we have other add-ons so it is easier to convince the clients to buy our idea as compared to something that is not visible to them so I think in terms of how we got it that first client was our major breakthrough how effective has this been over the other methods that have been there longer in the market? I think in terms of referral we can say like it has like 80% success rate because one you find doctors are also very smart people so that when they go to a clinic they themselves they observe what is being used there they see the reports like maybe the receipt and stuff invoice so it is quite effective compared to even the online marketing and so I can say referral first then pay is also cost effective because you see we are not exactly spending just someone referring this is a good system you can see it gives me this and also like for the app I was talking about the M lock where doctors are able to even share with other doctors you can see my revenues so the app is self selling itself how viable is this software to handle future eventualities maybe you can expand more on the future eventualities assuming technology keeps advancing more things will keep coming up is a project or rather is a software how viable is it to future changes actually we adapt daily I remember when we started like the technologies we are using right now we have really adapted from where we started even right now this part of the project where we are doing an AI health and it is something which I can mention it is called Ozima Health so during the COVID time period we did sort of an AI project that is able to detect someone is suffering from COVID based on their symptoms and on that project we won the Africa versus virus challenge which was an African competition so we are constantly evolving right now in the AI that is something that we are developing slowly by slowly and testing so technology wise we are constantly evolving I think you have answered it well and so for us it is all about we are agile even as part of our we keep on learning day to day from doctors from the clients so we keep on adapting to the changes that are coming up in the healthcare sector have you expanded outside Kenya like have you tried it outside Kenya probably in the neighboring countries or somewhere else so far not yet but we have done some integrations to some clients in Tanzania but not the whole software to them and our key focus is first of all to make sure the Kenyan market gets the right we basically get the good grip of the Kenyan market then you can now focus on moving to other East African countries and I think just to add on it when we started our first year was quite tough because also in healthcare we were not quite conversant with the developing software for the healthcare market but now over the years like the first three years our main market was in Nairobi but right now in Kenya we are going to Nakuru, Nuki Skisumu, Bugoma, Liffy so at least after we have managed to capture that get a good market in Kenya it will be easier for us to expand to other markets because also we have learned from the different market dynamics let's say clients in Nairobi have different requirements from let's say clients in Nuki or Nakuru the government has been quite has been lack of a better word has been making noise or rather has been big actually that's the word I should use has been big on digital expansion and moving to the digital space is that an avenue you look for to probably pursuing if you've not yet started probably selling the idea to the government to adapt that software for now what we have been doing counties have been we have been looking for to digitize the healthcare since it's healthcare healthcare right now it's under the counties so we have been applying for tenders to the counties that have basically been able to list the tenders online and on newspapers we have been applying for those tenders and we hope to be able to provide this solution to the counties because basically they have that challenge any other thing you'd want to add yeah maybe on that in terms of like the counties we have been able to do some demos to some health like the Moranga County we have been able to go there present and the challenges that we have had from them from the the CEC from the from the superintendent is basically there is a lot of the controls that we have been mentioning about they are missing like drugs we are not able to tell if the counties are buying drugs but they are not able to tell where did this drug actually go were they given to the patient were they stolen did they expire so there is that challenge in terms of especially on the drugs part in the counties so there is a gap that can be addressed so that patients can be able to if the counties buy drugs then they get into the right hands to the patients who deserve them yes we have seen once people move digital a lot of entrenchments happen of course we have seen it in the media spaces and into other spaces what is the risk of having any care on the employment of physical employees for that one I can use an example of what I have encountered for the clinics you have installed I think what has done it has made people more efficient and also it has made people to do more useful tasks maybe instead of but in terms of retraction in the healthcare sector I don't really see it yeah I think that is true it is basically because the numbers for the healthcare sector is still doctors for the same in fact it makes them to be more efficient and one of the key things that it has helped is the medical records people because I think their key role should be doing research rather than filling in manual papers they should be focusing on it is doing research which diseases are becoming more common which drugs are becoming more resistant rather than focusing on inputting what my colleague had mentioned a bit earlier about those books that MOH requires so it makes them more efficient if you are able to generate from the system their reports then they will focus more on doing the research researching the diseases researching on their field basically what they are taught to do yeah and also I think it being an enabler I think it provides a work life balance because like there is a clinic which you went to it had two receptionists they were working from morning to the night they get out very tired but when you look at the work they were really doing it is mainly just writing yeah so it was not exactly what you can call productive work but now once we installed our system patient registration patient registers themselves so right now it is easy for them if by five you are good to go where do you see this project in the future? okay for us our focus is number one is to be to be the place to be an ecosystem that will make sure everybody gets quality healthcare from the patient to the doctors makes them more efficient and to the health facilities so where we want the app to be is to be an ecosystem that is able to serve all health institutions with a key focus to the patient and with a center person being the patient and to grow with technology whereby we have artificial intelligence to assist the doctors to be more efficient the patient to get more quality care like in future we want to have based on your diagnosis based on the drugs that we have been given we are able to tell the next time you come we are able to track your diagnosis with service the drugs with service how you reacted such that by the time you come back to the facility the doctor already has knows like this patient doesn't need to be done because already based on the history the system is able to alert them so we want it to be more to be a system whereby it is able to assist in clinical diagnosis with time so that is the future that we are looking forward to and also to add on it like the Ozima Health I was telling you about we also want to be part of that AI revolution in health care such that you see like if there is an auto pedicle for new disease it is easy to know the government is able to a pattern it is able to be easily identify this a pattern here before it blows out less into a pandemic and also from our website you will see we want to actualize to become the number one health tech provider in East Africa and possibly now we will be able to go to other markets also something else which we are doing actually one of the first product we are also in the kitchen in the terms of patients actually like if you visit metropolitan hospital I think it is one of the the only hospital I have encountered in Kenya whereby patient meal orders are being taken by a tablet it was actually one of our first products so we want to see to be in health when you say the ecosystem we want to really empower the ecosystem in every aspect of health care as we bring this conversation to a close where do you now as individuals see yourself in the future you don't know where it is today okay I want to be the bill gate in the health care sector I think for me it is just the same thing with the guest also my mentor so that's where we see ourselves and yeah maybe the company to be in the leagues of safari comes someday for us basically the company is us basically do you have any final remarks mine is is a a drive to the players in the health care sector is a is people to to come together and share ideas on how we can make health care great in Kenya and globally yeah I think for me is just say thank you for the opportunity yeah you really appreciate it yeah that's all you're welcome thank you so much for making time for coming sharing insights with us about health care no not all of us not a lot of people about it actually we about it when I saw it online and I was like oh wow they such an up must be nice it's not funny there's a time I went to Coptic you have to run around keep running you're going the reception is somewhere else maybe the consultant you're seeing is on 3rd floor the lab is on first floor the finance is down there you know it's it becomes really quite something but now you see with such ups makes life a bit easier thank you so much for sharing with us that was for those were the directors of Crestweb Limited which is an innovation software company and we have been sharing insights on e-care which is a software that is used to register do a bit of everything in the health care management