- Courtesy Of Thinkmd
- ThinkMD staff
In 2014, University of Vermont pediatrician Dr. Barry Finette cofounded the tech startup THINKMD with the goal of preventing millions of children in low- and middle-income countries from dying each year from treatable conditions such as pneumonia, malaria and dehydration.
Working with tech entrepreneurs and software developers in Vermont, as well as international aid groups such as Save the Children and UNICEF, THINKMD spent more than two years designing, testing and distributing a diagnostic and treatment app, downloadable on virtually any laptop, tablet or smartphone.
Then, when the coronavirus first appeared in the United States in January 2020, the company immediately shifted its focus to developing a similar screening and education tool for COVID-19. Using its existing technology, as well as its partnerships with nongovernmental organizations and mobile network operators in Africa and Asia, the company took just eight weeks to get its new coronavirus product into the field, in 14 languages.
Since last March, THINKMD's COVID-19 mobile triage app — which enables users to identify symptoms of the disease, determine when to seek medical care and learn how to prevent its spread — has been downloaded in more than 80 countries.
Though THINKMD operates as a for-profit entity, Finette said that the Burlington-based firm decided early on to provide its app for free. Because it's registered as a public benefit corporation — a type of for-profit business entity with a legally mandated social mission — THINKMD is committed to its core humanitarian mission of eliminating preventable deaths, something the app clearly aims to accomplish.
But that doesn't mean the pandemic hasn't posed a real threat to the company's own existence.
"From a big-picture standpoint, we had to determine how we were going to stay alive," Finette said. "We're a growing tech company ... We don't have deep pockets."
In a sense, the pandemic has been a double-edged sword for THINKMD. On one hand, all public health funding "switched on a dime" to combating COVID-19. But at the same time, Finette noted, "Everything else was forgotten," as public health ministries and NGOs around the world hit the pause button on adopting new technology aimed at addressing other public health crises.
"That put us in a really challenging position," he said. "We were able to continue and renew our contracts and get some new ones. But so many groups and agencies were staring like deer in the headlights, unsure what to do next."
THINKMD also faced the challenge of distinguishing its own products from "the noise," as Finette put it. As the pandemic spread, dozens of individuals, organizations and businesses began flooding the health care market with their own digital technologies aimed at addressing the disease.
Meanwhile, THINKMD has faced most of the same challenges as other companies in the midst of the pandemic — namely, keeping its staff of 12, most of whom are based in Vermont, healthy, employed and productive. Finette, who still works at the UVM Medical Center and teaches at the Larner College of Medicine, has had most of his employees working remotely for months, with all foreign and domestic travel effectively halted.
The company has been thrown a few critical lifelines. Last spring, it secured a federal Paycheck Protection Program loan of $144,000. And, as part of its efforts to fight the pandemic, THINKMD was awarded a UBS Optimus Foundation COVID-19 Response Fund grant of $500,000, one of several such grants the company received.
From a clinical and technical standpoint, the coronavirus itself posed some unique challenges to THINKMD, too. Because so little was known about COVID-19 in February 2020 when the app was in development, Finette and his team had to constantly monitor the medical literature about the emergent disease, including how it affects different age groups and subsets of the population.
And, because THINKMD is committed to making recommendations that are consistent with those from the World Health Organization and the U.S. Centers for Disease Control and Prevention, the app, which also can be used on the company's website, has gone through several different iterations as those agencies' recommendations evolved over time.
One fascinating component of COVID-19 that's likely to be studied for years to come, Finette noted, is that it hasn't hit low- and middle-income countries nearly as hard as it has higher-income countries. "And nobody knows why," he said.
One possible theory, he suggested, is that countries such as those in Southeast Asia and sub-Saharan Africa have been dealing regularly with epidemics — including dengue, SARS (severe acute respiratory syndrome) and Ebola — for years.
"So they respond to these things with significant respect and with appropriate public health measures — wearing masks, social distancing and all that," Finette said. He spent years working as a physician for international aid groups in the developing world.
Another possible explanation: In many poorer countries, children comprise more than 50 percent of the population, and thus far they have been less affected by COVID-19 than adults. Indeed, even when accounting for the underreporting of COVID-19 cases in the developing world, as well as less widespread testing, Finette said that rates of hospitalizations and deaths in many poorer countries have been lower than those in the U.S. and Europe.
In order to understand and better respond to this pandemic and future ones, researchers need data — something THINKMD can readily provide. Like the previous app, its COVID-19 tool gathers data that can be used to identify where the disease is spreading fastest, allowing public health officials and international aid agencies to deploy personal protective equipment and other medical supplies to that region. The data also can be aggregated to build predictive models of where the disease is likely to spread next, allowing health agencies to speed their responses to the pandemic.
This technology could find a local market in the years to come, as U.S. health care providers, including the UVM Health Network, continue using methods adopted during the pandemic, such as remote triaging and home patient assessments.
In short, saving the lives of others has the added bonus of keeping THINKMD alive, too.