Q&A with Flare: An ambulance app for Nairobi

How one startup is providing an Uber-like ambulance app for patients in Kenya

In Nairobi, patients in a medical emergency call the police, who then connect them to an ambulance. There is nothing like 911. This is now a thing of the past Maria Rabinovich, the co-founder of Flare tells IDG Connect.

What is Flare and what problems does it try to solve?

Flare is a next-generation emergency response infrastructure. Much like 911 or 112, Flare serves as the complete emergency response system: from the organizational backend for ambulance companies to the hotline, web, and mobile applications for all users within the emergency ecosystem. This includes people experiencing an emergency, families, doctors, insurers, corporates, hospitals, and quality emergency response providers. Flare unites existing resources and professionals in one platform, creating an integrated response network

After testing several iterations for three months, we officially launched in March 2017 with select companies: giving ambulance providers dispatching and tracking systems. We are currently rolling out new features as we prepare to launch additional parts of the platform, including the hotline and consumer app, this summer.

What do I need as a Nairobian to use Flare? Can someone else “Flare me up” (use Flare to get me help)?

Flare was initially conceived in and for Nairobi, but is actually designed to be used anywhere in the world where there is no emergency response system. In order to use it, a caller (this can be a patient, a friend, a family member, or a bystander) can simply use the app or telephone hotline to connect to the most appropriate dispatcher. So yes, anybody can use Flare to get help for anybody else.

Tell us about this product and services it offers/makes possible.

The last thing you want to be doing in an emergency is researching and calling different numbers. You are also in no position to calculate your best options based on GPS coordinates or current traffic conditions. Having real-time data on emergency responders, as well as facilities and the services they can offer at any given time, is critical for emergency cases. It saves lives. Flare is this critical infrastructure. For emergency responders, Flare provides logistics for their operations: improving dispatching, fleet-management, and response services across different providers.

How much does it cost to use Flare? Does the patient pay you directly?

The payment methods and modes of payment depend on the company that ultimately provides you the services. While Flare facilitates payments and works with different payers to reduce cost, we do so through our trusted network of providers. Their services range in price from free to more expensive specialty services. We are working to make it affordable.

Tell us about the tech features in Flare’s app that make it possible for you to operate?

Flare is easy to use, to set up, and to work in even the harshest conditions. It is cloud based, and includes several components: dispatchers have their own desktop app; ambulance teams have mobile apps that send and receive GPS coordinates, track real-time traffic conditions, and help the teams provide the best care; patients and users with emergencies use a hotline or the consumer app to access care; other members of the process - family members, doctors, hospitals, and payers or insurers - have their own portals within our system.

On the backend, we are focused on data security and resilience: creating redundant systems (fallback options when one server is down, for example) that aim at constant up-time. In an emergency, a patient knows who to call, and to get the fastest help right away. They should also be able to loop in their loved ones, and to plan not just their pickup, but their entire time to care, as well as their best treatment options. All of the features are just critical, lifesaving, information, location services, and connectivity.

How is Flare unique from others being offered in this area (the one by Red Cross Kenya, India’s Amber Health and Dubai’s Murgency)?

Amber Health and Murgency have a similar product, but are operating in different geographies. All of us are in different stages of product creation and use, and have slightly different approaches to solving a similar problem. We have done a lot of ideas sharing and remain in touch. Some of the most interesting differences stem from the unique geographies we operate in.

We bridge the different components of the emergency response landscape and work with them and the other companies you mention to create a complete and all-inclusive response network. The most important part of expanding access to emergency response is incorporating as many different apps and services as are functional, robust, secure, and beneficial to our patients and users. We are trying to bring it all together.

What motivated the development of Flare? And do you feel “Uber for Ambulance” correctly describes that motivation? Why and why not?

Caitlin [Flare’s other cofounder] and I conceived Flare after working for years in the healthcare space in Nairobi. We realised that even after a combined ten years of working in the healthcare space here, neither of us knew what to do in case of an emergency. In our research, we found that there are a large number of quality providers - but that a lack of information infrastructure limits access and use. That is why we started Flare.

Calling it an “Uber for Ambulances” can be helpful because many people are familiar with Uber’s ability to simplify getting a taxi. People have seen how the on-demand nature of Uber democratises the taxi business and increases access. In that sense, we like the comparison.

Unlike Uber, we are putting different companies onto one system, allowing them to retain their company identity and distinctions in price and offerings. We are improving their ability to collaborate, both in subcontracting or sharing rides, and in larger-scale responses, where several responders and vehicles may be necessary. Finally, we are looking at the entire emergency response system: beyond the initial pickup and drop-off points, we are considering the entire time to care and treatment selection, helping users understand their options and find the right solutions for their emergencies. With an Uber ride you generally know where you are going. Conversely, in an emergency, patients rely on the professionals to help them navigate their options and find the right treatment centre. We seek to improve access to all of the necessary information.

How far have you penetrated Nairobi and how do you tackle the price issue?

We are growing the number of ambulances on the platform and have doubled the number in the last month. In terms of coverage, our current providers operate in and outside of Nairobi to surrounding cities, and complete long-haul trips throughout Kenya. We were surprised at the number of long distance trips that happen around Kenya for specialty services at specific hospitals to air-evacuation trips from all over the country to the different airports.

To address your question on cost: we partner with companies that provide services with a large range in pricing. At first, we are focused on creating the infrastructure: at the moment even customers willing to pay are unable to reach help in time. However, almost all of the providers we have met in Nairobi already have some form of sliding-scale payment system. A significant number of them even provide completely free rides for select patients. Others offer affordable cover that includes ambulance transfers.

Ultimately, our partners are the service providers, so part of our job is to create a workable ecosystem for them: they have to be able to stay profitable while providing affordable services. A big part of this is increasing access and demand, allowing the ambulance providers to do cheaper trips at higher quantities, similar to how Uber lowered the cost of a taxi trip by guaranteeing drivers more trips per day. However, with highly trained professionals like emergency responders, and the cost of maintaining expensive ambulance equipment, it cannot become a bidding war; we are careful not to create pricing competition that incentivises any sacrifice in quality. Instead, we seek to work on cost reduction through several initiatives including price transparency, our own pricing options and guarantees, and collaborations with payers who cover rides for select patients. In parallel, we seek to incentivise quality through fair pricing, and to help our partners run successful businesses focused on quality and fast response.

How much is your subscriber/download base? How many patients have you served so far?

We are not currently able to share specific statistics or names of the companies we are working with. However, I can tell you that we are adding new ambulances onto the platform weekly and new companies are joining monthly. [At pilot stage, 50 ambulances and 10 fire engines were on board by end of 2016, according to Lily Kuo, Quartz Africa.]

Have you met the eight-minute threshold (recommended international standard for response time)?  

We have had response times of less than eight minutes. And given the circumstances of some of the other dispatches, we think that response times were quite good. However, our aim is that every critical trauma patient or anybody with a heart condition (these are the most time-sensitive) on our system is able to get help in under eight minutes every time. And based on current data, I think we can get there. Some key steps to reaching our goal include adding more ambulances and getting better data sets to help our partners dynamically position themselves for faster response.

You are also interested in Fire Responses in addition to ambulances, yes?

We have begun to add fire engines to the system. We know emergencies often require more than medical assistance, and we want to be the access point for any help you may need. At the moment we are in the testing phase with fire engines. We have found that fire response requires additional resources and coordination, and we are close to releasing those components to our partner responders.

However, using the responder location data in our system, we have manually dispatched one fire truck to a burning house in Nairobi. The team managed to save the building - so that was great encouragement! The ambulances on our platform have also responded to fires that required medical assistance.

What do you think of Nairobi’s 110-year old Fire Department? Are they on Flare yet?

We have met with them, and plan to onboard them when our fire response system is ready. They are really committed to their work, and like all emergency response professionals we have spoken to, expressed quite clearly that having access to a system that allows them to respond to more emergencies more effectively would be very welcomed.

What was/is the source of your funding in your operations?

We have raised money and support through MIT (Legatum Center, 100k finalist and IDEAS winner), Merck pharmaceuticals, and several angel investors in Kenya and abroad. As a startup, we are always raising, so we invite any readers to get in touch if you would like to join our team of angels or participate in a future round.

What about awards, recognitions, international mentions etc.?

We have received the following mentions and awards: MIT Legatum Fellowship, Merck Pharmaceuticals: selected for the first class of the Nairobi Incubator, MIT 100K Finalist, MIT Ideas Global Challenge 2nd Place winner, Pivot East finalist, Disrupt Africa: named one of 21 African Startups to Watch in 2017, Apps Africa Innovation Awards: Most Disruptive App Finalist, IT News Africa: named one of 10 African Startups to Watch in 2017.

Healthcare startups have not traditionally gotten a lot of attention from investors, what do you think Flare is doing differently?

We are approaching the problem from an infrastructure and systems level. One of the things our investors have been attracted to is that Flare is scalable and applicable to many parts of the world. We are using cutting edge technology to provide essential life-saving services. And life-saving emergency services provide a lot more than the obvious need that anybody would want for themselves and their families: having reliable life-saving infrastructure in any city or town is a critical measure of livability and security for its citizens.

What are some of the greatest challenges that you have encountered and how have you addressed them?

Our biggest challenges have been in design and development. We are creating something very new, so we have had to do a lot of research and trials to figure out the best solutions. I have worked on digital startups and larger scale enterprise software in the past, so these are not new challenges for me, but rather a normal part of the process. However, in this case, getting it right is very important: it can save a life. Flare has to work well all of the time, and it has to provide very accurate and helpful data. Another challenge is continuing to raise money while building the product with our small team. Everything takes time, so we are trying to balance getting some sleep, with getting more people on board and more users onto the Flare system. We are happy with our progress and encouraged by the support and uptake from our partners, but as a growing company, we are always looking for the next step.

What are your short and long term goals? The rest of Africa maybe?

1 2 Page 1
Page 1 of 2