Watsi Revolutionizes Crowdfunded Healthcare with “Radical Transparency”

Anna Borenstein    March 10, 2017

Watsi is a non-profit crowdsourcing platform that enables anyone to fund life-changing medical procedures for patients in developing countries who might not otherwise have access to healthcare. At the time this case study was written, 22,102 Watsi donors had funded healthcare for 11,559 patients in 25 countries. Patients waiting to be fully funded included Vehn, a farmer from Cambodia who needs a hip replacement, Olga, a single mother from Guatemala who needs treatment for diabetes, and Dah Htoo, a 2 year old boy from Burma who needs surgery to repair burn damage.

When Watsi founder Chase Adam was a Peace Corps volunteer, he was traveling through a small town in Costa Rica when a woman boarded the bus. Her son required medical treatment she could not afford; she showed his medical records and asked passengers for money to help pay for his treatment. The town was called Watsi and the idea of developing a platform to crowdsource funding for vital health care in developing countries was born. Soon after the platform launched, the idea gained traction on Hacker News, and eventually led to Watsi being the first non-profit startup funded and accelerated by Y Combinator.

This is how the Watsi process (or supply chain) works:

  1. The patient seeks care at one of Watsi’s hospital partners.
  2. If the patient cannot afford treatment, they are told about Watsi and asked if they would like to participate in the program by sharing their story with the world.
  3. The hospital submits the patient’s profile to Watsi. Once the profile is received and approved, the hospital may begin providing care, even before the patient’s profile is posted or funded.
  4. Watsi posts the profile so donors can begin funding the patient’s healthcare.
  5. The hospital submits a post-treatment update on the patient, which is sent to his/her donors, and Watsi transfers the funds raised to the hospital to cover the cost of care.

On the donor facing side of the Watsi system, people interact with the Watsi website to view patient profiles and decide which patient they would like to fund. On the healthcare facing side, providers upload and manage patient information. The two ends of this chain meet in Watsi’s “Transparency Document” (a Google spreadsheet).

Watsi is committed to “radical transparency”, which means the organization makes every step of the funding process visible. Their “Transparency Document” details patients, financials, performance and partners.

In Jon Reed’s article, The Technology of Transparency – with Watsi’s Grace Garey, Garey has this to say:  “We had this huge transparency document – literally just a Google doc. We manually published twenty fields of information about every single patient posted on Watsi, from the name of the doctor who diagnosed them, to the cost of their care, to their expected treatment date, to a link to the screen shot of the fund transfer from our bank account to the hospital’s bank account.”

Garey goes on to explain that maintenance of this document is now automated using third party tools, incorporating data clips powered by SQL queries.

In addition to fulfilling their commitment to transparency, opening up their data to stakeholders and other interested parties has resulted in operational efficiencies for Watsi. One example of this is their partnership with Segment. In 2015, Watsi and Segment collaborated on an event called “Analytics for Good”, in which Watsi opened up their SQL data for Segment’s partners to explore.

In her article What We Learned from Watsi’s Data, Segment’s Diana Smith outlines the analysts’ findings and recommendations in the areas of activation, retention and conversion. As an example, “a glitch” in renewal behavior was identified by Chartio:  “[Chartio] also found that, on average, it takes Watsi donors more than a month to make a second donation… Grace Garey from Watsi hypothesized that after someone makes a donation to a patient on Watsi, it takes about a month for that patient to get fully funded, and for Watsi to email out a success story on their surgery. Because these emails are likely driving repeat donations, Chartio recommended Wasti test sending more emails earlier in the process that feature other patients’ success stories.”

Most recently, YC Research (the research arm of Y Combinator) has funded a Watsi project that will study the use of technology to improve the quality and reduce the cost of healthcare. Details are provided in Sam Altman’s blog post YC Research: Universal Healthcare:  “For the initial project, Watsi will fund primary healthcare for a community in the developing world and build a platform to run the system transparently. Once the platform is in place, Watsi will start to experiment with improving the quality of care and reducing the cost – e.g., by streamlining operations, minimizing waste and fraud, and identifying medical errors in real-time.”

I reached out to Grace Garey, who shared her thoughts on what the the future held in terms of Watsi’s vision for transforming healthcare:

“In short, Watsi’s vision is to accelerate access to universal healthcare by powering a technology platform where payers of any size — from a mom in the Midwest to a government in East Africa – can transparently, efficiently, and effectively fund the full spectrum of universal healthcare. You can see this in action for individual donors on the crowdfunding platform, Watsi.org, where every donor can see data about exactly where their money goes, who it supports, and what the outcome of the care they funded was. Increasingly larger donors (like corporate foundations or global aid funders) are taking advantage of the same platform to allocate their giving more transparently. We’re hopeful that if we can keep pushing the boundaries of transparency and efficient giving — where 100% of the donation makes it to the patient and we share the real-time data to prove it — it will unlock more funds from donors that can make a huge impact. We’re also beginning to extend this to primary healthcare. The Universal Healthcare Project we’re piloting [is] intended to demonstrate the same thing – that running a primary healthcare system on technology can make the care cheaper, better, and hopefully more attractive for funders (perhaps even one day the world’s governments) to fund.”

Lessons for Others

Showcasing supply chain details through readily accessible platforms like Google docs can enable an organization to demonstrate its commitment to transparency.

It also presents an opportunity to collaborate with stakeholders and other interested parties, with the goal of identifying opportunities for improved efficiencies and growth. This can be especially important for nonprofit organizations, who often operate with limited resources and budget restraints.

Organization: Watsi
Industry: Non-profit (healthcare)
Name of Organization Contact: Chase Adam, Watsi Ops; Grace Garey, Donor Ops

Authored by: Anna Borenstein

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Watsi (2017). Watsi website. Retrieved from https://watsi.org/

Wikipedia (2017). Watsi Wiki. Retrieved from https://en.wikipedia.org/wiki/Watsi

Reed, J. (2015). The technology of transparency – with Watsi’s Grace Garey. Retrieved from http://diginomica.com/2015/09/01/the-technology-of-transparency-with-watsis-grace-garey/

Entis, L. (2015). This Nonprofit Acts Like a Tech Startup. Why Don’t More Nonprofits Do the Same? Retrieved from https://www.entrepreneur.com/article/252481

LaPorte, N. (2013) . Medical Care, Aided by the Crowd. Retrieved from http://www.nytimes.com/2013/04/14/business/watsi-a-crowdfunding-site-offers-help-with-medical-care.html

Smith, D. (2015). What We Learned from Watsi’s Data. Retrieved from https://segment.com/blog/what-we-learned-from-watsis-data/

Altman, S. (2017) YC Research: Universal Healthcare. Retrieved from https://blog.ycombinator.com/yc-research-universal-healthcare/