Coding better healthcare

Though Byron Zhang (B.S.’15 EECS) got his bachelor’s degree from Berkeley’s Electrical Engineering and Computer Sciences (EECS) program just two years ago, his programming skills have already been instrumental in securing health insurance for an entire village in Uganda.

As a web developer at Watsi, a San Francisco-based nonprofit organization working in developing countries to provide accessible and affordable healthcare, Zhang put his coding and intercultural skills to the test earlier this year in Rwibaale, a village of 2,700 people. In just one month, he and another Watsi engineer developed a platform integrating the village clinic’s electronic medical records and financial management system. During the same time period, the team also created a mobile app where patients and providers could easily access the system.

“When I graduated, I knew I wanted to work at a nonprofit focused on technology and healthcare,” Zhang says. “I liked how with technology, you could get to work immediately and make an impact. No one would say, ‘You’re too young.’”

In the summer before his junior year, he worked on a project in Panama to provide education about clean water and trash disposal — and made a key observation.

“Many people in town didn’t have access to water, but everyone had satellite TV and smartphones,” he says. “I was flabbergasted and realized we didn’t need to go knocking door-to-door to change things. We could start using tech and text mechanisms to implement public health goals.”

“In Panama, it’s all going straight to cell phones, even things like banking and health care,” says Zhang. “It got me thinking about tech solutions for developing countries.”

Upon his return, Zhang joined Blueprint, a Berkeley student group that develops pro bono tech solutions for nonprofits. He worked on two projects, including one for the San Francisco group Project Homeless Connect.

Participating in Blueprint also turned out to be the way Zhang connected with his future employer. During the spring of his senior year, co-founder Chase Adam visited Cal and gave a talk to the Blueprint members about his path to launching Watsi.

After Adam’s presentation, Zhang took the initiative to talk with him further. Then, later that summer, he reached out to Watsi to let them know that he was interested in working for the organization. Shortly after, Zhang became Watsi’s ninth hire.

When he joined the organization in 2015, it was focusing on crowdfunding to pay for surgeries for people around the globe. And because the group wanted to help the hospitals grow more efficiently, it started to develop electronic medical record systems and financial models for hospitals.

Watsi has worked in about 20 different countries (mainly in Central America, East Africa and Southeast Asia) and developed relationships with about 12 different medical partners, including the clinic in Rwibaale.

But though paying for patient surgeries had helped individual patients, Zhang says, Watsi decided to pivot toward projects that provided universal health care to everyone in one location, as preventive care would help reduce the number of needed surgeries in the first place.

Rwibaale fit Watsi’s criteria for their first universal health care project, since residents spoke English, were already familiar with technology and had a local medical partner Watsi could trust. So in November 2016, it started planning the project, including consulting with global health leaders to provide some insight on how their health care systems and delivery work in developing countries.

In February, Zhang and a fellow developer arrived in the village to start work. First, Zhang and his colleagues had to determine how to uniquely identify people, since the villagers didn’t have addresses, social security numbers or even the same way of spelling the same name. So Watsi went door to door, collected each person’s photo, recorded the GPS coordinates of where they live and a copy of their fingerprints using a scanner.

The second task involved close observation of how the clinic worked.

“We didn’t want to assume anything until we got there,” he says. “So to design the entire system, we sat in the clinic for a month and focused on every person and tried to understand every workflow.”

Everything about each patient’s care was put into the health care app. Zhang and his colleague wrote code that calculated exactly how much their care cost, the total overall costs of care for that month and how much each person should pay for their monthly insurance fee.”

That fee was calculated to U.S. 78 cents a month, per person, for insurance that includes preventive care, dental, pharmacy needs, childbirth, vaccinations, lab draws and HIV/AIDS services.

Every few days, Zhang would show users them a new version of the app, watch them use it and keep iterating what he observed. And since he and his colleague were living in a convent of nuns who owned the clinic, they’d spend three meals a day with their hosts learning more about the local culture and how the clinic approached health care.

Their health care system launched in March. Before leaving the country, Zhang and his colleagues appointed a few point people to help monitor the system. In June, he returned to the clinic to see how the system was working, as well as to collect health outcomes since the system was implemented.

He says the experiences he had in Panama and with Blueprint showed him that solutions to the biggest and most pressing issues don’t always reside within American industry.

“A lot of the things you can do with an engineering degree are completely outside of your realm of awareness,” Zhang says. “The only way to find them is to explore and have conversations with people who aren’t in the same sphere that you’re in.”