mTOMADY: Expanding the Reach of Healthcare to Underserved Countries

by Joseph Mandros June 8, 2020 | 5 min read

Every year, roughly 100 million people around the world are pushed into extreme poverty because of health-related expenditures. Analysis from the World Health Organization (WHO) found that more than 800 million people spend at least 10% of their household budgets on health expenses for themselves, a sick child, or other family members. For almost 100 million of these people, these expenses are high enough to push them into extreme poverty, forcing them to survive on just $1.90 or less a day.

While these numbers are grim, innovation in healthcare and financial technology is opening the door to opportunities for people to gain access to healthcare and financial assistance on a global scale. Enter mTOMADY, which got its start as a project of the NGO Doctors for Madagascar, and is a digital platform that facilitates resilience to medical impoverishment and universal health coverage, particularly in countries with underserved healthcare systems such as Madagascar.

And as a PagerDuty Impact Pricing customer, mTOMADY is one of the organizations committed to helping bring essential medical care to people who need it, in the hardest-to-reach places, in the moments they need it most.

Increasing Healthcare Access Through Technology

Samuel Knauss, a medical doctor and digital health clinician, oversees mTOMADY’s Product team and is responsible for the organization’s development and operations of end-user software solutions, as well as strategy around the distribution of care and support for their patients and users through those solutions. “Our teams are distributed across Germany, Madagascar, and parts of Sub-Saharan Africa,” shared Knauss. With a small, distributed team operating in different workstreams, it’s important that communications are properly directed to the right people at the right time. “Between the team of on-the-ground agents and software developers, it is important for our teams to be able to communicate timely and effectively when incidents with our systems occur.”

mTOMADY’s services have to be online and available 24×7 in extremely rural areas to serve patients, so uptime and connectivity is critical to ensuring patients have access to proper care and financial support solutions, especially during global crises.

mTOMADY is built upon the foundation of five main principles:

  • Transparency. Collecting real-time data on healthcare system usage, disease prevalence, and treatment costs enables impact to be traced down to individual health outcomes.
  • Universal Access. Technology that works in resource poor settings, on any mobile phone, allows patients and healthcare workers to access the platform even in isolated, rural areas.
  • Cost Reduction. Simple-to-use technology that can be easily integrated into existing procedures to reduce costs and streamline administration obstacles, improving operational efficiency.
  • Advanced Technology. Cutting-edge pattern recognition and data analytics provide actionable insights to prevent insurance fraud and improve quality of care.
  • Scientific Evidence. Research conducted to collect measurable, empirical evidence on how the solution works in the real world enables continuous optimization.

Manual vs. Real-Time Incident Management

Before PagerDuty, mTOMADY’s incident management process was completely manual. They used a spreadsheet for on-call directories, which led to delays in response and confusion around how to prioritize alerts for certain teams with different expertise. The manual directory also created a bottleneck in terms of scheduling because on-call rotations were globally distributed and cascaded across time zones. “Organizing our duty times and who’s responsible for what at what time is crucial in our field. If we don’t know who’s on call, we can’t provide the level of care we promise to our patients,” Knauss explained.

Since the implementation of PagerDuty, mTOMADY has seen significant improvement in their on-call and incident management processes. They replaced manual on-call spreadsheets with automated rotation schedules, which let responders know precisely when they are on call and what services they are responsible for. They also leverage PagerDuty’s ecosystem of over 350 integrations to centralize tools like Kibana, Sentry, and Slack into a single point of ingestion. With these implementations, the mTOMADY team has seen significant improvements in metrics like MTTA/MTTR, as well as better alignment around who the point person is for incidents involving certain applications and services.

“Timeliness is the most crucial factor in our field of work; knowing that the PagerDuty platform holds my teams accountable in response scenarios gives us the peace of mind we need to focus on our work, both on-the-ground and internal operations.” said Knauss. If mTOMADY is unable to respond to inquiries in a timely manner, it could mean that someone out there isn’t getting the care or support they need.

Healthcare in the Sahara During the COVID-19 Outbreak

Since the outbreak of COVID-19, mTOMADY has drastically changed the way it operates: They have canceled or delayed all non-essential meetings until further notice and have moved from much of their on-the-ground work to a predominantly digital approach.

However, mTOMADY is also constantly looking for ways to offer assistance. This includes working directly with rural hospitals to provide support and shift their focus to COVID-19-related response by distributing protective equipment to local and rural communities to help slow the spread of the virus. Looking ahead, mTOMADY wants to create a way to integrate PagerDuty into their global health emergency systems so they can detect spikes in illnesses or outbreaks in both local and rural communities.

Looking Into the Future

mTOMADY plans to continue expanding its use of PagerDuty into different facets of the business and go beyond just on-call management. They plan to integrate PagerDuty into their emergency response processes, including integrating with their ambulance service that works directly with rural communities. Additionally, they are looking to expand PagerDuty into their supply and equipment networks so that when there is some sort of communal shortage, they are alerted in real time and can act accordingly.

To learn more about how PagerDuty is working to provide resources to healthcare companies, specifically around the COVID-19 outbreak, visit our COVID-19 resources page. Additionally, visit to learn how PagerDuty partners with organizations to deliver on their mission when moments matter, including providing Impact Pricing to organizations like mTOMADY.