Utilizing Aadhar for Healthcare Delivery

India launched the prestigious Unique Identification Project (Aadhar) on the 28th of January 2009. After 7 years, around 95,00,00,000 have Aadhar Card. Even though having Aadhar is not mandatory, Government has been increasingly launching initiatives which are linked to the Aadhar Card and hence the number of signup’s have been increasing.

How can we use Aadhar Card to improve Healthcare?

To begin with, tracking Health records. India’s Healthcare system is a three tier architecture – Primary Health Center (PHC), Secondary Care and Tertiary Care. The PHC is the first point of care for the Government and according to the design, there should be 1 PHC for every 5,000 population in the rural areas and 1 PHC for every 10,000 population in the urban center.

With the Aadhar number, personal health records can be created for every individual at the PHC level. In the urban areas, Aadhar number can be utilized to register individuals at Private hospitals/clinics or at the PHC. Alternatively, we can have a centralized website which can create Health records for Individuals and they can signup using their Aadhar Number.

When there is a birth, before issuing the Birth Certificate, a Medical record should be created and all the vaccination information should be pushed through electronically. Today, this is done manually through medical cards which carry important vaccination information for the child.

What are your thoughts?

Idea for Healthcare Startup – Mobile Diagnostic center

Two weeks ago, unfortunately, my dad fell down at home and has a displaced hip bone. We got him admitted to an Orthopedic Hospital. They had to wait for three days to ensure all vitals are normal before they did the procedure to correct the hip bone. During these three days, the Doctor wanted to have a CT Scan done too. However, since they did not have the CT Scan equipment, we were asked to take dad to a Diagnostic lab.

During this time, it struck me as to why we do not have mobile diagnostic centers. It would have been a lot easier for us to call them and they come and get the test done at the client’s residence or any hospital. It would make life so easier for elders especially.

Can this be done? Any startup’s which are providing this kind of service?

Toughest part of Idea Execution

Few days ago, I met with a person who left his job in the US and came back to India to start up. His family continues to live in the US and he shuttles between the two countries every six months. His idea is unique and to both of our knowledge, he does not have any threatening competition as on date. The idea is good, it is self-funded and he is good with it for some time. Since his idea is a platform to bring stakeholders together and provide service, he is doing financially fine as of now.

As we spoke, I asked him what was the toughest part of bringing his idea to reality – convincing family, Money or signing up people? He smiled and said “Marketing”.

He is correct. Having an awesome idea is just not related to the functioning of the brain and connecting with people, but to market the idea to the appropriate stakeholders.

In a startup’s context, Marketing is just not about showcasing your idea to the world, but it is the art of showcasing the idea as it connects to your potential clients.

Marketing fundamentally needs an understanding of what your client is wanting, what is the value proposition of what you are offering and how the offering is positioned.

When Radio Mirchi (98.3 FM) was born way back in 2000, the biggest challenge for them was to make listeners tune into their frequency. No one was switching on the Radio at home or in the car. At this time, Radio Mirchi focused on playing English music which was considered hip and cool. During the time slots of 7 AM – 10 AM and evening between 5 PM – 8 PM, they played English music and slowly people started tuning in to follow the trend.

When an idea is conceptualized, we need to first create our offering in a way such that clients would come to us and then we can build on what our unique proposition is.

What book changed your life?

Fortune at the Bottom of the Pyramid

I read this book way back in early 2005 and it did quite change my thought process. Even though this book focus’s on helping Organizations understand how Innovative Products work in the Emerging markets, there is a key takeaway for Social conscious people like me.

The book embarks on a journey, in which Late Dr. Prahlad argues that organizations always work with the top and middle of the pyramid, but forget the largest part of the pyramid. Any products and service can be produced at better quality for a lower price when it reaches more than what is anticipated. The discussion/argument is not about the exclusive products like cars or luxury items, but others which are quite necessary. The book takes you through case studies of organizations who have innovated to help people who absolutely need few things, ranging from Home to HealthCare to daily consumables.

I am not going to go deep into any of the case studies, but would like to share how it motivated me to think differently. Before I read this book, my understanding of the world and organizations was very limited, but this book opened my eyes to a whole new world of understanding what consumer needs and how this has changed they organizations did business.

Today, we have organizations building even cars exclusively for the price sensitive population. The products and services which have been innovated for the bottom of the pyramid (price sensitive population) also has impacted the middle and top of the pyramid. Organizations realized this a bit late. The prime understanding of any good producer is that any product/service accepted by consumers will always be accepted. However, one aspect which organizations miss is that even in non-price sensitive markets, people consume only limited quantities. However, when you produce goods and services in smaller quantities, acceptance might also go up!

Look at the classic example of Aravind Eye Clinic in Madurai, Tamil Nadu, India. This organization has constantly innovated from the beginning to provide cost-effective eye care. If you speak to the founder, his inspiration is McDonald’s. He was amazed the Quality of food available at any of the McDonald’s outlets across the world, which is precisely the same anywhere and everywhere. Being an ophthalmologist, he wanted to create something which has the same quality anywhere and everywhere. Today, Aravind Eye Clinic performs more than 600 eye surgeries each day and these surgeries cost as low as $50. What is the outcome? Acceptance in the 80% of Rural India that they too can better their lives.

If I keep quoting case studies, the list goes on. However, the key takeaway for me is to produce something/anything which can be accepted at the bottom of the pyramid and impacts their lives. This will translate to acceptance at the middle and top of the pyramid too.

So, which book changed your life?

Thinking for the ‘app’ markets

In today’s world, startup’s are focusing on utilizing technology to bring in elements of convenience to the end user. Strategies for market penetration and consumer usage (downloads) have evolved over the period of time.
Few elements of marketing have remained the same and will do so.

Word of mouth marketing has a lot of value. Have you tried using this product? or have you downloaded this app? makes a lot of difference. I would like to use something which has been tested by someone else. In the pre-technology era, advertisements made a good value. If Nirma has become a household name, it is only because of its advertisement in the TV.

In the technology space, we do not see a lot of advertisements on the TV and a few in these days are utilizing the power of radio. Most of the ideas and apps still go with a word of mouth or sometimes a mention in the media.

Apps do not have market segmentation – they are same for everyone. If someone drives an Audi, BMW, Volvo or Jaguar, we identify them differently when compared with someone who drives a smaller car. In the technology space, you cannot differentiate between someone using Uber or Ola app.

One of the biggest challenges for tech startup’s is understanding their consumer needs. Very few companies actually do survey’s and understand the user preferences and then build their application.

Traditionally, market surveys in the ‘target’ market segment helped companies to identify what their consumers want. Even in the tech space, few companies do the market survey, but these surveys do not cover various geographies. If the startup is based in Bangalore, the maximum the survey’s reach is to the metros and smart cities where people are using email or The Internet. But, there is a lot of population who do not see the email or cannot use the internet to answer questions. For Tata tea to become number one in the country, they had to understand the taste of tea in various parts of the country. In UP, people preferred large granular tea where as in Orissa people preferred the fine tea dust. The taste’s are different and so, the company had to innovate and bring out a different category in the product to ensure maximum reach. How can we do this in the technology space?

I don’t think there is a formula to understand this. The market time for technology product is few days or months and for a goods companies, it is months or probably years. So, it is very important for them to do the survey’s and get their product right. In technology companies, if uses complained, then they can immediately make changes to their design or functionality and roll out a new release.
Is there a formula to get the app right the first time? It is time to Think…

Resilience – The way I work with it

I read and heard about resilience quite a few times in my life. Through the journey, whenever something happened and I learned from it and incorporated the learning into my life, I looked back and thought I was getting more resilient.

Building resilience needs a lot more strength and mental ability. This is the best life skill you can ever learn.

A year and a half ago, I, unfortunately, lost my mother. I last sat with her, ate with her and spoke her wholeheartedly eight months before she passed away. I was away from home and by the time I came back, she was in bed. That was the most testing and tiring times for me. It was totally unexpected and came in as a rude shock.

Just after her death, I was hitting unexpected bumps in my other aspects of my life. Suddenly life is being jolted. Was getting hit from all facets of life. I was not able to do anything that I wanted to do. Even if I did, things were just not working for me. I was frustrated and irritated to the core. Lost all my dreams. Gave up on tomorrow and was really feeling low. This continued for the next few months. Each day was hell. I get up looking forward to the day to end, rather than to live the day.

Then after 5 months, I met someone who redefined and changed the way I think. I could identify my blind spot. Since then, everything looked different. The problems I was facing still exist, but the way I look at them have changed. Situations are the same, but the way I identify and work towards addressing them have definitely changed.

When I look back the last one year, identifying my interest areas and working towards them without looking at the results has benefitted me. I started writing a Gratitude Journal, got back to running, started to write and read again.

Today, I don’t react to situations anymore. My anger and my openness to speaking straight are mostly gone. Earlier, when someone on the road is not driving properly I used to be frustrated and would take the frustration to other things. Today, I do not do that anymore. I am silent and let the anger pass away.

If you are not happy with yourself and things are not working the way you want, the only thing you want to do is focus on what you wish to achieve ( the purpose of life) and do things which motivate you and deviate your attention from the not so good things which are happening.

Building resilience is not easy, but something which you will develop over time.

Innovation in Healthcare – How India is thinking different?

In an interview someone asked Dr. Devi Shetty, the Founder of Narayana Hrudayalaya (NH) as to why the Healthcare costs are increasing in India and he said “Over a decade ago, a heart surgery costed over Rs. 2 Lacs; and today it costs a little over half”.

Over the last decade, the Healthcare landscape in India is considerably changing. Healthcare is reaching to more people than before and many are benefitting with the new and innovative models Healthcare organizations are adapting.

One of the innovative models Healthcare organizations are adapting is the Hub and Spoke model. In this model, the central facility is situated in the urban area with all the specialists available. The Spokes are the smaller centers which are situated in smaller towns with connectivity to the Hub.

With this model, Specialist Hospitals are able to provide quality Healthcare to a larger population.

This one illustrates how India is innovating in its Healthcare reach. There are numerous data points which illustrate how India is behind in Doctor to Patient ratio, Number of beds to population, shortfall in the number of nursing staff etc. We are behind in most of the WHO metrics when compared to the United States and even with China.

Even though traditional methods are helping, reaching the over Billion population in the country needs different thinking.

Hospitals are increasing their reach and this does not mean we are compromising on the quality of the outcomes.

To add to these innovative models, startup’s in Healthcare are helping to bridge the gap even further. Over the last two years, there are more than 200 startup’s which have been addressing this problem. More than $500 million has gone into funding these startups. What also gains our attention is that these startups are not only focusing on care, but also building systems which connect anyone with a smartphone to the best of the care.

How to think? – Challenge assumptions

In the first part of How to think, we started with Questioning. This is the first step towards improving our thinking. What’s next?

The next step to sharpen our thinking is to Challenging assumptions.

Challenging assumptions is developing our curiosity quotient. How do we practice curiosity? Start by asking Why? to things around. Why are we afraid of what we are afraid of?

Let me share my story. Long ago, I was afraid of the middle sex. When ever I saw them on the road coming towards me, my heart would pound. One day when I was with a good friend of mine, she noticed it and asked me. I told her. She asked me if I reasoned as to why I am afraid? I said no. The next week on a Saturday, she invited me to come to an NGO. I went. This was the NGO which was run by the middle sex for various social causes. She introduced me and told the gathering that I would be teaching them Fundamentals of Computers. With my inhibitions, I started to teach them. Over the next 2 months, everything changed for me. I got to know them better and I realized how wonderful and nice people they are. My fear was absolutely baseless. They loved me so much that after my sessions were over, they actually called me to come back few times.

Look around, start by asking simple questions. There are mostly no questions which have no answers. We just need to spend time with the question and we will get the answer.

If you are an Entrepreneur, ask yourself why you are solving the problem. If you work for a company ask why you are doing what you are doing.

Developing curiosity enhances your ability to challenge assumptions. When you challenge the assumptions, the way you look at dealing with things completely changes.

Asking the question right..

All of us ask questions. Is there a right or wrong way to ask? I am sure once in your life you heard – “That’s a very good question”. How do we different the questions? Is there a logic behind asking what we want to ask.

The answer is Yes. There are patterns in which we ask questions. Few ask to know if the other person knows the subject or not; few genuinely ask; others ask to confirm if they understanding is correct and few ask for the sake of asking.

If you have taken a course on How to do presentations or teaching a class, you would have definitely covered the topic on how to manage your audience. Based on the tone and involvement of your participants, you know the genuinity of the question.

Asking the right question comes with the understanding of the subject. If the subject is new, the questioning pattern comes from inquisitiveness.

Based on my experiences, I identified 3 attributes which make it best.

– Start with the situation (Set the stage) – Before you ask a question, it makes it easier for the narrator/speaker to understand the context. So, highlight what he/she said and then start the question.

– Repeat what the other person said before you ask the question (Providing clarity) – After setting the stage, ensure you repeat the last line what you heard and then start with your question. This will help in connecting the story with the situation.

– Close the question with your understanding (if possible) – After the question is answered, close it by repeating what you have understood. This gives confidence to the speaker that their effort is valued.

How to think?

During my +2 days, my Mathematics teacher used to write a problem on the board and turn to us and ask “How to think?”

We used to make fun of the question.

Fast forward 20 Years, here I am pondering on the same question. Over the last few years, this question has been coming back to me regularly. How to think? can be a tricky one at times.

How to think is a very genuine question we don’t usually ask ourselves. In the Indian system, we have been bought up with a tradition of not asking why, what and how? to our elders. At home, when parents tell us to do something and we ask a logic for it, we get back the answer “Our elders said so” and at school when we ask a question, we get a reply “So, you think you are intelligent eh?”. All these have deep impact on our thinking and we are continuing to follow the same in today’s world.

What we need to focus on and make effort is to change is the way we approach the questioning part. Asking questions is the way we need to think. What we need to accept is that we do not have answers to all the questions we have, and usually, the easiest way is to conclude. Instead of concluding, when we start questioning, many things open up and the complete approach to dealing with life changes.

So, the next time someone asks How to think?, the answer is Questioning.

Questioning is an art and it needs a lot of practice.