Tag Archives: HealthCare IT

Building the Healthcare ecosystem

Leave a reply

Over the last two years, Healthcare has been on an exponential growth. Previously, Healthcare was limited to professionals who have been in the field and others stayed away from it even though they thought they could solve the problems. However, things changed. There are many non-Healthcare professionals who have been in the technology space who are partnering with people from other streams to solve and address the Healthcare needs.

Today, there is more than $100 Billion riding on Healthcare technology alone in India with expectations of it growing to $280 Billion by 2020.

What we have today is the opportunity to identify the pain points and build a workable solution around it. This provides the opportunity to look at aspects which were non-existent earlier. For instance, with the advent of apps being available for finding Doctors and medical services in a particular area, provided an opportunity for people to explore nearest medical services and get just in time help.

With Doctor’s consultations being available on Skype, it is easy now to find a specialist and set up an appointment and speak to them in detail. The list goes on.

What we need to focus is to build sustainable models which can be replicated across. Moving away from the core infrastructure problems such as Doctor:Patient ratio has not even started with the advent of technology, but on a long run, this can be addressed.

Startup’s focusing on addressing Healthcare should understand what is the existing infrastructure and how we can utilise it to build our offering around it. In simple words, building mutually inclusive offerings is the need of the hour.

Anatomy of Healthcare Startup’s

Leave a reply
Healthcare startup’s have raised close to $10 Billion worldwide in 2015 and the numbers are only increasing.
What is interesting is apart from the e-Commerce, finding Doctors and Networking for Doctors, today’s startup’s are addressing almost all parts of the human body re-defining the way we live.
What components of the Human Body are startup’s addressing? 
 
Brain
Autoimmune
Lungs
Liver
Blood
Heart
Gastrointestinal
Kidney
How is it each of the components are being looked at by technologists? We will go deeper into them soon.

Why, What, How of Predictive Analysis in India 

Leave a reply

Enough is said about the Healthcare infrastructure in India. All what we have is problems. Doctor to Patient ratio is very less, Population to Hospital beds is less, Manpower is less. Everything is on a downward trend.

Healthcare startups are focusing on bridging various aspects in Healthcare – Delivering medicines, connecting Doctors, Virtual consultation, Telemedicine etc. However, there is one thing Startups are not focusing on – Preventive Care.

Why?

The answer is simple, for Preventive Care, we need data and in India, that is what we lack. We do not have historical data to predict the future. The other aspect which is worrysome is that, there are very few (countable on fingers) that are focusing on automating the care delivery. This can be attributed to not so strong Healthcare Management in India. 70% is private care and out of pocket expense and 30% is the Public model.

What?

I personally do not believe that Government has to do everything, but in the current context, Government has to focus on at least structuring the Healthcare laws and delivery model in the country. Startups should focus on data collection and developing algorithms for using this data to predict the future course of action.

How?

Hospitals are ready to work with Startups to provide the data. Initially, hospitals might not allow public sharing of the algorithms, but if the Quality of Care increases, more and more will be forced to adapt to the model.

What we need today is just one case study, which can use the existing data, utilize technology to design predictive analysis and then, the ball starts rolling.

Innovation in Healthcare – How India is thinking different?

Leave a reply

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.

Solving the Healthcare maze

Leave a reply

When India got Independence in 1947, average life expectancy was 47 Years and today, average life expectancy is at 66.21 Years (we rank 139). Japan leads the list with average life expectancy at 84 Years followed by Spain, Andorra, Australia, Switzerland, Italy, Singapore and San Mario at 83 Years. The country with the least life expectancy is Sierra Leone at 49 Years.

Previously, technological solutions in Healthcare have been focusing on advancing the care (how to provide better solutions), but now, we are focusing on advancing the care process (how to deliver better solutions).

In the Indian context, Tech startup’s focusing on Healthcare have increased over the last few years. This is good and it will help bring Healthcare to the fingertips.

Most of the startups are focusing on providing “services”, meaning, connecting the consumer to the service. Apps for finding Doctors, finding Services available, e-Commerce, Wellness etc. This is a good approach. All of us have an inherent fear for Health. We are over cautious and we generally tend to avoid visiting the Doctor/Hospital and also at times go with self-medication. The technology today is focusing on providing introductions to the end user to managing Health proactively. With the advent of apps for monitoring nutrition, work out’s, doctor appointments, enrollments into wellness programs, the common person is now getting to understand how to manage and monitor his/her health.

Also, with Health programs getting advertised, many who did not have an understanding of various health scenarios are now getting educated. If you are someone who is born after 1990’s, chances are that your parents are maintaining your health record with all the vaccinations were given and the history of your well-being.

Biggest health problems cannot be solved in one day and the approach is painstaking. Governments should focus on building the infrastructure and organisations (startups and the big one’s alike) should help support the initiatives by connecting people with the care providers.

There is no short-cut’s especially in managing Health of individuals and the nation alike. Connecting the dot’s proves pivotal in creating a healthy nation.

In the next decade, I am sure India would be in a much better place in creating a healthy environment for all of us. With initiatives like the Aadhar (UID) slowly gaining popularity, am sure solutions would stem out connecting people to Government (to prioritise their health initiatives), Insurance firms coming forward to provide better Insurance assistance and Hospital’s connecting to communities to provide better proactive care.

Personally, I think we should look at various models across the globe and adapt what worked well into the new system we are creating. India being the world’s second most populated country, if we create a system which works, then the entire landscape of Healthcare in the world would change.

Considerations for #healthtech Startup

2 Replies

We see that on an average, there are at least 10 new startup’s every month across the country trying to address Health Care IT Problems. Are we really solving or are we complicating things?

According to IMS Institute for Health Care Informatics and Health Care IT News, there are more than 165,000 Health-related apps available and a mere 36 of them have 50% or more downloads. Just 10% can connect to a device or sensor and 2% can sync into providers systems (US App’s).

In the Indian Health Care app scenario; there are around 100 Apps and Websites which are addressing the Health Care segment (My personal research) and quite a few are coming up. Out of these 100, around 40% are catering to search (Doctor, Hospital, Diagnostic Center etc.), 22% are in the Wellness segment, 10% in e-Commerce (Medicine delivery), and the others are distributed in Nutrition, EMR/EHR, Medical Devices, Personal Health Management, Chronic Disease Management, Doctors Networking, Analytics etc.

If you look at the big picture and identify sectors in Healthcare which startup’s are trying to solve, majority of the solutions are coming out in Doctor Search, Booking online appointments, Home Tests and Medicine Home Delivery etc. One concern I personally see is that these solutions are being focused on particular region and this poses challenges for scalability. In India, where we have diversified Health Care models it is very important to understand the scalability, adaptability and acceptability for the solutions which we design.

The other vulnerable area specifically in Medicine delivery is that the control, distinction and distribution of duplicate / fake medications.

There are certain key contributing factors for Startup’s and large organisations alike to bare in mind while defining the problem and designing the solutions.

The Big Picture – It is very important for aspiring entrepreneurs who are attempting to solve Healthcare problems to understand the big picture as to how the system is structured and how can we take this solution to the maximum consumers. Also, one should understand if the solution which is being designed will scale up to address the problem at the Nation’s level and will it contribute to uplift Healthcare delivery. Why is this important? Because scattered solutions do not help.

Workflow oriented – When we design Technology solutions for addressing Health Care IT, the most important aspect we should understand is to create solutions based on the Health Care delivery workflows. Even though you design the best solution, if it is not following the delivery workflow, you are loosing consumers.

Scalability – The next important consideration. Why? Health Care IT is not a problem for a specific city / district / state. It is the Nation’s need. Diversifying solutions for each geographical location is not a viable solution. If not today, at a later stage we will need to codify and bring solutions to a common platform.

Adaptability – How are consumers adapting to the solution? India is a culture rich economy where we trust more from family, friends and acquaintances while attempting to utilise HealthCare services. How are we as Entrepreneurs attempting to address this scenario in the tools we build? Today, everyone is using technology to get suggestions and help for their requirements, but do not completely go with the solution they find, but definitely ask others around if it is a viable approach. We need to understand the adaptability of the solutions we design and this comes with additional research on what key areas are people likely to gain deeper understanding before attempting to utilise the services.

Contextual – (Will this solution help better the situation) – This goes next to understanding the big picture. The solution we design should be contextual and if required work in tandem with existing solutions to address the scalability and adaptability.

Data Security – Very important aspect of building Health apps. We need to builds systems/applications following he Data security rules because Health data is very vulnerable and it is the responsibility of the Entrepreneur to ensure security.

To quantify, Entrepreneurs wanting to address HealthCare IT, should begin with the end in mind, understand the System and help develop workflow solutions which contribute to the Macro level.

Which HealthCare System should India follow? 

2 Replies
India is a very interesting, unique economy in this world and there are many reasons for that. We are the country with the highest “working population”, we are a country with various traditional medical practices (which prove to work), we are a country with considerable number of people Below Poverty Line, we are a country, where in the last two decades have seen changes in our lives, livelihood, migrations and better quality of life.
With this, even the HealthCare landscape in India is changing. The model we follow is the “Out of Pocket Model”. Even though the Government has a very good spread for reaching each person in the Country, due to various factors, this does not work as expected. Private players are increasing and Technology is playing a bigger role in bridging the HealthCare needs to the common man.
Let us quickly examine the 4 HealthCare models on this Planet:
The Beveridge Model
This model is named after William Beveridge, the man who designed and developed the Britain’s NHS (National Health Services).
In this model, the complete Health Services are funded by the Government from the tax’s collected from public. The best example of complete Beveridge Model adoption is Cuba.
The Bismarck Model
This model is named after Prussian Chancellor Otto von Bismarck. This is an Insurance Model where employers and employees pay for Health Insurance through their payrolls. The Government holds a very strong control on the payout’s and hence the HealthCare costs are controlled. This is a pure “not-for-profit” model and this is the reason even though there are private Health Services, the costs do not go up.
This model is followed in Germany (where there are more than 200 funds which contribute to HealthCare services) and other European countries including Japan and Latin America.
The National Health Insurance Model
This is a combination of Beveridge and Bismarck models. This model uses private providers but funding comes from the Government’s Insurance Programs to which people contribute to. Since payments are controlled by Government, there are no denials/exploitations in the costs and services.
Best example for NHI Model is Canada.
 
The Out of Pocket Model
About 25% of countries in this world have an established HealthCare Systems are the remaining are Out of Pocket Models.
This is a straight forward model where you pay for the services utilised (Minimal/free in Government Hospitals and completely paid for in Private Hospitals).
Is it time we follow a model / combination of models / Create a Model for ourselves? 

HealthCare Startups in India

2 Replies

I am trying to compile a list of HealthCare Startup’s in India, mostly Technology startup’s focusing on building products/services for India and Emerging Markets like India.

Here is a list which I could put together. Please share with me if I have missed any names: 

Does India Need an EMR?

Leave a reply

When we look at understanding how we can address the major gaps in providing Quality HealthCare, the one point which comes to mind is why we are not utilizing the power of Technology to bridge this gap.

Let me start with a story – Few years ago, I had to take my Dad to a Doctor for cough. We went to a Speciality Hospital near to a home (a Major Brand, do not want to use the name here though). This hospital had two facilities in the City. When we went there, the first thing which happened in the Registration. A Plastic Card (dimensions of a Credit Card) was printed with a picture and basic details – DOB, MRN and Place of Issue were printed.

After the initial check up, the Doctor wanted a test to be done which was not available in this facility and hence we were requested to go to the other one. After going there, I provided the card to bring out the details of the test ordered. The front office person informed me that they do not have connectivity with the other Branch and hence I had to pay the registration fees (Rs.100) and post that, looking at the Hard Copy of the Prescription, entered the details. Then I had to go to another Doctor (since the consolidated list of Doctors in the Hospital is not available and the prescription had to be cross checked) to re-confirm the test and then we proceeded for the test.

This hospital has made major investments in using Technology in their Hospitals. Staff are trained and the charges of this Hospital is also definitely not nominal.

What does this story illustrate? A simple aspect of integrating two facilities has not been taken seriously. Why? Is it because they lack the technological infrastructure? Or, is it because they can make more money (Double registration fees)? Or, is it unwillingness to invest further on the technology required to integrate? There are many questions which arise, however, for me, it is just the fact of lack of “Ownership” from the management side.

In a country like India where the demographics play an important role, there are many multi-national Hospital Chain’s and single facilities which have setup shop across the country over the last decade and continue to do so with huge investments coming up in the next decade.

The Government, with due respects has its own, things to do and hence am not even considering the fact that they should take ownership to force Hospitals to implement any automation to their care facilities.

With the vastness of the Country dynamics and considering the fact that the system works in a silo, is it easy to consider implementing basic EMR across all Hospitals and Clinics across the country? I do not think so.

Even though technology has become affordable, the socio-economic factors like affordability of Care facilities with-in a 10 KM radius across the country makes it difficult to even imagine implementing EMR across the country.

Continued – Part 2