Patient portals, a growing trend in India, is improving healthcare connectivity and communication between doctors and their patients, with the help of easy-to-use technology By Lakshmipriya Nair
India’s healthcare system is witnessing rapid growth with increasing coverage, services and spending in both public and private sectors. As a result, it has paved the way for a huge market for healthcare-related IT solutions like patient portals
The trend is already well-placed in developed countries like the US and the UK and is set to grow even further. A Frost and Sullivan report titled, ‘US Patient Portal Market for Hospitals and Physicians: Overview and Outlook, 2012-2017’ predicts a 221 per cent growth in the market to nearly $900 million by 2017. However, in India, the trend began only in 2008 when some tech entrepreneurs, recognising the potential in such kind of services, decided to invest in patient portals and EMR software to improve healthcare connectivity and better communication between doctors and their patients.
Drivers of demand
Over the years, the concept has found acceptance among the youth and tech-savvy individuals as it allows them to easily fix appointments with preferred practitioners, opt for second opinions and maintain their electronic health records (EHR) through these portals.
Moreover, the adoption of meaningful use (MU) and its stages have ensured that ‘providers need to show they’re using certified EHR technology in ways that can be measured significantly in quality and in quantity.’ MU Stage 2 especially focuses on advanced clinical processes, stressing on ‘health information exchange between providers and promoting patient engagement by giving patients secure online access to their health information.’ This has given an impetus for patient portals to grow since they allow patients to access their health records electronically and offer secure medical information to improve patient care.
Lately, several such portals have made their entry into this largely unexplored, yet lucrative market in India driven by growing consumer awareness, Internet-penetration, increasing bent for technology-adoption and larger concerns like need for accountable care and accessibility of healthcare etc.
Convenience is the key
One such portal is Practo.com which was co-founded in 2008 by Shashank ND and Abhinav Lal, two final year engineering students. “We dreamt of a day when every patient has access to all medical records, when he/ she can seamlessly find and choose a new doctor through informed decision-making and be able to pass on medical history and records at a click,” shares Shashank, speaking about the motive behind launching such a portal. He further informs, “Today, Practo.com has over 1,00,000 doctors listed from over 310 Indian towns and cities, with comprehensive coverage from the metros of Bangalore, Mumbai, Delhi, Hyderabad, Chennai, Pune and Singapore. It has over 1.3 million page views and 30,000 appointments booked every month, with traffic growing at 24 per cent per month.”
Similarly, HelpingDoc is an online gateway for healthcare providers to connect to their patients. Founded by a UK-based team comprising Amit Bansal, Dr Hemant Singhal, Julian Hall and Srinivas Gattamneni, its inception in 2011 was a result of a need to structure the largely fragmented healthcare delivery mechanism in India. Bansal, CEO, HelpingDoc.com says, “The idea took shape during an extensive survey we conducted in India to understand the healthcare needs of general public. We found out that people usually ignore going to the doctor as they are afraid of the hassles in taking the doctor’s appointment. Hence, we conceived this idea of launching HelpingDoc. It intends to enable a digital platform to enhance the healthcare visibility and convenience via Internet mobile and telephone.” He also informs that the site observes close to one lakh visits in a month and has around 4000 doctors listed on the site.
Addressing the unmet healthcare needs in semi-urban and rural India is what prompted Sanjoy Mukerji, Ex-Chief Commercial Officer of Vodafone India and Varun Berry, MD, Britannia Industries to launch iClinic Healthcare, another health portal. It seeks to offer onsite specialist medical care by connecting local doctors and specialists in metros with small town patients to ensure best medical assistance, even in tier-II and tier-III cities. “The long term vision is to have ‘iClinic consult facility’ in every hospital in tier-II, tier-III India and connecting their patients with super specialist doctors. Healthcare should no longer be a distant dream for these people,” says Mukerji.
Even alternate medicine streams like homeopathy are getting on to this bandwagon. Recently, Welcome Cure, a homeopathic portal was launched under the aegis of Dr Jawahar Shah, MD, Wecome Cure. Talking about the venture, he says, “Welcome Cure is a unique disease treatment and health maintenance portal born out of the desire to treat individuals with holistic medicines globally regardless of their location. This vision, when combined with the modern principles of homeopathy and global expertise, makes Welcome Cure a one-stop solution for disease treatment, prevention, and wholesome health.”
So, what are the major features and benefits offered by these portals? How do they seek to simplify and improve healthcare delivery?
Most of these portals offer common features such as online appointment requests, availability of medical reports, communication with the concerned physician and patient education material.
The beneficial aspects of these portals and their features are:
- Understanding of medication
- Knowledge sharing regarding medical awareness and diseases
- Automatic tracking of medications and reports
- Cost effectiveness
- Open and easy line of communication
A study published in the Journal of Medical Internet Research, an international scientific journal for medical research, information and communication on the Internet claims, “Portal group patients demonstrated increased satisfaction with communication and overall care. Patients in the portal group particularly valued the portal’s convenience, reduced communication barriers and direct physician responses. More online messages from patients contained informational and psychosocial content compared to telephone calls, which may enhance the patient-physician relationship.”
The differentiators
But, what set these portals apart from each other? What are the USPs?
Answering this question, Shashank, CEO, Practo Technologies says, “Practo.com solves the consumer problem of meeting the right healthcare provider by enabling powerful search, empowering instant comparison and executing online appointment booking. It also enables patients to securely store, access and easily share their electronic medical records across healthcare service providers, something that no other player in India is doing at such scale.”
Bansal informs, “The key differentiator for HelpingDoc is the instant appointment to a panel of doctors in real time compared to the other directory services in the market like Just Dial or access to Google which provides a list of medical offerings, all based on a different business model. The portal is supported by contact centre and automated reminder system. The venture is improving transparency and visibility of healthcare in India, empowering patients to make more informed decisions in managing their health.”
Mukerji, on the other hand, feels, “Most patient portals are information portals only – with a few offering appointment services. A few portals like ours actually enable the patients to connect with doctors and actually do a consult online. However, we are differentiated from all other portals due to our tie up with over 100 specialists who are available to our online patients through appointments. Also our on-site services, wherein we tie up with small hospitals in small towns that deploy our platform and are able to do doctor assisted consults is unique and this is the main stay of our proposed expansion plan.”
Streams of revenue
So far so good. But how do the entrants in this segment make these portals financially viable?
Practo platform has three business models. They offer Practo Ray, a practice management Software as a Service (SaaS), for healthcare providers which comprises:
- A free appointment schedule manager through a practo.com profile.
- A software product for practice management, retailed on a subscription-based SaaS model
Practo.com, the free-for-use web portal for both providers and patients, is monetised through sponsored listings and contextual advertisements that are independent of the organic listings.
HelpingDoc also offers a SaaS-based subscription model for doctors. It charges a subscription fee from each of the doctors enlisted in its website but the services to patients are free.
Welcome Cure operates on a different model. The patients are charged a fee for their services.
Fad or trend?
More and more players are entering this arena, signalling that the concept has found many takers and they see a lot of growth potential for these kinds of digital platforms. Most of them are of the opinion that e-health segment in India is set to grow further and are in a bid to leverage the opportunities available.
Bansal opines, “The online healthcare industry in India is still in a nascent stage and has the potential to grow rapidly over the next three to five years. The team at HelpingDoc has a strong vision and is likely to develop the platform into a key player in this nascent industry. The doctor to patient ratio in India is amongst the lowest in the world. The technology would help to improve efficiencies in the healthcare industry. The efficiencies would be brought in multiple ways — exposing hidden supply of doctors, filling unutilised time slots, self and remote health management, and pre and post consultation patient engagement.”
Shashank predicts, “Moreover, with new and upcoming applications such as electronic medical records and e-prescriptions, IT investments on software would further increase with a focus on integrated billing and seamless online availability of patient records. As patient education and insurance penetration simultaneously increase, the demand for EMR is anticipated to increase robustly.”
Mukerji reiterates this view and states, “The future of telemedicine, given the availability of 3G is extremely bright and is bound to proliferate.” Dr Shah also believes that e-health in India is set to rise. He says that due to growing computer literacy and tough work as well as personal schedules, e-health has a major scope of development in India. “It is convenient, reliable and anyone can seek it with the help of their laptops, tablets and even through mobiles,” he adds.
Looking at the growth potential in e-health, the players have already put their strategies in place for the next years, indicating that patient portals are a trend that is here to stay and not just a fad.
Gearing up for the future
Bansal informs, “HelpingDoc plans to grow beyond the Delhi-NCR area into other major cities of the country like Mumbai, Bengaluru, Kolkata and Chennai over the next 18-24 months. It also aims to scale up by four to five times and enroll over 20,000 doctors in the next two years.” In August this year, it had raised Rs 10 crores in Series A funding from a Singapore firm, from Senior Marketing Systems (SMS). A company release from HelpingDoc had informed that the capital will be used to enhancing technology back-end and strengthen the field force.
Practo also has huge expansion plans. Already present in six cities, it intends to expand its presence in tier-II cities. “We will expand to around 6-12 tier II cities like Ahmedabad, Chandigarh, Jaipur and Cochin in 12-18 months,” reveals Shashank. He also informs that Practo could look at raising more capital in 12-18 months. However, most of the expansion would come from internal accrual. “We have been growing 50-100 per cent quarter on quarter, and are looking to close this fiscal year at Rs 20 crores,” he adds. They are also looking at expanding their footprints overseas. He imparts, “We entered Singapore market around 18 months ago. We are looking at entering one more country by later this year or early next year—we are looking at the markets of Philippines, Malaysia and the Middle East.”
Welcome Cure, though recently launched, has also charted its growth plan. Dr Shah imparts, “We have a vision of being able to reach 500 expert panel doctors across 150+ countries for homeopathic and wholesome treatments. We also look forward to being a part of various health-based government projects (state and national) giving quality treatments to government employees and their families. We are also looking at tie-ups with various hospitals and medical institutes.”
iClinic Healthcare intends to raise Rs 25 crores for its expansion. Mukerji says, “We are talking to a number of large individual investors plus venture capital firms. We plan to reach all towns outside of the top 20-30 towns (these already have specialists) that have 3G or good quality broadband. These are places which can operate our platform due to availability of 3G. The number of such towns (with 3G but lacking specialists) is over 1000. The top 20-30 towns will act as hubs where the specialists are present.”
Dealing with the pitfalls and challenges
Thus, the patient portal market is all set to broaden their areas and range of services in the coming years. But, is it going to be plain sailing journey for them?
Not really. Though there is growing IT implementation, a large of part of the populace in India are slow to adopt technology. Building their faith in these methods of healthcare delivery and would be a huge challenge. Striking a balance between providing security of data and validating its authenticity alongwith offering easy access to medical records will be another challenge to tackle.
They will also have to decide on crucial issues like: Medical data should be provided only by their healthcare providers, or should the patients be able to enter their own data? How to ensure that the information received are reliable and authentic? How to avoid information overload for both patients and clinicians and make the data useful and usable to both?
The way forward
Challenges exist but it is undeniable that the healthcare IT space is thriving with opportunities. As Shashank puts it, “Indian healthcare is experiencing a great transformation, with the application of newer, better IT systems and application, and adoption of IT has become one of the top priorities for healthcare companies. The healthcare sector spend is projected to grow to nearly $40 billion, which throws up a lot of opportunities for IT players as more and more healthcare practices adopt information technology apart from medical technology.”
Patient portals have also opened up new avenues to improve healthcare and their global experience has been largely positive. If leveraged well, India too can benefit and mitigate some of its healthcare challenges.
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