Abhishek Dwivedi, co-founder, AlternaCare explains how start ups can add value to public health delivery in India. He further speaks about the public health scenario of the state of Uttar Pradesh and his tie-up with the UP and Rajasthan government, in an interaction with Raelene Kambli
How has technology helped you to re-imagine healthcare in India?
Within the Indian healthcare ecosystem, accessibility and affordability have always been a pain point for the majority. Technology has been instrumental in improving accessibility as well as affordability in healthcare. Some products leveraged the amalgamation of information technology and cloud telephony to enable patients connect with the most relevant doctors to consult within 60 seconds. Moreover, evolution of the digitalisation of the prescriptions, applications of IOT in the diagnostics domain, remote monitoring, instant lab report generation, innovative world class surgical devices, etc., have been attributed to the advancement and acceptance of technology within the Indian healthcare domain.
How is technology changing the business landscape of the Indian healthcare sector?
Any business landscape becomes more lucrative if there is a substantial increment in the ease of doing the same while maintaining exponential year-on-year growth in profits. Technology has done the same in the Indian healthcare sector. It has made discovery and delivery of doctors, hospitals, diagnostic labs, ambulances, pharmacies, etc., extremely easy. Not only this, the health-related content available online also plays a vital role in the education on diseases, medicines, symptoms, instruments, etc. The remedies on multiple issues be it around alternative therapies or scientific general medicine are readily available. The brick and mortar model of healthcare has always been highly cost intensive but technology has reduced the recurring operational costs. Medicine practices in the past used to be very secluded, however, with the help of technology, doctors from across the globe can share their insights about various cases on one platform seamlessly.
What role can start ups play in improving public health?
Start ups can and are already playing a vital role in improving the public health in various ways. From online registration to the generation of medical records electronically, the startups can been highly instrumental. The accurate analytics on the EMRs, telemedicine can definitely help in the proper channelising of healthcare resources including the medicines, health tech wearable devices, diagnostic machines, remote monitoring, etc. All thanks to a multiple well funded startups, which are actually growing the awareness among the masses around the generic drugs, online booking in hospitals/ clinics for primary, secondary and even tertiary care.
Which initiatives have you taken from your end in this regard?
We are in the process of starting health kiosks in PHCs based in tier III towns and even in the rural areas of India. The UP and Rajasthan governments have extended good support to us on the same. Apart from this, more than 50 per cent of our consultations over the call still come from tier II and III towns. The main issues revolve around diseases prevalent in these towns such as HIV, TB, sexual disorders, renal, gastro problems. Our platform seamlessly connects those patients to highly qualified doctors for consultations and within 48 hours, the patients also receive medicines through our delivery partner across 4000 pincodes or through speed post by Indian post (in case that PIN code is not covered by our delivery partner). Within villages, there is still a huge scarcity of qualified doctors. World Health Organisation (WHO) has specified the doctor : patient ratio to be maintained at 1: 1000 but in Indian rural towns, it is 1: 2800. We are also trying to bridge this gap through the concept of virtual clinics implemented in multiple tier III towns.
How effective can experiential learning be in terms of incubating start ups in public health?
While incubating a public health startup, key experiential learnings mostly include the user behaviour of customers in tier II-III towns or even in deep rural areas. The ability of the product is to make swift penetration in various diverse remote geographies while maintaining decent ROIs. Secondly, start ups working in the public health domain also need to hand hold their potential customers and merchants as most of them are not tech-savvy. Hence, entrepreneurs belonging from smaller and not so developed towns would be more aware of the ground realities and hence can develop solutions to serve the public health space. However, healthtech start ups in the public health domain need to form an advisory board consisting of experienced doctors of tier II-III towns in order to leverage the learnings gained from their experiences.
What should be the primary focus for start ups who intend to venture into the public health domain? How should they go about achieving their goals?
Well, I think the best way to go about this is to identify challenges one by one and try to solve it in series using relevant technology. Build a tech product which is simple, easy to use, which will connect the dots in the best operational flow while maintaining the unit economics. It is very difficult for the the healthcare sector in India to completely shift focus towards technology, therefore it imperative to adopt technology phase by phase. Always focus on the trust to be built on the users/ patients rather than the discounts to be offered.
Since you closely work with the UP government, can you share your opinion on the current state of public health there?
- Limited budget allocation for public health by the Central Government
- Increasing infrastructure requirements for fulfilling healthcare demands of rapidly growing population
- Low penetration of healthcare services in villages
- Extensive travel and waiting time to get from rural to urban care
- High out of pocket expenditure for low income population
- Shortage and absenteeism of doctors at government healthcare facilities
- Doctors’ preference to practice in metro cities
- Accessibility for under served population and delay in care
- Increasing disease burden of the state
- Presence of quacks or under qualified doctors
Can you share some details your UP and Rajasthan public health project?
We would be solving the issues such as availability of good doctors, ease of consulting, medicine deliveries EMRs, training of patients, awareness on preventive healthcare and a couple of more things on the same lines.
Share some key learnings from this partnership?
The book of renowned rural journalist P Sainath, ‘Everybody loves a good drought,’ claims that most of the tier III towns have government doctors refusing to see patients in government premises. Moreover, they themselves refer those patients to their private clinics where they are overcharged most of the time. Let’s not talk about the deep interiors/ rural regions where the term health or medicine is completely alienated due to similar or even more serious reasons.
Our alliance is not only successful in tracking the work of government doctors but patients now have the option to consult doctors by investing less time, money and energy.
Which are the other state governments that you would be interested in partnering?
We are in talks with Government of Karnataka and Rajasthan and looking forward to similar alliances soon.
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