Health is an issue that affects our entire population in varying degrees. With limited facilities and limited access to existing facilities, healthcare is a huge Innovation sensitive area for India.

Many initiatives, both government and private have been started in the past decade to address the issues of India’s healthcare system. Government initiatives and funding are far below international recommendations and there still remains a severe shortage of sub-centers, primary health centers, and community health centers and basic health care initiatives are lacking. A Boston Analytics study on the state of healthcare in India indicates that “It is expected that the private sector will continue to take on an increasing role in India’s healthcare system“.

Innovation Alchemy hosted the 3rd session of Alchemix to address and explore some of these opportunities through a discussion with entrepreneurs exploring Healthcare in India. The session was held at the DREAM:IN Center in collaboration with Idiom.

We invited the founders of two innovative, Bangalore based businesses that are attempting to create impact in the healthcare space to speak at the session. Dr. Shantanu Rahman and Dr. (Maj.) Satish Jeevannavar from NationWide Primary Healthcare Services Pvt. Ltd. and Nandu Madhava, Founder & CEO of mDhil shared their experience and insights.

The NationWide team attended our last Alchemix session as participants (Innovation in Sanitation and Waste Management). We were intrigued by their model and researched it to understand more (read the blog post). This became the basis to seek out a few more Healthcare models to bring together at the Alchemix session.

NationWide Primary Healthcare Services have set up clinics in neighborhoods in Bangalore that provide accessible, affordable primary healthcare options to families in the area. They are not looking to set up large multi specialty Hospitals – but instead smaller, local centers with high quality General Practitioners.

Nationwide Team at Alchemix Session 3

The emphasis on the use of a General Practitioner, extensive use of EMR’s (Electronic Medical Reports) and their focus on providing primary care to urban Indian Families makes them unique.

The Innovation Challenge: Enable a shift in mindset for large scale adoption

What emerged from the discussion around the NationWide model was that in order for the model to be successfully adopted, NationWide would have to work through the challenge of shifting the mindset of people who use medical facilities. Right now, the belief is that a medical specialist is your go-to person when dealing with any health issue; this is evident from the great advancements in India’s secondary and tertiary healthcare facilities. People self diagnose or head to a specialist or large specialty hospitals to treat small ailments like a fever or a headache when what they need to do is visit a General Practitioner. A GP offers better, more customizable services, deeper familiarity, will know when to recommend a visit to a specialist and should be the first point of contact. But this form of medicine has almost vanished in urban India.

Similarly with the use of Electronic Medical Records (EMRs). NationWide creates EMRs for all its patients and makes them accessible via the web to the patient anywhere anytime. But, as one of the participants asked, why should one share details of their medical history with a private organization like NationWide? Because it will create transparency and the ability for any doctor anywhere to help the patient with those records. But again this requires a mindset shift for adoption.

Clearly, innovation in healthcare would require a disruption of some of the current approaches and paradigms – and a new value proposition to be identified.

mDhil is attempting to take the subject of health directly to users via a mobile & web enabled platform. They provide information and education on basic health and health issues via sms, online literature and simple video clips available via the web.

Nandu Madhava, mDhil’s founder, after graduating from college volunteered as a medical transcriber with the PeaceCorp in South America, and it was there that he realized “many people suffer due to a lack of basic health info”. Urban Centers in India are also seeing a huge growth in very basic, preventable health problems due to a lack of simple information. mDhil tries to address this issue by providing basic info to the urban population.

A lot of mDhil’s content is on taboo subjects like sex, STD’s, HIV, menstruation and reproduction. The Indian cultural opinion and values on sex and other related subjects make it difficult to discuss and learn about. Indian teenagers have questions about sex and often have no available, reliable source to go to.

mDhil info is available on mobile phones through the regular service providers like Airtel and Vodafone and is a great way to educate in a manner that also retains personal privacy. With recent developments in 3G technology, the mobile phone offers the best, most private way to access information and learn about taboo subjects. As Nandu said “…these days a 2nd hand smart phone is available as cheap as Rs. 2500..” making this content accessible to a large target audience through a simple sms.

An individual’s sexual health is a personal issue and dealing with it requires a certain level of sensitivity. That being said, it is crucial that personal, taboo issues like sex, contraception, STI’s not be neglected or ignored. mDhil is sensitive to this and provides  a private forum for clear, factual information that is relevant and useful.

Innovators Challenge: Finding Investors willing to risk investment during the prototype and experiments phase

Nandu shared that he found it challenging to convince investors to initially contribute to mDhil as the business model did not seem to generate any direct revenue – and he was playing around in a taboo subject where no real tangible value seemed visible. Initially, investors could not see the value in simply generating and publishing health related content. mDhil worked backwards, created content before establishing a pool of users. The content generated attention from followers online and via social media networks. From here emerged a value proposition for Mobile Service providers to provide this information via SMS downloads. Teenagers and young adults are a huge base of Mobile users – and service providers are always looking for ways to engage this audience in pay for use options. This fits in perfectly.

Now, mDhil.com generates revenue through advertising, sms content and their popularity has also generated investments. The primary goal of mDhil continues to be to focus on creating relevant content for its targeted user base.

Basic Primary Healthcare Gaps and the Potential to Scale

The Alchemix session yielded a rich discussion on these models and what is clear is the need for disruption at the primary level. Creating far higher access and ease of use to the basic health care needs. The government or large multi specialty Hospitals do not have to be the only players in the healthcare space as privately run social enterprises like mDhil and NationWide Primary Healthcare Services are finding ways to create value and function within the gaps.

Alchemix

Alchemix is a platform for people to learn about new models and have discussions about innovation and enterprise. If you would like to contribute by writing a blog or have an interesting idea for us to explore, do get in touch by sending an email to info@innovationalchemy.com.

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View more pictures from the Alchemix Session here.

Author: Mansi Reddy, Innovation Alchemy, Bangalore, 18th August 2011.