E-swasthya

The health scenario in India is a matter of great concern. Fertility, mortality and morbidity remain unacceptably high, both compared to countries in the region and those at similar income levels.

Only 30% of Indians have access to modern medicine and Piramal e-Swasthya was created to explore ways to dramatically increase that number while building a profitable business model. Our dream is to democratise healthcare and give the average Indian access to what many consider a luxury today.

Healthcare indicators in rural India are significantly bleaker than those in urban areas. For instance, the difference in life expectancy between urban and rural India is at 12 years. While the national doctor-patient ratio is 1:1700, in rural areas this is said to plummet to 1:25,000.  Even at substantially higher salaries, doctors are unwilling to serve rural areas. With 70% of our populations living in villages, this is a population that is too significant to ignore. Therefore, our first model, developed in partnership with Prof. Nitin Nohria of the Harvard Business School, is specifically tailored to serve the grossly underserved populations in the remotest of rural areas.

It is ironical though that an average Indian in rural India still spends a significant proportion of his income (over 10 % according to McKinney ‘Bird of Gold’ study) in healthcare. The value that they derive from this money is disproportionately less as travel to towns for treatment accounts for 20 % (NCAER 2003) of total healthcare spent while the cost of medicines stands at only 15% (opportunity cost of wages lost due to travel time also multiplies the burden to the consumer). Much of the value spent is lost in inefficiency and therefore there is a huge opportunity to make a difference if quality healthcare can be provided at their doorstep. We believe that technology coupled with the empowerment of local women is the solution.

Our first model is in 40 ‘no-doctor’ villages in Jhunjunu district in Rajasthan. This is how it works:

1. Local literate women (Piramal Swasthya Sevaks) are recruited undergo a rigorous training programme in which they are trained to collect simple diagnostic information, preventive medicine, first-aid and customer service.
2. These women are given a medical kit, marketing material and a mobile phone. They are then assisted in setting up a tele-clinic (Piramal e-Swasthya Centre) at their own homes.
3. Villagers who feel ill come to the Piramal e-Swasthya Center or are visited by the Piramal Swasthya Sevak. After talking to and examining the patient, the health care worker communicates this diagnostic data through a cell-phone to a centralized call centre.
4. At the back end, a call centre worker enters the information provided into a simple e-diagnosis system, which generates an automated response with the recommended prescription and treatment. Doctors manning the call centre also validate this.
5. The total treatment costs between Rs.30 - Rs.50 depending on the medical condition.  The Piramal e-Swasthya Centre is also a village level pharmacy stocked with medicines necessary to fill the basic prescriptions recommended by the call centre. If the ailment appears serious, the call centre recommends that the patient visit a secondary or tertiary healthcare facility immediately.
6. The healthcare worker also conducts preventive health workshops, which generate awareness about issues such as sanitation, nutrition and first aid.

The model provides reliable, high quality healthcare at a villager’s doorstep through cutting edge technology developed from sophisticated diagnostic protocols. Also, patients for the first time, have access to world-class medicines at an affordable price. In addition, patients are treated in villages itself, not only receiving immediate relief but also saving on valuable time and money lost in travelling to see a doctor in a nearby town. Our aspiration is to experiment with a number of such breakthrough ideas that provide affordable access to quality healthcare in rural India.