The responses have been given by Dr Alexander Kuruvilla, Chief Health Strategy Officer, Practo

All around the world, people are facing unprecedented challenges and uncertainties as a result of the COVID-19 pandemic. As InnovatioCuris (IC), we are always on a lookout for healthcare innovations that are affordable and provide quality care. Most governments across the world have lifted restrictions or limitations imposed on telemedicine to provide home-staying patients with remote access to healthcare. The US, for example, allowed Medicare payments for virtual visits, while India’s Ministry of Health issued new guidelines permitting registered medical practitioners to use telemedicine services. In the wake of this, InnoHEALTH magazine scouted and interviewed some innovative telemedicine providers/startups to build an army of health transformers to mobilize and address this global health crisis.

Disha Soni and Prateek Malhotra interviewed Dr Alexander Kuruvilla, Chief Health Strategy Officer, Practo, on behalf of InnoHEALTH magazine to bring out some virtually perfect telemedicine solutions available during the Covid-19 crisis, also to understand challenges and opportunities posed by such a situation and how our startup ecosystem is tackling it.

What do you think needs to change in the health sector?

India has some of the best medical experts and institutions in the country. Indian doctors and scientists are considered among the best in the world and India has emerged as one of the finest medical tourism destinations in the world. 

According to a McKinsey report, India could save up to $10 billion in 2025, if telemedicine replaced 30% to 40% of in-person outpatient consultations and there is digitization in the overall healthcare industry. Much of the current focus in healthcare is on the near-term challenges of the COVID-19 pandemic. However beyond the current crisis, healthcare technology veterans are already seeing major changes that promise to become permanent realities — from the sudden boom in telemedicine, to regulatory shifts impacting healthcare billing.

The COVID-19 pandemic has shone a spotlight on the need for a strong technological ecosystem within healthcare not only in India but across the globe. In the wake of pandemic, technology which was only being used in the back-end is now at the forefront of this health crisis through tools like telemedicine. This has encouraged countries to implement long-term telehealth tools and enhance interoperability of electronic medical records. 

What tools and resources do you propose to bring these shifts in healthcare delivery?

Technology is and will continue to be the catalyst for a thriving future of India. Not too long ago, healthcare for Indians was limited to their friends/ families’ recommendations being inconvenient with ‘wait time’ at clinics as high as three hours. Today, you can get in touch with a doctor in less than 60 seconds and meet with a doctor in as less as 15 minutes. There is less friction and more empowerment.

Uberisation in Healthcare has been long coming and there’s no way you can build ‘Health for All’ without integrating online and offline channels. Online and offline will continue to co-exist. Online healthcare increases access and efficiency for patients, while they would continue seeing their doctors physically for serious illnesses, conveniently with the help of technological solutions. 

Share with us about your technology that powers this company?

Dr Alexander Kuruvilla shared that at practo, every single solution that they have built and will continue to build will have the doctor-patient interaction at its core. They wanted to ensure patients and doctors can connect at any time, communicate asynchronously or synchronously depending on their needs. They also wanted to ensure the experience is fast and seamless, so both patients and doctors can focus on health rather than technology. 

They have built a smart matching algorithm that connects a patient to qualified and registered doctors, depending on the patient’s health problem, the doctor’s area of speciality and his availability. Once an identification of a pool of available doctors is done, they reach out to them in real-time to accept a new consultation. This unique approach allows them to connect a patient with a doctor 24 hours a day, 365 days a year.

What are the factors that influence market innovation and its impact on your organization?

There are few factors that have been observed in the society which are bound to make an impact on the market innovation and so on the organization:

• Patients are becoming aware and engaged and are increasingly able and willing to take greater control of their health. Hence it is important to ensure they are armed with the right tools and technology
• Uberisation of healthcare has been long coming and consumers expect the same level of service from healthcare services, as they do from players in other industries regarding Personalised care, Real time service and responsiveness and a fuller, integrated engagement and experience
• With the ongoing global pandemic, the insights have shown that India is embracing telemedicine like never before. The econsult platform of Practo has seen a 500% growth since the lockdown, reiterating the fact that people are using telemedicine as the first line of defense, instead of crowding hospitals during the COVID-19 outbreak. Furthermore, this also means that telemedicine has enabled access to healthcare to the remotest locations of India. This trend is likely to stay and we are expecting that people will continue to embrace telemedicine for their regular healthcare needs, anytime, anywhere

Do you consider bringing telemedicine in rural areas and what are your initiatives towards that?

India’s doctor to patient ratio stands at 1:1700, while WHO recommends 1:1000. There are approximately 1.1 beds per 1,000 persons, compared to the world average of 2.7. Our country has a wealth of medical expertise, yet it is also one of the largest countries in the world in terms of both area and population.  Public hospitals are typically overcrowded, while private care stays out of reach for many. In about 6 lakh villages, where 69 percent of India’s population lives, the number of doctors is only a fourth of those in urban areas. Approximately 12 percent of patients go without access to primary health care every day.

Dr Alexander said they are bridging the gaps in both urban and rural parts of the country through their telemedicine services. Telemedicine is a tool that allows a patient to consult a respective Medical Council verified doctor, 24*7, from anywhere in the country. If one has a smartphone, he/she can consult a doctor, irrespective of their location. So definitely, telemedicine allows people to instantly consult a verified doctor instead of either delaying or self-medicating and do all that affordably. Moreover, location is no longer a constraint –  a person in Arunachal Pradesh can consult a specialist in Delhi, without having to move / travel the distance.

India’s digital connectivity is expected to reach 80% access in 2034, with rural Internet users increasing by 58% annually. With smartphone and internet penetration growing, rural India is getting tech savvy with every passing day and are adopting new technologies that can improve their lifestyle. Given the lack of access to quality healthcare, especially in rural India, telemedicine can be a revolutionary tool that has the power to minimise these critical imbalances through technology. Anyone with a smartphone will have 24*7 access to verified doctors no matter which part of the country they are in. This trend can drive the adoption of telemedicine and other digital technologies, thereby increasing access to healthcare for people in rural areas.

What were the challenges you faced in initial days and how are they different in today’s scenario, especially during this pandemic and what is your role in that?

One of the core challenges that the organisation has faced is technology adoption in healthcare. Healthcare has always worked in a traditional way and has been one of the few last industries to see digital transformation, and that has been a big challenge. The focus has always been on solving the consumer problem and simplifying the technology so that it becomes very easy to ensure the transition from technology not being a major factor in a particular industry to becoming the driver of the next set of growth and improvements. And, this thought about technology has helped us in managing some of the challenges that we have faced.

There is greater acceptance and attention for digital health solutions during the coronavirus crisis and believe that the trend will continue even after the pandemic. Doctors have never been more supportive of digital technology than now, and patients are slowly getting used to telemedicine as an option of accessing healthcare.

Do you see any major growth opportunity in the post covid-19 world

The COVID-19 pandemic has shone the spotlight on the need for a strong technological ecosystem within healthcare not only in India but across the globe. In the wake of the pandemic, technology which was only being used in the back-end is now at the forefront of this health crisis through tools like telemedicine. This has encouraged countries to implement long-term telehealth tools and enhance the interoperability of electronic medical records. 

There is greater acceptance and attention for digital health solutions during the coronavirus crisis and we believe that the trend will continue even after the pandemic.

Much of the current focus in healthcare is on the near-term challenges of the COVID-19 pandemic. If we all succeed in sustaining the current high level of acceptance and simplified regulatory framework into increased long-term use for digital healthcare, especially telemedicine, the coronavirus pandemic will in retrospect be remembered as the breakthrough point of the digital health industry in India.  

What is the biggest setback your organization has faced and what are your learning’s from that?

Healthcare is not an immediate impact domain; it takes time and patience to create real impact. Dr Alexander said that they have been at it for 12 years, and will continue to do so. There are no challenges or setbacks as such, roadblocks maybe, which we strive to solve by working with the authorities and ecosystem partners, so maximum value and impact can be generated.

Share a bit more about the culture and values of your company? What is important to you and why?

To this, Dr Alexander said “We are passionate dreamers, thinkers and do-ers rolled into one for one purpose. Our three principles help us keep moving towards our mission with a zeal to excel are Inspire Trust,Growth is Oxygen, and Think first Principles.”

These are not just principles for the, their products, or their company, but a reflection of who they are as Practeons. Their work impacts millions of people around the world. Do Great is the company’s motto and is the hallmark of a true Practeon. This means Practeons do their best work, not for the want of rewards or recognition, but because it is the right thing to do, to take them closer to their vision.

What are your Future plans and any message for our readers?

The vision has always been to simplify healthcare by making quality healthcare more accessible, affordable and convenient. In such a time of crisis, solving for access is what all are working towards, so patients can continue consulting their doctors. A lot of groups are all finding ways to support the authorities and caregivers to ensure patients have access to care, when and where they need it, and Practo is doing exactly the same.

 Dr Alexander also shared that, over the last few days, they’ve received requests from a large number of hospitals and clinics to make the online consultation services live for them. They’re also reaching out to a lot of establishments, so they can continue consulting their patients online. During such times when stepping out is advisable only in times of emergency, teleconsult plays an important role. All are working hard towards ensuring there’s uninterrupted access to care, and that patients can continue consulting their doctors, virtually.

Interviewed by Disha Soni & Dr Prateek Malhotra

The responses have been given by Ankur Gigras, VP, E-commerce, 1 mg

All around the world, people are facing unprecedented challenges and uncertainties as a result of the COVID-19 pandemic. As InnovatioCuris (IC), we are always on a lookout for healthcare innovations that are affordable and provide quality care. Most governments across the world have lifted restrictions or limitations imposed on telemedicine to provide home-staying patients with remote access to healthcare. The US, for example, allowed Medicare payments for virtual visits, while India’s Ministry of Health issued new guidelines permitting registered medical practitioners to use telemedicine services. In the wake of this, InnoHEALTH magazine scouted and interviewed some innovative telemedicine providers/startups to build an army of health transformers to mobilize and address this global health crisis.

Disha Soni and Prateek Malhotra interviewed Ankur Gigras, VP, E-commerce, 1 mg, on behalf of InnoHEALTH magazine to bring out some virtually perfect telemedicine solutions available during the Covid-19 crisis, also to understand challenges and opportunities posed by such a situation and how our startup ecosystem is tackling it.

What are the objectives and your vision to start this organization?

1mg was launched in 2015 with a vision to make healthcare accessible, understandable and affordable. In the last five years, they have moved fast and have contributed towards evolving the digital health ecosystem. With a strong supply chain across India and a fast growing profitable B2B business line, and a strong partner ecosystem with unique integrations with Insurance, Hospitals & Pharmacos to deploy novel models of healthcare delivery to patients across India, patient centricity forms the core values of the company. 

In the times of this pandemic, a digital healthcare platform is incomplete without online consults or telemedicine. With a belief in offering the users a complete treatment cycle: from online consultations to ePharmacy and Lab tests, 1mg’s integrated healthcare platform is acting like “Wiki” for healthcare information & India’s largest ePharmacy, eDiagnostics and eConsultation lines of business. 

What do you think needs to change in the health sector?

In healthcare, the information around our medicines and lab tests is either unavailable or incomprehensible to us, and that is the biggest change the sector needed to go through. Hence, with an aim to democratise healthcare, they came up with a platform for transparent, authentic and accessible information for all. 

Unavailability of doctors due to a low patient to doctor ratio is another issue faced by the healthcare sector, especially in rural areas. With video, audio and chat consultations, they are working wholeheartedly towards filling the gap.

What tools and resources do you propose to bring these shifts in healthcare delivery?

In addition to the transaction & information services, they have built and launched many popular digital health tools such as medicine reminders, digital health locker, emergency profile etc. They also work on several unique models for patient support programs, digital health education programs, insurance solutions etc. 

eConsults or telemedicine is another tool that they believe can bring about this shift. With most people practicing social distancing and minimizing contact, online doctor consultations, as per the guidelines issued by the Government of India, seem to be the safest option of seeking expert medical opinion and diagnosis. 

Can you share about your business model?

1mg operates on a marketplace model where they have tie ups with licensed pharmacies, accredited diagnostic labs and with registered doctors/medical professionals. 1mg is an information technology platform on a digital and electronic network and acts as a facilitator between a buyer and a seller. Their business model is tied to the online transactions completed by consumers for Pharmacy and Diagnostics. The partners pay a small commission for bringing them orders and as volumes drive up, so will the profitability. As consumer usage increases, they plan to try and introduce other monetization models through advertising. However, they have plans to keep the offering free for consumers. 

What is the key strategy you adopted for acquisition?

With a ~35% share of category amongst all medical apps in India, by far, they have crossed 33 million app downloads.

Building trust among the people with the authentic information was the key mantra for them to acquire such a big user base. Ankur also shared that the major chunk of customers that they have are those who came to their platform to consume health content.

What are the factors that influence market innovation and its impact on your organization?

To put it simply, the needs of the customers impact market innovation. For example, in the current times as the world is battling COVID-19, there is an urgent need for authentic and updated information around the same. So, we took it upon us to keep people informed. We experimented with different forms of content like ebooks, mailers, app notifications, website landing pages and more to help people consume as much authentic and medically accurate information as possible.

What are your strategies to deal with your competitor and what makes you different from others?

Being an integrated healthcare platform, 1mg is contributing to drive the digital healthcare innovation in the country. Today, they are one of the most preferred integrated healthcare app for consumers/patients, and stand-out in the competition in terms of – (i) Relevance and speed of search results (ii) Quality of medical data/content available (iii) Predictive algorithms and machine learning. 

Ankur shared with us that they have great respect for their competitors, but as per him, their qualities and values set them apart from others. Clarity of vision,superlative team and clarity in values is an integral part of their winning formula. 

What were the challenges you faced in initial days and how are they different today’s scenario, especially during this pandemic and what is your role in that?

Access to healthcare has been a challenge even before the pandemic, and health tech companies have tried everything to knit the gap existing in the healthcare system, be it telemedicine, online doctor consultation, mobile hospitals, etc. But, with the demand surging due to Covid-19 across different parts of the country, health tech companies are witnessing a new behavioural shift in Tier 2 and Tier 3 cities, which is here to stay.

Do you see any major growth opportunity in the post COVID-19 world?

Doctors have now started recognising the need for technology to engage better with their patient base. Hospitals too have become receptive of the change, as most of them are seeing a 40%-50% reduction in footfall. Suddenly, they have started to feel the pain that they are not connected with the patient when they are at home. Onboarding doctors on telemedicine platforms has been a major challenge in the sector. Realising which, existing telemedicine companies have even adapted to models like collaborating with hospitals, or local pharmacy chains.

In the post-Covid-19 world, there is a belief that consumer behaviour would shift towards teleconsultations. The consumer’s fundamental pain point has never been about saving money on healthcare or ignoring it, it’s always about access. Going to a doctor’s clinic, waiting for two hours, and having to leave work early is often seen as an inconvenience. But with telemedicine they can consult the doctor anywhere without having to go through the hassle of visiting a clinic. 

Further, the involvement of corporates and insurance companies in digital healthcare is also expected to go up.*

Share a bit more about the culture and values of your company? What is important to you and why?

“Done is better than perfect”, “Be CEO”, “accountability with empathy” and “team before individual” are some of the values that enable them to rapidly innovate and test real products out in the market, to take charge and do what’s right without an organizational bureaucracy and enshrines collaboration.  

What are your Future plans and any message for our readers?

Since the inception, the organisation has believed that technology and data will fundamentally change healthcare delivery. Over the years they have invested significantly in product and supply chain and most of the investments will continue or get accelerated. Some areas which will see disproportionate investment, according to Ankur, will be the ones below: 

– AI and Machine Learning – Artificial Intelligence will fundamentally change healthcare 

and will make it personalized, predictive and preventive. With billions of healthcare data points, they are already working on AI models and will continue to accelerate work in that direction. 

– New healthcare models -The models, such as smart hospitals, outpatient insurance etc. will be the models of the future and will make healthcare accessible and affordable. Accessibility and affordability are 2 core pillars of their vision. 

– Integrated Care plans – Their goal is to enable truly integrated outpatient care in the country. Such a plan will provide a patient with continuity of care both online and offline and across all their healthcare service needs. 

We congratulate and wish all the luck to Ankur and his team to continue to help deliver superlative value to the Indian healthcare ecosystem. 

Interviewed by Disha Soni & Dr Prateek Malhotra

The responses have been given by Rahul Narang, Co-founder and CTO, Lybrate

All around the world, people are facing unprecedented challenges and uncertainties as a result of the COVID-19 pandemic. As InnovatioCuris (IC), we are always on a lookout for healthcare innovations that are affordable and provide quality care. Most governments across the world have lifted restrictions or limitations imposed on telemedicine to provide home-staying patients with remote access to healthcare. The US, for example, allowed Medicare payments for virtual visits, while India’s Ministry of Health issued new guidelines permitting registered medical practitioners to use telemedicine services. In the wake of this, InnoHEALTH magazine scouted and interviewed some innovative telemedicine providers/startups to build an army of health transformers to mobilize and address this global health crisis.

Disha Soni and Prateek Malhotra interviewed, Rahul Narang, Co-founder and CTO, Lybrate, on behalf of InnoHEALTH magazine to bring out some virtually perfect telemedicine solutions available during the Covid-19 crisis, also to understand challenges and opportunities posed by such a situation and how our startup ecosystem is tackling it.

What are the objectives and your vision to start this organization?

Mr Rahul Narang, the co-founder and the CTO, shared with us that they noticed that people were consuming medicines just on the advice of chemists and making severe compromises with their health, unintentionally. The chemists were prescribing medicines without requisite skills and expertise. This was rampant in Tier 1 cities where people had time constraints and skipped visiting a doctor because of waiting time at clinics and traffic jams.

Those in Tier 2 & 3 cities faced a different issue, which was non-availability of quality doctors. We found out that the core problem of Indian healthcare delivery was the huge crunch of doctors in the country, which was causing their severe scarcity. So while finding a doctor was easier, communicating with them was a big challenge.

So, with a thought to connect patients with doctors, they came up with a platform that would enable them to communicate with each other, and thus solve the real problem that plagued the Indian healthcare system.

With Lybrate, they are on a mission to fix the huge shortage of doctors in the country and democratize healthcare delivery.

What do you think needs to change in the health sector?

The adoption of digital medium is very low in the healthcare sector in India. Digital has immense potential as availability of high-speed internet and smartphones in every nook and corner has changed the landscape drastically over a decade. Smart use of digital medium, machine learning and artificial intelligence can greatly impact healthcare delivery outcomes in the country, improving overall healthcare scenario.

Can you share about your business model?

There are multiple ways in which Lybrate serves its users, both doctors and users. The focus is on communication and that remains the core of all their solutions, says Rahul. Users can use the platform either through the free mobile app available on Android and iOS, or web. Majority of the platform is free for users and doctors to use but there are a few ways in which the platform makes money:

1. LybrateAdvice – gives a seamless and frictionless way to communicate with a doctor. It enables users to talk to a doctor via text, audio or video. Users can consult their choice of a doctor privately by paying a consultation fee online. On top of the doctor’s consultation fee, the user has to pay an internet handling fee to the company which makes up for the company’s revenue.
2. Lybrate GoodKart – It brings together authenticated health and wellness products that are delivered to people at their doorsteps.It is similar to an e-commerce platform.

Share with us about your technology that powers this company?

Machine learning is the technology being used to provide customised solutions to the users. A huge amount of data has been generated since the launch of the platform- January 2015. This made them use machine learning to suggest customized healthcare solutions to the users.

Machine learning facilitates learning of users’ interest and preferences over time to create a customized Health Feed, consisting of health tips from doctors themselves and free answers by doctors to questions asked on the platform. This prevents users from getting bogged down by information not much of their interest.

Besides, when users ask queries on the platform, they do not know which doctor is best suited for them. Machine learning fixes this issue by deciphering users’ query across more than 15 parameters in real time and helping them get answers from relevant doctors. In the times of information overload, customized solutions are important for patient engagement.

What are your strategies to deal with your competitor and what makes you different from others?

According to Rahul, unlike other platforms, Lybrate is not doing things in bits and pieces. They have committed themselves to fixing the root cause of the country’s healthcare delivery problem. The platform, thus, focuses on communication and multiplying the presence of doctors.
 

Once people are on the platform and are able to communicate with the doctor, they experience the convenience it provides and other valuable services being offered on the platform. Giving users a worthwhile experience and convenience is imperative for building engagement. This has led to a high repeat traffic on the platform.

What were the challenges you faced in initial days and how are they different today’s scenario, especially during this pandemic and what is your role in that?

The initial challenge that the company had to face was the low awareness about telemedicine, both among users and doctors. Another was hesitance. Over the last couple of years, the situation changed for good. Especially now after the coronavirus outbreak, the perception of people towards has changed in a very positive way. Basically, there existed two categories of people. One which had little or no idea about telemedicine services for want of awareness, while the second category of people not talking to doctors online was the hesitant lot who considered touch and feel to be a must. 

During the lockdown, the awareness of telemedicine grew remarkably as even governments pushed for the use of platforms like Lybrate owing to social distancing norms. Thus the platform has seen a jump of over 120% in online doctor consultations post the announcement of lockdown.

Certainly, it is a positive development for the entire telemedicine industry because it has huge potential to improve healthcare delivery outcomes. 

Do you see any major growth opportunity in the post COVID-19 world?

Because of the lockdown, the physical activity of people has come almost to a halt while screen time has risen. Owing to that, patient consults relating to wellness issues have risen significantly on the platform. Apart from that, consultations around mental problems have also increased.

It will be very optimistic to say people will depend upon telemedicine services for healthcare-related issues like they are doing now. Certainly, there will be a section of people which will go back to the traditional ‘in-person’ way of consulting doctors. While the trend would see a decline when the situation would begin normalizing, it would settle at a point which will be notably higher than the pre-crisis level.

What are your Future plans and any message for our readers?

“In the short term, we are focussing on meeting the demands of online consultation on our platform that has spiked significantly on account of the coronavirus crisis,

In the long term, we will continue making healthcare accessible to the people of the country and fix the issue of shortage of doctors by multiplying their presence, which is only possible when they are online and begin consulting remotely from where they are.” says Rahul.

Interviewed by Disha Soni & Dr Prateek Malhotra

The responses have been given by Dr Karthik Anantharaman, Director e-Pharmacy at Medlife

All around the world, people are facing unprecedented challenges and uncertainties as a result of the COVID-19 pandemic. As InnovatioCuris (IC), we are always on a lookout for healthcare innovations that are affordable and provide quality care. Most governments across the world have lifted restrictions or limitations imposed on telemedicine to provide home-staying patients with remote access to healthcare. The US, for example, allowed Medicare payments for virtual visits, while India’s Ministry of Health issued new guidelines permitting registered medical practitioners to use telemedicine services. In the wake of this, InnoHEALTH magazine scouted and interviewed some innovative telemedicine providers/startups to build an army of health transformers to mobilize and address this global health crisis.

Disha Soni and Prateek Malhotra interviewed, Dr Karthik Anantharaman, Director e-Pharmacy & Private Label Business, Medlife, on behalf of InnoHEALTH magazine to bring out some virtually perfect telemedicine solutions available during the Covid-19 crisis, also to understand challenges and opportunities posed by such a situation and how our startup ecosystem is tackling it.

What are the objectives and your vision to start this organization?

Dr Karthik Anantharaman, the director e-Pharmacy & Private Label Business shared with InnoHEALTH  that the company did begin as an e-health company, rather E pharmacy company, that was the first business that medlife set up. Later on, the company diversified into setting up labs as a business. And recently, they have set up the teleconsultation business as well. From a user journey perspective, it is going to be the same consumer or the patient who would avail medical consultation services through telemedicine. It’s the same patient who will be issued an e-prescription by the consulting doctor and the e-prescription primarily would have three things in it. 

1. lifestyle modification, like a diet or an exercise for most of the chronic diseases, chronic therapies. 
2. Medications 
3. Lab investigations. 

Therefore, the company actually serves as a fulfilment partner of the medicines and for the lab test as well. So, broadly that is how the company became more of an integrated e-health service to the end consumer. He also shared that, they plan to come up with a unified storefront where when a consumer comes into the app, they will be able to add a medicine fulfilment, a lab fulfilment and a consultation request together into the same cart and then check out in a seamless manner. So therefore, a combination of all three verticals of service that Medlife offer can be potentially combined into one single integrated service.

What do you think needs to change in the health sector?

Looking at the current situation, social distancing and hygiene is going to be like a norm for every place and I think healthcare sector is no different in that. That being said, I think what significantly going to change in the healthcare sector is the adoption of digitalization. Therefore, routine OPD, consultations, routine follow-up visits at doctors, etc are not going to happen as it was in the pre-COVID era. There is going to be a lot more emphasis on patients using teleconsultation service for routine follow-up consultations where they do not mandatorily have to visit a clinic or a hospital physically. Patient can always just dial them up, fix up an appointment, do a video consultation or a teleconsultation and be done with an e-prescription. Only for very critical illness, it will be mandated that the patient physically visits a hospital or the nursing home. So that where, I am sure, it is going to be a very good balanced mix of digitally enabled teleconsultation for regular cases and physical face to face consultation only when it is absolutely required for critical illness. So that’s going to be the different.

What tools and resources do you propose to bring this shift in healthcare delivery?

Anything that is telemedicine enabled, and at the same time, what would also become equally important and critical is EMR, electronic medical record. So, now there will be much better and structured EMR or electronic data upkeep that will happen which telemedicine will enable, because every patient naturally is uniquely identifiable and every doctor is uniquely identifiable as well as a part of the service. Therefore, a lot of companies will now basically kind of get into the mainstream market in terms of offering telemedicine as a licensed service. So that’s going to be quite interesting to see.

Can you share about your business model?

To this, Mr Kathik said, “It’s pretty simple, right? People who need pharmacy services order medicines from us, we deliver”. People who require lab tests, place an order online, the company delivers. And for the people who are looking for teleconsultation services, fix up teleconsultation requests, and then the company delivers on that as well. So that’s basically about it. People pay online through various types of payment gateways like credit card, debit card wallet, net banking, etc all are enabled. And that’s how they kind of build the service that they need.

What are the factors that made you influence the market innovations and its impact on your organization?

Following the market needs is more about following what are the therapeutic areas or what are the product lines which are making a significant difference in the market. For example, even during the lockdown period, the medicines that grew well were actually diabetic and cardiac medicines because people realize that if they don’t keep their sugar under control or their heart disease under control, their immunity is going to drop, and hence it could impact their health. So, that is where people realize that they need to be more compliant to their therapy, especially when it comes to chronic disease. It was seen that these therapies like cardiac, diabetes, grew upwards of 15 to 20% while many of them declined during the lockdown, mostly acute therapies. So yes, we follow market trends, we follow pharma-industry growth, and accordingly, all our communications, marketing, etc are aligned to it, said Mr. Karthik.

What are your strategies to deal with your competitor and what makes you different from others?

In the health sector there is enough market space that is still left unexplored. In the Indian pharma market, we are less than 2% of the Indian pharma market, so there’s a lot of room that’s available for every health sector to grow. Therefore, with that kind of a headroom, which is almost more than 98% of the market still available to adopt health, the adoption rate is going to be very quick. 

Adding to this, Mr Karthik said “I was reading one of the reports which says that e-commerce is going to be one of the industries that is going to recover the fastest in the post-COVID recovery phase. So, everything to do with digital is going to recover the fastest as well. That being said, I think what makes us different from others is that we become an integrated e-health portal, where it is a combination of pharmacy service, lab service and consultation service that can be availed from a single player. While many others could be offering just one individual service on their platform”.

Do you consider bringing telemedicine in rural areas and what are your initiatives towards that?

Rural areas are definitely a yes for the company. Now that there is going to be a significant improvement with BSNL and internet service providers in the rural area and there is going to be good penetration of these services in the rural areas as well. So, with that happening, it is going to be like a good market to explore. Of course, the pricing will have to be a little different there, but broadly there is going to be a significant rural digital health upside.

What are the cyber securities issue organization like you faces? How do you deal with them?

According to Mr Karthik, mostly these questions are going to come from the doctors who are offering consultations and also the patients who are using telemedicine platforms to seek consultation because people certainly would want to keep their medical consultation and medical data private and that is of paramount importance. The steps are taken to ensure that the patients’ and doctors’ data are secure and reliable whether it’s through our compliance or through service providers. There must be a licensed approach for operating the software on which services are offered right to customers, so naturally the company which is offering the software as a service should be absolutely secure in terms of data. So, some of those things have become very relevant as we move forward.

What were the challenges you faced in initial days and how are they different today’s scenario, especially during this pandemic and what is your role in that?

To answer this, Mr Anantharaman said, most of the challenges have been quite operational. Definitely at a business level, the demand for most of the healthcare businesses have kind of gone up. But yes, broadly what is going to differentiate things going forward is that there is going to be increased adoption of e-commerce for availing quite a bit of almost every kind of healthcare service or healthcare products. What we need to get better at is a lot more on operational efficiency, turnaround, time-based efficiency that will kind of determine this whole thing and the expectation on discounting going forward. Some of these will be kind of impacted quite interestingly in the post-COVID phase.

What are your views about reimbursement in healthcare delivery model?

It’s going to be around OPD coverage and covering OPD cost will be quite critical. In addition to inpatient costs because now a lot more OPD work will happen.

What is the biggest setback that your organization has faced ever and what are your learnings from that?

There are many things for which we do not have any precedence to it. So the company  didn’t know how consumers would behave. They didn’t know what was going to be the approach. So therefore, broadly it  is going to be more of understanding about new consumer behaviour. “We also saw that; customers are now becoming very choosy in terms of how much they buy as well and the amount of money customers are willing to spend on various types of services including healthcare is going to change significantly”, said Mr Karthik. Also, because there are quite a few companies who are going through a job cut, pay cut, etc. so therefore, affordability will be significantly different than it was earlier. So yeah, many of those things that are anticipated, in terms of customers, trying to save more and spend less for getting more.

Could you share a bit more about the culture and values of your company and what is that and what is important to you and why?

In our organisation we follow an open culture, no idea is a bad idea and we try to experiment to get better every day. A collaborative approach is going to be so much more important than ever before. And I think as an organization, all our people have very well adapted to the new work from home culture and still be productive and still be collaborative with each other. So yeah, I think that’s something that we feel very happy about our culture, said Mr Karthik.

Could you tell me what major growth opportunities do you think in this post-COVID-19 world for your organization?

It is impacting chronic disease management, services delivery through a faster and more reliable teleconsultation service and e-lab service, is going to make a significant difference. Over a period of time, ICMR would also consider e-health partners, as a partner in COVID testing and define clear rules of how it can be enabled. Possibly some of those will be quite interesting and quite valuable for us to add to society.

Would you like to share any message with our leaders?

“These are interesting times and that being said this pandemic has redefined the way we live, you know across all facets of mankind. It has brought in heightened awareness about the hygiene practices of self and family as well and special care towards senior citizens and children would be required towards the maintenance of good health. So, that immunity is kept strong and strong immunity is naturally a good barrier to ward off any kind of infection”, said Mr Karthik. The heightened awareness about wellness and health itself, which takes precedence over any other thing. In simple words, health is wealth, is something that we knew for ages and this is indeed very true and there can’t be anything more important than that.

Interviewed by Disha Soni & Dr Prateek Malhotra

The responses have been given by Vaibhav Tewari, COO, Portea Medical

All around the world, people are facing unprecedented challenges and uncertainties as a result of the COVID-19 pandemic. As InnovatioCuris (IC), we are always on a lookout for healthcare innovations that are affordable and provide quality care. Most governments across the world have lifted restrictions or limitations imposed on telemedicine to provide home-staying patients with remote access to healthcare. The US, for example, allowed Medicare payments for virtual visits, while India’s Ministry of Health issued new guidelines permitting registered medical practitioners to use telemedicine services. In the wake of this, InnoHEALTH magazine scouted and interviewed some innovative telemedicine providers/startups to build an army of health transformers to mobilize and address this global health crisis.

Disha Soni and Prateek Malhotra interviewed Vaibhav Tewari, COO, Portea Medical, on behalf of InnoHEALTH magazine to bring out some virtually perfect telemedicine solutions available during the Covid-19 crisis, also to understand challenges and opportunities posed by such a situation and how our startup ecosystem is tackling it.

What are the objectives and your vision to start this organization?

Portea Medical has been delivering consistent and quality medical care to its customer’s doorstep in various parts of the country for the last seven years. The healthcare sector in India has a chronic shortage of doctors and qualified medical staff. As per the World Health Organisation (WHO), India has just 0.9 beds per 1,000 population, a number far below the WHO’s recommendation of 1.9 beds per 1,000population. The situation becomes more challenging due to the massive disease burden and the increased risk of hospital-acquired infections. This is what the organisation set out to address.

What do you think needs to change in the health sector?

The healthcare sector in India has been witnessing a major transformation and the need of the hour is more public-private partnerships. The current pandemic has only accelerated this need and it is imperative to integrate home healthcare and telemedicine as core elements of the overall healthcare ecosystem. The country has a severe shortage of doctors, trained medical staff as well as hospital beds even under normal circumstances. The gaps have been severely exposed by the spread of Covid-19. From a primarily institutional healthcare strategy, we need to move ahead towards a composite structure where hospitals take care of patients requiring intensive care, surgeries, and other such specialized services.

The private clinics, tech-based health start-ups and home healthcare/telemedicine companies should be entrusted with regular day-to-day care of minor ailments, non-surgical procedures, chronic disease management and other aspects such as mental health and physiotherapy etc. The great reach and efficiency displayed by the private players during the pandemic has received favourable response from the authorities as well. In the post Covid-19 world, we are confident of a greater role being played by home healthcare and telemedicine as well as other allied technology driven services.

What tools and resources do you propose to bring these shifts in healthcare delivery?

At the outset, technology must be integrated into every aspect of healthcare delivery. For instance, the Covid-19 pandemic has underscored how telemedicine can become a game changer in ensuring everybody has access to timely healthcare. Technology such as predictive analytics and AI will help strengthen services in terms of personalization, accuracy, seamlessness, and cost-effectiveness. Technology will also help hospitals offload their burden of occupancy and bring down the cost of medical care depending on the facilities and services availed. Another major step would be to provide impetus to home healthcare which is an extremely cost-effective option compared to regular hospital treatment and the focused care can help in quicker recovery. Currently, most insurance policies only cover tertiary care which requires a 24-hour hospital admission.The government could look at providing better support infrastructure for home healthcare such as insurance coverage.

Can you share about your business model? What is the key strategy you adopted for acquisition?

Mr Vaibhav shared with us that they have their own team of doctors, caregivers, and nurses – both short and long term. Through them, they provide at-home care to the different target groups such as post hospitalization discharged patients, critically ill patients requiring assistance, the elderly, among others.  They also have various packages such as PorteaInControl (for diabetes management) and Portea Health Prime (an exclusive service for people over 65 years of age). Apart from this, they have partnerships with over 50 leading hospitals in the country, which refer patients to us. This forms 50% of the users while the other half come organically to the platform since we have been in the business for about 7 years now.

Share with us about your technology that powers this company?

Cutting edge technology, custom-built ERP systems to run our operations, advanced patient treatment management platform( used to manage the patient journey, basis a treatment plan created for him), extensive focus on patient engagement are the core powers of the organisation. 

What are the factors that influence market innovation and its impact on your organization?

Patient centricity and their needs influence the innovation the most for us. Most of our new product launches, solutions, service extensions have all been driven by our focus on our patients. We marry the latest technology and process innovations with patient needs to create the most useful solutions and processes for them.

What are your strategies to deal with your competitor and what makes you different from others?

Quality forms the bedrock of all the initiatives. Having been in the business for over 7 years, we understand the market well and have provided home healthcare to about 3.5 million patients pan India so far, having said this, Mr Vaibhav also said 

“Home healthcare industry in India is still in its early stage but we have seen an increased pace of growth in the recent years. We grown to a leading position in the market by virtue of its service diversity and excellence. We have transformed the way home delivery of healthcare has been functioning so far. Critical services such as home dialysis and home chemotherapy have been introduced into the market by us. We rely on our expertise and deeper understanding of Indian healthcare sector to stand out among the crowd. Further, we are aiming to diversify into various much needed verticals including training of medical workers and innovation.”

Do you consider bringing telemedicine in rural areas and what are your initiatives towards that?

Teleconsulting is becoming reality today, more so in the wake of the Covid-19 pandemic. Earlier in March, the health ministry and NITIAayog, jointly announced guidelines for medical practitioners to ramp up telemedicine services in the fight against COVID-19. Under the new norms, registered medical practitioners can use all channels of communication, including voice, video, and text, for diagnosis. That means even WhatsApp, Facebook Messenger or mobile health apps can facilitate consultation. “Portea Medical saw a 60% spike in teleconsultation since the pandemic broke out and we plan to integrate telemedicine as an integral aspect of our future initiatives”, says Mr Vaibhav.

What are the cyber security issues an organisation like you faces and how do you deal with them?

The organisation has an extensive security policy and its followed in letter and spirit across the organization. Given the dealing with patient data, it is extremely critical.  The organisation also has external certifications and regular audits.  

What were the challenges you faced in initial days and how are they different today’s scenario, especially during this pandemic and what is your role in that?

Pioneering the home healthcare Industry and continuous work to serve patients with the best outside the hospital care, the organisation has been building scalable processes, and technology. Hiring and training a high quality workforce, strong focus on medical SOPs and quality checks in the distributed service delivery environment are some of the focus areas. 

Mr Vaibhav also added that “In the pandemic scenario, supporting patients in the comforts of their home with a combination of technology, our medical expertise and on the ground clinical staff is the big focus. We see increased demand for technology driven healthcare for patients at home going forward.”

Do you see any major growth opportunity in the post COVID-19 world? What are your views about reimbursement to enhance healthcare delivery models?

The healthcare services in the post Covid-19 world are going to be very different from what we all are used to. There is definitely a lot of opportunity for the private sector in terms of using their technological capabilities to come up with scalable solutions. The lack of institutional healthcare resources and coverage have been a major challenge in dealing with the pandemic. The government has introduced several contingency measures to build capacity and the private sector has also played an important role in spreading awareness of the disease. 

There will be a greater emphasis on contactless healthcare for non-critical services such as minor ailments, fever, and health-related queries etc. Technology evolution has also enabled home healthcare providers to provide specialized services. Combined with telemedicine and doorstep delivery of medicines as well as diagnostic services, the home-based healthcare services are expected to form the bulk of the healthcare ecosystem in India. This will not only give a wider reach to the providers but also enable the patients to receive better and more affordable care across the country.

So far, services such as telemedicine and home care have also not been widely adopted due to lack of coverage. The time has come to mainstream such services and bring them under the ambit of insurance coverage at par with the other conventional treatments. This will help in popularizing technology driven care services and bring down their costs. We hope to see this happen in near future and it is important for the growth of Indian healthcare industry.

What are your future plans and any message for our readers?

Portea Medical plans to support its patients with all their medical needs at home as much as possible. Continue to build more solutions to support patients like chemotherapy at home, critical care at home etc. Future plans would involve:

• Reaching to Tier II cities as well. 
• More emphasis on technology and telemedicine and creating training infrastructure for skilled medical workers in the country. 

To our readers, I would request them to stay at home as far as possible. Non-essential travel, visiting crowded places or using public transport must be avoided and social distancing measures should be paid attention to. Ensure that the elderly and children at home are well taken care of. Prevention is the best cure for the pandemic.  

Interviewed by Disha Soni & Dr Prateek Malhotra