The Resilient Health-Tech Startups (Part –II): Challenge Accepted!

Challenge accepted! This hilarious catchphrase was used by Barney Stinson – the character played by actor Neil Patrick Harris in the American sitcom How I Met Your Mother – every time he stood up to take up the craziest of challenges. He never shied away from any of them and tackled them with utmost dedication. Flashback to all the challenges faced by the health-tech startups – the numerous obstacles in the path of these startups that decided to venture into this domain, well aware of what they were getting into.

This sequel is not meant to dissuade the budding health-tech entrepreneurs from entering this space. Therefore, instead of continuing the never-ending list of challenges involved, the focus shall be on the kick-ass ability of health-tech startups to convert these challenges into opportunities.

Turning Venom Into Antidote

“Every challenge is an opportunity in itself, as it makes us iterate and improve our product to be able to make more people get benefitted from it. These challenges will exist and even new problems will surface, but that will actually give the opportunity to learn new ways to tackle them,” says Saurabh Arora, CEO & co-founder of Lybrate.

The unorganised nature of the healthcare space in India is a major hurdle for these startups. Practo found an opportunity here. It decided to build its own healthcare map of the world. It has its on-ground team that literally goes street by street, city by city, to capture doctor and clinic information, which is then carefully verified to ensure the authenticity of the shared information.

The other really big challenge is that the healthcare information is not digitised and hence not readily accessible  all the time. This means that most consumers don’t really have a comprehensive healthcare history – which can often lead to incorrect or sub-optimal diagnosis and treatment.

To deal with the same, Practo came up with its cloud based SaaS practice management software for doctors, called Practo Ray. “We enable them to manage their practice (scheduling, billing and inventory) and most importantly – create and share digital records with their patients and patients can in-turn share them with others if they want,” explains Shashank ND- Founder and CEO of Practo.

The challenging nature of this space is a boon in itself for these startups. Dr. Deepu Sebin, co-founder & CEO of Daily Rounds, believes that since the entry barrier to this space is so high, it’s easy to lead the market. Not many players are able to achieve the right blend of tech and medical expertise; the ones that manage to do so, hit the jackpot.

“In an Indian context, the term healthcare startups is almost synonymous to Practo. It is an amazing feat that they have managed to sustain and thrive for so long. However, the complex nature of the industry has still taken its toll on even the very best of them,” says Mudit Vijayvergiya, co-founder of Curofy.

Given the complex nature of the industry, only few would survive and the ones who do are most likely to be the market leaders of this space. Also, big companies are built when disruption is possible, and since the whole is now moving towards digital, it’s a huge opportunity for entrepreneurs to leverage, he adds.

Meena Ganesh, MD & CEO of Portea Medical, also believes that the health-tech sector in India has immense opportunities, with the following areas being ripe for disruption.

• Information discovery
• Preventive/proactive care and incentivizing positive healthcare behaviours
• Diagnostics through smart devices, wearables, point-of-care devices
• Therapeutic areas such as telemedicine and robotics, among others

“Another large area is home healthcare or non-facility based care where technology is used to monitor patients, manage the healthcare delivery process, seamlessly connect with specialists and clinicians across the value chain,” she adds.

When it comes to overcoming the lack of health-tech enabling infrastructure, especially the shoddy internet connectivity, the answer lies in adapting. If evolution has taught us anything, it is to survive with whatever little is available and make the best possible use of those limited resources. The ones, who can do so effectively, are the ones who will survive this harsh healthcare ecosystem – survival of the fittest.

“These challenges should actually make a startup focus on the core problem and accordingly make a product that is easy to use and could work in even low bandwidth areas,” avers Saurabh.

Phanish believes that 80% of the problems that require high input on the infrastructure side can also be solved with limited access if you have innovative ways – text chat instead of video chat. Instead of focusing on what is not available, one should start with what is available and learn how to use those resources to find a solution.

He aptly substantiates the same by referencing Matt Damon’s endeavour to survive in Mars and finally escapes back home to Earth, in the movie ‘The Martian’. He used what was available to find his way out of Mars and gets back to Earth. “As an entrepreneur, you are living ‘The Martian’ – you have to find your way out,” he states.

Rx

Name: Startups, Health-Tech  

Diagnosis: A challenging ecosystem

Dosage: Follow these pointers everyday till you succeed (before or after meals).

P.S: These pointers never expire; you can keep up with the dosage even after you succeed.

1. Keep updating your product: Users need to be satisfied with your online as well as offline experience. The product, therefore, has to be seamless when it comes to the end user experience.
2. Be tenacious & patient: You are in here to disrupt an industry which has a lot to static inertia and making an impact is going to take time. You should not expect overnight success. Healthcare startups need to have the tenacity to negotiate complexity and lengthy timelines, because the opportunities come with long gestation periods.
3. Don’t get carried away: There will a number of startups springing up every other day and some investor will fund them. When you come across such news, don’t get tempted to emulate what others do. The key to success is to maintain focus and deepen your current positioning, instead of acting like an ‘Alice in the Wonderland’.
4. Be generous with apps: Never create ‘one single app’ for all your healthcare services. Also, a mobile-first approach is imperative for the success of health-tech startups.
5. Get your Tteam right: Building the right team is the first and foremost objective. The mindset of the doctors and engineers in the team needs to be in sync. Building a team by bringing together the worlds of tech, non-tech and HCP alike, is a proposition that requires serious consideration.
6. Define actionable metrics: Healthcare space doesn’t have reference points; hence the metrics are not predetermined. Therefore, defining actionable metrics is of utmost importance.
7. Gain access to capital and key industry insights: Health-tech startups require capital. Therefore, raising funds from an investor with a deep pocket and domain knowledge, alike, would surely go a long way.

Shashank shares his learnings garnered during his journey of building Practo from scratch:

“I think the success rules are similar for startups across the board, not just healthcare. Over the last 8 years that I have been building Practo, there are a few things I’ve learned,” he says.

First, always optimize for the vision. Articulate the vision continuously and ensure each step you take is towards this. Vision helps align the entire team behind a common purpose.

Second, usage is king. Focus more on the usage of the product than how much the users are paying for it. Usage is the single most important metric to determine product value. Pay close attention to what your customers tell you. Product insights will come through interpretation of customer feedback.

Third, solve hard problems. At the start, try picking the tough problems to solve. These are usually the ones no one else would have tried solving. Ask yourself, ‘Why hasn’t anyone done this before?’ Logically, due to technology advancements, problems that were harder to solve so far, would become easier now.

Fourth, hire A level players only. That should be one of your top priorities. Only get the best of the best. They can give you exponential growth. Ensure they buy into the vision of the company and focus equally hard on retaining them. One of the keys to retention is to build a great culture from day one. It will remain through the life of the company.

Fifth, think global. One of the best things we did was launch in Singapore. The market there really stress tested our product and helped us improve by leaps and bounds, which was instrumental in us getting such a high market share so quickly.

Sixth, get advisors & consultants. There are many industry experts out there. Take advantage of their expertise, it’s faster. Don’t try to do everything on your own.

Seventh, growth is the only oxygen for a startup. Continuously focus on the growth percentage. Take risks and do everything possible to grow fast.

Eight, build great products. Never ever ship a subpar product. Customers have an innate sense to detect carelessness. They will penalize you by moving away.

Ninth, choose the right investors. Don’t optimize for valuations, optimise for building a great product or service that people love. Investors will see value in that. Optimize more according to the investor, rather than the invested amount. Investors can be great partners in helping you grow, so they must share your medium and long term vision, and their goals should be aligned to that.

Tenth, focus. You have limited resources and time. Don’t spend too much time attending conferences, networking events, etc. Focus all energy on ensuring there is progress. In our earlier days, we used the mantra of ‘Code & Sell’, everything else is useless.

And finally, have fun. You will spend long hours doing this so make sure you love doing it and are excited by it. There is no room for half-heartedness.

In one of those viral Rajnikant jokes, the superstar was shot in the head during a fight, and instead of killing him, the bullet simply passed through his ears, thereby curing him of the incurable tumour that was slowly killing him. This is the most befitting analogy of the feat that these health-tech startups have achieved. Like the deadly bullet turning into a blessing, these health-tech startups are converting the challenges, in their path, into opportunities. Let’s wait and watch how many more market leaders emerge in this space.