The doctor to patient ratio in India’s allopathy sector is one of the worst in the world with one doctor for every 1,596 Indians
Startups say providing quality healthcare in rural areas can be solved through tech enablement, data structuring
Startups such as Practo, mFine, Lybrate, DocsApp, MedCords are bridging the healthcare gaps in rural areas
In the Indian market, as with most technology-driven sectors, healthtech and healthcare analytics is largely only relevant in the urban context. With only 5% of the total healthcare infrastructure coming under the recognised and supported data reservoirs, an Asean Chambers of Commerce and Business report suggested last year that the government start collecting and structuring medical data from hospitals across the country to better treat illnesses.
Further, the impact of structuring and organising healthcare data can be seen in online consultations in the western markets, where the doctor gets remote access to a patient’s history and profile, to support their diagnosis. In particular, this is seen as the solution to bridging the infrastructure gaps in the Indian market between urban and rural areas.
Inadequate and unorganised healthcare data is not the only challenge faced by the country’s healthcare system, high cost of quality healthcare, inefficient processes, and lack of doctors in remote semi-urban and rural regions of the country also proves to be a death blow to many each year. In India, the doctor to patient ratio in the allopathy sector stands at 1:1596 (far lower than the 1:1400 WHO standard) and the country is ranked 145 among 195 countries on the healthcare index.
Tapping the urgent need for improved healthcare data and quality access to doctors, telemedicine startups have sprouted in many cities in India. Practo, mFine, Lybrate, DocsApp, MedCords and others help bridge the access gap in healthcare even in rural areas, where telemedicine is the need of the hour.
Speaking to Inc42, Prasad Kompalli, cofounder and CEO at mFine said that since doctors are inclined towards urban areas, the access to rural areas is constrained. Further, he said that the common thing is that there is a lot of wait time, travel time, and patients often struggle to find the right doctor, be a paediatrician, gynaecologists, neurologists etc.
In addition to this, most doctors are not available at the rural hospitals as they have to travel 300 Km making it hard for patients in rural areas to access healthcare, he said.
However, in recent times, the state of quality healthcare and access to a proper diagnosis is evolving in India because of the various efforts in healthtech and remote care, including the recent step towards legalising telemedicine that the government has been putting in place. “A lot has been changing in that direction and it is a good start and a long journey to go ahead,” said Ayush Mishra, founder and CEO, Tattvan E-Clinics.
Today, there is a growing demand for healthcare facilities, especially advanced healthcare in Tier 2 and Tier 3 cities. However, more than 80% of specialists and super-specialist doctors live in metros or in big cities. Mishra said that even people in Tier 2 and Tier 3 cities who have disposable income and are willing to travel, move to metros for better healthcare facilities.
Further, he said that if we consider the present day scenario, India is rapidly becoming urbanized. Also, it is assumed that by 2030, around 40% of the country’s population will start living in urban areas. If we look at urban India, it has a high concentration of healthcare providers, but now everyone has easy access to healthcare. Rural areas, on the other hand, have limited or fewer healthcare facilities available.
Healthcare experts said that the major issues behind this unavailability and limited access to healthcare facilities are due to lack of empowerment and financial barriers to accessing healthcare. Therefore, it becomes crucial for the government to help those in need and educate the rural masses.
Enabling The Healthtech Infrastructure Outside Urban India
Ever since Covid-19 pandemic-led healthcare situation began to emerge in early March, the Indian government has shifted its focus completely towards healthcare and has eased the regulation to uplift the sector. Under its Pradhan Mantri Jan Arogya Yojana (PMJAY), the central government is looking to provide access to healthcare and good quality hospital services, primarily focusing on poor and weaker groups of the society. Under this initiative, the government provides health insurance worth INR 500K to over 100 Mn families every year.
Also, in the Union Budget 2020-21, the government had announced INR 69K Cr ($9.87 Bn) outlay for the healthcare sector that is inclusive of INR 6.4K Cr ($915.72 Mn) for PMJAY.
But, according to many healthcare experts that Inc42 spoke to, the only way to provide quality healthcare access to people in India relies on leveraging technology and bridging the existing gap to ensure smooth distribution of equipment and supplies, faster and reliable turnaround time and healthcare at home services in rural areas.
Dr Devi Shetty, founder and chairman of Narayana Health — a chain of multi-speciality hospitals and primary care facilities — said recently that the purpose of technology is to make healthcare safer, affordable and accessible for patients. “Entrepreneurs need to develop products beyond the scope of Covid-19, identify large hospital chains for strategic and partnerships, and build products that doctors can advocate,” he added, “hopefully, next time, we will be more prepared.”
Apart from telemedicine and teleconsultation services, healthcare experts said that there is a need for remote monitoring of ICU patients using connected mobile devices, user-friendly electronic medical records, low-cost smart cardiac monitors, AI-powered multi-language communication applications, RFID tags with backed tools to manage the use and distribution of medical equipment and supplies among others. While most Indian cities may have such technology-enabled services, the rural areas are struggling for even basic care. Startups have naturally turned their attention to this section to solve problems.
Solving Access And Fighting Medical Misinformation
Gurugram-based OPD-teleconsultation platform Tattvan said that it has taken a Swastha Samasta programme, to assist and help the private practitioners connect better with their patients. Under this initiative, the company has offered its platform to the doctors to consult their patients from the comfort of their homes, free of cost to the doctors. “It is a step to ensure that while a lot of regular services have come to a standstill, healthcare, as a service remains accessible to the people sitting in any part of the county,” said Mishra.
But beyond this, there is a need to educate patients and consumers in their native language. New Delhi-based myUpchar is working to improve the knowledge quotient of India’s rural consumers through regional language health and medicine content. It also offers free doctor consultation in various languages and prescription service for quick delivery of medicines at the doorstep. Also, the company offers lab test bookings with a facility of home sample collection in some areas.
myUpchar’s founder Rajat Garg said that currently, in India there are several inferior quality clinics and quacks operating in every nook and corner. These healthcare facilities do not have the required provisions or trained staff with knowledge about the disease which the patient has. The mediocre diagnosis which they provide sometimes even put the patient at higher risk of not recovering from their current illness, he added.
The startup claims that it has a structured solution for standardised prescriptions, treatment algorithms and more for greater transparency, accountability and a better health outcome.
For Bengaluru-based Practo, which is one of the earliest healthtech platforms in India, doctor-patient interaction (online or offline) is a core operation. Dr Alexander Kuruvilla, chief health strategy officer at Practo, said that in these times where the use of smartphones, tablets and other internet-connected devices is increasing exponentially, it is only natural to make healthcare accessible at the click of a button. Like edtech removed the learning barriers for children in rural areas, Kuruvilla is hoping healthcare can also be democratised through tech.
Practo said that it has increased its doctor base by close to 50% in the last few weeks so that access to hospitals or doctors and continuity in care is not disrupted. “It not only helps avoid gathering and overcrowding at hospitals but also keeps the medical staff safe if say an infected person shows up unannounced,” added Kuruvilla.
Access To Quality Healthcare Is The Need Of The Hour
India has always been a country with faces, like two sides to a coin, one of an urban India and the other of a rural India. From the quality of life to quality of healthcare everything has a huge gap. It becomes imperative for both public and private players to play an active role in knitting the gap given the current pandemic situation.
“In a time of a public health crisis such as Covid-19, solving the access to healthcare is all we are working towards, so patients can continue consulting their doctors. Most importantly, we will continue to work towards expanding our reach in smaller cities and towns, where quality and access may be a challenge,” concluded Practo’s Kuruvilla.