The doctor-patient ratio in India is 1:1700, as per a World Bank, report 2012.
This is the state of a country with 1.2 Bn population with not enough doctors to serve the masses. However, the practice of telemedicine, online healthcare services on smartphones and through the Internet is looking to change this ratio. Present day health issues relating to lifestyle, and family history (diabetes, high BP etc.) do not require a physical examination and can be diagnosed and treated online.
According to a report by Deloitte Touche Tohmatsu India, the overall Indian healthcare market, which is worth around $100 Bn, is likely grow at a CAGR of 23% to reach $280 Bn by 2020, thanks to smartphone and Internet adoption.
Entrepreneurs and academics, Satish Kannan and Enbasekar D, too sensed an opportunity to work for the underserved segment of India by starting up in the online healthcare space with DocsApp – a startup that commits online specialist consultations within 30 minutes, 24×7, all over India.
“After Enba and I quit our jobs, we spent a lot of time talking to doctors, waiting at hospitals and clinics. That’s where we witnessed the problems that our fellow Indians were facing. Some people travel far and wide, sometimes over 100 kilometres, spend hours standing in serpentine queues, just to show some reports. We wanted to do our bit to help the country that gave us everything and made us who we are,” begins Satish Kannan, CEO and co-founder, DocsApp.
Launched in July 2015, DocsApp is a mobile app that connects patients with doctors through chat or calls on-the-go without any geographical constraints. The startup aims to provide a cost-effective solution for primary healthcare, a second opinion in chronic diseases such as diabetes, cardiac ailments, arthritis, and cancer.
The app offers tech-enabled multi-language service across India with more than 1,200 registered doctors on the platform, offering services like doctors on call, medicine support, and sample collection. The extensive bouquet of features has enabled them to raise funds worth $1.2 Mn from a clutch of investors.
Building The WhatsApp For Healthcare
Satish, an IIT Madras alum, kickstarted his career with Philips Healthcare with R&D on large machines used by cardiologists and ortho specialist doctors for conducting surgeries. Whereas, fellow alum Enbasekar was working with IIT-M research park on a technology used to detect diabetic retinopathy (blindness in diabetics).
The duo worked on multiple tech projects in college and always wanted to do something in the healthcare sector and, finally, quit their jobs in 2015 to start their entrepreneurial journey.
Enba and Satish wanted to build a solution which is as easy to use as WhatsApp. This led to the foundation of DocsApp allowing users to chat or call specialists effortlessly. “I was always amazed with how companies like Facebook and WhatsApp have managed to get people accustomed to their app with next to no effort. Everyone uses WhatsApp, no one taught us how to use the app. Hence, the name DocsApp!,” says Satish.
Bengaluru-based DocsApp began its journey with a six-member team which has now grown to 60 members – from institutions like IIT, BITS, VIT, CMC Vellore etc.
Ask A Question, Make A Payment – Talk To A Specialist
DocsApp works on the same principle as WhatsApp – in that it is a chat/call platform for patients to connect with doctors for diagnoses and second opinions. The key differentiator is that these doctors are all specialists (MBBS and MD) and super-specialists (MBBS, MD, and DM), with their extensive profiles available on site. The specialists consult in over 18 areas such as Paediatrics, Gynaecology, Psychology while super specialists work in Cardiology, Neurology, Oncology.
The platform allows users to sign up, select their health concern, make the payment for the same and get talking with the doctor and all this within 30 minutes of coming online at any point of the day. Using a combination of natural language and machine learning, the backend programme helps doctors by vetting patients through the first round of questions (asking for symptoms, follow up questions to said symptoms, history of family illnesses etc.) before the doctor in question takes over.
This programme saves precious consultation time by classifying the case in the appropriate field of medicine and makes it easier for the specialist to get to the round of investigation regarding the patient’s illness.
As more serious cases such as brain injuries, heart patients, and cancer diagnoses require documentation, DocsApp also provides a file-sharing facility. Through the feature, the patient can upload PDF files of medical histories, scanned copies and hi-res pictures of X-rays, MRI films etc. When asked about the viability of having such valuable and sensitive patient information online, Satish says, “All patient and medical-related data is stored according to global Health IT standards. The set of guidelines that prescribe the correct way to store this data, who can access the data and when as well as how long will the data be stored for. In standard medical ops, it’s seven years.”
DocsApp allows for a free follow-up with the same doctor if further consultation is required for the next three days, as well as enabling the buying of medicines if the consulting specialist uploads an e-prescription for the same.
Decoding DocsApp’s Patient-Doctor Demographic
DocsApp caters to patients all across India – from Tier I, II cities including all state capitals from where 60% of the consultations come from. These patients are either busy with stressful jobs/lifestyles, want privacy to discuss sensitive issues related to Gynaecology, mental health etc. or need an opinion on which surgery is the right option. The other 40% of consultations comes from patients in small, interior villages and towns with not a single doctor in the immediate vicinity.
For the patients in the interiors of India, paying online is a problem – even with facilities like net banking, mobile wallets, credit/debit cards etc.
“It wasn’t possible for us to problem solve the issue of payment for those patients until a patient from Bihar suggested paying via a mobile recharge. The money would get debited from his prepaid account and show up in ours and they could proceed with the consultation.”
As per Satish, this idea was so effective that the mobile number received INR 1 Lakhs-INR 2 Lakhs worth of recharges in a single month. But this transaction was off-the-books so the company tied up with leading telcos such as Airtel, Idea, Vodafone and Tata DoCoMo to allow mobile recharge transactions to DocsApp via a one-time password.
The average ticket size for a DocsApp consultation costs anywhere between INR 150-INR 500 and, as Satish reveals, the platform is facilitating 1,000 consultations a day. Satish reveals that the business has been revenue positive and operates on a revenue-sharing basis with the bulk of the revenues going to the specialists on board.
The first year was spent in acquiring customers, educating them on ease-of-use as well as onboarding doctors. “I personally spoke to and convinced only a few initial doctors of the 1,200 we have today.”
Perhaps, the large number of specialists present on the platform can be attributed to the revenue-sharing model but Satish defends their presence with, “Our specialists do work for the monetary benefit, as no one will consult for free – as they tell me, they would rather go to a village and open a clinic there as pro bono work. It is also about widening their reach to help more and more patients. It’s not very often that a doctor sitting in Mumbai or Pune or Delhi can help a patient in Uttar Pradesh or Tamil Nadu or wherever with a few taps of the keyboard.”
Beating Out The Competition: All Day, All The Time
DocsApp is not the first in its field to attempt connecting remote India with doctors. Startups such as Lybrate, JustDoc, DoctorInsta, Ask Appollo, as well as Practo’s consulting arm exist in the space already. JustDoc, backed by Mohandas Pai, Tracxn Labs and others, is an online video consultation app, that provides the ‘touch-feel’ connect to their users. Lybrate, which has raised $11.4 Mn in funding, is a forerunner in the business – with more than 100K doctors onboard.
“In Lybrate, has a Quora-like model, doesn’t it?” In the case of free public queries, specialists simply answer questions put forward by the users on the platform to be discovered by all. As for JustDoc, the platform is video-only, which in Tier II and backward areas cannot be accessed properly due to surmountable problems in infrastructure and connectivity.
Satish also reveals that DocsApp has always kept the diverse population of India in mind which speaks many different languages and does not always communicate in English. The app is available in 17 different languages. The doctors present are proficient in about eight of these languages. with all doctors, combined, well-versed in 8 of these languages. “This feeling of personalisation, of ensuring the trust and comfort level of our patients was paramount to us.”
With the platform’s availability round the clock and a doctor or two on call available for patients and the TAT – Turnaround Time which, according to Satish, varies between 22-30 minutes – makes DocsApp stand out of the crowd.
The platform also has a unique way of distinguishing cases into ‘Do/Not Do Online’.“After the initial consultation, if the algorithm or the doctor decides that the case cannot be properly treated online, they press the Cannot Do Online button and the money goes back to the patient.”
With smart technology working in the background, doctors onboarding fellow doctors as well as a solid commitment to reaching out to their patients, DocsApp is so far able to hold its own amongst worthier opponents.
The founders claim to have managed to serve 600,000 patients, across India. The duo envisions to take this number to a million in the next one year and to 100 Mn five years down the line – with plans to expand in three countries in Southeast Asia.
“We wish to serve over 10,000 patients, per day, by the end of this year. We are growing steadily, we witness over 30% month-on-month growth rate. As of now, more than 50,000 patients use our app for paid consultations every month,” concludes Satish. While he is reluctant to reveal actual revenues, he does disclose that the company is growing 25% M-o-M in revenue too. With steady growth, the startup certainly looks to be on the right track to catering to the medically underserved of India.
If we look at the Indian healthcare sector, 150,000 specialist doctors serve a population of 1.2 Bn people. 80% of these doctors are located in urban areas, serving only 28% per cent of the Indian populace – as per a report released by KPMG and the Organisation of Pharmaceutical Producers of India (OPPI). This uneven distribution of doctors and the cost of infrastructure to scale up existing healthcare setting pose an extremely big problem in the country.
With affordable digitisation as well as the government’s Digital India initiative (UPI, BHIM) these problems are slowly being mitigated, but it will take years more of concentrated efforts for startups such as DocsApp, JustDoc, Ask Apollo and others to achieve the kind of instant popularity and trust that their global counterparts such as HelloMD, Microsoft HealthVault, DoctorOnDemand have achieved.
DocsApp has got several things right – the NLP and ML-enabled backend programme, doctors with the ability to converse in the patient’s tongue and a refunding facility that is sure to boost the model’s estimation in consumers. But, the vertical itself is fragmented and consultations are a very small part of the medical whole, and their competitors such as Lybrate and JustDoc have extensive funding and a larger platform to their credit. How DocsApp will combat these internal and external challenges will pave the way for the kind of growth they want to sustain over the coming years.
DocsApp is part of Inc42’s 42Fellowship – a year-long fellowship programme for India’s top growing and upcoming startups with the aim to build a close-knit community who can help each other multiply their impact.
[With inputs from Aarti Venkatraman.]