Communication tech and health make for heady mix

Written by Soma Das | New Delhi | Updated: Apr 7 2012, 09:11am hrs
Two broad factors the acute dearth of medical facilities in remote rural areas and the growing penetration of mobile and internet in urban areas could permanently transform the way healthcare is consumed in this country.

The hunt for the 'right models' is still on. An ECG application, which enables doctors to receive real-time heart data of patients on their BlackBerries, a R35 consultation with doctors in the middle of the night over mobile phone and kiosks in villages with BP machines, stethoscope, ECG machine are quietly but indelibly changing the healthcare landscape in the country.

"Delivery of healthcare services through communication technology is an area that can be described today as 'promising' but not yet 'perfected' from a business angle," says Ashok Jhunjhunwala, professor, IIT Madras, extensively associated with such pilot projects. Most entrepreneurs and companies who have taken a plunge in this evolving interface of health and communication technology report more learnings than earnings, but are optimistic about the future.

When Religare Technologies teamed up with Airtel and Fortis healthcare to launch 'Mediphone' a year ago, a 24x7 medical assistance service on mobile for R10 per consultation, they expected it be an instant hit in the rural areas. Instead, the project gained traction in cities and they attend to over 1,200 calls daily, even though the price per consultation has been raised to R35.

"We are looking at recreating the entire general physician experience, minus the physical touch and feel. And more than 20% of the calls that we get are repeat callers. The second differentiator is that unlike many other players who are charging per minute, we have emulated the per visit model," said Pankaj Vaish, president, Religare Technologies. Any of Airtel's 180 million subscribers can call in and one of the firm's 'health officers' would process information, refer it to a team of doctors in a backoffice at Noida, who either generate a prescription or talk to the patient. If it is an emergency, the health officers coordinate with an ambulance. The service has been rolled out in 11 states and the firm plans to expand into the remaining states and multiple languages.

An internal research by an E&Y team zeroed down on many such projects, which are shifting the point of delivery closer to patient. For instance, eUNO R10, a portable ECG device launched by Maestro Medline Systems sends heart rate information of the patient to a medical record server, from which doctors can access it on their BlackBerry handsets.

This was first tested at Mumbai's Nanavati Hospital on Vodafone network. A similar mobile healthcare pilot was launched by Mazumdar Shaw cancer centre in partnership with Devi Shetty's Narayana Hrudayala and SANAa research group at Harvard Business School and MIT. They used trained nurses and physicians to screen people for oral cancer using high resolution lesion pictures and automated questionnaires in Karnataka. The data collected on phones was uploaded on Narayana Hrudayalaya's electronic medical records so that specialists can send feedback and recommend line of treatment.

Another start-up hired 20 specialists to float mDhil, which offers basic healthcare advice to people via text messaging, mobile web browser on common health conditions and medications. The service boasts of 150,000 paid users on SMS subscription services within months of starting.

"With over100 million internet subscribers and 850-plus mobile users, India is still being hailed as one of the fastest-growing 'internet nations' and telecom market. Add to that India's smartphone market, which is set to cross 80 million in next three years, life sciences companies would have to invest in new business models to encash on technology revolution," said Hitesh Sharma, partner, E&Y.

In rural India, the opportunity stems from acute paucity of medical personnel and facilities. While 70% of the country's population lives in rural areas, 80% of medical work force serves just 20% of Indians living in cities necessitating technology to intervene in unserved areas and unaddressed population. Most experimental ventures that dot the backwoods, however, are either not-for profit or are government-aided projects. For instance, MP government partnered with Cisco four months back to connect remote clinics to district hospitals so that the patients can communicate with specialists through video links.

A nurse at the clinic checks their vital signs while a distant doctor at the hospital consults and makes a real-time diagnosis. The pilot involves 11 primary and community health centres. Apollo Telemedicine Networking Foundation, a not-for-profit initiative from Apollo hospitals has 150 telemedicine centres. It uses application Medintegra to convert patients data into confidential electronic medical record and transfer it to telemedicine specialty centre, which then is studied by specialists, whose advice is sent back to doctors at patients physical location to act upon.

Jhunjhunwala says although the failure rate of enterprises in the area is very high, atleast 10 models worth scaling up would emerge in next couple of years. The locally half-successful models are being celebrated. But one must study the failures well to reach the right formula, he said.