HealthCursor Consulting Group India- Distribution and Marketing- Mobile network operators in Africa have identified the growing demand for financial services and micro insurance . Airtel Africa has partnered with MicroEnsure for Mobile Micro Insurance. The range of Airtel-branded insurance products includes life, accident, health, agriculture, and other forms of cover.
Connecting intermediaries, customers and surveyors- ICICI Lombard India's mobile initiative started simply enough, with a set of basic applications that gave customers a consolidated view of all their policies, a reminder service to renew a policy, and a way to track the status of a claim. But as they matured with the mobile platform, they re-visited the paradigm and devised new ways to provide customers with more value-added and user-friendly features. This is however restricted to Auto insurance only.
Encryption, Transactions and handling customer grievance- Public sector general insurance company United India Insurance launched a mobile-based real-time fund transfer facility for payment of premium. M-Power enables customers to renew their policies and also remit the premium for approved proposals. To use this facility, one has to get an MMID (an identification number called - mobile money identifier) from his/her bank and enable one’s mobile with the application given by the bank. However, there are only 10 banks on board with this platform. This initiative follows the launch of its Internet-based sales, customer grievance portal and information-cum-sales kiosks.
Sales, awareness and providing access- Bima, a young Swedish microinsurance company, is using mobile phones to sell as many as three billion new insurance policies to the global poor. Bima, that has begun to access this untapped market, is now one of the largest mobile insurance platforms in the world. In just three years, Bima has acquired 4 million clients in Africa and Asia and is adding 400,000 new subscribers per month. Bima has been tackling many of the obstacles—education, pricing, premium collection—that prevent poor people from obtaining such benefits. For instance, Bima products such as life, accident and health insurance cost "as little as $0.20 to $6.00 a month. Last month, Leapfrog invested $4.25 million in Bima, which will allow the company to expand even further within Africa and Asia as well as reach into new markets in Latin America.
3. The Indian Healthcare Divide
•
India has 17% of the world's population
• Poorest healthcare infrastructure among growing
economies
• Healthcare accounts for only ~5% of GDP
•
•
•
Healthcare Delivery Market in India ~ US$ 60 billion in 2010
•
•
Significant supply deficit
Healthcare market expected to grow at CAGR of 15%
Indian Healthcare Market Growth
15%
CAGR
Accessible, reliable and affordable healthcare continues to
be a challenge
Growing middle class with rising income levels , health
awareness
Indian Healthcare Capacity Shortfall (in mn)
8
6
3.7
3.6
4
1.9
1.8
1.3
0.9
0.7
1.5
Bed
Doctors
Nurses
Existing
Required (2010)
1.9
2
0
Source: Public Research
3
Required (2020)
Source: Public Sources, Technopak Analysis
4. Health Services Utilization
Ageing Population and Chronic
Care management
No. of Years
Chronic Care
Disease Patients
Social Class
Less than 7
Years
More than 7
years
Total
High
24
12
36
Middle
18
11
29
Low
7
13
20
Very Low
12
12
24
TOTAL
61
48
109
Percentage
(56%)
(44%)
Source: Health services utilisation in urban India: a study By C. A. K. Yesudian
Out of pocket expenditure is more
than 80%
4
Rising demand for medical services
and timely medical intervention
Need for measures to provide health
specialists’ access anytime anywhere
and not only at the point of care
4
5. Supply Problems
Ageing Population and Chronic
Care management
Resource Constraints
•There is 1 doctor per 1000 people in India.
•Most of India’s estimated 1.2 billion people have to pay
for medical treatment out of their own pockets (That is
more than 80% of the total health expenditure as per
2011 stats).
•Less than 15% of the population in India today has any
kind of health-care cover, be it community insurance,
employers’ expenditure, social insurance etc.
•Over 72% (that would be over 620 million) of India’s
population lives in its 638,588 villages.
•It is hard to believe but in India, a common man is most
indebted to healthcare after dowry.
Call a Doctor/ Second Opinion
5
Patient education and Health
Tips
Home health and Remote
monitoring
Tele-Diagnosis and eprescription
5
6. Empowerment
Ageing Population and Chronic
Care management
Resource Constraints
Patient Empowerment
With increasing Internet and mobile
broadband access, available in-depth
information on medical conditions
and their treatment has enhanced
patients’ knowledge, generating an
increasingly consumerist attitude
toward
medicine
and
higher
expectations regarding treatment.
6
6
7. Integrated care
Ageing Population and Chronic
Care management
•
•
Resource Constraints
Patient Empowerment
Integrated Care
In the face of the enormous challenges of managing chronic diseases, delivery innovations appear to have the most impact when
multiple parties (e.g., physicians, nurses, payors) interact seamlessly to provide the best possible patient care over an extended
period of time.
Such integrated models have the potential to reduce costs dramatically, while increasing patient satisfaction and clinical quality.
7
7
8. Health Innovation ecosystem in INDIA
Healthcare
Providers
Government /
Regulators
... are regulated and funded by ...
..several others….
... provide access to ...
.. fund and regulate ...
Implemented remote
monitoring solution
Sharing of medical images
Medical data
management
Digitization of health records
… provide platform to and partner with …
Operators/Distributors
Solution Providers
Remote monitoring solution
8
14. Innovation Strategy
Innovation Strategy- From the Books
Platform
Inclusion
Ecosystem
Drivers
Innovation Strategy- From the Ground
Creation
Protection
Exploitation
Innovation Defined- For a Country like India
Meaningful=
Design Driven
14
Disruptive =
Technology
driven
Incremental=
User Centric =
Market driven
Discourse
18. Innovation brings economic growth
“India is an entrepreneurial country, but its
entrepreneurs have had to struggle to create and
grow their business ventures. There is, however, a
growing
group
of
first-generation
Indian
entrepreneurs – the founders of companies such as
HCL, Cognizant, Infosys, Bharti and others that have
generated large scale employment and significant
wealth. They and others such as IndiaBulls,
Makemytrip and Naukri have also demonstrated
value creation through a public listing. These
successes have encouraged a new breed of
entrepreneurs especially in the internet and ecommerce space.
India has the potential to build about 2,500 highly
scalable businesses in the next 10 years – and given
the probability of entrepreneurial success that means
10,000 start-ups will need to be spawned to get to
2,500 large-scale businesses. These businesses
could generate revenues of Rs10 lakh crore ($200
billion)”
Moreover, entrepreneurship tends to be innovation-driven and will also help generate solutions to India’s myriad social
problems including high-quality education, affordable health care, clean energy and waste
management, and financial inclusion.
Entrepreneurship-led economic growth is also more inclusive and typically does not involve exploitation of natural resources.
18
20. Application of usable innovation
Health Awareness and Education- Existing health content could be aggregated, filtered and
indexed, under the guidance of global domain experts and made available on IVR, mobile devices
and tablets like “Aakash”.
Said innovation will help achieve &:
1. Assist India with meeting the MDGs by providing support to the social sectors; WHO says that
India will fail to achieve some of the most important Millennium Development Goal (MDG)
targets like reduction in maternal and child deaths, and increase in child immunization rates by
2015.
2. Solve the economic implications related to the burden of NCDs in the country- In 2004, 4.8
million (59.4 percent) of the estimated 8.1 million Indian deaths were due to NCDs. A 2011
study shows that about 25% of families with a member with CVD and 50% with cancer
experience catastrophic expenditure and 10% and 25%, respectively, are driven to poverty.
3. Help ASHA/ Aanganbadi workers stay connected to useful resources at the time of need.- The
information challenges facing health workers include lack of routine systems for seeking and
sharing information, lack of high-quality and current health information, and lack of locally
relevant materials and tools. Without such basic information, the provision of quality services
by health workers, the effective management of programs, and the use of evidence to
formulate health policy all suffer. This information deficit contributes to poor health outcomes,
including increased morbidity and mortality.
20
21. Case Study- INDIA
Case Study 1: Health Awareness and Education- Existing health content could be aggregated, filtered and indexed, under the guidance of global
domain experts and made available on IVR, mobile devices and tablets like “Aakash”
Mediphone
1
4
Regulators
2
Solution Provider
Process
5
Mobile
IVR
System
Decision support
Tele-Triage
system
Healthcare
Providers
6
3
Patient Profile
Technology
Providers
7
Airtel
Subscribers
8
Success Factors
21
Medical
Organizations
Patients
• Call helpline
•Ask questions on
health-related
problems
•Describe an ailment
Community workers
•Visit families
periodically
•Are on call for serious
ailments
•Connect villagers with
call center
•Promote awareness
•Educate
•Deliver medications
Call center agents
Receive incoming
calls and
triage to
– Physicians
– Nurses
– Educators
– Field workers
Place outgoing calls
to
– Follow up on
patients
– Monitor
community worker
performance
Physicians
in
call
centers
•Speak with patients
•Conduct interviews;
use images and videos
if required
•Make a diagnosis
•Recommend
treatment including
medications,
educational advice
•Refer to agent to
coordinate medication
delivery and follow-up
Mediphone has the capability to scale up on several platforms and can work seamlessly on Landline, Mobile and Internet.
The service can be provided in regional languages as well.
Mediphone can also be supplemented with a health classifieds service that will further enhance the call flow.
Mediphone will also act as a platform to browse and buy Health related packages from several providers.
Currently Mediphone is handling more than 1500 calls per day and will soon start Hospitals referrals, Appointment
scheduling and emergency management 24X7.
22. Application of usable Innovation
Crowd-sourcing Healthcare- provide an opportunity for scientists, doctors, technocrats, students
and others with diverse expertise to work for a common cause.
Said innovation will help achieve &:
1. Drug Discovery- Crowd-sourcing will help assist India with controlling morbidity of Tropical
diseases by providing a global platform where the best minds can collaborate & collectively
endeavour to solve the complex problems associated with discovering novel therapies for
neglected tropical diseases like Malaria, Tuberculosis, Leshmaniasis, etc. Drug discovery can be
made successful by pulling together informaticians, wet lab scientists, contract research
organizations, clinicians, hospitals and others who are willing to adhere to the affordable
healthcare philosophy.
2. Best Practices- Sharing best practices in solving some of the most complex issues around NCDs
and related complications in the country. Take an example of Multiple sclerosis- It is very
difficult to prognosticate effectively for MS patients. Some individuals have a very benign
course and/or respond well to treatment, whereas others become rapidly disabled within
several years of diagnosis. Sharing of best practices related to treatment, prognosis and follow
up can hence lead to success.
3. Clinical Trials- Governments and public funded institutions in the countries with high burden of
disease has a responsibility to contribute to the drug development. The cost of trials can
therefore be brought down considerably on a platform which is crowd-sourced and open.
22
23. Case Study- Hungary
Case Study 2: The Webicina- "Webicina," a site where medicine combines with social media to allow physicians within the country as well as
across the world to communicate their findings easily, quickly and effectively.
Webicina
1
4
Social Media
2
Components
5
System
Integrated
PlatformMobile App/
Web 2.0
Personalized
Search
Drug Discovery
Second Opinion
Healthcare
Providers
6
3
Patient Profile
Medical
Resources
Medical
Organizations
7
8
Empowered
Patients and
providers
Webicina has the capability to scale up on several platforms and can work seamlessly on KPO/IVR, Landline, Mobile and
Internet. The service can be provided in regional languages as well.
Success Factors
23
24. Major Players
Players
Definition
Regulators
Medical regulatory authorities such as FDA,
HIPAA etc
Healthcare
Providers
Individuals or institution s providing health care
services
Fitness
Providers
General fitness providers and diet clinics
Application
Developers
Data Management
Independent medical / mobile Software
developers
Medical information providers
Health Device
Manufactures
Manufacturers of sensors that interface with
application on mobile phones
Medical
Organizations
Medical education & research institutions,
publishers, pharmaceutical companies and
pharmacies
Network
Providers
Mobile
Manufacturers
24
Wireless data network providers
Smartphone and feature phone manufacturers
Examples
28. Digital Health Efforts- Collaboration areas
Health Information systemsCHIS- India will also put in place a Citizen Health Information System (CHIS) - a biometric based health
information system which will constantly update health record of every citizen-family. The system will
incorporate registration of births, deaths and cause of death.
Surveillance- Maternal and infant death reviews, nutrition surveillance, particularly among under-six
children and women, service delivery in the public health system, hospital information service besides
improving access of public to their own health information and medical records would be the primary
function of this effort. Placed on a GIS platform, it can identify geographic concentration of disease.
Medical Records- The system will also provide hospital information service to improve the quality of
care to patients through electronic medical records, to lower response time in emergency and improve
hospital administration. It will support emergency response systems and referral transport
arrangements, the organ retrieval and transplantation programme.
Resource Mobilisation- The system will also support financial management -- from resource allocation,
resource transfers, accounting and utilization to financial services like making of payments to facilities,
providers and beneficiaries. It will provide a platform for continuing medical education and support
regulatory functions of the state by creating a nation-wide registration of clinical establishments,
manufacturing units, drug testing laboratories, licensing of drugs, approval of clinical trials
28
29. Approach and Innovation
The major part of public investment in information technology in health care
would go to institutional capacity building for understanding and use of
information.
Incurring large expenditures on hardware and software without making a
matching input in capacity development and institutionalization can be an error.
Every state should have the skilled human resources needed at state and district
level. This would require a mix of those with IT skills and public health informatics
skills.
State centres for health information, either standalone, or embedded in existing
institutions would be essential and district teams of three to five persons for
managing information flows and interpreting information would also be essential.
29
30. Lessons learned
•The future of Healthcare innovation requires accessing and managing distributed
networks of knowledge providers.
•Health/Biomedical research infrastructures need to be accessible, high quality and
sustainably financed.
•The intellectual property landscape should evolve to better leverage strategic intangible
assets.
•New research and business models are needed to meet economic and public health
objectives.
•Intellectual Asset Valuation could facilitate trade in the under –exploited knowledge assets
of the Healthcare/Biomedical sector.
•Regulatory evolution, in consultation with industry, is critical to ensure the development
and diffusion of breakthrough biomedical technologies and the innovative use of existing
technologies.
•End users of new biomedical technologies have an increasingly strong impact on
innovators and public policy.
30
31. Challenges
Development
Delivery
Uptake
31
There remain a number of outstanding questions
with reference to the development, delivery, and
uptake of health innovations where further
research might be pursued in order to help
inform policymaking.
The thematic areas for possible future work
include:
1. Progress in governance and the regulatory
system.
2. Open innovation models in health.
3. Commercialisation of innovation derived
from research and health infrastructures.
4. Financing models for health innovation.
5. Intellectual asset management.
6. Patient needs and demands.
7. Metrics and indicators of health innovation.
8. Policy challenges of disruptive technologies.