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An innovative solution for
Affordable & Quality Health & Wellness
                Neeraj Mahajan 2009
                                         1
A new health management tool that is:
     Custom made

     Efficient

     Personal

     Password-secure

     Innovative

     Priced transparently

     Flexible

     Improves Quality

     Reduces the cost of service.

     Improves patient access


    On-demand, need-specific Healthcare at the Doorstep of the Consumers
                                     Neeraj Mahajan 2009
                                                                           2
 Transforming Healthcare
 Prevent and manage chronic diseases
 Help control the rise in health care costs
 Try and bridge the gap between the Have‟s and the Have-not's
 Expand healthcare coverage for the long-term uninsured
 Restructure the way in which doctors and hospitals are paid




                 More Smiles Per Mile– Across the World

                             Neeraj Mahajan 2009
                                                                 3
   High-quality healthcare services

   Available and Affordable

   Choice of Premium, Optimum & Budget category facilities & specialists

    On demand Health, Wellness & Medicare at reasonable costs

   Virtual Hospital - 24x7 worldwide



    Smart America = (Healthy + Prosperous America ) x Wellness worldwide

                                Neeraj Mahajan 2009
                                                                            4
Hospital
                                                                     Patient
                                                                     Care
    Physician
                                                                     Family

Pre/ Post Op Care                                                    Support
                                                                     Groups
                                                                     Social
 Physiotherapy
                                                                     Community

   Counseling


   Meditation
                                            Step by Step Process

         Health & Wellness does not begin and end with the patient
                               Neeraj Mahajan 2009
                                                                               5
   Access to care

   Quality of care

   Cost of care

   Technology adoption

   Burden on providers

   Shortage of providers

   Margins for providers declining

   Policy Concerns


                            Neeraj Mahajan 2009
                                                  6
   Who wins if America looses ?

   Who gains from the inherent inefficiencies of the US healthcare
    system?

   Can there be more accessible and affordable healthcare options for
    US citizens?




                               Neeraj Mahajan 2009
                                                                         7
80:20 Formula
Solution: Inside-Out



           Neeraj Mahajan 2009
                                 8
   80%         goal - Healthcare at the doorstep of the consumer –
    Streamline operations at a wide network of state of the art medical
    facilities so that patients does not have to travel overseas and finds it
    prudent to receive superior treatments at comparable costs, that too
    within walking distance from their homes.


   20%       goal – Assurance of Streamlined, Safe and Supervised
    treatment at pre-selected overseas facilities in cases where the
    same procedure cannot either be done at a lesser cost or requires
    immediate,     unavoidable     treatment,  economically  unviable
    investment, staffing or maintainance


                                 Neeraj Mahajan 2009
                                                                                9
 Centralized planning for 300 million Americans is unrealistic
           Doesn‟t work anywhere else in the economy
           Goes against the American grain

 By developing a market driven and government endorsed strategy to
  streamline health care costs, US citizens can significantly reduce their health
  insurance expenditures and lower overall costs to the health care system.

 The savings can spur the growth and development of a healthy &
  economically wealthy America

 The spin-offs can benefit many friendly nations and add to their economic
  development -- leading to generation of employment and opportunities within
  their own boundaries

 In the long run this can result in reduction of immigrants to t he US

                                  Neeraj Mahajan 2009
                                                                                    10
   Even if a small percentage of the amount spent on traveling abroad
    for medical treatment could be saved and reinvested into the US
    facilities, the long term benefits could be much more than the
    immediate gains

   Investment in hospitals, research and medical education, can spur
    sustainable economic development and employment opportunities in
    US with enough spin-off for the rest of the world.

   Only strong healthy and economically strong America can be the
    true Super power that can not only transforms itself but the rest of
    the world as well



                               Neeraj Mahajan 2009
                                                                           11
Strategic Win-Win America Project (SWAP)
     for Smart Health & Prosperous Economy (SHAPE)

                  Solution: Inside-Out




                     Neeraj Mahajan 2009
                                                     12
Advantage
                         Humanity




             Advantage
               India


                                  Advantage
                                   America




Strategic Win-Win America Project (SWAP)
   for Smart Health & Prosperous Economy (SHAPE)
                 Solution: Inside-Out
                 Neeraj Mahajan 2009
                                                   13
 Advantage America – Health & Wellness 3600 Plan
      Healthy Healthcare Industry, Satisfied Doctors & other professionals, Satisfied patients



 Advantage India – Health & Wellness 3600 Plan
      Healthy Healthcare Industry, Satisfied Doctors & other professionals, Satisfied patients



 Advantage Humanity
      Sharing of knowledge, expertise and infrastructure

      Recession proof growth of Health, Medicare & Wellness industry worldwide

      One Big Virtual Hospital- anyone, anywhere in the world can consult a doctor across
       another continent without stepping out of their homes

      Better Patient Awareness though specially designed Audio-video, print material and web
       content. Cost effective option to seek expert advise through live web chat and email
       queries

      Better and More Informed Choices- Libraries, reading rooms and counseling by qualified
       Doctors whose job is just to explain the how‟s, whys and other complicated medical
       terminology to the patients
                           Neeraj Mahajan 2009
                                                                                                  14
1. Advantage America – Health & Wellness 3600 Plan Healthy Healthcare Industry,
    Satisfied Doctors & other professionals, Satisfied patients

        Centres of Excellence impart quality Medicare
        Horizontal Integration- One Country, one rate for the same medical treatment or services


                                                         – also from other states, even those uninsured
                                         on unfavorable terms of Insurance Companies


                                       & choice A, B or C category Doctors -- almost at the patient‟s
             doorsteps

                                 – recommended Quality Medicare & Wellness Centres to chose from

                                                                          under Premium, Moderate
             and budget panel based on the fee, professional experience and minimum infrastructure &
             services in each category

                           – as different centres and doctors with similar experience & facilities within
             the same country charge the same fee
                                                 Neeraj Mahajan 2009
                                                                                                            15
Case Study # 1: Doctor is unavailable – A 100% insured person needs immediate medical
attention for a sudden and excruciating pain at midnight but the regular doctor is asleep or on a
vacation
SWAP ADVANTAGE – It may be midnight in USA but day time in India when almost all the
doctors are working and can be available - they can at least advise you if it‟s a false alarm or a
real need to rush to a hospital. In case of a real emergency – a standby evacuation /
ambulance team is rushed and responds to the call
Case Study # 2: Experienced Doctors are available but too expensive to afford – An usual
dilemma for many people in USA
SWAP ADVANTAGE – Reach to some other comparable quality and affordable facility or
Doctor in the same city, across USA or India and get the right treatment at the right time !!
Case Study # 3: Patient is insured but the disease isn‟t – A 100% insured person in USA needs
treatment which requires out-of-pocket expenses or is not 100% covered in his health
insurance policy
SWAP ADVANTAGE – Assured and affordable facilities and Doctors in the same city, across
USA or India.

Universal access to 24 x 7 x 365- on demand healthcare at the doorstep of the
consumer. Doctor on call – anywhere, anytime from across the universe.
                                         Neeraj Mahajan 2009
                                                                                                     16
Case Study # 4: Both the Patient and the disease are inadequately covered by Insurance
SWAP ADVANTAGE – Choice of opt-in Premium, Moderate and budget category facilities and
doctors. Right and appropriate value for money !!
Case Study # 5: Patient goes abroad for medical treatment but still needs care, support and
counseling in the pre and post operative phase
SWAP ADVANTAGE– Assurance of single window for pre and post-operative care, Safety &
coordinated travel arrangements & monitored treatment even at the overseas facilities
Case Study # 6: Patient is willing to go abroad for treatment but needs a doctors
recommendation and advise as to which hospital or doctor to visit
SWAP makes it possible
Case Study # 7: Patient is willing to go abroad for treatment but wants the trusted family doctor
to monitor his progress
SWAP makes it possible
Case Study # 8: Patient, on his own, is unable to differentiate between a real emergency or
false alarm as well as short term v/s long term disease management options
SWAP can open a plethora of possibilities.

Universal access to 24 x 7 x 365- on demand healthcare at the doorstep of the
consumer. Doctor on call – anywhere, anytime from across the universe.
                                  Neeraj Mahajan 2009
                                                                                                    17
2. Advantage India – Health & Wellness 3600 Plan Healthy Healthcare Industry,
  Satisfied Doctors & other professionals, Satisfied patients

     Centres of Excellence impart quality Medicare

     Horizontal Integration-                One Country, one rate for the same medical treatment or services



                                                     – also from other states, even those uninsured

                                      on unfavorable terms of Insurance Companies



                                    & choice A, B or C category Doctors -- almost at the patient‟s doorsteps

                              – recommended Quality Medicare & Wellness Centres to chose from

                                                                         under Premium, Moderate and budget panel
              based on the fee, professional experience and minimum infrastructure & services in each category

                              – as different centres and doctors with similar experience & facilities within the same
              country charge the same fee

                                                  Neeraj Mahajan 2009
                                                                                                                        18
Case Study # 1: Doctor is unavailable – A person needs immediate medical attention for a
sudden and excruciating pain at midnight but the regular doctor is asleep or on a vacation
SWAP ADVANTAGE – It may be midnight in India but day time in USA when almost all the
doctors are working and can be available - they can at least advise you if it‟s a false alarm or a
real need to rush to a hospital. In case of a real emergency – a standby evacuation /
ambulance team is rushed and responds to the call
Case Study # 2: Experienced Doctors are available but too expensive to afford – An usual
dilemma for many people in India
SWAP ADVANTAGE – Reach to some other comparable quality and affordable facility or
Doctor in the same city, across India or USA and get the right treatment at the right time !!
Case Study # 3: Patient is insured but the disease isn‟t – A 100% insured person in India
needs treatment which requires out-of-pocket expenses or is not 100% covered in his health
insurance policy
SWAP ADVANTAGE – Assured and affordable facilities and Doctors in the same city, across
India or USA.


Universal access to 24 x 7 x 365- on demand healthcare at the doorstep of the
consumer. Doctor on call – anywhere, anytime from across the universe.
                                         Neeraj Mahajan 2009
                                                                                                     19
Case Study # 4: Both the Patient and the disease are inadequately covered by Insurance
SWAP ADVANTAGE – Choice of opt-in Premium, Moderate and budget category facilities and
doctors. Right and appropriate value for money !!
Case Study # 5: Patient goes abroad for medical treatment but still needs care, support and
counseling in the pre and post operative phase
SWAP ADVANTAGE– Assurance of single window for pre and post-operative care, Safety &
coordinated travel arrangements & monitored treatment even at the overseas facilities
Case Study # 6: Patient is willing to go abroad for treatment but needs a doctors
recommendation and advise as to which hospital or doctor to visit
SWAP makes it possible
Case Study # 7: Patient is willing to go abroad for treatment but wants the trusted family doctor
to monitor his progress
SWAP makes it possible
Case Study # 8: Patient, on his own, is unable to differentiate between a real emergency or
false alarm as well as short term v/s long term disease management options
SWAP can open a plethora of possibilities.

Universal access to 24 x 7 x 365- on demand healthcare at the doorstep of the
consumer. Doctor on call – anywhere, anytime from across the universe.
                                  Neeraj Mahajan 2009
                                                                                                    20
3. Advantage Humanity –         The world as one big                          where anyone can consult an expert doctor
 anywhere in USA or India and get their advise, even without stepping out of their homes-- just by paying a fee online.

  Lesser need for travel to unfamiliar places away from ones own country for medical treatment

  Monitored & less risky emergency medical travel even outside ones country where it cannot be
    avoided

  Structured pre-and long term, post emergency care – within the country of regular stay

  Pre approved, Doctor– recommended Quality Medicare & Wellness Centres to chose from

  Less waiting – as different centres with similar facilities and experienced doctors nearby the
    patients home town charge the same fee

  Better patient advocacy through specially designed literature – printed brochures, audio-video and
    web content

  Live counseling by qualified doctors and health motivation staff who explain the How‟s, Why‟s as
    well as complicated medical terms in layman terms– which normally remained unexplained as
    Doctors have to attend to other patients as well, and in the process help them take right decisions.

                                                 Neeraj Mahajan 2009
                                                                                                                          21
   One country one price for the same or similar procedure and consultation
   Standardized care- pre-op screening in one country to be acceptable in the
    receiving facility in another country as well.
   Owned Centres, channel partners & Virtual Hospital– experts for tele-
    diagnosis, tele-consultation, second opinion, referral and tele-nursing care.
   Assurance of Post-op follow up, long-term rehab and disease management.
   No waiting -- the Patient can but disease, pain and suffering doesn‟t wait…
   Minimum need for cross country travel--travel only if you must for
    emergency treatment but get pre and post op care in the home country
   Real time Monitoring -- the doctor whom you trust is in the loop at every
    stage and can see your blood sugar level, weight or BP and well as
    prescription and treatment course of action at his own computer work station
    in the home country, and thus give his own suggestions, if need be, even
    during the duration of emergency translocation
                                   Neeraj Mahajan 2009
                                                                                    22
Multiple choices, can even work like a parallel or                                       –
The consumer is the king with options to choose from either of the following options:
   One time Joining, nominal annual fee and rest as per actual expenses, as and when
    needed– Patients enroll just for maintainace of medical records and later make
    payment for services and facilities as and when used
   Alternate Insurance model- Patients join the program with a commitment to pay a
    minimum amount – irrespective of whether the services are consumed or not. May get
    rollover benefit to accumulate certain points and use later at approved facilities
   Healthcare deals and discounts – Patients who are not adequately insured, those who
    do not wish to pay premium for diseases they may not even enquire or those with pre-
    existing diseases like heart stroke or diabetes who may end up paying heavy premium
    in any other insurance scheme can opt for this. All they have to do at the beginning is
    to agree to consume a certain minimum hours of treatment for a specific disease
    during the year. This makes them eligible for a package or discount. As members of
    this program, they may also avail treatment of other diseases at the pre approved
    facilities in USA and India – at normal rates – on use
   No strings attached- Just enroll and pay on use basis
                                       Neeraj Mahajan 2009
                                                                                              23
   Network of own Centres, Channel Partners and tie-up facilities across USA & India
   Assurance of quality and reliability – Each centre follows a standard operating
    procedure and is certified by a medical board on the basis of experience, facilities
    offered, infrastructure, technological expertise, patient feedback and success rate
   Information at the fingertip, doorstep and desktop of the consumer- Before even
    stepping out of the home a patient can check the past experience of other patients,
    community opinion as well as medical rating of a healthcare facility or doctor
   Common pricing - Next to quality, price is a common concern for the patients. This is
    resolved as all facilities enrolled in the program are graded under Premium, Moderate
    and Budget category. All facilities in the same city or country essentially charge a pre-
    determined fixed charge. For instance doctors with 25 years or more professional
    standing charge the same price – if their equipments and facilities are comparable.
    Likewise all doctors with similar infrastructure with 15-25 years fall in B- category
    while those with less than 15 years practice fall into the budget category. The price list
    for each individual category is fixed
   Zero waiting- Since the quality and price across the board in a particular category is
    fixed, a patient can or may visit some other doctor with similar skills and charges
                                        Neeraj Mahajan 2009
                                                                                                 24
   Economically viable and affordable treatment – For all, including those who are
    uninsured or economically not so well off
   No Headache- Single window services for medically supervised and monitored travel
    for emergency treatment- Same agency books premium, moderate and budget
    category hospitals and Doctors, provides trained nurses for the journey as well as
    booking airlines, hotels, travel insurance, currency exchange, money transfer and
    helps in processing of insurance claims, if need be.
   One point –management & up gradation of patient history and prescription data-
    standard, user friendly format incorporating all the required information in a single
    source makes it easier for doctors and convenient for the patients
   Centralized billing and payment of taxes- avoids duplicate efforts and tax on taxes
    already paid.

   Mobile ICU- Specially equipped helicopters, air & ground ambulance services in USA
    & India for emergency evacuation of critical patients.

   Similar Diagnostic standards and bench-marks for every report within a city, country
    or across the continent – for world wide acceptance and reliability.
                                      Neeraj Mahajan 2009
                                                                                            25
   Virtual Hospitals – Universal access to 24 x 7 x 365- on demand healthcare at the
    doorstep of the consumer. Doctor on call – anywhere, anytime from across the
    universe.

   Matrix of High-tech Diagnostic Base Camps in major cities across USA & India, each
    with a network of as many as possible collection centers and report pick-up points,
    ideally within 2-5 km radius of patients homes.
   Global centres of learning:

      Global Lifestyle Modification Academy- specific training to individuals already suffering from a
       disease to manage their life and remain healthy, the rest of their lives.

      Corporate Employee Training seminars and short term workshops– specially designed short
       term courses for corporate entities and professional bodies

      Modules for training the Insured Persons– Insurance companies can save money by training
       the insured persons – on how to live healthy and beat stress & tension.

   Corporate Social Responsibility Programs- Responsible corporate citizens can reap
    indirect benefits of good health by contributing towards their social responsibilities
                                            Neeraj Mahajan 2009
                                                                                                          26
   Uniform & affordable Healthcare services and choice of provider nearer to home
   Single window services for medically supervised and monitored travel for emergency
    treatment- Same agency quotes and takes orders for booking premium, moderate
    and budget category hospitals as well as fixes appointment with the best Doctors in
    the affordability range (from a Medical Board recommended pre-approved panel of
    hospitals and specialists– rated on the basis of qualifications, proficiency and
    facilities), provides trained nursing escorts as well as does the bookings for airlines,
    hotels, travel insurance, currency exchange and money transfer . And helps in
    processing of insurance claims on behalf of the patient, if need be.
   One point – universal management & regular up gradation of patient history and
    prescription data- standard, user friendly format incorporating all the required
    information in a single source makes it easier for doctors and convenient for the
    patients
   Centralized billing and payment of taxes- to avoid duplicate efforts and tax on taxes
    already paid.
   Economic model to make treatment affordable for even the uninsured and
    economically not so well off
                                       Neeraj Mahajan 2009
                                                                                               27
   Mobile ICU- Specially equipped helicopters, air & ground ambulance services in USA
    & India for emergency evacuation of critical patients. Imagine a person “Alpha” on the
    way to attend a business meeting or holiday in a third world country when the medical
    emergency strikes… This place does not seem to have appropriate medical facilities
    and his family is insisting him to USA or nearby big hospital which has the latest
    medical facilities with modern diagnostics to evaluate and stabilize the patient‟s
    condition. This is where ground & air ambulance or helicopters and specially fitted
    jets can play a life saving role.
   Standardized Diagnostics & reporting– similar Diagnostic standards and bench-marks
    with common minimum factors in every report within a city, country or across the
    continent – for world wide acceptance and reliability.
   Economically viable and cost effective matrix of High-tech Diagnostics– Matrix of
    High-tech Diagnostic Base Camps in major cities across USA & India, each with a
    network of as many as possible collection centers and report pick-up points, ideally
    within 2-5 km radius of patients homes.
   Online Medical Library, Reading Space & real world Information Kiosks
   Online & Real world Patient Support Groups & Community Participation programs
   School and Community Awareness programs
                                      Neeraj Mahajan 2009
                                                                                             28
   Global Lifestyle Modification Academy- imparts specific and relevant training to
    individuals already suffering from a disease to manage their life and remain healthy
    for the rest of their lives. Different modules and course content can be specially tailor-
    made for groups of patients suffering from specific diseases. These courses can he
    held both in real and virtual world. Lectures, demonstrations, webinars, participatory
    group discussions and exposure to new ideas from the domain of
    yoga, pranayam, art of living, reiki and meditation techniques besides lessons in
    breathing, body toning and conditioning – can help to rejuvenate as well as motivate
    the people who attend.
   Corporate Training seminars and short term workshops– specially designed short
    term courses for corporate entities and professional bodies which teach people who
    attend how to de-stress and simultaneously manage their disease and work efficiently.
   Modules for training of the Insured Persons– This will help insurance companies save
    a lot of money by reducing the stress, BP, Blood Sugar as well as chances of Heart-
    stroke, paralysis or other lifestyle diseases.
   Corporate Social Responsibility Programs- Rich and influential classes pay for the
    underprivileged masses and indirectly benefit from lesser disease and infections
                  All these will help people who live longer, live better
                                        Neeraj Mahajan 2009
                                                                                                 29
    The world that we live in today is a flat world now where even disease is a country or
     person‟s personal problem
    No country or people have the ultimate answer to all medical and health problems
    Good Doctors are available to cure disease – its just that a patient needs to reach out
     to them at the right time and in the right manner
    Access to high quality care – without any delay at the hour of need can make a big
     difference between life and death
    Technology and mediums of communication has made it possible for the patient as
     well as the doctor to reach out to each other and defeat both, the disease and
     imminent death.


    Virtual Hospital- A level playing field which bridges the gap between need and
    availability in the virtual domain where even the have-nots and deprived
    people can avail the cheapest and best services or facilities sitting at home -
    from across the seven seas
                                        Neeraj Mahajan 2009
                                                                                               30
First Point of Contact
             Trouble Shooting Teams:
            A nurse or junior Doctor with a laptop
                                                          Emergency on the spot
             and GPRS enabled mobile phone -                 follow up Team
          just to record the physical symptoms like
         BP, weight, blood Sugar etc at the behest
                     of the remote expert
                                             Control Room
                          O. P. Gupta Memorial Virtual Hospital
                                            Doctors on Duty
                                            Doctors on Call



            Emergency evacuation &                       24 x 7 Surgical / OT and
            Stabilization teams, Mobile                  Diagnostic Lab back-up
            ICU & Ambulance Service                      at a nearby Tie up facility



For those times when – it‟s a few minutes race between life and death and the
winner takes it all
                                            Neeraj Mahajan 2009
                                                                                       31
First Point of Contact
              Trouble Shooting Teams:
             A nurse or junior Doctor with a laptop
                                                           Emergency on the spot
              and GPRS enabled mobile phone -                 follow up Team
           just to record the physical symptoms like
          BP, weight, blood Sugar etc at the behest
                      of the remote expert
                                              Control Room
E-Mail for Help            O. P. Gupta Memorial Virtual Hospital                   Dial-in for Help
                                             Doctors on Duty
                                             Doctors on Call



              Emergency evacuation &                      24 x 7 Surgical / OT and
             Stabilization teams, Mobile                  Diagnostic Lab back-up
             ICU & Ambulance Services                     at a nearby Tie up facility




     Timely, Quality and Affordable medical services at the point of Need.
                                             Neeraj Mahajan 2009
                                                                                                      32
Second Life & Teen Second Life :       Benefits to the Doctors:

                                            Doctor‟s Consultation Chambers in the
                                             virtual world.

                                            A place were Doctors meet other
                                             Doctors,   attend Web      Seminars,
                                             Conferences     and    watch   video
                                             demonstrations of new products

                                            They get points for each log-in, give
                                             consultation and advise to patients.
                                             These points can be later redeemed for
                                             gifts and family holiday Packages


    Timely, Quality and Affordable medical services at the point of Need.
                                   Neeraj Mahajan 2009
                                                                                      33
Case Study # 1: An uninsured or underinsured patient in New York, USA needs emergency medical
consultation but can only afford to pay US$ 20
   Option 1: Visits a specialist in New York whom he cannot afford

   Option 2: Visits a relatively inexperienced GP in a far off state who charges less than $ 20
   Alternative 3: Dials/ logs-into Virtual Hospital- pays US $ 20 and receives consultation from a
    highly experienced doctor in Delhi or Mumbai while sitting on own bed in New York, without even
    having to travel down town in a local bus.

      A fee is quoted for online consultation with the expert doctor and the payment is processed electronically at
        the beginning of the session.
      The Doctor does not mind receiving US $ 20 as after dollar to rupee conversion – the price works out to Rs
        1000 which is approximately close to his regular charges
      The patient too is happy because he is receiving the best possible treatment by a top end doctor.
      The session begins on realization of the payment
      An intern doctor or trained nurse without much experience in clinical practice physically examines the patient
        and records the weight, BP, Pulse and other physical symptoms on a laptop connected to a web server
      An expert doctor sitting across the globe is monitoring the process through a web cam
      The patient receives a printed prescription in hand, electronically signed by the expert at the end of session.


    As long as there is someone committed to serve, there are ways to do so…
                                                  Neeraj Mahajan 2009
                                                                                                                         34
Case Study # 2: A patient in remote Muzzafarpur district in Bihar, India, suffering from an acute
disease requires immediate medical attention
   Option 1: Visit the nearest facility in Patna : Cost Rs 1500 or US $ 30 + Time wasted
        Cost of cheapest two and fro travel : Rs. 500
        Cost for local transport + Food     : Rs 150
        Doctor‟s fee & lab tests            : Rs. 250
        Medicines                           : Rs 300
        Loss of Income / productivity     Rs 300 per day (Two persons – one patient and one attendant, even if we calculate
         on the basis of minimum earning @ Rs 150 per person, per day )

   Option 2: Treatment at to a moderate clinic in New Delhi: Cost Rs 3400 or US $ 70 + Time wasted
        Cost of cheapest two and fro travel        : Rs. 1000
        Cost for local transport + Food             : Rs 400
        Doctor‟s fee & lab tests                    : Rs 300
        Medicines                                   : Rs 300
        Loss of Income / productivity               : Rs 1500 five days (Two persons – one patient and one attendant, even if we calculate on
        the basis of minimum earning @ Rs 150 per person, per day )

   Alternative 3: Dials/ logs-into the Virtual Hospital- Cost: US $ 50 for i.e. Rs 2500; conveniently
    sitting on own bed in Muzzafarpur and without any additional income or productivity loss.
      A fee is quoted for online consultation with the expert doctor and the payment is processed electronically at
         the beginning of the session. The session begins on realization of the payment
      An intern doctor or trained nurse without much experience in clinical practice physically examines the patient
         and records the weight, BP, Pulse and other physical symptoms on a laptop connected to a web server
      An expert doctor sitting across the globe is monitoring the process through a web cam
      The patient receives a printed prescription in hand, electronically signed by the expert at the end of session.

                                                            Neeraj Mahajan 2009
                                                                                                                                                 35
   BPL Mobile, Mumbai‟s leading mobile service provider, recently launched „Doctor on
    Call‟, a 9-to-9 service for live interaction between doctors and patients over the phone.

   Powered by HealthcareMagic.com, the service will provide consultation over the
    phone where the doctors will diagnose the patient‟s problems under three categories -
    „Acute‟, „Chronic‟ and „Emergency‟.

   While the service does not claim to replace a family Doctor, „Doctor on Call‟ will be
    useful on all occasions when one can‟t reach the trusted doctor; in an emergency, for
    second opinions and for recurrent ailments

   Priced Rs 15 per minute this service may be beneficial for people who worry about
    loss of pay/ business during absence from work, dread long queues or those who
    haven‟t got a prior appointments. Such people often end up denying themselves
    timely medical advice just to avoid upsetting their busy and tight schedules. Even the
    aged, sick and those who cannot travel unaccompanied can now call this number
    without any need to worry about the travel. This way one could even seek the doctor‟s
    advice when traveling on a far away business or holiday.

                                       Neeraj Mahajan 2009
                                                                                                36
   The Doctor who attends the call probes to understand the patient‟s condition
    of the on the phone and then offers home remedy to the subscriber.

   Acute condition: the attending doctor suggests a future course of action in
    terms of Lifestyle change, preventive measures and specialist to be
    consulted for further management of the disease

   Chronic condition- in case of an Emergency, the doctor gives the suggestion
    if the calling patient needs to be rushed to the nearest hospital, based on the
    history and will immediately end the call.

   Such medical assistance over the mobile phone be able to reach out further
    more to the typical Mumbai dwellers who are always on the move.

   Use of mobile phone as a platform for healthcare delivery may ultimately
    prove to be the next logical and innate step towards easing the suffering in
    people‟s lives that too at a affordable cost…

                                   Neeraj Mahajan 2009
                                                                                      37
Doctor on Phone Service                                                Virtual Hospital
Limited reach confined to Mumbai                                Both the Patient and the Doctor could be anywhere in the
                                                                world
No Physical contact with the patient                            If need be, all it requires is a laptop and a GPRS enabled
                                                                mobile phone in the hands of even a semi-trained nurse
                                                                who is capable of just recording the temperature, BP, Pulse
                                                                etc – to be present on the ground. An experienced Doctor
                                                                is monitoring this at the other end of the web cam
Is not the complete solution as a patient stills has to visit   The patient receives a complete diagnosis and prescription
another doctor for prescription                                 at the end of the session
Dependent on the patient to describe all his symptoms on        Fool-proof – even a deaf and dumb patient who cannot
phone                                                           speak or express his feelings or some one who does not
                                                                know how to type can be examined by a nurse who
                                                                explains these to a doctor at the other end
One patient – One doctor at a time                              A doctor could be addressing several patients at the same
                                                                time in different chat windows as a results those who need
                                                                immediate attention get preference over others who can
                                                                wait
Performance is likely to affected by shortage of Doctors        Can be the solution for limited availability of Doctors

Cost effective solution                                         Cost effective and Multiple benefit system, not likely to be
                                                                affected by even resource crunch or other shortages

                                                     Neeraj Mahajan 2009
                                                                                                                               38
   The next healthcare provider will not have to search for or guess about a patient's
    allergies, medications, or current and recent past diagnoses and other pertinent
    information.

   The next healthcare provider will be informed about the patient's most recent healthcare
    assessment and services.

   The next healthcare provider will be informed about recommendations of the caregiver
    who last treated the patient.

   As patient demographics will be provided, time and effort will be saved by not having to
    repeatedly ask a patient for demographic information in detail.

   Rather, this information can be more quickly and easily verified.

   Costs associated with the patient's care will be reduced, for example through avoiding
    repetitive tests and basic information gathering. The effort required to update the
    patient's most essential and relevant information will be minimized

                                       Neeraj Mahajan 2009
                                                                                               39
Recent innovations like Motorola's world-class mobility products and healthcare software
applications may help extend mobility to the point of care and beyond.

Such healthcare solutions allow sharing of real-time information anywhere, inside or
outside the facility, for increased patient safety and more attentive care. These include:

   Medication Administration Solutions- Ensure that the right patient receives the right
    medication, the right dose, by the right route, at the right time..

   Mobile Physician Rounding Solutions- Access information, order tests, scan billable
    items and more – all from the patient‟s bedside.

   Remote Patient Monitoring Solutions- Monitor patient vital signs and adjust medical
    equipment while moving throughout the healthcare facility.

   Specimen Collection Solutions - Protect and streamline the collection process to
    improve accuracy and speed test results.

   Wireless Broadband for Healthcare- High-speed, reliable and secure connectivity and
    information access.
                                      Neeraj Mahajan 2009
                                                                                             40
   Patients can keep all of their health and insurance information in one place,

   Make appointments and stay in touch with their physician's office via e-mail

   Receive information via RSS feed on subjects they choose

   Receive reminders about medication schedules, classes, exercise timetables and
    other health calendar entries,

   Participate in support groups and read health journals.

   Helps build trust & strengthen relationships

   Feedback and appraisal-- A doctor can learn more about the patient‟s wants and
    needs and accordingly adjust or fine-tune their programs.



          Social Network & Health Support Groups : Reach Global, Bonding Local
                                       Neeraj Mahajan 2009
                                                                                     41
Online Resource Centre & Virtual Traffic Control Room

            Friends                                                                                 Doctors


                                                                   Patients Like Me
            User
                                           Patient Support                                         Specialty
Parents    Groups     Children                                         MD junction    Specialist
                                                                                                    Groups
                                                                                                               Healer
                                             Groups &
           Patients
                                               Health               Wellsphere.com
                                            Communities
             Well                                                 DailyStrength.org
                                                                                                   Surgeons
            wishers
                                                             Health Blogger Network

                                                                 Organized Wisdom

                                                      Patient Empowerment Forum
          Town Hall                                                     Healthcare
                                                                                                   Community
                                                                       Peer Trainer

                                                                        Trusted MD

                                                                     Health Diaries

                                                                  HealthyPlace.com




                                                    Neeraj Mahajan 2009
                                                                                                                        42
Online Resource Centre & Virtual Traffic Control Room
         Traditional
           Media                                                                      New
                                                                                      Media


Print      Radio        Television                              Web                                         Mobile


                                                                                                                 Payment
                             Intranet     Internet    Webcast         Podcast   RSS           Email   SMS
                                                                                                                 Gateway


Social     Face book
                             Portal       Website      E Zine
Media
            Linked In

            MySpace                            Patients Like Me
                               Support
                              Groups &               MD junction
               Orkut          Communit
                                 ies            Wellsphere.com
              Twitter                         DailyStrength.org

            YouTube                     Health Blogger Network
                                            Organized Wisdom
             Blogger
                                             HealthyPlace.com
                                         Patient Empowerment
           Wikipedia                                    Forum
                                               Neeraj Mahajan 2009
                                                                                                                       43
Alternative
  Inform       options &            Prevention
                 prices


                                    Perception      Remain
  Inspire      Payment
                                   Management       Healthy


                                                      Adjust
 Motivate       Booking                News          Lifestyle
                                                  after disease


                                      Online      Community
 Educate       Feedback
                                    Advertising    opinion



Verify Facts   Research              Promotion      Support


                        Neeraj Mahajan 2009
                                                                  44
Neeraj Mahajan 2009
                      45
1.   Blog - Increasingly, those who suffer from serious diseases look to the Internet, not
     only for information on their disease, but also for patient communities. As a result,
     blogs on serious diseases are fast becoming an important and undeniable media for
     PR professionals in healthcare.

2.   Agony Aunt - Interactive forum answering questions from patients & their families

3.   Friends for Friends Community Discussion Forum: In this forum members give
     and receive support; discuss issues; exchange ideas, information, news, and
     comments; and discuss their concerns, fears, and methods of coping with disease,
     disorders and learn about various alternate therapies. Messages of each member
     of the Forum will be distributed by e-mail to all other members, any of whom can
     respond and cross-respond to all others.

4.   Third Umpire Live Chat : Like a third umpire in cricket, there are often situations in
     life when faced with a complicated medical problem, parents need to seek second
     or third opinion. In this format we can have a subject expert who is available to the
     online audience on specified weekdays say Monday to Friday. During this time they
     can ask him whatever they wish to know about the disease or its management.

                                      Neeraj Mahajan 2009
                                                                                              46
5.   Partnerships with Federal Agencies and Medical Groups: strategic alliance with
     NGOs and government agencies working in public health, healthcare advocacy and
     public policy like Public Policy Research Institute, National Initiative for Centers for
     Disease Control and Prevention (CDC), Consortium for Citizens with Disabilities
     (CCD) and National Health Council.

6.   Public campaign to reach out to state and federal lawmakers : Mass e-mails to
     local Legislators and members on important Senate committees like
     Health, Education and Labor to take speedy action on legislation affecting health
     issues.

7.   Med-Update—E-mail newsletter / RSS feed to Doctors and patients on the latest
     research and trends.

8.   Campus zone and hang-out Corner: Children are among the most vulnerable
     sections of society, easily affected by the manner in which their playmates, teachers
     and quite often parents treat them. Teasing and name calling make the impact of the
     disease even more harsh. This could be a forum where children and youth interact
     with others facing similar problems and evolve mechanisms to cope with social and
     psychological aspects of a problem and in general hang around to have fun, without
     being made to realize that they are in any way inferior to their peers.
                                        Neeraj Mahajan 2009
                                                                                                47
   Reach out to people where they already are
   Use the power of community and social networks to create change
   Use existing, or newly developed technology tools for social impact
   Generate online conversation for community-building
   Serve as a clearinghouse for evidence-based information on various diseases,
   Serve as a family support group for families and individuals affected by diseases,
   Serve as an advocate for appropriate public policies in response to needs of families & patients

   Key Features:
        Dynamic Content- Different content on the Homepage, each time a person logs in.
        Comprehensive & Credible user-friendly information on disease and their symptom, tell-tale Signs, When to say that
         something is abnormal, Why and whom to consult, FAQs, Share your Story, Growth Charts and Calculators for BMI, BP,
         Height- Weight etc., Comic strips & Quiz on how‟s and why behind diseases, prevention and difficult terms
        Second Opinion– Online Consultation with a panel doctor
        Points for reading articles, commenting on stories, polls etc and subsequent log ins.
        Searchable by key words
        Easy and user-friendly Audio-Video playback options
        Translations in popular European languages
        Viral marketing or word of mouth promotion on social sites and blogs.
        Search Engine Promotion, RSS mailing lists and Posts on social forums, chat sites and health support groups
        Senator, Congressmen, Lawmaker sensitization campaign
        Networking with other NGOs and governmental agencies for advocacy
                                                         Neeraj Mahajan 2009
                                                                                                                              48
    Customer Relationship Management

    Media Relations

    Internal Collaboration

    Knowledge Management

    Recruitment

    Test ideas or products

    Rank high in Search Engines


    All the information about various diseases under the sun that people need to know
    but don’t know whom to Ask.
                                     Neeraj Mahajan 2009
                                                                                        49
   With the advent of social media, patients now have power to share information, express opinions
    and influence the direction service and device providers will take.

   People are seeking personal health information from a broad range of online sources.

   Web enabled health searches is a fast-growing feature of social media. According to Manhattan
    Research , top three online brands for health information are:
      Google, with about 77 million searchers;
      Yahoo!, with about 45 million searchers; and
      MSN, with 20 million searchers.
   According to Harris Interactive, 80%, U.S. adults use the Internet to search for health-related
    information and 16% i.e. 136 million adults who have searched for health information online at
    some point of time in their lives.

   People are relying on blogs and other social media. Five percent of those searching online for
    information about the antidepressant Lexapro went to CrazyMeds.org -- a blog that contains
    information about the safety and efficacy of psychiatric medications.

   Jupiter Research found 34% of adult Internet users in the U.S., or 54 million people, browsed
    online content created by other consumers about health issues.

   Patients today take content created by advocacy groups, physicians and fellow consumers more
    seriously than pharmaceutical companies. A Kaiser Family Foundation report found only 18% of
    consumers trust pharmaceutical company
                                          Neeraj Mahajan 2009
                                                                                                      50
   Overall Project Management Outline
   Budgeting and Financial Planning
   Team Identification, motivation and build-up
        Overall Management
        Corporate Affairs, HR & Administration
        Medical Board for empanelment of facilities & Doctors
        Corporate communications, Content Development, PR & Image Management
        New Business Development
        Booking, Appointments, Travel & Logistics
        Transcription, Billing, & Recovery
        Insurance & Mediclaim
        Finance & Taxes
        IT- Database management, programming & Web Development
        Online Marketing & Search Engine Promotion
        Legal Affairs and Affiliations
        Coordination
        Operations
        Medical Response Teams- Obesity, Diabetes, Hypertension, Heart Stroke, Dentistry and other areas
        Alternative Therapy, Meditation and Health SPAs
        Diagnostics and Microbiology
   Roles & Responsibilities
   Execution Timelines
   Infrastructure
   Project Implementation
   Operations
                                                Neeraj Mahajan 2009
                                                                                                            51
J HEALTH FOR ALL J




   Neeraj Mahajan 2009
                         52
Neeraj Mahajan 2009
                      53

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Tansforming healthcare condensed

  • 1. An innovative solution for Affordable & Quality Health & Wellness Neeraj Mahajan 2009 1
  • 2. A new health management tool that is:  Custom made  Efficient  Personal  Password-secure  Innovative  Priced transparently  Flexible  Improves Quality  Reduces the cost of service.  Improves patient access On-demand, need-specific Healthcare at the Doorstep of the Consumers Neeraj Mahajan 2009 2
  • 3.  Transforming Healthcare  Prevent and manage chronic diseases  Help control the rise in health care costs  Try and bridge the gap between the Have‟s and the Have-not's  Expand healthcare coverage for the long-term uninsured  Restructure the way in which doctors and hospitals are paid More Smiles Per Mile– Across the World Neeraj Mahajan 2009 3
  • 4. High-quality healthcare services  Available and Affordable  Choice of Premium, Optimum & Budget category facilities & specialists  On demand Health, Wellness & Medicare at reasonable costs  Virtual Hospital - 24x7 worldwide Smart America = (Healthy + Prosperous America ) x Wellness worldwide Neeraj Mahajan 2009 4
  • 5. Hospital Patient Care Physician Family Pre/ Post Op Care Support Groups Social Physiotherapy Community Counseling Meditation Step by Step Process Health & Wellness does not begin and end with the patient Neeraj Mahajan 2009 5
  • 6. Access to care  Quality of care  Cost of care  Technology adoption  Burden on providers  Shortage of providers  Margins for providers declining  Policy Concerns Neeraj Mahajan 2009 6
  • 7. Who wins if America looses ?  Who gains from the inherent inefficiencies of the US healthcare system?  Can there be more accessible and affordable healthcare options for US citizens? Neeraj Mahajan 2009 7
  • 8. 80:20 Formula Solution: Inside-Out Neeraj Mahajan 2009 8
  • 9. 80% goal - Healthcare at the doorstep of the consumer – Streamline operations at a wide network of state of the art medical facilities so that patients does not have to travel overseas and finds it prudent to receive superior treatments at comparable costs, that too within walking distance from their homes.  20% goal – Assurance of Streamlined, Safe and Supervised treatment at pre-selected overseas facilities in cases where the same procedure cannot either be done at a lesser cost or requires immediate, unavoidable treatment, economically unviable investment, staffing or maintainance Neeraj Mahajan 2009 9
  • 10.  Centralized planning for 300 million Americans is unrealistic  Doesn‟t work anywhere else in the economy  Goes against the American grain  By developing a market driven and government endorsed strategy to streamline health care costs, US citizens can significantly reduce their health insurance expenditures and lower overall costs to the health care system.  The savings can spur the growth and development of a healthy & economically wealthy America  The spin-offs can benefit many friendly nations and add to their economic development -- leading to generation of employment and opportunities within their own boundaries  In the long run this can result in reduction of immigrants to t he US Neeraj Mahajan 2009 10
  • 11. Even if a small percentage of the amount spent on traveling abroad for medical treatment could be saved and reinvested into the US facilities, the long term benefits could be much more than the immediate gains  Investment in hospitals, research and medical education, can spur sustainable economic development and employment opportunities in US with enough spin-off for the rest of the world.  Only strong healthy and economically strong America can be the true Super power that can not only transforms itself but the rest of the world as well Neeraj Mahajan 2009 11
  • 12. Strategic Win-Win America Project (SWAP) for Smart Health & Prosperous Economy (SHAPE) Solution: Inside-Out Neeraj Mahajan 2009 12
  • 13. Advantage Humanity Advantage India Advantage America Strategic Win-Win America Project (SWAP) for Smart Health & Prosperous Economy (SHAPE) Solution: Inside-Out Neeraj Mahajan 2009 13
  • 14.  Advantage America – Health & Wellness 3600 Plan  Healthy Healthcare Industry, Satisfied Doctors & other professionals, Satisfied patients  Advantage India – Health & Wellness 3600 Plan  Healthy Healthcare Industry, Satisfied Doctors & other professionals, Satisfied patients  Advantage Humanity  Sharing of knowledge, expertise and infrastructure  Recession proof growth of Health, Medicare & Wellness industry worldwide  One Big Virtual Hospital- anyone, anywhere in the world can consult a doctor across another continent without stepping out of their homes  Better Patient Awareness though specially designed Audio-video, print material and web content. Cost effective option to seek expert advise through live web chat and email queries  Better and More Informed Choices- Libraries, reading rooms and counseling by qualified Doctors whose job is just to explain the how‟s, whys and other complicated medical terminology to the patients Neeraj Mahajan 2009 14
  • 15. 1. Advantage America – Health & Wellness 3600 Plan Healthy Healthcare Industry, Satisfied Doctors & other professionals, Satisfied patients  Centres of Excellence impart quality Medicare  Horizontal Integration- One Country, one rate for the same medical treatment or services – also from other states, even those uninsured on unfavorable terms of Insurance Companies & choice A, B or C category Doctors -- almost at the patient‟s doorsteps – recommended Quality Medicare & Wellness Centres to chose from under Premium, Moderate and budget panel based on the fee, professional experience and minimum infrastructure & services in each category – as different centres and doctors with similar experience & facilities within the same country charge the same fee Neeraj Mahajan 2009 15
  • 16. Case Study # 1: Doctor is unavailable – A 100% insured person needs immediate medical attention for a sudden and excruciating pain at midnight but the regular doctor is asleep or on a vacation SWAP ADVANTAGE – It may be midnight in USA but day time in India when almost all the doctors are working and can be available - they can at least advise you if it‟s a false alarm or a real need to rush to a hospital. In case of a real emergency – a standby evacuation / ambulance team is rushed and responds to the call Case Study # 2: Experienced Doctors are available but too expensive to afford – An usual dilemma for many people in USA SWAP ADVANTAGE – Reach to some other comparable quality and affordable facility or Doctor in the same city, across USA or India and get the right treatment at the right time !! Case Study # 3: Patient is insured but the disease isn‟t – A 100% insured person in USA needs treatment which requires out-of-pocket expenses or is not 100% covered in his health insurance policy SWAP ADVANTAGE – Assured and affordable facilities and Doctors in the same city, across USA or India. Universal access to 24 x 7 x 365- on demand healthcare at the doorstep of the consumer. Doctor on call – anywhere, anytime from across the universe. Neeraj Mahajan 2009 16
  • 17. Case Study # 4: Both the Patient and the disease are inadequately covered by Insurance SWAP ADVANTAGE – Choice of opt-in Premium, Moderate and budget category facilities and doctors. Right and appropriate value for money !! Case Study # 5: Patient goes abroad for medical treatment but still needs care, support and counseling in the pre and post operative phase SWAP ADVANTAGE– Assurance of single window for pre and post-operative care, Safety & coordinated travel arrangements & monitored treatment even at the overseas facilities Case Study # 6: Patient is willing to go abroad for treatment but needs a doctors recommendation and advise as to which hospital or doctor to visit SWAP makes it possible Case Study # 7: Patient is willing to go abroad for treatment but wants the trusted family doctor to monitor his progress SWAP makes it possible Case Study # 8: Patient, on his own, is unable to differentiate between a real emergency or false alarm as well as short term v/s long term disease management options SWAP can open a plethora of possibilities. Universal access to 24 x 7 x 365- on demand healthcare at the doorstep of the consumer. Doctor on call – anywhere, anytime from across the universe. Neeraj Mahajan 2009 17
  • 18. 2. Advantage India – Health & Wellness 3600 Plan Healthy Healthcare Industry, Satisfied Doctors & other professionals, Satisfied patients  Centres of Excellence impart quality Medicare  Horizontal Integration- One Country, one rate for the same medical treatment or services – also from other states, even those uninsured on unfavorable terms of Insurance Companies & choice A, B or C category Doctors -- almost at the patient‟s doorsteps – recommended Quality Medicare & Wellness Centres to chose from under Premium, Moderate and budget panel based on the fee, professional experience and minimum infrastructure & services in each category – as different centres and doctors with similar experience & facilities within the same country charge the same fee Neeraj Mahajan 2009 18
  • 19. Case Study # 1: Doctor is unavailable – A person needs immediate medical attention for a sudden and excruciating pain at midnight but the regular doctor is asleep or on a vacation SWAP ADVANTAGE – It may be midnight in India but day time in USA when almost all the doctors are working and can be available - they can at least advise you if it‟s a false alarm or a real need to rush to a hospital. In case of a real emergency – a standby evacuation / ambulance team is rushed and responds to the call Case Study # 2: Experienced Doctors are available but too expensive to afford – An usual dilemma for many people in India SWAP ADVANTAGE – Reach to some other comparable quality and affordable facility or Doctor in the same city, across India or USA and get the right treatment at the right time !! Case Study # 3: Patient is insured but the disease isn‟t – A 100% insured person in India needs treatment which requires out-of-pocket expenses or is not 100% covered in his health insurance policy SWAP ADVANTAGE – Assured and affordable facilities and Doctors in the same city, across India or USA. Universal access to 24 x 7 x 365- on demand healthcare at the doorstep of the consumer. Doctor on call – anywhere, anytime from across the universe. Neeraj Mahajan 2009 19
  • 20. Case Study # 4: Both the Patient and the disease are inadequately covered by Insurance SWAP ADVANTAGE – Choice of opt-in Premium, Moderate and budget category facilities and doctors. Right and appropriate value for money !! Case Study # 5: Patient goes abroad for medical treatment but still needs care, support and counseling in the pre and post operative phase SWAP ADVANTAGE– Assurance of single window for pre and post-operative care, Safety & coordinated travel arrangements & monitored treatment even at the overseas facilities Case Study # 6: Patient is willing to go abroad for treatment but needs a doctors recommendation and advise as to which hospital or doctor to visit SWAP makes it possible Case Study # 7: Patient is willing to go abroad for treatment but wants the trusted family doctor to monitor his progress SWAP makes it possible Case Study # 8: Patient, on his own, is unable to differentiate between a real emergency or false alarm as well as short term v/s long term disease management options SWAP can open a plethora of possibilities. Universal access to 24 x 7 x 365- on demand healthcare at the doorstep of the consumer. Doctor on call – anywhere, anytime from across the universe. Neeraj Mahajan 2009 20
  • 21. 3. Advantage Humanity – The world as one big where anyone can consult an expert doctor anywhere in USA or India and get their advise, even without stepping out of their homes-- just by paying a fee online.  Lesser need for travel to unfamiliar places away from ones own country for medical treatment  Monitored & less risky emergency medical travel even outside ones country where it cannot be avoided  Structured pre-and long term, post emergency care – within the country of regular stay  Pre approved, Doctor– recommended Quality Medicare & Wellness Centres to chose from  Less waiting – as different centres with similar facilities and experienced doctors nearby the patients home town charge the same fee  Better patient advocacy through specially designed literature – printed brochures, audio-video and web content  Live counseling by qualified doctors and health motivation staff who explain the How‟s, Why‟s as well as complicated medical terms in layman terms– which normally remained unexplained as Doctors have to attend to other patients as well, and in the process help them take right decisions. Neeraj Mahajan 2009 21
  • 22. One country one price for the same or similar procedure and consultation  Standardized care- pre-op screening in one country to be acceptable in the receiving facility in another country as well.  Owned Centres, channel partners & Virtual Hospital– experts for tele- diagnosis, tele-consultation, second opinion, referral and tele-nursing care.  Assurance of Post-op follow up, long-term rehab and disease management.  No waiting -- the Patient can but disease, pain and suffering doesn‟t wait…  Minimum need for cross country travel--travel only if you must for emergency treatment but get pre and post op care in the home country  Real time Monitoring -- the doctor whom you trust is in the loop at every stage and can see your blood sugar level, weight or BP and well as prescription and treatment course of action at his own computer work station in the home country, and thus give his own suggestions, if need be, even during the duration of emergency translocation Neeraj Mahajan 2009 22
  • 23. Multiple choices, can even work like a parallel or – The consumer is the king with options to choose from either of the following options:  One time Joining, nominal annual fee and rest as per actual expenses, as and when needed– Patients enroll just for maintainace of medical records and later make payment for services and facilities as and when used  Alternate Insurance model- Patients join the program with a commitment to pay a minimum amount – irrespective of whether the services are consumed or not. May get rollover benefit to accumulate certain points and use later at approved facilities  Healthcare deals and discounts – Patients who are not adequately insured, those who do not wish to pay premium for diseases they may not even enquire or those with pre- existing diseases like heart stroke or diabetes who may end up paying heavy premium in any other insurance scheme can opt for this. All they have to do at the beginning is to agree to consume a certain minimum hours of treatment for a specific disease during the year. This makes them eligible for a package or discount. As members of this program, they may also avail treatment of other diseases at the pre approved facilities in USA and India – at normal rates – on use  No strings attached- Just enroll and pay on use basis Neeraj Mahajan 2009 23
  • 24. Network of own Centres, Channel Partners and tie-up facilities across USA & India  Assurance of quality and reliability – Each centre follows a standard operating procedure and is certified by a medical board on the basis of experience, facilities offered, infrastructure, technological expertise, patient feedback and success rate  Information at the fingertip, doorstep and desktop of the consumer- Before even stepping out of the home a patient can check the past experience of other patients, community opinion as well as medical rating of a healthcare facility or doctor  Common pricing - Next to quality, price is a common concern for the patients. This is resolved as all facilities enrolled in the program are graded under Premium, Moderate and Budget category. All facilities in the same city or country essentially charge a pre- determined fixed charge. For instance doctors with 25 years or more professional standing charge the same price – if their equipments and facilities are comparable. Likewise all doctors with similar infrastructure with 15-25 years fall in B- category while those with less than 15 years practice fall into the budget category. The price list for each individual category is fixed  Zero waiting- Since the quality and price across the board in a particular category is fixed, a patient can or may visit some other doctor with similar skills and charges Neeraj Mahajan 2009 24
  • 25. Economically viable and affordable treatment – For all, including those who are uninsured or economically not so well off  No Headache- Single window services for medically supervised and monitored travel for emergency treatment- Same agency books premium, moderate and budget category hospitals and Doctors, provides trained nurses for the journey as well as booking airlines, hotels, travel insurance, currency exchange, money transfer and helps in processing of insurance claims, if need be.  One point –management & up gradation of patient history and prescription data- standard, user friendly format incorporating all the required information in a single source makes it easier for doctors and convenient for the patients  Centralized billing and payment of taxes- avoids duplicate efforts and tax on taxes already paid.  Mobile ICU- Specially equipped helicopters, air & ground ambulance services in USA & India for emergency evacuation of critical patients.  Similar Diagnostic standards and bench-marks for every report within a city, country or across the continent – for world wide acceptance and reliability. Neeraj Mahajan 2009 25
  • 26. Virtual Hospitals – Universal access to 24 x 7 x 365- on demand healthcare at the doorstep of the consumer. Doctor on call – anywhere, anytime from across the universe.  Matrix of High-tech Diagnostic Base Camps in major cities across USA & India, each with a network of as many as possible collection centers and report pick-up points, ideally within 2-5 km radius of patients homes.  Global centres of learning:  Global Lifestyle Modification Academy- specific training to individuals already suffering from a disease to manage their life and remain healthy, the rest of their lives.  Corporate Employee Training seminars and short term workshops– specially designed short term courses for corporate entities and professional bodies  Modules for training the Insured Persons– Insurance companies can save money by training the insured persons – on how to live healthy and beat stress & tension.  Corporate Social Responsibility Programs- Responsible corporate citizens can reap indirect benefits of good health by contributing towards their social responsibilities Neeraj Mahajan 2009 26
  • 27. Uniform & affordable Healthcare services and choice of provider nearer to home  Single window services for medically supervised and monitored travel for emergency treatment- Same agency quotes and takes orders for booking premium, moderate and budget category hospitals as well as fixes appointment with the best Doctors in the affordability range (from a Medical Board recommended pre-approved panel of hospitals and specialists– rated on the basis of qualifications, proficiency and facilities), provides trained nursing escorts as well as does the bookings for airlines, hotels, travel insurance, currency exchange and money transfer . And helps in processing of insurance claims on behalf of the patient, if need be.  One point – universal management & regular up gradation of patient history and prescription data- standard, user friendly format incorporating all the required information in a single source makes it easier for doctors and convenient for the patients  Centralized billing and payment of taxes- to avoid duplicate efforts and tax on taxes already paid.  Economic model to make treatment affordable for even the uninsured and economically not so well off Neeraj Mahajan 2009 27
  • 28. Mobile ICU- Specially equipped helicopters, air & ground ambulance services in USA & India for emergency evacuation of critical patients. Imagine a person “Alpha” on the way to attend a business meeting or holiday in a third world country when the medical emergency strikes… This place does not seem to have appropriate medical facilities and his family is insisting him to USA or nearby big hospital which has the latest medical facilities with modern diagnostics to evaluate and stabilize the patient‟s condition. This is where ground & air ambulance or helicopters and specially fitted jets can play a life saving role.  Standardized Diagnostics & reporting– similar Diagnostic standards and bench-marks with common minimum factors in every report within a city, country or across the continent – for world wide acceptance and reliability.  Economically viable and cost effective matrix of High-tech Diagnostics– Matrix of High-tech Diagnostic Base Camps in major cities across USA & India, each with a network of as many as possible collection centers and report pick-up points, ideally within 2-5 km radius of patients homes.  Online Medical Library, Reading Space & real world Information Kiosks  Online & Real world Patient Support Groups & Community Participation programs  School and Community Awareness programs Neeraj Mahajan 2009 28
  • 29. Global Lifestyle Modification Academy- imparts specific and relevant training to individuals already suffering from a disease to manage their life and remain healthy for the rest of their lives. Different modules and course content can be specially tailor- made for groups of patients suffering from specific diseases. These courses can he held both in real and virtual world. Lectures, demonstrations, webinars, participatory group discussions and exposure to new ideas from the domain of yoga, pranayam, art of living, reiki and meditation techniques besides lessons in breathing, body toning and conditioning – can help to rejuvenate as well as motivate the people who attend.  Corporate Training seminars and short term workshops– specially designed short term courses for corporate entities and professional bodies which teach people who attend how to de-stress and simultaneously manage their disease and work efficiently.  Modules for training of the Insured Persons– This will help insurance companies save a lot of money by reducing the stress, BP, Blood Sugar as well as chances of Heart- stroke, paralysis or other lifestyle diseases.  Corporate Social Responsibility Programs- Rich and influential classes pay for the underprivileged masses and indirectly benefit from lesser disease and infections All these will help people who live longer, live better Neeraj Mahajan 2009 29
  • 30. The world that we live in today is a flat world now where even disease is a country or person‟s personal problem  No country or people have the ultimate answer to all medical and health problems  Good Doctors are available to cure disease – its just that a patient needs to reach out to them at the right time and in the right manner  Access to high quality care – without any delay at the hour of need can make a big difference between life and death  Technology and mediums of communication has made it possible for the patient as well as the doctor to reach out to each other and defeat both, the disease and imminent death. Virtual Hospital- A level playing field which bridges the gap between need and availability in the virtual domain where even the have-nots and deprived people can avail the cheapest and best services or facilities sitting at home - from across the seven seas Neeraj Mahajan 2009 30
  • 31. First Point of Contact Trouble Shooting Teams: A nurse or junior Doctor with a laptop Emergency on the spot and GPRS enabled mobile phone - follow up Team just to record the physical symptoms like BP, weight, blood Sugar etc at the behest of the remote expert Control Room O. P. Gupta Memorial Virtual Hospital Doctors on Duty Doctors on Call Emergency evacuation & 24 x 7 Surgical / OT and Stabilization teams, Mobile Diagnostic Lab back-up ICU & Ambulance Service at a nearby Tie up facility For those times when – it‟s a few minutes race between life and death and the winner takes it all Neeraj Mahajan 2009 31
  • 32. First Point of Contact Trouble Shooting Teams: A nurse or junior Doctor with a laptop Emergency on the spot and GPRS enabled mobile phone - follow up Team just to record the physical symptoms like BP, weight, blood Sugar etc at the behest of the remote expert Control Room E-Mail for Help O. P. Gupta Memorial Virtual Hospital Dial-in for Help Doctors on Duty Doctors on Call Emergency evacuation & 24 x 7 Surgical / OT and Stabilization teams, Mobile Diagnostic Lab back-up ICU & Ambulance Services at a nearby Tie up facility Timely, Quality and Affordable medical services at the point of Need. Neeraj Mahajan 2009 32
  • 33. Second Life & Teen Second Life : Benefits to the Doctors:  Doctor‟s Consultation Chambers in the virtual world.  A place were Doctors meet other Doctors, attend Web Seminars, Conferences and watch video demonstrations of new products  They get points for each log-in, give consultation and advise to patients. These points can be later redeemed for gifts and family holiday Packages Timely, Quality and Affordable medical services at the point of Need. Neeraj Mahajan 2009 33
  • 34. Case Study # 1: An uninsured or underinsured patient in New York, USA needs emergency medical consultation but can only afford to pay US$ 20  Option 1: Visits a specialist in New York whom he cannot afford  Option 2: Visits a relatively inexperienced GP in a far off state who charges less than $ 20  Alternative 3: Dials/ logs-into Virtual Hospital- pays US $ 20 and receives consultation from a highly experienced doctor in Delhi or Mumbai while sitting on own bed in New York, without even having to travel down town in a local bus.  A fee is quoted for online consultation with the expert doctor and the payment is processed electronically at the beginning of the session.  The Doctor does not mind receiving US $ 20 as after dollar to rupee conversion – the price works out to Rs 1000 which is approximately close to his regular charges  The patient too is happy because he is receiving the best possible treatment by a top end doctor.  The session begins on realization of the payment  An intern doctor or trained nurse without much experience in clinical practice physically examines the patient and records the weight, BP, Pulse and other physical symptoms on a laptop connected to a web server  An expert doctor sitting across the globe is monitoring the process through a web cam  The patient receives a printed prescription in hand, electronically signed by the expert at the end of session. As long as there is someone committed to serve, there are ways to do so… Neeraj Mahajan 2009 34
  • 35. Case Study # 2: A patient in remote Muzzafarpur district in Bihar, India, suffering from an acute disease requires immediate medical attention  Option 1: Visit the nearest facility in Patna : Cost Rs 1500 or US $ 30 + Time wasted  Cost of cheapest two and fro travel : Rs. 500  Cost for local transport + Food : Rs 150  Doctor‟s fee & lab tests : Rs. 250  Medicines : Rs 300  Loss of Income / productivity Rs 300 per day (Two persons – one patient and one attendant, even if we calculate on the basis of minimum earning @ Rs 150 per person, per day )  Option 2: Treatment at to a moderate clinic in New Delhi: Cost Rs 3400 or US $ 70 + Time wasted  Cost of cheapest two and fro travel : Rs. 1000  Cost for local transport + Food : Rs 400  Doctor‟s fee & lab tests : Rs 300  Medicines : Rs 300  Loss of Income / productivity : Rs 1500 five days (Two persons – one patient and one attendant, even if we calculate on  the basis of minimum earning @ Rs 150 per person, per day )  Alternative 3: Dials/ logs-into the Virtual Hospital- Cost: US $ 50 for i.e. Rs 2500; conveniently sitting on own bed in Muzzafarpur and without any additional income or productivity loss.  A fee is quoted for online consultation with the expert doctor and the payment is processed electronically at the beginning of the session. The session begins on realization of the payment  An intern doctor or trained nurse without much experience in clinical practice physically examines the patient and records the weight, BP, Pulse and other physical symptoms on a laptop connected to a web server  An expert doctor sitting across the globe is monitoring the process through a web cam  The patient receives a printed prescription in hand, electronically signed by the expert at the end of session. Neeraj Mahajan 2009 35
  • 36. BPL Mobile, Mumbai‟s leading mobile service provider, recently launched „Doctor on Call‟, a 9-to-9 service for live interaction between doctors and patients over the phone.  Powered by HealthcareMagic.com, the service will provide consultation over the phone where the doctors will diagnose the patient‟s problems under three categories - „Acute‟, „Chronic‟ and „Emergency‟.  While the service does not claim to replace a family Doctor, „Doctor on Call‟ will be useful on all occasions when one can‟t reach the trusted doctor; in an emergency, for second opinions and for recurrent ailments  Priced Rs 15 per minute this service may be beneficial for people who worry about loss of pay/ business during absence from work, dread long queues or those who haven‟t got a prior appointments. Such people often end up denying themselves timely medical advice just to avoid upsetting their busy and tight schedules. Even the aged, sick and those who cannot travel unaccompanied can now call this number without any need to worry about the travel. This way one could even seek the doctor‟s advice when traveling on a far away business or holiday. Neeraj Mahajan 2009 36
  • 37. The Doctor who attends the call probes to understand the patient‟s condition of the on the phone and then offers home remedy to the subscriber.  Acute condition: the attending doctor suggests a future course of action in terms of Lifestyle change, preventive measures and specialist to be consulted for further management of the disease  Chronic condition- in case of an Emergency, the doctor gives the suggestion if the calling patient needs to be rushed to the nearest hospital, based on the history and will immediately end the call.  Such medical assistance over the mobile phone be able to reach out further more to the typical Mumbai dwellers who are always on the move.  Use of mobile phone as a platform for healthcare delivery may ultimately prove to be the next logical and innate step towards easing the suffering in people‟s lives that too at a affordable cost… Neeraj Mahajan 2009 37
  • 38. Doctor on Phone Service Virtual Hospital Limited reach confined to Mumbai Both the Patient and the Doctor could be anywhere in the world No Physical contact with the patient If need be, all it requires is a laptop and a GPRS enabled mobile phone in the hands of even a semi-trained nurse who is capable of just recording the temperature, BP, Pulse etc – to be present on the ground. An experienced Doctor is monitoring this at the other end of the web cam Is not the complete solution as a patient stills has to visit The patient receives a complete diagnosis and prescription another doctor for prescription at the end of the session Dependent on the patient to describe all his symptoms on Fool-proof – even a deaf and dumb patient who cannot phone speak or express his feelings or some one who does not know how to type can be examined by a nurse who explains these to a doctor at the other end One patient – One doctor at a time A doctor could be addressing several patients at the same time in different chat windows as a results those who need immediate attention get preference over others who can wait Performance is likely to affected by shortage of Doctors Can be the solution for limited availability of Doctors Cost effective solution Cost effective and Multiple benefit system, not likely to be affected by even resource crunch or other shortages Neeraj Mahajan 2009 38
  • 39. The next healthcare provider will not have to search for or guess about a patient's allergies, medications, or current and recent past diagnoses and other pertinent information.  The next healthcare provider will be informed about the patient's most recent healthcare assessment and services.  The next healthcare provider will be informed about recommendations of the caregiver who last treated the patient.  As patient demographics will be provided, time and effort will be saved by not having to repeatedly ask a patient for demographic information in detail.  Rather, this information can be more quickly and easily verified.  Costs associated with the patient's care will be reduced, for example through avoiding repetitive tests and basic information gathering. The effort required to update the patient's most essential and relevant information will be minimized Neeraj Mahajan 2009 39
  • 40. Recent innovations like Motorola's world-class mobility products and healthcare software applications may help extend mobility to the point of care and beyond. Such healthcare solutions allow sharing of real-time information anywhere, inside or outside the facility, for increased patient safety and more attentive care. These include:  Medication Administration Solutions- Ensure that the right patient receives the right medication, the right dose, by the right route, at the right time..  Mobile Physician Rounding Solutions- Access information, order tests, scan billable items and more – all from the patient‟s bedside.  Remote Patient Monitoring Solutions- Monitor patient vital signs and adjust medical equipment while moving throughout the healthcare facility.  Specimen Collection Solutions - Protect and streamline the collection process to improve accuracy and speed test results.  Wireless Broadband for Healthcare- High-speed, reliable and secure connectivity and information access. Neeraj Mahajan 2009 40
  • 41. Patients can keep all of their health and insurance information in one place,  Make appointments and stay in touch with their physician's office via e-mail  Receive information via RSS feed on subjects they choose  Receive reminders about medication schedules, classes, exercise timetables and other health calendar entries,  Participate in support groups and read health journals.  Helps build trust & strengthen relationships  Feedback and appraisal-- A doctor can learn more about the patient‟s wants and needs and accordingly adjust or fine-tune their programs. Social Network & Health Support Groups : Reach Global, Bonding Local Neeraj Mahajan 2009 41
  • 42. Online Resource Centre & Virtual Traffic Control Room Friends Doctors Patients Like Me User Patient Support Specialty Parents Groups Children MD junction Specialist Groups Healer Groups & Patients Health Wellsphere.com Communities Well DailyStrength.org Surgeons wishers Health Blogger Network Organized Wisdom Patient Empowerment Forum Town Hall Healthcare Community Peer Trainer Trusted MD Health Diaries HealthyPlace.com Neeraj Mahajan 2009 42
  • 43. Online Resource Centre & Virtual Traffic Control Room Traditional Media New Media Print Radio Television Web Mobile Payment Intranet Internet Webcast Podcast RSS Email SMS Gateway Social Face book Portal Website E Zine Media Linked In MySpace Patients Like Me Support Groups & MD junction Orkut Communit ies Wellsphere.com Twitter DailyStrength.org YouTube Health Blogger Network Organized Wisdom Blogger HealthyPlace.com Patient Empowerment Wikipedia Forum Neeraj Mahajan 2009 43
  • 44. Alternative Inform options & Prevention prices Perception Remain Inspire Payment Management Healthy Adjust Motivate Booking News Lifestyle after disease Online Community Educate Feedback Advertising opinion Verify Facts Research Promotion Support Neeraj Mahajan 2009 44
  • 46. 1. Blog - Increasingly, those who suffer from serious diseases look to the Internet, not only for information on their disease, but also for patient communities. As a result, blogs on serious diseases are fast becoming an important and undeniable media for PR professionals in healthcare. 2. Agony Aunt - Interactive forum answering questions from patients & their families 3. Friends for Friends Community Discussion Forum: In this forum members give and receive support; discuss issues; exchange ideas, information, news, and comments; and discuss their concerns, fears, and methods of coping with disease, disorders and learn about various alternate therapies. Messages of each member of the Forum will be distributed by e-mail to all other members, any of whom can respond and cross-respond to all others. 4. Third Umpire Live Chat : Like a third umpire in cricket, there are often situations in life when faced with a complicated medical problem, parents need to seek second or third opinion. In this format we can have a subject expert who is available to the online audience on specified weekdays say Monday to Friday. During this time they can ask him whatever they wish to know about the disease or its management. Neeraj Mahajan 2009 46
  • 47. 5. Partnerships with Federal Agencies and Medical Groups: strategic alliance with NGOs and government agencies working in public health, healthcare advocacy and public policy like Public Policy Research Institute, National Initiative for Centers for Disease Control and Prevention (CDC), Consortium for Citizens with Disabilities (CCD) and National Health Council. 6. Public campaign to reach out to state and federal lawmakers : Mass e-mails to local Legislators and members on important Senate committees like Health, Education and Labor to take speedy action on legislation affecting health issues. 7. Med-Update—E-mail newsletter / RSS feed to Doctors and patients on the latest research and trends. 8. Campus zone and hang-out Corner: Children are among the most vulnerable sections of society, easily affected by the manner in which their playmates, teachers and quite often parents treat them. Teasing and name calling make the impact of the disease even more harsh. This could be a forum where children and youth interact with others facing similar problems and evolve mechanisms to cope with social and psychological aspects of a problem and in general hang around to have fun, without being made to realize that they are in any way inferior to their peers. Neeraj Mahajan 2009 47
  • 48. Reach out to people where they already are  Use the power of community and social networks to create change  Use existing, or newly developed technology tools for social impact  Generate online conversation for community-building  Serve as a clearinghouse for evidence-based information on various diseases,  Serve as a family support group for families and individuals affected by diseases,  Serve as an advocate for appropriate public policies in response to needs of families & patients  Key Features:  Dynamic Content- Different content on the Homepage, each time a person logs in.  Comprehensive & Credible user-friendly information on disease and their symptom, tell-tale Signs, When to say that something is abnormal, Why and whom to consult, FAQs, Share your Story, Growth Charts and Calculators for BMI, BP, Height- Weight etc., Comic strips & Quiz on how‟s and why behind diseases, prevention and difficult terms  Second Opinion– Online Consultation with a panel doctor  Points for reading articles, commenting on stories, polls etc and subsequent log ins.  Searchable by key words  Easy and user-friendly Audio-Video playback options  Translations in popular European languages  Viral marketing or word of mouth promotion on social sites and blogs.  Search Engine Promotion, RSS mailing lists and Posts on social forums, chat sites and health support groups  Senator, Congressmen, Lawmaker sensitization campaign  Networking with other NGOs and governmental agencies for advocacy Neeraj Mahajan 2009 48
  • 49. Customer Relationship Management  Media Relations  Internal Collaboration  Knowledge Management  Recruitment  Test ideas or products  Rank high in Search Engines All the information about various diseases under the sun that people need to know but don’t know whom to Ask. Neeraj Mahajan 2009 49
  • 50. With the advent of social media, patients now have power to share information, express opinions and influence the direction service and device providers will take.  People are seeking personal health information from a broad range of online sources.  Web enabled health searches is a fast-growing feature of social media. According to Manhattan Research , top three online brands for health information are:  Google, with about 77 million searchers;  Yahoo!, with about 45 million searchers; and  MSN, with 20 million searchers.  According to Harris Interactive, 80%, U.S. adults use the Internet to search for health-related information and 16% i.e. 136 million adults who have searched for health information online at some point of time in their lives.  People are relying on blogs and other social media. Five percent of those searching online for information about the antidepressant Lexapro went to CrazyMeds.org -- a blog that contains information about the safety and efficacy of psychiatric medications.  Jupiter Research found 34% of adult Internet users in the U.S., or 54 million people, browsed online content created by other consumers about health issues.  Patients today take content created by advocacy groups, physicians and fellow consumers more seriously than pharmaceutical companies. A Kaiser Family Foundation report found only 18% of consumers trust pharmaceutical company Neeraj Mahajan 2009 50
  • 51. Overall Project Management Outline  Budgeting and Financial Planning  Team Identification, motivation and build-up  Overall Management  Corporate Affairs, HR & Administration  Medical Board for empanelment of facilities & Doctors  Corporate communications, Content Development, PR & Image Management  New Business Development  Booking, Appointments, Travel & Logistics  Transcription, Billing, & Recovery  Insurance & Mediclaim  Finance & Taxes  IT- Database management, programming & Web Development  Online Marketing & Search Engine Promotion  Legal Affairs and Affiliations  Coordination  Operations  Medical Response Teams- Obesity, Diabetes, Hypertension, Heart Stroke, Dentistry and other areas  Alternative Therapy, Meditation and Health SPAs  Diagnostics and Microbiology  Roles & Responsibilities  Execution Timelines  Infrastructure  Project Implementation  Operations Neeraj Mahajan 2009 51
  • 52. J HEALTH FOR ALL J Neeraj Mahajan 2009 52