This document discusses healthcare challenges in rural India and describes Piramal e-Swasthya's model for addressing these challenges. Key points: - Rural India faces inadequate healthcare infrastructure, resources, and spending imbalance compared to urban areas. - Piramal e-Swasthya aims to provide affordable primary healthcare in rural villages using village-based health entrepreneurs and telemedicine. - Local women are trained as health workers and set up village clinics connected to doctors via mobile phones and a clinical decision support system.

1. INNOVATION V Piramal e-Swasthya

3. In 2003 the patients treated for malaria were 1.65 million, for leprosy there were 2.4 million people and there were 214 cases of polio.

4. In 2001 India received $1,705 million as aid for the healthcare programs which were only 2% of the total healthcare expenditure by the government.

6. Inadequate human resource 13

8. The PHCs are supposed to have one medical officer supported by paramedical staff.

9. .While not a single PHC of UP's 3,660 PHCs have either a labour room or an operation theatre.

10. The number stands at 208 labour rooms (13%)

14. Inception in 2008

15. Offers a Scalable and Sustainable breakthrough in healthcare delivery models at rural level.

16. Developed in partnership with Prof. NitinNohria of Harvard Business Model.

18. Sustainable Service ModelsAFFORDABLE HEALTHCARE

19. eSwasthya Working Model Local literate women (PiramalSwasthyaSevaks) are recruited undergo a rigorous training programme in which they are trained to collect simple diagnostic information, preventive medicine, first-aid and customer service. These women are given a medical kit, marketing material and a mobile phone. They are then assisted in setting up a tele-clinic (Piramal e-Swasthya Centre) at their own homes. Villagers who feel ill come to the Piramal e-SwasthyaCenter or are visited by the PiramalSwasthyaSevak. After talking to and examining the patient, the health care worker communicates this diagnostic data through a cell-phone to a centralized call centre. At the back end, a call centre worker enters the information provided into a simple e-diagnosis system, which generates an automated response with the recommended prescription and treatment. Doctors manning the call centre also validate this. The total treatment costs between Rs.30 - Rs.50 depending on the medical condition. The Piramal e-Swasthya Centre is also a village level pharmacy stocked with medicines necessary to fill the basic prescriptions recommended by the call centre. If the ailment appears serious, the call centre recommends that the patient visit a secondary or tertiary healthcare facility immediately. The healthcare worker also conducts preventive health workshops, which generate awareness about issues such as sanitation, nutrition and first aid.

20. Working Model Approving doctors

21. Differentiation

23. Unavailability of skilled human resource at remote areas

24. Recruitment of PSS is a long drawn process

25. Low MarginsLow income for PSS

26. Quality treatment at doorstep

27. Easier Access to a doctor

28. No spurious drugs

29. High Quality treatment at affordable rates

30. Strong social impact by giving employability

32. PSS uses mobile to dial up the Nucleus, a telemedicine call centre manned by paramedics & doctors.

33. Paramedics receive the calls and enter information into web based Clinical Decision Support System(CDSS). This has been developed with TCS.

34. CDSS is state-of-the-art clinical diagnosis platform that automates the generation of provisional diagnosis and prescription.

35. Doctors review CDSS generated diagnosis.

37. PSS recruits and trains and deploys village based women health entrepreneurs, PiramalSwasthyaSahayikas, who enable healthcare access to rural patients.

38. eSwasthya centre is set up in her own home

39. PSS undergoes a 5 day training programme on how to conduct basic health service, use digital equipment, handle mobile usage, accounts and counsel patients.

40. PSS gets 20% of the consultation fees.

43. Makes access to healthcare affordable

44. Healthier rural population

49. Objective is to enable Government(NRHM) appointed ASHA Sahyoginis to provide telemedicine services in their villages.

50. PPP model with district administrations to enable ASHA volunteers work as PSS and leverage benefits of ASHA model an contain its limitations.