Presented at the International Telemedicine Congress 2011 in Mumbai

1. Convergence to mHealth
Pankaj Vaish Convergence
President, HealthFore
Why mHealth?
(Healthcare IT Division of Religare Technologies) Use Cases

2. Convergence – Voice, Video & Data
Convergence Provides
• opportunity to operate more
efficiently
• increased ROI on technology
• rapid market expansion and
new markets
• consumers new ways of
communication and do
business together at lower
costs than before
• convenience of having many
devices all in one, saving on
both size and ownership costs

3. Convergence – Impacting Our Lives
Pictures
Music
Video
Social Networks

4. Convergence - Technology and Platform
Convergence

5. Interoperability in Healthcare
The Paradigm Shift
5

6. Convergence
Why mHealth?
Use Cases

7. The Growing Healthcare Divide
Ageing Population
Resource Patient
and Rising Chronic Integrated Care
Constraints Empowerment
Diseases
Indian Healthcare Capacity Shortfall (in mn)
8
6
3.6 3.7
4
1.9 1.8
2 1.9
0.9 1.5
1.3 0.7
0
Bed Doctors Nurses
Existing Required (2010) Required (2020)
Source: Public Research Source: McKinsey & Company CII Seventh India Health Summit Dec 2010
Need for measures to provide health
Rising demand for medical services and timely
Out of pocket expenditure is more than 80% specialists’ access anytime anywhere and not
medical intervention
only at the point of care
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8. The Mobile Revolution
• Mobile phones is one of the most disruptive change of
the millennium – it has changes how, how much, why
and to whom we communicate Mobile Density in India
• Mobile devices are personal technology that enable
consumers to establish personal preferences for sharing
and communicating
• Connectivity is driving the world
Users Global India
Mobile 5.3 bn 900 mn
Internet 2.1 bn 100 mn
Mobile Internet 0.5 bn
Facebook 0.6 bn 20 mn
• Mobile devices bring the rural geographies into the
mainstream to deliver health and wellness
• While Economic indicators of a country have a directly
co-relation to their healthcare system, it is not the case
with mobile penetration
Tele-Health market in India is expected to grow at a minimum of 15% CAGR for the next decade

9. Convergence
Why mHealth?
Use Cases

10. mHealth Services: Use Cases
Tele-Triage
Tele-Clinics
Tele-Medicine
Chronic Disease Management
Disease Surveillance & Disaster Management
Call a Doctor/ Patient Education Home Health and Tele-Diagnosis and e-
Tele-Counseling
Second Opinion and Health Tips Remote Monitoring Prescription
10

11. Tele-Triage
(Typical OP consultation services to subscribers)
Service Highlights Benefits
Scope of Services: • Improved quality of care, access, reimbursement,
• Emergency referrals for critical, life and cost reduction.
threatening illnesses or non-life • Tele-triage is an access tool for patients that can
increase patient satisfaction, as well as their
threatening cases that require urgent
compliance with telephone advice.
medical care
• Vital tool for Health Authorities to control demand
• Ambulance services in view of the limited healthcare resources and
• Consultation services with physician manage costs as well as care
• Referral services to nearest hospital
• Regular/ routine cases
Caller Intent Call Result
• Consultation with “Advice Nurses”
Call Ambulance 0.2 % Call Ambulance 2%
• Prescription of OTC drugs
ED Visit 47 % ED Visit 10 %
• Pathology/Radiology/Pharmacy referrals Symptom
Urgent GP Visit 6% Urgent GP Visit 17 %
Assessment
Customers for Tele-Triage services: Dr. Appointment 26 % Dr. Appointment 32 %
• Individual Subscribers Non GP 18 % Non GP 2%
Self Care 37 %
• State Health Authorities Self Care 2%
• Corporates/Employers
• NGOs
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12. Chronic Disease Management
Service Highlights
• Population based strategy as well as
approach to personal health
• Personalized suggestions, health tips,
symptoms management through IVR
calls, SMS, mobile internet
• Interaction of multiple parties (e.g.
physicians, nurses, medical device
manufacturers, mHealth players, telecom
service providers) to provide best
possible extended patient care Benefits
• Reduced disease burden: individual/community
Applications: • Improved quality of life: prevention/limitation of
• Mobile Apps and SMS based patient effects of chronic disease
management • Reduced costs
• Remote Monitoring • Improved patient satisfaction, compliance.
• Mobile Clinics

13. In Conclusion …
• Convergence in technology and
interoperability amongst
various healthcare stake
holders is changing the way
care gets delivered
• mHealth/ tele-health is helping
bridge the healthcare divide
that exists in the developing/
underdeveloped countries
• mHealth solutions and success
stories exist but there is a clear
need to find the right business
models to scale up these
solutions

14. Thank You

15. Disease Surveillance & Disaster Management
Service Highlights
• Provide innovative, integral platform of
information and communication to aid in
prevention/mitigation of disasters and
disease outbreaks
• Information and communication technology
based platform to send reports to
appropriate agencies in the event of disease
outbreaks and disaster, both natural and
man-made.
• Use of devices such as:
Benefits
– Mobile Phones
– Fixed phones • Availability of greater and better information in
a short time
– Paging Devices
• Compilation of information and feedback.
– Computers connected to internet
• Significant reduction in response time to major
• System saves the data, produces
disasters/disease outbreaks.
dashboards and summary reports in real-
time to make decisions and send alerts. • Involve citizens and social organizations in
disaster response.
• Ideal platform for PPP

16. Tele-Clinics
(Clinical care at a distance through e-clinics or centers)
Service Highlights
• Care at a distance through Technician managed
Kiosks at strategic locations:
• Hospital Waiting Areas
• Premium Residences
• Airports
• Kiosks are booths that have connectivity and
software/hardware that have Audio-Visual capability
• It is almost like a “self-check-in” counter setup
where a technician can assist patient record their
vitals, talk to a doctor etc.
Benefits • Healthfore – Solution Design and Implementation,
• Improved quality of care, access and cost reduction. Program Management, Business Models
• Healthcare Provider – Medical Experts, Technician,
• Appointment scheduling
Nursing and Paramedics
• Real time patient status: separate U/I* for Doctors as • Telecom Service Provider – Connectivity, Telecom
well as patients. Support and Uptime.
• Increased customer satisfaction. • Application and Devices – Remote Monitoring
• Value added services such as FAQs, Mind maps devices, Integrated Application.
U/I: User Interface
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17. Tele-Medicine
(Tele-Radiology, Tele-Pathology, Tele-dermatology, etc.)
Service Highlights
Telemedicine can be broken into three main categories:
 Remote monitoring: primarily used for managing
chronic diseases or specific conditions, such as heart
disease, diabetes mellitus, or asthma.
 Store-and-forward telemedicine: involves acquiring
medical data (like medical images, biosignals etc.) and
then transmitting this data to a doctor or medical
specialist for assessment offline.
 Common specialties that are conducive to
asynchronous telemedicine: Benefits
• Radiology
• Access to improved, quality health
• Pathology care especially for rural patients.
• Dermatology • Saves time, travel and other expenses
 Interactive Telemedicine services: Real-time for the patients.
interactions between patient and provider (or • Second opinions: accuracy of
between 2 or more providers), to include phone diagnosis, reduction in medical errors
conversations, online communication and home visits.
• Platform for Continuing Medical
 Important application: Tele-ICU Education