Innovation 5: Piramal E-Swasthya Centre Team Trojans: Supriya, Sana, Nitin, Chirag

1. Innovator 5 Piramal e-Swasthaya Centre Team TrojansSanaSupriyaNitinChirag

2. Health Care Sector Only 30% of Indians have access to modern medicine Although 70% of our populations living in villages,difference in life expectancy between urban and rural India is at 12 years. While the national doctor-patient ratio is 1:1700, in rural areas this is said to plummet to 1:25,000 Fertility, mortality and morbidity remain unacceptably high

3. Piramal e-Swasthaya Centre Healthcare, pharmaceuticals, diagnostics, glass, real estate and financial services The Piramal Group runs the The Ajay G. Piramal Foundation, a non-profit organization E-Swasthya a Social Initiative of Primal Healthcare Limited, a first-of-its-kind project in Rajasthan, India addressing the issue of absence of doctors. They currently operate close to 100 villages in Rajasthan and have provided services to over 25,000 patients in the last two years.

4. Primary Research A patient at the clinic Piramal Care Centre pictures

5. Process Model Step wise procedure

6. Process Flow

7. SARVA JAL – Pure Water Service

8. USP of Innovation This model provides : Reliable, high quality health care At a villager’s doorstep Through cutting-edge technology developed from sophisticated diagnostic protocols Allowing the patient to receive immediate relief Saving on valuable time and money that is usually lost in travelling to see a doctor in a nearby town. For the first time, patients have access to world-class medicines at an affordable price

9. Cost Structure Total Cost : Rs. 30- 50/- Village Level Pharmacy stocked with medicines varying in price (To fill the basic prescriptions recommended by the call centre) Cost varies in Serious ailment -> Call centre recommends patient to visit a secondary or tertiary health care facility No. of people currently involved = 175 Past Growth(From Mar 2008 and April 2010) No. of patients treated: 25000 patients Villages: 40 Annual budget: $ 500,000 Future 60 new villages Ceased operations in 25 out of initial 40 villages. Centres in these villages were not seeing enough patients to make the service sustainable, profitable and scalable

10. SWOT

11. Stage I :- Table Analysis Rating the innovation on a scale of 0 to 5 (5 being the highest score) on each of the parameters outlined in the sandbox, the self assessment scores are:

12. C.K. Prahlad’s Sandbox moderate High High High High High

13. Untapped Opportunities Household spends over Rs 2,000 per annum on outpatient care Inpatient expenses are typically funded by loans at very high interest rates (5% per month) About 25% of inpatient events result in households getting caught in a "poverty trap" About 20mn people in India go below poverty line every year due to health event

14. Expand Reach Penetrate in other areas along with Rural Parts of Rajasthan Whole India needs such innovations to reach to the bottom of the pyramid

15. E-Swasthya Campaign Spearheaded by Mr AnandPiramal. Campaign launched in Rajasthan A nurse helps communicate ailments of local people to doctors, who diagnose the illness and prescribe medicines that are delivered back to the people. Still at a preliminary stage, if it takes off, the plan is to cover 100,000 villages in five years E-Swasthya Advertisement

16. Telemedicine – Can Be Promoted

17. Road Ahead On the demand side Consumers need access to basic health services (e.g. common drugs, diagnostics, first aid) at village level Consumers value convenient access to low cost capital in case of hospitalisation Consumers need comprehensive health package / plan covering both frequent outpatient care events and less frequent but high “shock” value inpatient care / hospitalisation events On the supply side Doctors looking to partner / be empanelled to increase patient flow and reputation in the area Hospitals keen to get empanelled and offering discounts and procedure wise fixed prices to increase patient flow Low cost, high quality generic drug manufacturers available and keen to increase volume a the cost of branded drugs

18. Future... Service Providers Doctor availability should be across different regions Doctors do recognize that they have spare capacity and are keen to increase patient flow Diagnostic laboratories should be available at town levels Drugs Drugs form ~80% of outpatient care costs High Drug cost a serious concern for consumers. So cost to be reduced. Pharmacy typically available close to doctors Most commonly used drugs cost 25-30% to manufacture and another 10-15% to deliver to the retailer level Hospitals Multi-specialty hospitals available at nearest town levels, which consumers are comfortable with Hospitals should have spare capacity and keen to increase patient� Join hands with NGOs working for penetrating to more areas Affordability Low costs of outpatient care, particularly drugs High one time premium for the entire family / true insurance Acceptability: Limited perceived health benefit since insurance benefit limited to hospitalization which has only 2-3% incidence, while there is no benefit on outpatient care > 100% incidence