This guest column is authored by Dr Dharminder Nagar, Managing Director, Paras Healthcare
For Sarita, 35 and her family of six living in a village of Bihar, accessibility of a doctor was a major concern. The family had to travel almost 35 kms to reach the district hospital. They travelled first on a bullock cart to the nearest bus stop, and following the bus journey, walked another 30 minutes to finally reach a doctor. However, things changed for good recently when a private company opened a telemedicine centre in their village, making it possible for them to seek remote consultation from a doctor through video chat.
Where there are challenges, there are opportunities for the visionary. As they say, you might look at the half glass empty or the half glass full!
Beleaguered by a series of challenges and lacunae, Indian healthcare is one such arena that presents numerous opportunities for entrepreneurs to tap into the unseen. Lack of trained medical human resource, creaking public health infrastructure, absent doctors in rural areas, paucity of trained emergency personnel and minimal focus on preventive care are only some challenges bedeviling the Indian healthcare sector. While at one level, these challenges pose a significant concern for a country of a billion plus people; at another level the same challenges offer a huge range of opportunities for healthcare entrepreneurs looking to make a difference in the field. Not only can they script impressive success stories by launching ingenuous and innovative healthcare solutions, the penetration of such ventures can also help fill major voids in services and care delivery.
Healthcare entrepreneurs in India would do well to look at the following areas for opportunities:
Setting hospitals in small town India and rural areas
For people like us sitting in urban centres, it is often hard to fathom the extent of deprivation faced by the countrymen and women living in rural areas. Despite a majority of the Indian population living in rural centres, the healthcare facilities are unevenly concentrated in urban areas. In fact, according to figures estimated by the National Rural Health Mission (NHRM), the ratio of rural population to doctors is six times lower than in urban areas while the ratio of rural beds vis-à-vis the population is 15 times lower than in urban areas. At the same time, 31 percent of the rural population in India has to travel over 30 km to get needed medical treatment. Forget villages, even small towns and tier II cities often lack quality healthcare facilities, and people have to travel to Delhi NCR to avail treatment.
For entrepreneurs and innovators, these glaring gaps present unique opportunities. Setting up hospitals in smaller towns and rural areas, and designing them to operate at minimalist costs can be a game-changer for the country. With urban centres already saturated, it is time healthcare entrepreneurs move to small town India to set up hospitals that also cater to rural population.
Low cost solutions for healthcare
When it was invented in the 1960s, the Jaipur Foot, a cost-effective and highly viable artificial limb proved to be a game-changing innovation. With improved accessibility, it was a life-changing solution for many disabled people who couldn’t afford high cost artificial limbs available in the market. India is desperately hungry for such innovations.
For a country where less than 30% of people have health insurance coverage, most healthcare requirements ranging from diagnosis to surgery are paid out of pocket. Developing and marketing frugal innovations and low cost solutions is therefore not just a good social initiative but also a fruitful business idea in a country which has a large under served population. Entrepreneurs can invest in developing low cost diagnostic kits for rural households, low cost dialysis technology, cheap sanitary napkins, cheaper cardiac surgery, among others.
Innovation in health care and medical technology can accelerate the country’s social and economic growth by making healthcare facilities available to the masses.
Remote care through telemedicine
As discussed at the onset of this argument, telemedicine and remote care can provide access to doctors to a large population of under-served people, especially in rural areas. This can also reduce the excessive burden on district hospitals that serve thousands of people every day. Thankfully, a number of independent investors and innovators are investing in telemedicine technology, which needs to penetrate down and deep. In fact every district hospital needs to have a telemedicine centre to cater to the remote population. Through remote care, a large number of patients with minor health issues can be treated without the need to visit the hospital; while more serious cases can be called for personal examination. This can also dramatically reduce the number of visits to the hospital.
Strengthening Emergency medicine
With the Medical Council of India recognizing emergency medicine as a separate specialty in medical training only in 2009, the branch of Emergency Medicine is still in quite a nascent stage in India. Apart from dedicated emergency departments and protocols, there is also an acute shortage of nurses and paramedics trained in emergency response to aid doctors in an emergency & trauma department. Lack of ambulances equipped with the right emergency equipment is also glaring. Only around 4% of the ambulance personnel in India have any certified formal training and one-third of our ambulances serve merely as transport vehicles with no paramedical staff. Unfortunately, pre-hospital care is virtually non-existent in the rural and semi-urban areas of our country, and as many as 30% of emergency patients in India die before they reach a hospital.
For healthcare entrepreneurs, the opportunity lies in launching educational and training initiatives to fill these gaps. Investing on developing equipped ambulance services is another much needed critical intervention.