Team TrojansSanaSupriyaNitinChirag

Innovator 5 Piramal e-Swasthaya Centre

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

 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. 

Primary Research

A patient at the clinic

Piramal Care Centre pictures

Process Model

Step wise procedure

Process Flow

Local literate women - Piramal Swasthya Sevaks -Recruited-Undergo rigorous training programme Trained to collect simple diagnostic info -Provide preventive medicine, first-aid and customer service

Given a -Medical kit-Marketing material-Mobile phoneAssisted in setting up a Piramal e-Swasthya Centre at their own homes

Ill villagers to Piramal e-Swasthya Center or visited by the Piramal Swasthya Sevak. -He / She talks to and examines patient, communicates diagnostic data through a cell-phone to a centralized call centre in Mumbai

At back end, A call centre worker enters info provided into a simple e-diagnosis system, which then generates an automated response with the recommended prescription and treatment.

Doctors manning the call centre also validate this.The health care worker also conducts preventive health workshops, which generate awareness about issues such as sanitation, nutrition and first aid.

SARVA JAL – Pure Water Service

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

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: 40Annual budget: $ 500,000

Future60 new villagesCeased operations in 25 out of initial 40 villages.Centres in these villages were not seeing enough patientsto make the service sustainable, profitable and scalable

SWOTSTRENGTHS:

1. Caters to Rural India2. Boon for underprivileged Indians3. Addresses issues of lesser doctors4. At a villager’s doorstep5. Cutting-edge technology

WEAKENESSES:

1. Demand still more than supply2. More recruitments required both for doctors and PSC3. More funds required

OPPORTUNITIES:

1. Lot of untapped areas in field of health, many rural areas

2. Can be expanded later in semi urban areas as well

THREATS:

1. Competition2. Cheap technology not easily

available3. Cost is more but profit less4. Risk of Untrained PSCs

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:

0 1 2 3 4 5

Capacity to scale up

Ensuring Social equity

Creating new price – performance levels

Fair & Transparent transactions & relationships

Environmental sustainability

Respecting rule of law and individual rights

C.K. Prahlad’s Sandboxmoderate

High

High

High

High

High

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

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

E-Swasthya Campaign

Spearheaded by Mr Anand Piramal. 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

Telemedicine – Can Be Promoted

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

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