Re-imagining the problem of healthcare
Being responsible for 60% of all deaths, chronic diseases can safely be called India’s biggest killers. These diseases which occur in form of various ailments like diabetes, stroke and hypertension rob our country of 4-10% of its GDP. At 65 million (Industry Report, Healthcare: India, The Economist Intelligence Unit, July 2014), India has the highest number of individuals suffering from diabetes in the entire world. Hypertension remains untreated for almost 40% of the people who have it. Fighting such a formidable public enemy will require reimagining the healthcare system.
“A WHO study says that just by controlling blood sugar level and blood pressure, 1.8 million premature deaths can be prevented every year” says Dr. Ashish Bondia, co-founder of NanoHealth while explaining the need to particularly focus on Diabetes & Hypertension. He along with his friend & fellow co-founder Manish Ranjan have taken unto themselves the task of delivering healthcare to the doorstep of millions of people who hitherto were left out from its grasp. They face 3 major challenges in their endeavour- ‘Under-diagnosis’, ‘Poor Treatment’ and ‘Poor Compliance’. Diabetes & Hypertension are notorious for being asymptomatic diseases which means people who have them don’t realize that they are suffering. This is severe in India since there’s no culture of regular health check-up. Almost 40% of people screened by NanoHealth as being at high risk didn’t know about their condition. Moreover, getting the right treatment at the right time is very difficult for most low income households given the overcrowded and underfunded government hospitals. This is further exacerbated by steep cost of medicines and continuous treatment required to keep the diseases in control. Thus most people drop out of treatment.
NanoHealth is progressively building an ecosystem of doctors, pharmacists, and women community health workers called ‘Saathis’ to reach low income households and provide them healthcare through affordable subscription plans. “After a survey we found that the biggest value for our subscribers is the health-card provided to them. It has a detailed record of visits by Saathi to their house, their Body Mass Index, their blood pressure & blood sugar level and thus helps us advise them a suitable diet and medication. They feel that we are the partners in their journey towards healthy life” says Manish. NanoHealth manages to get hefty discounts from doctors and pharmacies for its patients thus making healthcare affordable to them.
Journey so far
Manish and Ashish had widely disparate career tracks before they started NanoHealth. While Manish is a Mechanical engineer from IIT, Bombay who worked in a respected software company for 8 years, Ashish holds a Medical Degree from Armed Forces Medical College, Pune and worked as Doctor in the Indian Army for more than 7 years. Their individual paths converged at the Indian School of Business, Hyderabad where both signed up for MBA in 2013. Both of them shared the same passion for healthcare and had few ideas for starting up in this space. Their collective journey hit a major milestone when they won the Hult Prize in 2014 for their idea for solving Non-Communicable Diseases in Urban Slum along with a seed capital of USD 1 Million. “11,000 participated world over, 250 were shortlisted after the first stage followed by 6 finalists. We won the final prize at a function held in New York presided over by Bill Clinton. It was surreal! For the first time an Indian team reached the finals and won such a coveted prize” recalls Manish with a broad smile. With such a shot in the arm, it was evident that they had to bring their idea to life. Thus NanoHealth was born in March 2015.
In the last 8-9 months NanoHealth has screened more than 25,000 people in Hyderabad. Currently it has a network of 30 doctors and 70 Saathis spread throughout the city. It plans to soon open up operations in Mumbai and Bangalore.
“There is an imbalance in the resources & infrastructure on one side and the patient population on other. Thus the healthcare system cannot provide the care it is supposed to. There are simply not enough doctors and nurses and this is where our Saathis fill the gap. They are the eyes and ears of the doctor and take the reach of the healthcare system beyond the doctor’s cabin” explains Dr. Ashish. Each Saathi carries a set of basic tools in a bag, which is called ‘Doc-in-A-Bag™’. These include a Blood Pressure device, Blood Sugar monitoring device, log book, weighing machine and other items to carry out field tests. Recently NanoHealth has started equipping them with tablets to help them accurately and efficiently manage patient data from the field. Most importantly, Saathis provide the much-needed human touch by building personal rapport with people in a particular community that goes beyond mere monitoring their health. Manish puts it succinctly “Idea of a Saathi is based on the insight that a good neighbour is good for your health”
Saathis are recruited, trained and managed by a team of field executives. Each executive manages around 15 Saathis and there’s one Saathi for a community of 5000 inhabitants. All Saathis are women and mostly married with grown up children so that they can devote time for community work.
In a very short time NanoHealth has found out a way to keep its operational costs low and prides itself as the most cost effective way to manage Diabetes and Hypertension. It has been meticulously focusing on designing its systems and processes to be able to reach millions of people at the bottom of the pyramid as they expand. “A model like ours is not only applicable to developing countries but to developed countries as well. We want to go wherever we see chronic diseases are on a rise” says Manish. According to him NanoHealth’s future growth relies on their dual ability to make profits while chasing social impact. At least this debate’s settled!