Healthcare platforms for rural India

For the National Health Protection Scheme to succeed, all stakeholders must work together on a unified platform

The rhetoric over the National Health Protection Scheme seems to be dying down and the news that the final scheme will soon be announced incorporating the best practices from some of the best state scheme is heartening. The promise of covering over 40 per cent of Indian citizens and nearly 100 million families through what is arguably one of the most ambitious health coverage schemes in the world is truly exciting. However, it would be sensible for all segments — healthcare providers, insurance payers, wellness solution providers, data and analytics firms, paramedic resource trainers, for-profit companies, social enterprises and civil society — to work together on a unified platform with the local and the central governments to pull off this gigantic mission.Systems thinking suggests that the best way to design large transformative systems is to approach it from the customer or end beneficiary’s point of view and it makes a lot of sense to define that customer as well. Let me choose my childhood friend from the village of Tatisilwai near Ranchi in Jharkhand. His name is Jamnadas Thakur and we will call him Funtoosh which was the name all his friends knew him by. Funtoosh still lives in a small rented house in Tatisilwai with his wife and two children and works as a contract workman in a nearby factory built by my father for a business family in the sixties. He gets a monthly wage of less than Rs 10,000 per month. Let us see how he could navigate through the healthcare platform by 2020 and truly benefit from it. To explain the platform constituent, we will name some real service providers, who are already doing work in rural India.

The platform itself would consist of four broad service areas — wellness and disease prevention for the family, early diagnostics and tele-medicine, secondary and tertiary healthcare with support through the insurance lifeline and post treatment physical and mental support. Collateral services on the platform would be the availability of skilled paramedics to help in the pre- and post-treatment support and sophisticated data and analytics services to assist diagnostics and treatment plans. While companies as well as social enterprises that would play the service provider roles on this platform need to be identified for every district in the country, a few such entities we have already supported or met through our national initiative — Social Venture Partners — would be used to explain the whole solution.To embark on a hypothetical citizen journey, which might enable a design thinking solution to emerge, Funtoosh and his family are part of a collaborative health group set up by Swasti Health Catalysts near the venue of the weekly village haat, which mobilises the community and generates interest in health, sells low-cost health products, provides a channel for insurance sales and enables healthcare access to Funtoosh, his family and friends.

When his daughter Rani develops symptoms that worry Funtoosh, they make the trek to the neighbouring village of Namkum where the technician at the primary healthcare center uses a comprehensive equipment called ReMeDi provided by Neuro-Synaptics Communications. ReMeDi is an integrated digital platform that enables basic medical tests and wide range of point-of-care diagnostics and connects Funtoosh’s daughter to an expert in the Rajendra Medical College and Hospital in Ranchi for consultation on a recurring throat problem. Tele-medicine itself has come a long way since its early days and systems like ReMeDi on a large platform would bridge the gap completely between the patient, the health worker, the technician at the local center and of course, to the secondary or tertiary service provider. It is apparent that almost 60 per cent of potential problems can be arrested at this stage and in the unfortunate event of hospitalisation, the costs as well as the stay can be minimised.

Finally, the need for data acquisition, de-duplication and serving up actionable information to all service providers in the channel to ensure that the early issues of fraud and collusion that have plagued early tele-medicine and healthcare insurance schemes do not recur. An Aaadhar kind of approach to data capture and sophisticated tools to enable predictive and prescriptive analysis in a cyber secure environment will be a must to enable a mission of this scale to succeed and provide value to all participants.What is the recommended course of action to get all these entities to work together for the benefit of Funtoosh and his family? A comprehensive digital platform that connects all the providers, can be easily developed and installed as a district-wide, state-wide or even national initiative. Once the enrolment of willing insurance companies and secondary and tertiary healthcare centres is done and the flow of the insurance funding is streamlined, it may be feasible for Funtoosh to truly look forward to highly affordable swasth future with new opportunities for livelihood and prosperity for his little family.

Originally Published in Business Standard on Thu, March 15, 2018