iKure: How regular broadband can help bridge the rural healthcare gap

The diagnosis was always known. The state of the country’s rural healthcare sector was in a dire need of a life transfusion. How much it has worsened was revealed in a recent survey, Understanding Healthcare Access in India: What is the Current State? by IMS Health Institute.

Here are the statistics: Around 72 percent of the Indian population that lives in rural regions have access to just one-third of the total available hospital beds. The distribution of healthcare workers including doctors, nurses and pharmacists, is highly concentrated inurban areas and the private sector.

Changing things
A personal experience with the appalling rural health sector in his home town in West Bengal encouraged 36-year-old Sujay Santra to turn things around. In 2009, his father, after undergoing an operation at a well-known hospital in Bengaluru, returned to his village inBengal. It was here that Santra saw the stark comparison between Bengaluru and healthcare in the rural areas that teemed with the poor availability of medicines and abysmal post-operative treatment.

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In 2010, Santra set up iKure Techsoft Pvt. Ltd, a Kolkata-based startup which provides low-cost primary healthcare facilities to the rural population.

“Most people who live in villages have to travel long distances for routine health checkups. As if that wasn’t trying, the treatment is costly too,” informs Santra.

Santra, a post-graduate in computer application, worked with technology biggies like IBM, Oracle and others for an in-depth understanding of software product lifecycles beforeventuring out on his own. “I was looking at creating a technology that would use low internet speeds, was easy to use and also low on capital,” says Santra. He was supported in his initiative with a seed capital of Rs 75 lakh by Webel Venture Fund, a governmentfunding agency of West Bengal. This helped Santra develop the first product-Wireless Health Incident Monitoring System (WHIMS), which was incubated at the Indian Institute of Technology, Kharagpur.

Online connectivity
WHIMS enables effective communication, integration and contact between rural medical practitioners (RMPs) and city-based doctors.

The cloud-based software is in sync with the hospital management software and allows transmission of patient data from health centers to larger clinics and hospitalsfor reference.

When a patient visits a rural health center, the health worker (who is trained to use WHIMS) takes down the relevant information for the first level of diagnosis. The worker also issues a health card to new users and conducts necessary examinations-the details of which are uploaded using the software.

For basic treatment, medicines are prescribed immediately. For specialized diagnosis, the patient is connected to a doctor. This is done in real-time using regular broadband or data card lines with an enlisted doctor at a hospital. The doctor, who now has access to thepatient’s details, asks for necessary clinical information and makes them take a few more tests if needed. These are done by an RMP who handles the specialized equipment at the center.

On the basis of the information given, the doctor decides to further investigate the case or seek additional reports. Once satisfied, the doctor can either prescribe medicines or give general advice. This is what Santra calls the hub-and-spoke model where treatment works out 75 percent cheaper for the patients.

The model
iKure earns through a subscription model. It charges clinics and hospitals anywhere between Rs 2000 to Rs 6000 a month to use software; however, rates vary depending on nature of inventory, pharmacy, diagnosis and other information which larger clinics and hospitalswould need access to. iKure has and will be setting up its own health centers where it carries out basic tests for patients, Santra informs.

“The company is bridging a huge gap and providing low cost healthcare. We came in as investors when they had one center. They’re growing at a healthy rate and plan to open 15 more centers by early 2014,” says Raghav Kanoria, Founder, Calcutta Angels and investor at iKure, unwilling to disclose funding details.

[caption id=“attachment_77180” align=“alignleft” width=“380”]  Image: Subrata Biswas[/caption]

Use and sell
Before Santra actually launched the first medical center of roughly 300 square feet in a village in Bengal in November 2012, he conducted 20 pilots with corporates and NGOs. Today, iKure has four doctors and six paramedical staff who shuffle across its six centers inWest Bengal.“We have tied up with three hospitals-two in West Bengal and one in Mumbai. Not only do these hospitals provide diagnosis and consultancy, they also give patients registered with us a five percent discount on secondary or advance treatments,” claims Santra.

Alongside, iKure sells its patented software to 15 hospitals and ten NGOs. “Most of the revenue comes through the sale of software. Our monthly operations are about five lakh rupees,” shares Santra. The startup posted Rs 30 lakh as revenues for FY12-13.

Treating good
“Only two percent of India’s GDP comprises of healthcare. However, the need for this service is so huge that the company will have to scale up,” says Satyajit Bose, Chairman and Senior Cardiologist, Mission Hospital, Durgapur, which uses iKure software.

Sandeep Sinha, Director, Healthcare & Life Sciences Practice, Frost & Sullivan, a market research firm, foresees a plethora of challenges.

“The first is scalability and the next, availability of finances. To create a sustainable model, it is important to have government inclusion because of the lack of insurance in these areas. If the model is not backed with healthy rates of insurance, then the model willfail,” he predicts.

Santra plans to open six more centers by the year end and have 300 centers across the country with a lofty revenue target of Rs 80 lakh in FY13-14. He plans to sell the software to government agencies in a few countries in Africa and is in advanced talks with some of them.

This article first appeared in Entrepreneur India magazine.