CHMI Innovations Webinar: Sehat First

www.HealthMarketInnovations.com Innovations Webinar Extending Access to Healthcare Through Technology A look at the Sehat First model Speaking: Kimberly Reott

www.HealthMarketInnovations.com Working to improve health market performance for better health and financial protection for the poor. Speaking: Kimberly Reott

Delivery of Healthcare Services through Franchised Health Centers Speaking: Dr. ShahidaSaleem

4 Key Challenges Scarcity of qualified HCPs (74 physicians per 100,000 people) Unavailability of medicines in rural & peri-urban areas Median availability of less than40% of essential generics Lack of control over the quality of the available medicines and pharmacy practice Unavailability of specialist care High cost of consultation & medicines Speaking: Dr. ShahidaSaleem

5 Solution: Franchised Centers Utilizing Technology Support Systems Business Model Benefits ,[object Object]

High Standard (for products, procedures, prices, record-keeping)

Technology Back EndFranchise Networks provide such an opportunity Speaking: Dr. ShahidaSaleem

7 e-Sehat Teleconsultancy Services

Key Challenges in the technology implementation Low literacy Levels of users Acceptance by Doctors Lack of Connectivity in far flung areas Hardware Maintenance Power Outages Language Cost 8

Technology Solution Self Designed Easy of Use (visual icons) Web Based to allow use of video phones as opposed to computers Low cost of implementation Low Bandwidth Operational over multiple connectivity modes (GPRS, Broadband, dial-up, EVDO, etc) Low Cost 9

10 e-Sehat: Salient Features Basic Patient Record Management E-Consultation Session (patient-doctor) Doctor-Doctor Chat Prescriptions Patient Referrals Reports Multi-language Support (Urdu/English)

Paying for the technology Franchise Business Model Support Multiple income streams Use the technology for other purposes as well (i.etelecenter) Low cost equipment (video phone cost = USD 100, compared to computer at USD 300) 11

12 Business Model: Health Clinic +Pharmacy & General Store & Telecenter Generic Medicines Life-Saving Drugs Immunization Relevant Consumer Items Clean Water Implementation of Standard Practices Telecenter provides basic internet access (emails, govt forms etc)

13 Benefits of the approach Holistic Approach Complete value chain to patients Entrepreneurial opportunities Employment to HCPs esp. females

14 Key Linkages Connectivity Doctors’ Network (for e-consultation) Supply chain for medicines & consumer items Training of Staff Monitoring & assessment mechanisms

Discussion QUESTIONS or COMMENTS? 27

Question/Comment #1 28 How do you balance your social goals with your commercial goals?

Question/Comment #2 29 The look through your pictorial journey suggested that you are using a conversion model of franchise, in which you have existing facilities that are converted to be part of your franchise network. Is this true?

Question/Comment #3 30 How are you managing the funding of these facilities (e.g. the network, the pharmacy, the medicine supply chain)?

Question/Comment #4 31 How much would it cost to replicate this elsewhere?

Question/Comment #5 32 Does it cost for a patient to see a doctor?

Question/Comment #6 33 I’d like to hear a bit more about your relationship with other stakeholders, like the pharma industry and the telecom industry, because I see that they can profit from the data [you have] about the clients.

Question/Comment #7 34 We are trying to build a similar model here in Brazil. And I was just asking because we were able, 2 years ago, to establish a business model with the pharma industry [to help them gather data on patients].

Question/Comment #8 35 Do you get paid for providing this data?

Question/Comment #9 36 Where do entrepreneurs get the capital to start their franchised clinic? Do they make a profit?

Question/Comment #10 37 What are the cost-savings that have been achieved by the IP-based video-phone?

Question/Comment #11 38 Considering that the doctor has to have access to the patient’s condition, the patients need to have access to basic body parameters. [How do you accurately take readings of the patient and communicate them to the doctor?]

Question/Comment #12 39 What kind of results do you track via the assessment mechanism? Do you track health outputs or other impacts?

Question/Comment #13 40 How do patients access the service and how is it provided? Is it similar to the HMRI model in India?

Question/Comment #14 41 [What technology are you using for the video-conference?]

Question/Comment #15 42 How do you manage exams? Do you use any portable exam equipment?

Question/Comment #16 43 Given the challenges of scale of telemedicine, what are your plans for expansion? Will you tweak the business model in any way?

Question/Comment #17 44 How are these franchised clinics financed?

Question/Comment #18 45 Does the entrepreneur independently dispense the drugs?

Question/Comment #19 46 Are patients able to use government-financed health insurance?

Question/Comment #20 47 Could you elaborate more on your use of lady health workers and female doctors?

Question/Comment #21 48 Could you explain more about the NayaJeevan [health insurance] model?

Question/Comment #22 49 With each clinics multiple streams of income, do you expect to recover all costs, or even make a profit?

Question/Comment #23 50 Have you had many problems with patients accepting the use of this new technology?

Question/Comment #24 51 How many consultations are given [in any period of time]?

CHMI Innovations Webinar: Sehat First

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