The document discusses opportunities in India's healthcare industry from a consumer perspective. It notes that more Indian healthcare consumers are using the internet to research health issues due to limited time with doctors and a desire to understand options. However, consumers also face an information overload and confusion. There is potential to structure shared experiences and wisdom of crowds online to help consumers navigate health information and alternatives. The growing burden of chronic diseases in India also presents opportunities for non-traditional business models to address issues like categorizing health problems and publishing medical findings.

1. Healthcare in India – Consumer Perspective Opportunities! Startup Saturday - Delhi Manish Rathi http://www.manishrathi.com

2. ‘ All the views expressed on this presentation are mine. It may or may not reflect the views of my employers – current or the past.’

3. My background Surrounded by Family and Friends of two generations of Doctors Experiences of dealing with Healthcare Services for Chronic Diseases in US and India Masters Degree in Industrial Management (HCI) and Computer Science. Personal Professional Technology industry specialist Have consulted and helped more than 12 startups in building consumer products and services (including 2 in Healthcare) Use of technology/non-technology/social platforms to facilitate a key need in society.

4. Agenda 10000 feet view of Healthcare in India Changing Patients Behavior Drivers Overview of Healthcare Delivery Process and Players Opportunities Overview Conclusions

5. Consumer Healthcare – The Big Picture!

6. Healthcare in India seems to be at a Crossroad! The Good News…

7. … and the bad news!

8. Varied Healthcare Consumer Behavior Paternalistic Model Overloaded but Confused Case Studies, Aggregated Data Internet Networks on Internet Content & Complaint Satisfied Least likely to seek information Least likely to compare alternatives Traditional but want to be engaged Less Satisfied & Compliant Will insist on comparing alternatives Ready to switch between alternatives

9. Internet Users - India 2009 – No. of Internet Users == 5 Crores (~49 Million) ~ 4 Crore in Urban ~ 1 Crore in Rural Still a small proportion – however the existing % is becoming livelier. 28% growth over last year in “Daily Internet Users”

10. India can now start generalizing Internet behavior from other countries India – 3% of population USA – 70% of population

11. Consumer’s trust in Doctors and Internet for information seems to be equaling… 68% 2009

12. … and also there is an increasing trust in other patient’s experiences!

13. What is also driving Consumers to Internet – Our perspective! Access to doctor is limited to minutes; Internet is 24 x 7. Internet also seems more friendly! Not able to understand doctor’s jargon; Internet provides an simplified and illustrative view. Increasing play of medical over- specialists hence the fear of uni-dimensional view; patients desire someone to look at them as a “whole”. Increasing practice of defensive medicine/one treatment-fits-all method; curious patients will desire alternatives. Trust/options in medical advice.

14. Simplified Healthcare Service Delivery Process Discovery Treatment Type-A Examples: Cold, Headache, etc. Discovery Treatment Type-B Examples: H1N1, Malaria, Pregnancy, etc. Diagnosis Discovery Treatment Type-C Examples: Rare Diseases, Organ Failures, etc. Diagnosis & Decision

15. Type-C: Players in the Delivery Hospitals; Nursing Homes Specialty Care (n*); Labs Paternalistic or Collaborative Primary Care; Dr. Google; Insurance WebMD.com; YouTube 1-800-Doctors; DoctorsNearYou.com Information Centric; Managed; 1:1 Interaction RateDoctors.com RateHospitals.com PatientsLikeMe.com PatientsLikeMe.com GetWellTogether.com Autonomous; Group based Interaction in Networked Environment Prospective (outcome has not occurred as yet) vs. Retrospective (outcome has occurred) Treatment Diagnosis & Decision Discovery

16. Opportunity Drivers (1/4) Fact - Increasing number of healthcare consumers in India are going on internet to know about the health issues You cannot hide a cheese from the mouse! Doctors should start considering this as an operating assumption. Other consumer industries are also seeing the same trend (e. g. Electronics, Travel, Books, etc.) Fact - Healthcare consumers are facing with an information overload – more knowledgeable now but increasingly confused and wary. Need for an understanding doctor is more acute now. Doctors need to acknowledge patient’s research/findings; yet maneuver them through the maze. Consumers will start questioning doctors more; would rely on them to help them traverse the information.

17. Opportunity Drivers (2/4) Fact – We learn from our experiences; so we can also learn from other’s experiences too. Structured “Wisdom of Crowd” technique already being adapted by other industries; can be adapted by Healthcare too. Religious places and/or fakirs have successfully used ‘crowd phenomenon’ to attract healthcare consumers; we believe modern medical science can benefit from this phenomenon too! Fact – Modern Healthcare consumers will share their health information on the internet with others. Lot to learn from how Indian consumers have openly shared their personal information on Matrimonial Sites to seek their other significant-half. There is a reasonably good chance that they will do the same for their own-self for healthcare purposes.

18. Opportunity Drivers (3/4) Fact - As a society, India is not becoming a healthy society New cases of ailments increasing by nearly 7-9% every year. (~ 150 Crore by 2015) Increase is getting driven by Rising population Increase in reported ailments due to better affordability Rapid change in Life Style Easier access to healthcare facilities Change in disease mix towards non-communicable diseases One in seven Indians today suffer (or will suffer) from some kind of Chronic Disease/Rare Disease.

19. Opportunity Drivers (4/4) Fact – Unlike most developed countries; India has a poor track record of categorizing and tracking health problems which its citizens faces. Our citizens still refer to health literature/information which is typically written for different environment, circumstances, and personas (e.g. United States, etc.) We do not have a visible concept of rare diseases categorization and tracking. Medical Service Providers in India have a poor track record of publishing their findings. Neither have our Government/Consumers incentivized them to do that. Unrealistic to expect Government to operationalize this. Should Consumers do it now using collaborative/Web 2.0 techniques (with support from providers)? Fact – Indian Healthcare Industry at present offers a big opportunity for non-traditional/disruptive business models to facilitate the challenges.

20. Thank you Manish Rathi