This document discusses healthcare challenges in rural India and describes Piramal e-Swasthya's model for addressing these challenges. Key points: - Rural India faces inadequate healthcare infrastructure, resources, and spending imbalance compared to urban areas. - Piramal e-Swasthya aims to provide affordable primary healthcare in rural villages using village-based health entrepreneurs and telemedicine. - Local women are trained as health workers and set up village clinics connected to doctors via mobile phones and a clinical decision support system.

1. INNOVATION VPiramal e-Swasthya

2. General Health Condition in IndiaIn 2002 investment in healthcare was only 0.9% of the total GDP.

3. In 2003 the patients treated for malaria were 1.65 million, for leprosy there were 2.4 million people and there were 214 cases of polio.

4. In 2001 India received $1,705 million as aid for the healthcare programs which were only 2% of the total healthcare expenditure by the government.

5. But most of this money go into urban areas and only a small amount is used by the rural areasInsufficient expenditure on healthcare

6. Inadequate human resource 13

7. Fall of rural Health InfrastructureAccording to the recent National Rural Health Mission report nearly 8% PHC don't have a doctor while nearly 39% were running without a lab technician and about 17.7% without a pharmacist.

8. The PHCs are supposed to have one medical officer supported by paramedical staff.

9. .While not a single PHC of UP's 3,660 PHCs have either a labour room or an operation theatre.

10. The number stands at 208 labour rooms (13%)

11. Moreover there is a shortfall of 70.2% specialists at the CHCs.Rural-Urban imbalanceNHA(2004-2005) Report Government expenditure on family welfare and other heakth servicesURBANExpenditure of 92,408 million rupeesRURALExpenditure of 52,970 million rupees

13. Piramal e-SwasthyaVISIONTo Democratize HealthcareMISSIONTo provide reliable, high quality and affordable primary healthcare to no-doctors zones of Rural IndiaGOALTo enable services in 100000 villages by 2013An initiative by Ajay G Piramal Foundation and a subsidiary of Piramal Healthcare.

14. Inception in 2008

15. Offers a Scalable and Sustainable breakthrough in healthcare delivery models at rural level.

16. Developed in partnership with Prof. NitinNohria of Harvard Business Model.

17. Uses innovative approaches of healthcare delivery like Telemedicine, Clinical decision support systems and village based health entrenpreneurs.ObjectivesPiramal e-Swasthya attempts to make affordable healthcare accessible to India’s rural communities using technology through a sustainable and scaleable service modelUse of Technology

18. Sustainable Service ModelsAFFORDABLE HEALTHCARE

19. eSwasthya Working ModelLocal literate women (PiramalSwasthyaSevaks) are recruited undergo a rigorous training programme in which they are trained to collect simple diagnostic information, preventive medicine, first-aid and customer service. These women are given a medical kit, marketing material and a mobile phone. They are then assisted in setting up a tele-clinic (Piramal e-Swasthya Centre) at their own homes.Villagers who feel ill come to the Piramal e-SwasthyaCenter or are visited by the PiramalSwasthyaSevak. After talking to and examining the patient, the health care worker communicates this diagnostic data through a cell-phone to a centralized call centre.At the back end, a call centre worker enters the information provided into a simple e-diagnosis system, which generates an automated response with the recommended prescription and treatment. Doctors manning the call centre also validate this. The total treatment costs between Rs.30 - Rs.50 depending on the medical condition. The Piramal e-Swasthya Centre is also a village level pharmacy stocked with medicines necessary to fill the basic prescriptions recommended by the call centre. If the ailment appears serious, the call centre recommends that the patient visit a secondary or tertiary healthcare facility immediately.The healthcare worker also conducts preventive health workshops, which generate awareness about issues such as sanitation, nutrition and first aid.

20. Working ModelApproving doctors

21. Differentiation

22. Strengths & Challenges of the ProgramSTRENGTHSCHALLENGESInfrastructure issues in rural areas

23. Unavailability of skilled human resource at remote areas

24. Recruitment of PSS is a long drawn process

25. Low MarginsLow income for PSS

26. Quality treatment at doorstep

27. Easier Access to a doctor

28. No spurious drugs

29. High Quality treatment at affordable rates

30. Strong social impact by giving employability

31. Long term scalability & SustainabilityTelemedicine & CDSSThis innovation in service removes the distance barrier in rural healthcare through cutting edge technology.

32. PSS uses mobile to dial up the Nucleus, a telemedicine call centre manned by paramedics & doctors.

33. Paramedics receive the calls and enter information into web based Clinical Decision Support System(CDSS). This has been developed with TCS.

34. CDSS is state-of-the-art clinical diagnosis platform that automates the generation of provisional diagnosis and prescription.

35. Doctors review CDSS generated diagnosis.

36. Prescription communicated to the PSS over the phone and SMS and she dispenses medicines from the kit provided.PiramalSwasthyaSahayika(PSS)Promoting Health Entrepreneurship and Woman Empowerment.

37. PSS recruits and trains and deploys village based women health entrepreneurs, PiramalSwasthyaSahayikas, who enable healthcare access to rural patients.

38. eSwasthya centre is set up in her own home

39. PSS undergoes a 5 day training programme on how to conduct basic health service, use digital equipment, handle mobile usage, accounts and counsel patients.

40. PSS gets 20% of the consultation fees.

41. A field supervisor appointed by Piramal oversees the PSSSandbox

42. eSwasthya -SandboxSocial Equity FocusEradicates the distance between good and reliable healthcare and rural patients.

43. Makes access to healthcare affordable

44. Healthier rural population

45. Empowerment of women under PSS.Global ScaleThe eSwasthya model of healthcare can be scaled up even on a global platform. The CDSS technology can be used at any level along with telemedicine.Environmental SustainabilityThe eSwasthya model does not hinder the principle of environment sustainability.SANDBOX continuedNew Price – Performance LeveleSwasthya provides affordable medical services which range from 30rs to 50rs, depending on the type of treatment.

46. At this low price quality is also mantained.Transparency in TransactionsUnder the aegis of Piramal Healthcare, the reputed pharma major, eSwasthya maintains fair accounting practices.Rule of Law – Individual RightsPiramaleSwasthya promotes the lawful practice of medical services.

47. It helps in eliminating quacks and maintaining the authenticity od healthcare services in rural lands.Growth

48. Piramal-AshaModel:Way forwardFirst partnership model that PiramaleSwasthya is launching in 2011.

49. Objective is to enable Government(NRHM) appointed ASHA Sahyoginis to provide telemedicine services in their villages.

50. PPP model with district administrations to enable ASHA volunteers work as PSS and leverage benefits of ASHA model an contain its limitations.

51. Pilot project launched in Churu district aministration, Rajasthan for 100 villages of Tarangpur block.Benefits of Piramal-ASHA model

52. ImpactRURAL ECONOMIC DEVELOPMENTWage earners eliminate the loss of daily wages due to time consumed in travelling to cities for treament

53. Savings from travel costs and high medical fees charged by private playersWOMAN EMPOWERMENTThrough training of PiramalSwasthyaSahayikas rural women are enabled to earn a living as PSS get 20% of consultation feesQUALITY HEALTHCARE ACCESS IN RURAL AREASHelps in removing Quackery

54. Helps in improvement in general levels of health in rural areasBRIDGING THE URBAN-RURAL DIVIDE IN HEALTHCARE FACILITIESThrough Telemedicine technology and systems like the CDSS, Rural India can share same medical facilities as in urban areas at their doorstepThank YouTEAM SCAMPERSomyaBhargavaShauryaBhushanTyagiSonaliAbrolSukeshaSajwan