This document summarizes Piramal e-Swasthya, an initiative that aims to provide affordable and reliable primary healthcare to rural India using innovative technology and service delivery models. It trains and employs local women as health entrepreneurs to set up telemedicine clinics in their homes. Villagers can visit these clinics to get diagnosed by the health worker, who then communicates the information to a call center via mobile phone. Experts at the call center provide treatment recommendations through a clinical decision support system. The model aims to scale up its services to reach 100,000 villages by 2013. It has the potential to improve healthcare access and quality in rural areas while empowering women.

1. INNOVATION V Piramal e-Swasthya

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.

6. Inadequate human resource 13

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%)

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.

18. Sustainable Service ModelsAFFORDABLE HEALTHCARE

19. eSwasthya Working Model Local 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 Model

21. Differentiation

22. Strengths & Challenges of the Program STRENGTHS CHALLENGES

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

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

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

27. Doctors review CDSS generated diagnosis.

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

30. eSwasthya centre is set up in her own home

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

32. PSS gets 20% of the consultation fees.

35. Makes access to healthcare affordable

36. Healthier rural population

40. Journey So Far

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

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