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 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 Model

21. Differentiation

22. Strengths & Challenges of the ProgramSTRENGTHSCHALLENGES

23. Telemedicine & CDSSThis innovation in service removes the distance barrier in rural healthcare through cutting edge technology.

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.

28. 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.

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.

33. A field supervisor appointed by Piramal oversees the PSSSandbox

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

35. Makes access to healthcare affordable

36. Healthier rural population

37. 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.New Price – Performance LeveleSwasthya provides affordable medical services which range from 30rs to 50rs, depending on the type of treatment.

38. 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.

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

40. Journey So Far

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

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.

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

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

46. 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

47. 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