Vieillissement

We aim to deliver quality in-home care to the elderly who are currently in need of senior care but are unwilling or unable to get a bed in retirement homes due to limited facility care beds supply. China is rapidly aging, accompanied with the demand of senior care is surging. However, the senior care industry is still in its infant stage. There is an obvious shortage of institutional care, where public operators account for the majority of facility care supply. Public senior care facilities are generally fully occupied due to low cost and limited number of beds available.

We offer cost-effective in-home senior care with experienced nursing professionals to the elderly in developed cities (Shanghai) in China. The services we plan to provide range from assisted living service (e.g., companionship, housekeeping, meal preparation) to skilled nursing (safety supervision, bathing and hygiene care, medication support) from a few hours a day to 24 hours a day.

Our vision is to become a pioneer in-home senior care provider for the seniors who prefer home care to institutional care or who are unwilling to spend long time waiting for vacancies in retirement homes in China market. Our overall objective is to develop a distinctive senior care business.

Our value proposition is that we provide quality in-home senior care service not only complementary to facility-based solutions but also with high degrees of care than traditional live-in service, which makes the elderly live at home in a comfortable and healthy way.

Our target customers include 1) the elderly of high-income families in high-end communities who prefer to live home; 2) the middle class Chinese families who need help but cannot get a bed in retirement homes.

We will reach our future customers through opening a physical display office near the community, distributing promotion brochures to residents, and cooperating with local healthcare institutions to harness their recommendation.

We plan to develop a business model for delivering in-home care. In the model we will identify our potential customers, define our service offering, search potential partners and recruit experienced nursing professionals.

Currently there are a few foreign companies that recently entered home care market in China through franchise or partnership. These foreign home healthcare companies mostly focus on high end customers. They may have first mover advantage in terms of comprehensive service offering and large customer base. To differentiate ourselves, we will also target the middle class families, adopt a competitive pricing strategy and provide a flexible service offering.

There are uncertainties in negotiation with local health care institutions and recruitment of experienced nursing professionals. We will try to convince local health care institutions that we provide in-home senior care as a supplement to hospital-based treatment and facility-based solution. In terms of recruitment, we will work with nursing schools to hire their graduates.

More customers: we intend to roll out our business to other communities in Shanghai.
More services: we intend to expand our offering to make our service more attractive.

We have done extensive market research, competitor case study, customer survey, high-level financial modeling about the project to make sure that this model can work. We are currently preparing to set up an in-home care service company.

We plan to offer in-home care service to thousands of seniors, with 200-400 in-home care associates, covering dozens of communities within 5 years. Our revenue will reach Rmb50-100 million revenue at that time.

In short term we plan to begin our pilot project in one or two communities, with 20 nursing professionals by the end of 2013. In the mid-term, we will expand our business with an estimated revenue growth of CAGR 50%-100%.

Even in a developed country like the Netherlands, 50% of stroke patients who are admitted to the hospital while having AF, are not previously known with and treated for the arrhythmia. Early identification and treatment of these patients can prevent thousands of strokes. In developing countries, limited access to health care results in even more underdiagnosis of AF and preventable strokes.
We want to address the epidemiologic global growth of AF and subsequent strokes. In the developed countries, screening programs will identify patients with silent (asymptomatic) AF. In developing countries, both symptomatic and asymptomatic AF needs to be diagnosed. Increasing awareness of the importance of diagnosing AF and treatment with anticoagulation will prevent thousands of strokes

Unique technology developed for very easy, fast and reliable screening. No infrastructure needed in order to diagnose AF
Automatic build-in ECG based algorithm. Storage of more than 140 ECG recordings. The AF ECGs are not overwritten, unless all non-AF strips are replaced by AF recordings. This allows for long-term autonomous use of the device without the burden of loosing relevant ECG data. Up to 1000 datasets of diagnosis will be stored.

We want to start screening programs in developing countries such as Russia, Ukrain, India, Turkey, China or Brazil by training of primary health care providers on how to use the MyDiagnostick in which patients and when to start anticoagulation by prescription of one of the new oral anticoagulants (and how to control the ventricular rate).

To dramatically improve AF detection and start therapy in order to prevent ischemic strokes (and heart failure), both in the western society as well as in developing countries

Easy and fast AF detection and start of anticoagulation by primary health care providers will reduce unnecessary strokes and costs. This will increase Qualy's at a low price.

In developed countries the MyDiagnostick is used by general practitioners, neurologists (in case of cryptogenic stroke), geriatricians, internal medicine specialists, and cardiologists. At present, several pharmaceutical companies recognized the importance of this tool for detection of new AF patients which need anticoagulation and have purchased MyDiagnostics devices.
In developing countries our main customers will be primary health care providers.

In the developed countries, we increase awareness of the importance of AF detection by educational programs. Furthermore, 2 large screening programs in the general practitioners office are planned in The Netherlands and the UK. Several cardiology departments have purchased MyDiagnostics to follow-up treatment on their AF patients. Also clinical programs are under way in the area of the geriatric population and patients with cryptogenic strokes.

Development, sales and marketing of the MyDiagnostic.
We recently received CE approval. Next year we plan to enter the US market and will file for 510k FDA-approval in 2013

Perceived competitors are manufactures of event-recorders, blood pressure monitors with build-in AF algorithms, and an iPhone application. At present, none of the perceived competitors combine automatic AF detection and ECG recording on an off-line basis, without the need of a special infrastructure, with a 100% sensitivity, while maintaining 96% specificity. Furthermore, the price of the MyDiagnostic (appr. $660) is highly competitive.

We expect a boost in the demand for MyDiagnostick devices, This will require a larger responsive organization to serve al customers. This organization should be properly linked to local networks supporting the availability of MyDiagnostick in the various health care settings and parts of the world. These local networks might include profit and non-profit health organizations, distributors, pharmaceutical companies.

We invited clinical key opinion leaders from several countries to initiate clinical trials and screening programs for AF. We plan to gain evidence in order to become incorporated in future guidelines on the management of AF.

The MyDiagnostic was developed and tested in close collaboration with cardiologists. The validation study provided excellent results (100% sensitivity and 96% specificity). As the device is CE marked, we can produce and distribute devices to customers at this moment.
Results from the first studies with the MyDiagnostic were received well by the medical community and led to increased demand.

We plan to sell 2000 devices in 2013, and doubled in 2014, approaching 10.000 devices/year within 3-4 years.
We plan to derive new opportunities for other diagnostics each 2 years
We plan to extent service with online expertise support

See above

Disability, facing 1/7 of the world’s population is an important development issue with an increasing body of evidence showing that persons with disabilities experience worse socioeconomic outcomes and poverty than persons without disabilities. With these ever-increasing volumes, access to care is limited and the quality of care resources are archaic. The most commonly reported tools used by clinicians are hand-written notes and sketches to communicate ‘accurate’ instructions to the patients and caregivers. In order to increase access to care and improve communication between patients and clinicians, there is a need for tools which provide access to quality content in an engaging and meaningful way.

In line with world community-based rehabilitation guidelines, our suite of mobile applications, the first being StrokeLink, are designed to empower patients facing disability and their family members throughout their care journey by providing them with access to information and tools to help them regain their independence. With StrokeLink, in addition to providing a digital library of information relating to stroke, the app works with patients to set goals, provide access to therapy programs and monitor their progress over time. Using StrokeLink Capture, a specialized tool that allows clinicians to build custom therapy programs with ease, patients leave the hospital with highly personalized therapy programs communicated effectively to them and those helping them with therapy.

Our vision is to improve access to rehabilitative care and reduce global disability. Our objectives are to improve patient outcomes as well as improve the utilization of healthcare resources throughout the care continuum. We are doing this by empowering patients and family members with high quality tools to effectively manage their own health while at the same time providing clinicians (therapists) with an efficient way to prescribe therapy programs.

Addressing the problem of global disability involves the development of unique and strong value propositions for each stakeholder involved:

For healthcare providers who face the challenge of providing services for a growing population of individuals facing disability, mobile apps, like StrokeLink, allow for the optimization of healthcare resources by better enabling patients and their families to take on an active role in therapy. Clinicians are better equipped to effectively and efficiently communicate and monitor therapy plans while patients benefit from an enhanced understanding of the steps needed to regain independence through engaging independently in therapy in a community based setting.

Our primary customers are individuals affected with a disability and their family members. Ultimately, in order to create positive change in rehabilitative care, it is important that we engage all key stakeholders involved which include clinicians, healthcare providers and healthcare associations in addition to patients and their families.

A channel partnership strategy will be taken to reach our customers and facilitate growth into new markets. This strategy entails partnering with the leading patient advocacy organisation representing a form of disability in a geographic region. For example this could mean the MS Society of Canada, to reach MS patients in Canada, or the Mongolian Stroke Association, to reach stroke patients in Mongolia. This partnership provides us with key suppliers of validated content and strong existing channels to reach patients. In return we provide a white-labelled mobile platform to improve access to specialized rehabilitation resources and a proportion of the revenues generated.

Software Development - Building our platform and suite of mobile applications.
Partnership Development - Creating content and distribution partnerships with national patient advocacy organizations.
Relationship Development - Marketing to Healthcare Professionals and securing endorsement from experts in each field.

Our main competitor in the market is the most commonly reported method for the prescription of rehabilitation plans: the hand drawn stick figure! There are also substitutes for our technology including the multiple web-based exercise prescription tools, but these ultimately lack the flexibility that clinicians require and are removed from the patient-clinician interaction. Both these processes reinforce a highly prescriptive environment while our tools seeks to foster a more personal and collaborative care model whereby patients are incorporated into the exercise prescription process.

The biggest challenges we are currently facing relates to geographic growth and working with hospital timelines and budgets. Entering new markets requires both strong channel strategies as well as a clear understanding of the unique regulatory environments that exist in the region. Our partnership channel strategy will help us overcome both of these by utilizing existing channels to reach patients as well as connecting us with local experts to ensure compliance with regulations.

Our clinician-users are passionate about the possibilities that our platform can create in terms of more collaborative care models, but often lack the authority to make purchase decisions. Moving forward, we plan to empower a large network of clinicians as key stakeholders in our change process.

In order to capture a larger portion of the market our partnership strategy is critical to grow both geographically and across disease states. This strategy will provide us with capital up-front, from licensing our technology, in order to facilitate additional development across technology platforms to increase global accessibility.

Our numerous pilot studies in different stages of the care continuum have provided key insights into the incentives and objectives of all our major stakeholders. We have learned what engages patients and families most, we have iterated on our technology so that it integrates seamlessly within a clinician’s workflow, and we have identified a payer whose objectives are aligned with ours.

In the next 3 years we will meet the following objectives:
1) Develop 15 jointly developed applications with partner organisations from different disease states and geographic areas.
2) Increase membership in clinician network to over 10,000 clinicians from 25 countries
3) Expand our technology to operate on the iOS smartphone and all Android devices in order to improve accessibility

Short Term (2nd & 3rd Quarter 2013)
- Release of StrokeLink 2.0 to continue to measure the usability and effectiveness of our technology
- Private testing of web based management portal
- Develop two channel partnerships to accelerate growth into new markets
- Begin engaging clinicians in the United States, Australia and the UK through social media, conferences and tradeshows

Mid Term (4th Quarter 2013 & 1st Quarter 2014)
- Launch of first two applications with partner organizations
- Establish two new channel partnerships, and continue to fill partnership pipeline
- Expansion to the iOS Smartphone
- Development of a professional certification program to identify key champions in our professional network

La plataforma nace de la necesidad generalizada en el sistema de salud global de integrar información del paciente que, habitualmente, está atomizada. Esta situación da lugar a una pérdida de información y duplicidad de pruebas, con los correspondientes incrementos de costes y una disminución en la eficacia del servicio al paciente, entre otras consecuencias negativas. Esta situación deficitaria se ha visto negativamente afectada por el incremento en el número de pacientes crónicos, consecuencia del mayor envejecimiento de la población, del cambio de sus hábitos, y por el aumento unitario del correspondiente gasto público (atención, medicación, transporte, etc).

Los pacientes pueden, en uPatient (software del paciente), integrar todos sus datos y ficheros médicos (pruebas médicas, resultados de laboratorio, etc), conductuales y contextuales y hacer el seguimiento periódico de los parámetros que su doctor determina necesarios. Esta información, que se presenta de forma fácilmente comprensible, puede ser introducida por el paciente para ser posteriormente validada por el doctor, o por este último en primera instancia, a través de uClinics (software para profesionales). Si, en alguna ocasión, estos datos se sitúan fuera de los parámetros aceptables, el doctor recibe una alerta y puede gestionar esta nueva situación. El profesional puede proveer el tratamiento preciso y necesario, al momento, eficientemente.

Nuestra visión se basa en el concepto de Paciente Universal, el uPatient. Éste es un paciente que va más allá del Paciente Empoderado, aquel que sólo busca información médica o intercambia impresiones con otros pacientes. El Paciente Universal dispone de toda su información médica sin distanciarse del agente sanitario ni caer en una sobrecarga de información. Tiene más control de su salud a la vez que entiende su rol como corresponsable de su atención sanitaria. Esta mayor independencia y compromiso con su salud y tratamientos médicos le permite mejorar en calidad de vida, que es nuestro principal objetivo.

Queremos posicionar la plataforma como estandarte de un cambio de paradigma en la forma de ofrecer atención sanitaria; personalizada para cada paciente y optimizada desde una perspectiva de uso de recursos y tiempos de respuesta.
La plataforma ofrece, así, ventajas sustanciales para doctor y paciente por igual. Ahora (al reducir el tiempo dedicado a tareas rutinarias, al disponer de todos los datos y ficheros médicos del paciente, etc.), el doctor puede priorizar, personalizar y hacer más eficientes los procesos de prevención y seguimiento que ofrece a sus pacientes. Al mismo tiempo, hacemos que el paciente entienda mejor su salud y le empoderamos al ofrecerle disponer de toda su información médica y conductual unificada.

El principal beneficiario de la plataforma es el paciente. uPatient puede ser utilizado tanto en fase de prevención de diferentes enfermedades y mejora del bienestar, como en fase de seguimiento y evaluación continua de enfermedades. Por ejemplo, se están beneficiendo de la plataforma tanto recién nacidos (gestionados por sus padres) como pacientes crónicos de diferentes edades.

Llegamos al paciente a través de las empresas y organizaciones que tradicionalmente han estado relacionadas con él (centros sanitarios, colegios de médicos, asociaciones de pacientes, empresas farmacéuticas, administraciones públicas, clubs y entidades deportivas), dando valor añadido a sus productos y/o servicios. Integramos todos los agentes del ecosistema sanitario, el centro del cual es el paciente.

Nuestra actividad principal es el desarrollo del software agregador de datos. Éstos son mostrados al usuario de una forma fácilmente comprensible. Se ofrece la posibilidad de cruzar estos datos para poder entender mejor la relación existente entre diferentes variables tanto médicas, como conductuales o contextuales (por ejemplo, presión arterial, peso, nivel de actividad física, administración de medicamentos, etc.).

Nuestros partenaires potenciales son los centros sanitarios, colegios de médicos, laboratorios clínicos, asociaciones de pacientes, empresas farmacéuticas, administraciones públicas, y fundaciones.

Nuestros competidores, mayoritariamente ubicados en EEUU y UK, ofrecen soluciones no integrales de gestión para doctores o de digitalización de los historiales médicos para los pacientes.

No obstante, los mayores obstáculos que se podrían plantear para nuestro crecimiento, provienen de organismos internos del país (restricciones o limitaciones de entrada, operación e integración), en el caso de países desarrollados, y de la deficiente vertebración y organización de los servicios de salud pública en los países en vías de desarrollo.

Otros obstáculos serían los relacionados con el acceso a internet, las limitaciones técnicas de entrada en un sector, o la reticencia en la aceptación de médicos y pacientes, no sólo por la adaptación de procesos médicos a un entorno electrónico, sino por el propio uso y aceptación de ordenadores, tabletas y smartphones.

Sin embargo, y dada la capacidad de integración con otros sistemas y a la verticalidad de la plataforma uPatient/uClinics, ésta se puede adaptar a diferentes contextos tanto en países desarrollados, como emergentes o en vías de desarrollo.

La continua/creciente colaboración con los diferentes agentes del ecosistema sanitario permitirá ampliar la base de pacientes. Además, con la información agregada de los hábitos de vida de los pacientes (disociada de los datos personales), se podrán elaborar estudios para desarrollar nuevas propuestas de atención médica y sanitaria con el fin de mejorar la calidad de vida de los pacientes.

Las características que nos permiten un rápido crecimiento son la escalabilidad y adaptabilidad de la plataforma base. La estructura modular con la que trabajamos, permite una continua mejora y adecuación al creciente número de pacientes, y a las necesidades de los agentes con los que colaboramos. Al operar en la nube, el acceso generalizado y global a internet facilita esta expansión.

Nuestros principales objetivos son consolidación en países UE e implantación en EEUU y otros países del continente americano. A largo plazo, entra la prospección e implantación en otros países en vías de desarrollo. Patologías: priorización de enfermos crónicos por razones sanitarias, socioeconómicas y presupuestarias. Colaboraciones: organizaciones y empresas líderes en el ámbito de la salud.

Corto plazo (18 meses): implantación en 3países UE. Prospección USA/Canadá, Centro/Sudamérica.
Medio plazo (18-36 meses): consolidación en 3países UE. Implantación en 4países USA/Canadá, Centro/Sudamérica.
Largo plazo (> 36 meses): Consolidación en 4países USA/Canadá, Centro/Sudamérica. Prospección e implantación en otros países en vías de desarrollo.

En países donde la sanidad pública se encuantra organizada, serán centrales los partnerships con la tipología de agentes préviamente citados, tanto públicos como privados.
Para lograr los objetivos en países en vías de desarrollo, se intentará llegar a acuerdos de colaboración con entidades nacionales y supranacionales de Coperación al Desarrollo.

As health care knowledge double folds every 10 years and population aging increases health care professional demand, a shared knowledge platform can be a better source of information than traditional knowledge exchange such as health care manuals or health publications.

Linkcare is an Integrated Care open platform allowing Health Care Professionals (Specialists, General Practitioners, Case Managers, Nurses,…) to share clinical knowledge around a patient centric health care model. The Linkcare mobility module allows to post activities to be performed by the patients using their mobile terminal, tablet or web portal. Such activities include follow up questionnaires and medical devices such as pulsioximeters, glucometers, scales, blood pressure and spirometers. Using Linkcare, Health Care professionals may exchange care protocols and clinical data around Integrated Practice Units or specific Clinical Research teams.

The dissemination plan is based in three steps:
1. Sponsored clinical research teams can me established around certain health conditions under the leadership of the team leaders. This provides fast dissemination for specialized teams
2. Hospital integrated practice units can also use Linkcare for patient centric case management
3. In a latter stage, Linkcare can also be adopted to provide district level care integrating primary cares, community hospitals and tertiary centers.

To provide an open platform for health care knowledge exchange based on case management oriented care

a. Health care professionals willing to exchange their clinical knowledge around a health condition and industry partners interested on sponsoring those teams to obtain better knowledge on their customers or products
b. Health care suppliers willing to deliver integrated care by collaborating at all care levels (primary care, community hospitals, tertiary centers,...
c. Health organizations interested on value measurement health care models that allow protocol benchmarking and health care outcome measurement

Linkcare relies exclusively on the reputation of its health professional users

To disseminate the Linkcare platform by enrolling clinical research teams
To introduce the Linckare platform to health service providers, payers and government offices

Linkcare is a complement or extension of existing health information systems.
It is also a complement of traditional knowledge exchange based models, such as health care publications

The health care information industry is highly segmented and diversifies. Linkcare tries to ensure easy connectivity by being an open platform that can be integrated with the existing information systems by the current integrators. Linkcare has already partnership agreements with some of those integrators, such as IBM and Accenture.
On the other hand, collaboration between health car professionals is not yet part of their daily culture. The fact that research teams are sponsored by industry companies provides and additional incentive to promote collaboration. On exchange, sponsors obtain very valuable information on the disease, the patient profile and the product effectiveness under certain protocols.

The company is now incorporated in Barcelona and London.
During the next years Linkcare is planning to open an office in Shanghai and Boston.
Most knowledge creation is expected to come from professional users adopting the Linkcare platform for knowledge sharing.
Linkcare plans to create a network of representatives, each one covering around 10 new health care service providers each year

The increase of interest of the health care professionals community to improve their knowledge around certain conditions. This need has grown as predictive medicine and personalized medicine has made clinical knowledge a "peer to peer" and community based process rather than a traditional "information exchange" (scientific publications, health care conferences) approach

As a knowledge sharing platform, Linkcare's corporate business developement indicators are based on:
a) Population served,
b) Health care service providers involved,
c) Active professional users, and
c) Patient profiles managed.
Linkcare goal is to reach 110 Health Care Service Providers, covering a population of 36 M (million) citizens and an estimated 1M (million) patients in 3 years

Within the next ten years, Linkcare is aiming to reach a population of 400M (million). Out of this population, a case prevalence of 7% has been targeted (standard prevalence estimated 25%). A market share goal of 5,2% represents a target case estimate of 28 M (million) and a total of 1.340 health care providers performing a year total of 366 research teams.

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Creating access to healthcare through service delivery at home. We shave money for client as we cut short hospital stay which is tedious for family members and associated care taking party and help hospitals make more money by making hospitals more active on bed occupancy reate by leveraging faster discharge and more flow of work. We create work for people who are left unemployed in healthcare service sector like nurses, doctors and physiotherapist. We also have created extra volume of work for similar professionals who are willing to work extra hours. We bring value to the employee whose work is more demanding as they cant give time to take care of their loved ones, its gives them relief and respite of social responsibilities.

We tried something completely out of box for healthcare delivery services. There has been growing healthcare services in Nepal like hospitals, tertiary care services and super speciality centers, and everything was happening in more conventional and orthodox healthcare service delivery models. So, as gap was evidently growing, we decided to create something new and serve people who were not getting service in that area where the ACCESS was missing. the creating of formal Access to mainstream healthcare staying at home has been our one of the focus. We also wanted it to be associated with mainstream healthcare so that the continuum of care is not broken ever. This fundamental concept has helped our patient to stay connected with care

Our objective is simple to create access of healthcare to people who need it at home at affordable cost. The service has to be self sustaining, replicable and scalable anywhere done. The service of healthcare is essential humanitarian service it has to be blend of social enterprise which evolves responsibly. We think this service is local now if done properly this service become global, specially for the societies or population in developing world like Asia and Africa.

We approach to individual issue independently and let the solution be totally customizable and compatible to the individual’s need of care value. As we respect the individual capacity should not be limiting factor we make program as customized possible. We have some values that we follow very closely.
1. Compassion we practice the value of compassion as the foremost value of healing.
2. Care with professional value, ethical practice, evidence based knowledge and professional skill are associated with true care value of ours.
3. Confidentiality is respecting individual’s identity and dignity and we value that most.
4. Customization of service is mandatory for the service of human as every human is different.
5. Comfort as comfort of home is unmatchable for any individual.

1. Sick people not improving with medical treatment and management at hospital for example in cancer care and palliative care.
2. chronic disease condition not necessarily requiring hospital care but require consistent medical vigilance and assistance for example in oxygen dependent people of respiratory illness, parkinsonism people with walking limitation, Dementia care and management etc.
3. People requiring multiple and frequent access to simple healthcare services like blood testing, medication management and physician visits in close intervals in weeks for example in old age related care.
4. Rehabilitation services like physiotherapy management at home.
5. Pharmacy deliveries, lab test and result delivery services,

.We have good network of our old clients who refer us to their other family members or friends.
.We have another network of good doctors who practice ethical and evidence based medicine.
.We also get walk in clients from social marketing and international base. Like Facebook and website.
.We have good relationship with good hospitals of Nepal like Norvic, OM, Medicare, Gangalal (Cardiac center), TUTH, Bir and other highly reputed and good flow hospitals.
.We have trusted office managers who ensure the link is maintained with the people who are eligible and willing to work and .we also have consistent flow of clients who maintain our work volume.
.We do marketing to that limit/extent where we can provide service. Till the record of our own existence we have not turn down any queri

#People significantly not improving with medical treatment and management or not responding to management protocol of treatment at hospital for example in cancer care and palliative care.
#chronic disease but not necessarily need hospital care but require consistent medical vigilance and assistance for example in oxygen dependent people of respiratory illness, parkinsonism people with walking limitation, Dementia care and management etc.
# People requiring multiple and frequent access to simple healthcare services like blood testing, medication management and physician visits in close intervals in weeks for example in old age related care.
# People requiring rehabilitation services like physiotherapy management and care who not necessarily need hospital stay etc.

We don't have market competition as of now in our service category. We are pioneer and have been able to create price tag according to our service design, which is considered as benchmark and revolves around the same value all the time. Where as there are group of nurses or physiotherapist who do pretend to present them self as a service provider, which have either had breakaway or had to shut down due to other reasons, which we don't get to know always.
There is none existing service provider in exact our value of integrated service provider in our market. There had been some nursing agencies and some physiotherapy services, which has evolved or inspired in our model. We don't think that is exact competitive model but they do take away some market share.

1. Personal (Non acceptance by family as a doable thing and rediculing process of quiting cardiac surgery residency to persue social enterprise and solution for service gap.)
2. Professional (Non support by senior practitioners as a service for needy one going out of hospital specially from the field of neurology, orthopedics and oncology. Humiliation of doing networking and asking for cases where as there were no one providing solution at the patients service.)
3. Financial (Non availability of fund for the start up both from personal front and banking sector)

1. Stabilize institutional development (Infrastructure, Training)
2. Marketing (Networking, Branding, MOU, Advertisements)
3. Verticals creations and spinoffs like nursing agency, physiotherapist-agency, equipment buy/sell/rent, doctor on call etc
4. IT integration for branding and e-commerce.
5. Starting training institution for home caregivers in local centre(HR development)

We have tested our product idea, solution concept design and service delivery to the level from where we can say it has worked well for the existing service gap in healthcare delivery. We have been able to make it responsible service both inside organizational value and outside in society (Award, Media and word of mouth referral). We have future plan to expand, stabilize and globalize the service.

We want to make it a concept/brand of service which is needed in every society.
No one has to think that the service of healthcare is only confined to the boundaries of hospital or individual.
The process of the service of home healthcare has to be affordable, sustainable, and suitable according to the social structure and values. Home healthcare has to be complimenting service.

Short term: We have plans to open new centers in other cities of Nepal or subcontinent.
We have been training in-house staff to run service centres independently.
We have two new independent services arm likely nursing agency and a physician service coming independently as spin off.
We are trying to sign an agreement with hospitals and healthcare organizations for referral base creation.
We are networking with independent specialist for specialist based services development.
Long term: Health at home has to be model of service for the any societies in world be it replicate or partner with our organization. health at home has to be complete institution with training modules, service mechanisms and success stories.

Having strong administration of a system is important however, success will ultimately be based on the amount of impact it has on the relationships between youth and elders. The discovery of knowledge and information between the youth and elders.

In the long-term, which would most likely be more than one year, success would be the adaptability of the service to variance in the volume of participants large or small and the ability to sustain itself as an organization.

I will measure success based on my sense of developing leaders within the community in both the youth and elder demographic. I feel that the wisdom that is being passed on is a two-way street – elders provide experience and perspective and youth can bring a modern version of that but also a rejuvenating level of ambition and courage. I would feel accomplished, when I know that this service has sparked behaviour change in a way that it facilitates relationships by removing stigmas between the different generations – relationships that are ongoing, fruitful and loving.