MeraDoctor

Competition Finalist

This entry has been selected as a finalist in the
Transforming Health Systems: Gamechanging Business Models competition.

MeraDoctor delivers unlimited medical advice from licensed doctors to low-income families across India, 24x7, for as little as 2 rupees a day.
We transform primary healthcare in India into an easy, affordable virtual consultation by innovatively deploying part-time, stay-at-home doctors; a massive rural distribution network; and innovative telecommunications and health technologies.

Organization Name

MeraDoctor

Organization Website

About You

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About You

First Name

Malika

Last Name

Anand

Innovation

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Name Your Entry

MeraDoctor

Explain what the "innovation" is about, e.g., is it the idea and/or the model you use to accomplish the idea, or your understanding of the target population, etc.?

MeraDoctor makes high-quality health advice easy and affordable by offering consultations with licensed doctors over the phone 24 hours a day. By making primary care virtual, we enable good doctors to serve patients at a low cost almost anywhere in India, exponentially expanding access to high quality health advice
A similar model -- phone triage by nurses -- is common in public and private health systems across the US, UK, Australia, Canada and New Zealand. However, in adapting this model to be a primary care service for rural and urban India, we have had to relentlessly innovate both in terms of service features as well as in terms of our operational model. For example, rather than nurses, we employ only licensed doctors since doctors are more trusted by rural families. Similarly, to reduce costs and barriers-to-use for poor families we have created a missed-call access system that makes calling us free and easy. Finally, we’ve used partnerships with large financial and retail players to deploy a massive distribution network that enables rural families to buy our service conveniently and in cash. Together, these innovations mean that we can bring affordable, easy, high quality medical advice to people all over India very quickly. We are just beginning to see how powerful this reach will become in transforming the delivery of healthcare in India.

Describe how your innovation model is distinct from any other organization in your field?

MeraDoctor stands out as the easiest way to get reliable medical advice. Unlike our competitors, people can use us from home, at any hour of the day, without incurring phone charges, and are instantly connected to a live, fully licensed doctor. In India, MeraDoctor competes with local doctors and quacks, telemedicine start-ups, and mobile operator hotlines. Compared to these players we are easier-to-use (24x7, free missed-call), more accessible (available for cash purchase at thousands of locations), and higher quality (only trained and licensed doctors supported by clinical software). Many of our rural customers say they have never had a healthcare experience like ours in which doctors are patient, compassionate, and proactively follow-up to ensure improvement.

What type of operating environment and internal organizational factors make your innovation successful?

Today, up to 80% of rural Indians rely on unqualified local providers (quacks) for everyday healthcare because although rural areas are home to 72% of India’s population, only 26% of licensed doctors live there. Most of these people want better care. MeraDoctor can help meet the demands of this market.
We have a highly experienced team, a track record of operations, scalable technology – and since early 2011 – we’ve provided more than 12,000 doctor consultations by phone to everyone from illiterate MFI borrowers to business executives in Mumbai. Having done more than 12,000 consultations for families across India, we’ve shown that doctors on the phone can resolve illnesses, correct mis-diagnoses, stop patients from wasting money on wrong treatments, and even save lives.

How do you make sure you constantly innovate in light of (potential) external challenges, or your growth plan?

Our strategy in creating MeraDoctor has been to constantly iterate to make our product more effective, more affordable, and easier to use. All the various aspects of our product, from service features to marketing techniques to doctor scripts, have been developed over time as we have gotten to know our customers and built our capacity. This culture of constant iteration and improvement pervades our company and processes. Furthermore, our plans for future growth and product development are build around this strategy. We approach product and service innovation as a core process in creating our business, not as an exercise to be completed apart from our daily work.

Business Model

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The systemic challenge you are trying to overcome (select one)

Bring accessible healthcare to communities in emerging markets

Health area (target market) where the need is [select only one]

Primary healthcare services

Categories along the health continuum you are covering [select all that apply]

Prevention, Detection, Intervention, Follow-up, Long-term care, Social integration.

Please describe in more detail: what problem are you trying to solve in the organization's specific context?

Up to 80% of rural Indians rely on unqualified local providers (quacks) for everyday healthcare because while rural areas are home to 72% of India’s population, only 26% of licensed doctors live there. For most families, their everyday healthcare "relationship" is still with the local quack. Sadly, most quacks treat symptoms and not ailments, and often misdiagnose, so patients get temporary relief but do not get cured. After repeated visits to the quack, getting quality advice comes too late and even routine illnesses get worse. Many patients end up spending thousands of rupees to resolve simple illnesses. In 2004, 63 million people slipped below the poverty line due to health spending. MeraDoctor solves this problem my making high quality health advice accessible for all Indians.

Stage that best applies to your solution [select only one]

Start-up and growth (pilot is successful and starting to expand)

Core strategies of your business model [select all that apply]

Patient-centered design, Redesign of the public healthcare system for more efficiency (in terms of processes, structure etc.), New/redefined roles for healthcare service provision, New approaches to distribution of health products and services, Unconventional partnerships (between traditional healthcare players and players outside healthcare).

If other, specify here:

Most relevant tools you are using to implement the strategies outlined above [select only two]

Technology, Consultation.

If other, specify here:

Please describe your solution in more detail

MeraDoctor makes high-quality health advice easy and affordable by offering consultations with licensed doctors over the phone 24 hours a day.
Customers buy unlimited doctor advice for as little as Rs 149 ($3) per month at chemists, mobile shops, banking agents, and government service outlets. After giving us a free missed call, the customer immediately receives a call from our staff and is quickly transferred to a trained doctor. The doctor listens to all of the customer’s issues and concerns, asks probing questions, and makes a diagnosis and recommendations with the support of MeraDoctor’s clinical software. After the consultation, a prescription for over-the-counter drugs and summary advice is sent by SMS. When required, the doctor refers the patient to a specialist.

What are your vision and overall objectives?

Our overall vision is for MeraDoctor to gain mass recognition in healthcare by delivering a unique value proposition, an easy way to get reliable health advice that embodies four key values that are missing in much of healthcare today: reliability, honesty, simplicity and compassion. To deliver on this vision, we will generate awareness and loyalty, and advance towards our company’s mission of becoming the trusted primary healthcare advisor for one million families in India by 2017. In the next twelve months we will acquire 100,000 new customers and validate a low-cost rural customer acquisition strategy.

What is your value proposition?

Compared to our competitors we are easier-to-use (24x7, free missed-call), more accessible (available for cash purchase at thousands of locations), and higher quality (only trained and licensed doctors supported by clinical software). To start, we offer unlimited consultations for a single price, seeking to build a reliable, trusted relationship with each family that will grow over time. Second, we only employ licensed, carefully selected and trained MBBS doctors to ensure our medical advice is accurate. Third, we believe in face-to-face contact with our customers as best, most simple way to sell our service. This is why we have partnered with companies with physical or financial relationships with our customers. Overall, we believe our product offers value on cost, care, and quality.

Who is your customer(s)?

Our target customers are the 84 million families in rural India that own a mobile phone and earn over Rs 7,500 ($137) per month, but lack ready access to licensed doctors. They spend Rs 8,000 crore ($1.5bn) annually on out-of-pocket primary care and outpatient fees.
U.P. state is our first target market due to its size (nearly 200 million people), population density, cell phone penetration, poor access to healthcare, and moderate levels of disposable income. Here, we strive to sell to men, ages 25 to 45, who are family decision-makers, have the disposable income and education to want good medical advice, and are comfortable using services on a mobile phone. We seek to become trusted advisors for them and their family members, particularly women who typically get less medical care.

What approaches to you use to reach your customers?

Most rural customers we meet have little faith in local providers, but still find them to be convenient for apparently minor ailments. For MeraDoctor to compete, it must be equally easy to access. We have already begun implementing this strategy by signing up many of India’s largest rural distribution networks in the financial and retail world. With a total of about 17,000 sales points signed up in U.P. alone, these partners (e.g., FINO, Eko, SREI Sahaj, Oxigen, Beam, Vayamtech, etc) allow us to reach our customer quickly and at a low cost. We will add to this reach by leveraging community members such as teachers, ASHA workers and part-time agents who themselves use our service, and can endorse and sell it to neighbors who need quick medical advice.

What are your primary activities?

Our primary activity is to manage and monitor a team of doctors who are serving patients remotely. As part of this activity we operate a call center, create and manage health records, and have built medical decision support software that links patients and doctors easily and seamlessly. Beyond the actual provision of medical advice we also manage a number of marketing and community outreach initiatives, as well as distribution and sales relationships with large channel partners.

Who are your peers and competitors? What problems could these players pose to your success or growth?

In terms of delivering primary care health advice MeraDoctor competes with local doctors and quacks, telemedicine start-ups, and mobile operator hotlines. Our most direct competition is the local quack, since our customers tell us they don't feel comfortable taking health advice from their airtime provider and want to speak to a licensed doctor (which other start-ups don't offer). With regards to the quacks, one might worry that they might malign our service in the community, but experience suggests quacks use and even market our service. Our hypothesis is that MeraDoctor will actually grow the number of doctor consults in a community due to its convenience, and that since customers will still use them for minor ailments, quacks won't suffer so much so at to motivate hostility.

What other challenges - individual, organizational, or environmental – are you currently facing or might hinder future success of your business, and how do you plan to overcome those?

Since 2011 we have steadily identified and resolved key unknowns in our business model. On the revenue side, we have shown that customers will pay to be able to consult with licensed MBBS doctors by phone. We have also demonstrated how to set up large-scale networks of transaction points where customers can purchase our services. On the cost side, we have validated various near-term variable cost levels (e.g., doctors, telecoms, telecallers) and identified those costs that will decline over time or with scale. Our focus now, therefore, is to validate acquisition models that can take us to scale.

Briefly describe your growth strategy going forward

To understand customer perceptions and usage we will acquire 100,000 new semi-urban and rural low-income customers in U.P and Maharashtra in the next twelve months. Our strategy is 3 fold:
1. Expand availability of MeraDoctor at retail outlets and community agents
2. Develop additional features that appeal directly to target segments
3. Engage communities with compelling stories/characters

What dimensions for growth are you currently targeting for your innovation [select all that apply]

New regions(s).

What makes your business "ready" for growth?

We have an experienced team, a track record of operations, and scalable technology. Also, we have:
- proven demand across segments
- seen strong uptake (60% repeat consultations)
- learned how to manage doctors remotely
- built software to guide consultations and conduct analytics
- recruited a world-class management team
- created distribution partnerships

What are your key growth objectives?

To acquire 100,000 new customers in U.P. and Maharashtra in the next 12 months, in the course of which we will build our understanding of customer usage and perceptions, and validate a standardized, low cost customer acquisition model for rural India.

What is your timeframe for growth, in the short and mid-term? What are the growth milestones and key activities going forward?

By the end of 2013, we anticipate acquiring 25,000 new customers and by March 2014, we will have acquired 100,000 new customers. This will require: 1) building operational capacity (in terms of medical staff) to handle growth, 2) validating a sales and marketing approach across our distribution partnerships, 3) developing more rigorous research and monitoring capacity internally to carefully track MeraDoctor usage and impact, and 4) continuing to develop service features that appeal to specific target segments in our market.

Organization Country

India, MM, Mumbai

Social Impact

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What has been the impact of your solution to date?

By giving people easy, affordable access to good doctors, we help them become healthier and more financially secure. MeraDoctor gives many people access to responsible doctors for the first time. This means they get engaging consultations, accurate diagnoses, advice on how to get better, careful prescriptions, and caring follow-ups. For many, this is the first time they will have experienced such a high level of care. By getting resolution quickly and avoiding repeat visits for simple illnesses, we expect direct healthcare costs to drop dramatically for the poor. Plus, by avoiding overmedication and offering advice by phone, we also save our patients money on medicine, transportation, and missed wages.
Some high impact cases include:
• A 40 year-old male with a lump on neck called after drugs prescribed by a nearby practitioner were ineffective. MeraDoctor took his history, suspected a diagnosis of tuberculosis (TB), and referred the patient to a lab for testing. The patient couriered his results to MeraDoctor, which confirmed a diagnosis of TB. MeraDoctor referred the patient to nearby DOTS (Directly Observed Treatment Short) center for free treatment.
• 26 year old female, 8 months pregnant, called about blood loss per vaginam. Unlicensed “village doctor” had advised bed rest. On history MeraDoctor found that she was passing clots and had contractions. MeraDoctor suspected premature labour and referred her to the hospital. Patient delivered a healthy baby girl the next day.

What methods for quantification of social impact are you applying (if at all)?

Currently, our evidence for social impact is based on qualitative investigations with select patients, as well as broad -based observational research in areas where we are operational. Going forward, we have plans to develop additional case studies of our impact, implement a "health diaries" research project, as well as collect more rigorous data about how patients use MeraDoctor relative to other healthcare options available to them. To date, documenting social impact has not been a priority as we were focused on establishing and refining our service. However, now that we have shown that the service is works, we are ready to invest in the systems and processes needed to show that it has meaningful social benefits.

Could your solution work in other geographies or regions? If so, where?

We believe our model can be effective in expanding affordable access to healthcare in other developing countries and regions. While we plan to concentrate our efforts in India, we would expect firms in other markets to replicate our success in other parts of Asia and Africa. Since we are delivering MeraDoctor through varied last-mile channels, including direct sales, microfinance institutions, and branchless and mobile banking, we are creating learning that may be adapted to diverse markets. Wherever there is demand for low-cost high-quality healthcare, as well as an affordable mobile infrastructure, our solution could be adapted.

What is your projected impact over the next 1-3 years?

We expect to create health and financial benefits for as many as 600,000 people over the next twelve months (including up to 6 family members for each membership). If we instead assume that each new customer registers only one patient, direct beneficiaries will number 100,000 at a minimum. Indirect beneficiaries will include these patients’ 500,000 family members (assuming 5 members to a family) who will benefit from savings resulting from cheaper consultations, less waiting time at clinics, less travel to providers, lower spending on unneeded drugs, and fewer repetitive outlays at multiple providers when an issue is not cured the first time.

Organization's Country of Operation

India, UP, Lucknow

Type of Organization

For‐profit

Sustainability

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Elaborate on your current financing strategy

We have received funding (in equity and convertible loans) from Aavishkaar India Micro Venture Capital Fund and an angel investor in India. Our investors will anchor an upcoming Series A investment round to finance growth through break-even and to lay the foundation for scaling up.

Share of revenue generation in total income of organization (in percent)

100

Direct sales to patients or other beneficiaries (in percent)

90

Of the possible sources of these sales listed below, check all that apply to your current strategy

Individuals, Patients, Private businesses.

Licensing fees, e.g., for technology/franchise model (in percent)

Of the possible sources of these licensing opportunities listed below, check all that apply to your current strategy

Service contract with organizations, e.g., government, NGOs (in percent)

10

Of the possible sources of the service contracts listed below, check all that apply to your current strategy

Private businesses.

Explain your revenue generation strategy in more detail

We sell multiple membership products directly to low-income families across semi-urban and rural India. These products provide unlimited doctor consultation for up to 6 patients for as little as one month, up to one year's duration. Our annual memberships include personal accident and hospitalization insurance as well as discounts at diagnostic centres and pharmacies. Packages sold directly to low-income customers (not online) range from Rs 149 ($3) to Rs 1299 ($24). Over time, we expect to earn about 15% of revenue from “incremental sources” such as partnerships with pharmaceutical companies, insurers, telecom firms, diagnostic labs, and healthcare providers. We have already established a number of such partnerships which we expect to expand over the coming years.

Share of philanthropy in total income of organization (in percent)

Philanthrophy strategies you are using

Diversified strategy.

Explain your philanthropic approach in more detail

To date, we have not pursued philanthropic capital and instead have depended on private investment and revenues to grow MeraDoctor. At this stage, we are pursuing several philanthropic organizations in an effort to raise capital for research and monitoring, as well as community outreach.

Expand on your selections; explain how you will sustain funding over the next 1-3 years.

We expect to break even on a monthly basis within about twelve months and finance growth through private capital infusions from impact and venture capital investors.

Year of launch of the organization

2011

Years in Operation

Operating 1-5 years

Has the organization received awards or honors? Please tell us about them

We want to hear about your “Aha!” moment. Share the story of where and when the founder(s) saw this solution’s potential to change the world.

The idea for MeraDoctor grew out of our conviction that mobile phones will transform the delivery of healthcare just as they have transformed the provision of financial services via mobile payments and transfers. Having experienced that transformation, we know that achieving a similar transformation in healthcare will require technology, customer influence, and business model innovation.

46 weeks ago MeraDoctor has been chosen as a finalist in Transforming Health Systems: Gamechanging Business Models.
58 weeks ago Malika Anand updated this Competition Entry.
58 weeks ago Malika Anand updated this Competition Entry.
58 weeks ago Malika Anand updated this Competition Entry.
58 weeks ago Malika Anand updated this Competition Entry.
58 weeks ago Malika Anand submitted this idea.