Health at Home Private Limited (HHPL)

Health at Home Private Limited (HHPL)

Kathmandu, Nepal
Year Founded:
2009
Organization type: 
for profit
Project Stage:
Start-Up
Budget: 
$10,000 - $50,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Health at Home (HHPL) stands for healthcare service access at home simplified and standardized by the help of compassionate, caring, customized team of people and delivered at your homely comfort with confidentiality. We are service of professional value which is governed by ethical and evidence based practice approach. Our service is flexible which is customized and designed around peoples need.

About Project

Problem: What problem is this project trying to address?

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.

Solution: What is the proposed solution? Please be specific!

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
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

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.

Impact: What is the impact of the work to date? Also describe the projected future impact for the coming years.

Social impacts 1. Patients/clients Saving patients money as they don't have to stay in hospital for extended stay.People recover fast and enjoy recuperating in home (clients satisfaction),personalized care and attention which is sense of exclusivity. 2. Healthcare institutions like hospitals/polyclinics/Insurance Increased patient rollover, which improves turnover for bed occupancy ratio, which is marker of increased performance of institution. If hospital are efficient with smaller capacity the overhead of the institution is lesser.Gives access to healthcare solution of beyond hospitals and infrastructure based services. Improves income if partnered with such organization and patient is rolled from hospital there can be resources sharing model that can be net income. 3. Healthcare professionals and individuals It is relief for professionals as such service gives them service expansion option to home. They will have better monitoring access and services like orthopedics specialist giving solution of physiotherapy, OB/GYN giving service of neonatal and infant sick baby care and neurologist giving service for dementia care and management etc. 4. Caretaking family and friends Reduces logistics support for caretaking of patient like duties in hospital (Attendants), food deliveries and freight and transportation cost. People of family are assured and are more productive as they will be able to do their daily work and duties/jobs. Saves money for all the cost and direct expense at hospital and treatment management. There are other impacts in social and environment too.
Sustainability

Financial Sustainability Plan: What is this solution’s plan to ensure financial sustainability?

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.

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

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.
Team

Founding Story

We started health at home as a preventive healthcare delivery organization for chronic care management with fixed package cost. When we saw the demand was on direct care management at home we changed the direction towards the demand base and our negative became positive and we decided to walk where there was demand base ie taking care of patient at home.
Organization Name

Health at Home private Limited (HHPL)

About You
About You
First Name

Bishal

Last Name

Dhakal

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Innovation
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.?

We are out of hospital healthcare service delivery channel. We want to be innovative on service design, development and delivery for the every aspect of life and its changing issues. There were no organization/institution service need of healthcare delivery in local market. We thought there has to be continuum of care before hospital and after hospital thats what health at home was conceived.
We do have healthcare provider who do home visits like nurses, doctors and physiotherapist. What we dint had was standardization of the service and delivery of it in understandable and ethical pattern. Service like health at home makes people to contact one organization and avail cradle to grave service at their comfort zone of home.
We restrict ourself to the strict boundary of ethical practice of evidence based and fully consented service delivery model. As of innovation we can proudly say we were first of its kind n this subcontinent born indigenously with local capacity and human resources and skill.

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

We dint had any such organization in our local market even not in subcontinent when we decided to create such service. We feel at times unfortunate and unlucky as we didn't get to learn for others failure. At the same time we got that opportunity to showcase we can delivery what was thought unnecessary or not very appropriate by traditional practitioners or healthcare institutions like hospitals and polyclinics. we defied the stereotype and became friends of patient even out of conventional healthcare organizations and we were able to do it consistently and constructively for last three years and more.
We take care of people who are unable to come out of their bed right at their home with more compassion and care.

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

We are frugal and we think simple solution can be derived for complex issues like cancer care or palliative care. We make every one work for the shake of team and end delivery of care is managed by the care managers. We think in hierarchy and coordinating with the primary care provider will retain confidence of specialists on us and have organic relationship build up capacity. We dont encourage our employee at the end to do things which is not advised and take orders only advised it makes their service more professional and quality assured. We also make sure the service provider is qualified and have the knowledge of our operational model. This makes us easy to move as a team.

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

We have already been able to create competition around us as there are some other small organizations starting up in home care front. We are simplifying our service and we are making our service more affordable. We are also making new innovative services available in different categories like we are creating nursing agency which is independent unit then we have coming up doctor on call service which is independent and so is physiotherapy and laboratory collection and reporting services. they all work in independent manner and health at home will be working for more complex cases and which needs more concentrated care and efforts.

Organization Country

, Kathmandu

Business Model
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]

Other specialty care

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

Long-term care.

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]

Approaches to behavioral change at the individual level, 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.

If other, specify here:
Most relevant tools you are using to implement the strategies outlined above [select only two]

Education/training.

If other, specify here:
What is your value proposition?

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.

Who is your customer(s)?

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,

What approaches to you use to reach your customers?

.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

What are your primary activities?

#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.

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?

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)

Briefly describe your growth strategy going forward

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)

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

New customer group(s), New regions(s), New market(s)/country(ies).

What makes your business "ready" for growth?

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.

What are your key growth objectives?

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.

Organization's Country of Operation

, Kathmandu

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

1. Our growth (numbers, retention)
2. Our sustainbility.
3. Social respect and impact.
4. Happiness of consumer and client including refferal from clients.
5. Award that we received as social enterprise recently.

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

When we started there was no service of such kind in our society so are many societies in global context such service is non existent. We did struggle and get it right to the extent its been praised and appreciated by both end user/society and service deliver agents/healthcare service providers etc. We think its fundamentally based in universal principal of healthcare where ever there is people and population base we can work.

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

We would like to become healthcare option at home for the people who need it. We will be more flexible with people capacity of both end on consumer end as affordability and technicality of handling complex and difficult cases on institutional capacity. We would like to have training integrated in the service and access to grassroots people for creating alternate job solution and service available for poor people too which will make it inclusive. We would like to be still self-sustaining, organically growing and replicable model of healthcare. We would like to partner with global leaders to learn, explore and exchange. We would like to be more universal and technologically driven which has to bring more value in care.

Sustainability
Elaborate on your current financing strategy

We are service oriented so our revenue is maintained in few streams, like of nursing care service, doctors call and services, physiotherapy services and equipment sales and rental, lab services, transportation services etc. We collect all revenue in one pool and disburse our service providers and other liability at the start of the month for previous month. We dont operate on advance payment. We always bill our clients after providing service at the end of the month. We are growing at the pace of 100% each year since inception. I started with the cash of 500K NPR in end of 2009 and we have revenue of 5000K for the last year balance sheet 2011-2012. Our financial values at the end of the year 2012-­‐13 should look as mentioned below, this with similar work flow and growth pattern.
Total revenue: 70-­‐100 Lacks NPR
Expenditure: 50-­‐70 lacks NPR
Net: 20-­‐30 Lacks NPR

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

20-30%

Direct sales to patients or other beneficiaries (in percent)

100%

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

Individuals, Patients.

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

Explain your revenue generation strategy in more detail

We generate revenue by placement in per-dime basis and in term contract basis. We have pool of flexible numbers as the number of client is changing all the time. We want to add more services and we also want to diversify service modality like integrating more nursing and physiotherapy agency format and outsourcing agency. Integrating equipment and rehabilitation store services.

Share of philanthropy in total income of organization (in percent)
Philanthrophy strategies you are using

Explain your philanthropic approach in more detail

We have adopted organization like old age home who are run in charity and specially looks after old aged people who are left in street for unknown reasons. We call it adoption as the service we will provide will be more valuable to more destitute people. Currently we are looking after 50 old people at old age home. Its managed by us completely by our resource and person.

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

We are making some profit and always been on positive balance side since we started our service. We have small growth all the time from the resources we generate. We have two scope of growth one is organic and another inorganic. In organic we will invest around 10-20% of our resource all the time for the development of organization capacity, promotion and networking. In inorganic we will invest from external source by dissolving some equity or seeking loan (currently seeking with external party, investor and individuals) to invest in physical capacity of institution and make it more productive. The service will come up in many verticals simultaneously and service will be more dynamic. We will invest in hardware and generate more revenue by the enhanced service delivery capacity. Basically we will sustain and grow by creating service and delivering it in balanced and frugal way.

Years in Operation

Operating 1-5 years

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

We received Surya Nepal Social Entrepreneurship Award 2012 in Dec 2012. We were one among 5 winners. There were 85 participators from all over Nepal of different domains and capacity.