E HealthPoint Transforming Rural Healthcare

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E HealthPoint Transforming Rural Healthcare

Organization type: 
for profit
$1 million - $5 million
Project Summary
Elevator Pitch

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

E Health Points units, started in rural India, provide families in villages with clean drinking water, medicines, comprehensive diagnostic tools, and advanced tele-medical services that “bring” a doctor and modern, evidence-based healthcare to their community. Because people come to pick up their water daily, the E Health Point has multiple opportunities to raise awareness about health issues and encourage early treatment of medical conditions. Tying healthcare delivery to water services also provides social cover for patients with socially-taboo conditions, such as tuberculosis or HIV. E Health Points positively changes the perspective of the public versus private health sector by implementing a technology-based social enterprise for low income groups.

About Project

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

E HealthPoint has combined various existing and emerging technologies (like Broadband and Telemedicine , Electronic Health Records, Point of Care&Mobile Diagnostics, Reverse Osmosis based water purification) to deliver this unique business model primarily for underserved rural communities. While a variety of organisations in Public/Private/NGO sectors are providing various components of Healthcare and Water services, we believe that The E HealthPoint model is a pioneering and unique model that has bundled all these 5 services for the low income communities , especially in rural. The combination of the various standalone components as a service delivery model, using broadband for a doctor-patient interaction , combining preventive and curative services , bringing urban facilities to rural rather asking rural to come to urban has been a new contribution to the field . Thus E HealthPoint has developed and implemented an innovative, effective, culturally acceptable, replicable , participative , scalable and sustainable model to reduce health inequities and enhance human productivity .
Impact: How does it Work

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

About You
About You
About Your Organization
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Organization Phone


Organization Address


Organization Country

, DL

Country where this project is creating social impact

, PB

How long has your organization been operating?

1‐5 years

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What stage is your project in?

Operating for 1‐5 years

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

Approximately 200 words left (1600 characters).About the Community that HealthPoint currently serves:
●200,000 rural communities in India have no source of safe drinking water; an even larger number have no effective access to qualified doctors, modern diagnostic tests, or a licensed pharmacy without travelling to a city. Most rural communities instead rely on informal (untrained/mostly non-qualified) health providers (there are 2.5 million informal health providers in rural India as opposed to 60,000 doctors), informal pharmacies that often sell fake , low potency or outdated medicines, and a total absence of modern diagnostic laboratories. The E HealthPoint model is designed explicitly to address these unmet needs, based on market research that showed rural households in India spend an average of $ 42 per year out of pocket on (poor quality) healthcare and prior experience that shows they are willing to spend Euro $ 15-20 per year for safe drinking water. The E HealthPoint model is a for pay (fee for service) model and relies on use of modern technologies (including rural broadband, telemedical software, low-cost point-of-care diagnostics, and inexpensive water treatment methods) and de-skilling of many aspects of primary care (through standardized procedures and thorough training of local staff) to bring costs within the ability/willingness to pay of most rural households. HealthPoint provides these services (described above) directly to individuals and households in the communities it serves, typically achieving at least 50 percent penetration of households within a few months and resulting a very high degree of economic , financial benefits to the community .The rural communities served by the Company have the following consumer segments:
•Upscale (landowners): at least 5% of village population, typically have automobile transport, can afford bottled water from urban areas. To this customer, E HealthPoint water and health services represents convenience; premium services (water delivery, no waiting for doctors, phone consultation with doctors from home, etc.) may be required. They seek High Quality by paying a premium if required, practice an urban-equivalent lifestyle, demand personalized attention and service, consciously make efforts towards achieving health & wellness;
•Dominant Middle (farmers, local merchants, family members working in nearby town/city areas, retired military): up to 65% of village population, upward striving. To this customer, E HealthPoint water is aspirational, an urban-quality service, with better taste, healthier. E HealthPoint health services are especially appealing to women (50% of customers), and our planned pre-paid health service “packages” for maternal/child care may offer a similar aspirational appeal. This consumer segment seeks value for money and the convenience of daily availability of water. They typically have a household income of between $6-$8/day.
•Landless Poor (day laborers, males of household often away): up to 30% of village population. To this customer, E HealthPoint water and healthcare appears out of reach or is simply not useful to the dominant decision-maker because he is not home. PPP vouchers or other subsidies may be required to capture these consumers, most of whom have incomes below the official Indian poverty line. They comprise sub-groups having varying degrees of perception, willingness and affordability to spend on accessing paid services in water and health. However, the lure of free health services from government facilities (even if intermittently available) and the availability of untreated water for free (even if contaminated) combined with inertia prevents this segment at present from using our services to any significant degree.
Waterpoint Customers. These customer are largely from the dominant middle customer segment, make up to 30 visits a month to a waterpoint to collect their water or (where available) get water delivered at the doorstep; typically waterpoint customers comprise 42% to 50% or more of community households; they spend $1.50/month via prepaid subscription on our water services;
•Drivers are taste, perceived quality, to a lesser degree health, also the aspirational appeal of a modern water supply; the “buyer” is the dominant household male, often strongly influenced by his wife/peers; buying decisions made in the home, not at the eHP, so “water promoters” and other social marketing outreach to household is critical; Water collector may be a boy child, an elder male, young man, or a woman
E HealthPoint Healthcare Customers.
•Walk-in traffic is about 50% women; walk-in customers typically spend $2.25 per visit (including diagnostics and pharmacy), are largely from the dominant middle; telemedical consultations seen as offering enhanced privacy (compared the informal providers that often gossip about their customers); Consultations are the dominant driver of diagnostic and pharmacy traffic, although walk-in or referral traffic for diagnostics and pharmacy is rising;
•Repeat walk-in traffic is sporadic and seasonal, reflecting illness patterns, and faces strong competition from entrenched informal providers;
• A key challenge, however, especially for chronic disease management or nutritional supplements, is that there is low culture of preventive healthcare in rural India; thus extended marketing efforts to change behaviors and possibly initial subsidies may be required to successfully introduce these services.

Share the story of the founder and what inspired the founder to start this project

The Co-founders Amit Jain and Al Hammond met each other at the Santa Clara Social Benefit Incubator in year 2008. At that conference, Amit and Al began sharing ideas and immediately noticed synergies between their ideas about delivering healthcare and associated health services to rural communities in India which are at the base-of-the-pyramid through a well designed social enterprise. This was a combination of ideas on telemedicine-pharmaceuticals-diagnostics which needed demand-generation and the delivery of clean water, an obvious component of healthcare, that would bring customers to the clinics and generate both demand and revenue. Amit and Al’s resources, skills, and capabilities were also complementary, as together they brought perspective on models for business at the base-of-the-pyramid and knowledge about willingness-to-pay and the much needed social marketing expertise, operational know-how, and experience with implementation. Both the co-founders recall, “We were sitting across the table from each other and we both thought, why don’t we do this together?” Essentially on the spot, Amit and Al forged the partnership that became Healthpoint Services. Since beginning of the pioneering E HealthPoint model in the later part of 2009 , there have been several innovations added which have been resultant of constant stakeholder engagement and a culture of innovation and need-based product and service delivery instituted by the co-founders.

Social Impact
Please describe how your project has been successful and how that success is measured

EHP clinics and WaterPoints provide local access to affordable high quality healthcare and preventive measures (safe drinking water) that are otherwise unavailable in the rural communities in India where we operate. There is generally no alternative source of safe drinking water, no local source of diagnostic tests, mostly informal pharmacies with a high content of fake or expired medicines, and for access to a provider the alternatives are poor quality (often damaging) care from informal providers, very limited availability of care at government primary care centers (typically only 1 afternoon a week), or the necessity of travel to a city to seek private medical care (very expensive, so often put off). Thus access to our services 8 hours/day, 6 days/week (and every day for water) within walking distance greatly improves both access to care and the available quality of care. We work primarily in under-resourced, low-income communities, and our prices are affordable for most low-income households in rural India.
We have gone through an initial proof of concept phase and then a pilot phase for demonstrating the business model (based around cluster units of a clinic and 3-4 WaterPoints, which we have shown can operate in a cashflow positive manner). We are now beginning a phased scaling process, in which we are rapidly building WaterPoints, and planning to scale e-health clinics (building each in the center of a cluster of WaterPoints) beginning in 2012. This strategy is capital efficient, as the cashflow from WaterPoints helps offset the startup costs of the clinic, and also accelerates the progress of the clinic to profitability, because it benefits from the community trust and traffic flow of the water units and the already existing social marketing infrastructure. At the same time, we are upgrading our health services by piloting maternal; /child care and chronic disease management services, in preparation for scaling the health business. Access to safe drinking water largely prevents water-borne disease. But the coupled provision of water and healthcare has important indirect effects. Because people come every day to pick up their water, the water service provides social cover for those with socially unacceptable conditions (such as HIV/AIDs or TB) to visit the clinic (“I’m picking up the water.”). We believe that our services improve both health and productivity in the communities we serve—indeed, that is our mission. We create 12-13 local jobs per cluster (a clinic and 3-4 WaterPoints), most of them for women, and pay for such staff averages about Euro 80/month (a good wage in rural India); plus we create employment as independent entrepreneurs for another 3-4 persons per cluster in distribution of water. All HealthPoint local employees have the benefit of half-price access to healthcare for them and their families at our clinics. Our customers benefit from avoided illness and better health through increased productivity, reduced days of lost work or missed school due to illness, and avoided costs (eg,to treat waterborne illness or the need to travel to a city for care). Families where we work will in future be able to identify early and treat a chronic condition such as diabetes or heart disease (see below for this proposed pilot) may avoid or postpone the need for hospitalization. Our customers also benefit aspirationally from the pride of having access to an urban-quality facility in their village. Our 8 clinics provide access to healthcare to 80,000 people; we currently treat about 2000 health patients/month; our 75 WaterPoints provide safe drinking water to more than 250,000 people per day. We expect to have 300 clusters providing access to 5 million people, and expect to treat more than 100,000 health patients/month and provide safe drinking to more than 1,000,000 households/day. Since water is provided to households, about 50% of water beneficiaries are women; currently, women are about 55% of our health patients. The HealthPoint model is environmentally net positive as on account of safe drinking water available locally , the need for burning wood /cooking gas for boiling water has substantially reduced. Also, on account of availability of high quality basic healthcare and diagnostics services in the local area, a considerable amount of travel to the nearby urban centres ( and the resultant vehicular pollution /carbon emissions ) have been reduced thereby resulting in positive impact on the environment . While we continue to employ in-house metrics- both qualitative and quantitative for assessing various indicators wrt social and business impact, CEGA at the University of California Berkley shall be commencing a Third-party outcome study spread over next two years for asceratining more closely and clearly the impact resulting out of E HealthPoint efforts. As some of the recent measures of success, we have started receiving a higher degree of walk-in traffic for diagnostics and enhanced enrolment for water . We have now been invited by atleast three state governments for pilot implementation of the E HealthPoint model and across one country each in Asia and Latin America ; also, we have started receiving invitations for strategic partnerships with some of the largest organisations across the globa working in the FMCG and Healthcare domains.Examples of some of the metrics areas are : Reduction in expenses on account of waterborne diseases, reduction in expenses on account of healthcare , savings in terms of wages days lost, increased school attendance days especially for girls , savings in terms of reduction in price paid for medicines earlier and now etc.

How many people have been impacted by your project?

More than 10,000

How many people could be impacted by your project in the next three years?

More than 10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

Expanding the range of services for customers,Enhancing operational efficiency , 2nd Phase implementation of Behaviour Communication Campaign, expanded partnership with Public & Private sector players

Task 1

Enhancing Operational Efficiency of the E HealthPoint Clusters by better cost management,capacity building of team ,improved supply chain and better/competitive sourcing and higher use of ICT

Task 2

Expanding the range of services for customers in health & wellness space;pilots underway in areas of mother and child health, chronic disease care and management,expanded distribution of water

Task 3

2nd phase implementation of Behaviour Change Campaign so as to enlist newer set of customers , reinforce and reassure the existing customers , raise health awareness and call for action

Identify your 12-month impact milestone

Higher contribution from expanded range of services , Faster Operational Breakeven for E HealthPoint clusters, Increased adoption rate amongst users , expanding to 2 more states in India

Task 1

Succesful implementation of new services pilots and devising products and services offering accordingly to meet customer expectation regarding benefits/value for money spent by her

Task 2

Communication campaign to build momentum for newer customers and repeat and regular customers for water and healthcare.Expanding reach of customer feedback mechanism instituted earlier this year.

Task 3

Dialogue , Demonstration and Engagement of other state government representatives regarding the efficacy/benefits and high social impact of the EHealthPoint program in Punjab, India

How will your project evolve over the next three years?

E HealthPoints are being recognised as a Disruptive Innovation providing bundled services at affordable price and hence a Gamechanger Solution for Low Income Groups across developing countries. E HealthPoints has planned tie-ups to expand the idea to Phillipines and Mexico later this year. The E HealthPoint idea uses the existing technology platforms on an Open-source partnership basis and is demostrating that this idea has the potential to positively transform healthcare Globally on a sustainable basis thereby generating high order social, economic and financial returns.Accordingly,in next 3 years we expectto have 300 clusters providing access to 5 million people,and expect to treat more than 100,000 patients/month & also provide safe drinking water to more than 1,000,000 households/day.

What barriers might hinder the success of your project and how do you plan to overcome them?

Some of the barriers and challenges we see in the project are : Policy changes by the government towards providing free healthcare to all, Price-undercutting by Quacks , Attrition of talented middle level & field staff , Low attractiveness of this model for the conventional Venture Capitalists , Deep-rooted Consumer preference for reaching-out to Urban facilities . With respect to Healthcare services becoming free for all - E HealthPoint considers that as a Low risk/barrier as such schemes are increasingly being restricted to the Below Poverty Line Groups only and offlate the government is supporting the Pay & Use /Fee for Service Models across education, healthcare , drinking water , energy etc. sectors
. With regards to price undercutting by quacks , E HealthPoint is employing a three pronged strategy- Providing a range of high quality differentiated services than what quacks offer, providing a pre-paid subscription model for health and water for the entire family and linking it with micro-health insurance, providing an incentive based referral scheme to quacks for referring clients to E HealthPoint . With regards to minimising the extent of and impact of the attrition of talented middle level & field staff , E HealthPoint is actively encouraging employing the staff from loacl areas who then have an incentive to stay closer to home , keeping an additional bench-strength of field staff , providing financial and non-financial incentives to staff at middle-mananement and field levels. With regards to the low attractiveness of this model for the conventional Venture Capitalists , within two years of start of its operations , the E HealthPoint model has started achieving operational breakeven and furthermore hasdemonstrated the highest degree of social and economic impacts for specifically the users and consumers and generally for the community . The recent winning of national and international awards and recognitions at some of the prestigious social enterprise forums has immensely helped E HealthPoint model gaining a renewed interest from such investors/partners. With respect to the Deep-rooted Consumer preference for reaching-out to Urban facilities , E HealthPoint has embarked upon a well designed Behaviour Change Communicatio strategy backed by a high quality of service delivery ; components in these include issue-based communication campaigns, high degree of interpersonal communication activities engaging individuals, families, groups and communities, quality accreditation of services by the quality councils/regulators, maintenance of high standards of staff interaction and service delivery and adherence to the prescribed protocols and Standard Operating Procedures (SOPs) , a range of services which are sufficiently differentiated from those offered by local quacks and are at par with the urban facilities ( especially wrt safe drinking water, medicines and diagnostics)- a combination of these and an increasing trust with community would help in this regard .

Tell us about your partnerships

Government : E HealthPoint is a pioneering healthcare model providing multiple services at highly affordable price points for the low income communities and hence has been working closely with the regional government under a unique Public Private Partnership model thereby supplementing the public sector efforts for ensuring health for the entire community. This also includes Secondary Care Referral Partners – Leading Hospitals in the Public Sector and carefully reviewed and thus empanelled hospitals in private sector in the districts that we implement E HealthPoints.
Technology Partners: Athenahealth is providing its athenanet clinic automation workflow
software (based around advanced electronic medical records) for E HealthPoint to use outside of
the United States; Dimagi for Android software integration, CommCare software and backend software for use by health workers on mobile devices, and integration of mobile data with athenanet electronic medical records; Sensaris, West Wireless Institute, and other developers of mobile diagnostic and/or monitoring tools ; Reliance Communications and Bharti Airtel already provide broadband and mobile services to EHealthPoint clinics, and we discussing with them about a partnership for expanded IT and
communications services .
NGO/Not for Profit : E HealthPoint is partnering with the combined initiatives of the mHealth Alliance + Ashoka Innovators for the Public + Public Health Foundation of India for implementing newer pilot approaches for improving maternal and child health .
For Profit Organisations : E HealthPoint has partnered with Procter & Gambel (P&G) for a collaborative learning & investment partnership wherein both sides would benefit in generating a higher order understanding of the low income groups ( especially I rural and peri-urban areas) and inturn would design , devise and distribute healthcare and wellness products and services. E HealthPoint
Academia /Universities : CEGA at the University of California Berkley Health will be conducting a Third Party Outcome study spread over next two years . The Harvard Business School is writing a case study on E HealthPoint , especially highlighting the need and relevance of this model for the underserved, low-income communities .
Partnership with Other Agencies - There are several partnerships with other agencies - both financial and non-financial ( strategic for business /technology/supply-chain/customer mobilisation/impact analysis) etc. which are in various stages of discussion and finalisation.

Explain your selections

The selections of individuals or organisations or customers have been guided by the following criteria- Mutual Fitment with respect the goal and mission orientation , Partnerships based on synergistic sets of products and services , Commonality of purpose for serving the low-income groups and other underserved communities, Geographical selection based on feasibility surveys comprising socio-economic and technical feasibility surveys , expression by potential customers of needs and willingness to adopt and use the services provided by E HealthPoint , Past proven experience of partner organisations in successfuly delivering such services

How do you plan to strengthen your project in the next three years?

E HealthPoint has devised a phased plan for next three years in terms of strengthening its business model and has three components - Financial, Technical and Partnership based . With respect to the Financial Component Phase I during FY 2009-2011 comprises raising Equity and Debt , Phase II during FY 2011-12 comprises raising additional Equity , Higher quantum of Debt , Small & Medium Grants , Phase III FY 2013-2014 comprises small Debts and grants and earnings and Phase IV FY 2015 onwards comprises growth based on Retained Earnings and small grants for specific services and new pilots . With respect to the Technical stregthening , E HealthPoint is actively involved in forging partnerships with technology organizations in the healthcare domain and over next three years the same would be strengthened in areas like mobile diagnostics, telemetry for water , remote sourcing of specialists from partner hospital organizations, introducing tech-based financial services beneficial to local communities , partnering with the E-governance initiatives of the government etc. With respect to the Partnership and Networking components, E HealthPoint has already partnered with a number of leading Government/Private/NGO/Academia/Civil Society organizations in health, water, education and rural development space and the same would continue in next three years.

Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.


Lack of physical access to care/lack of facilities


Lack of affordable care


Health behavior change

Please describe how your innovation specifically tackles the barriers listed above.

E HealthPoint works in under-resourced, low-income communities offering affordable care through physical & virtual access to high quality healthcare facilities.E HealthPoint is already contributing to early screening of anaemia amongst women and children, cardio-vascular risk assessment,diabetes screening ,screening of malnutrition cases, providing mother & child healthcare services,conducting eye camps,promoting personal hygiene etc. Thus access to our healthcare and safe drinking water services 8 hours/day,6 days/week(and every day for water)within walking distance greatly improves both access to care and the available quality of service thereby resulting in a high degree of social impact and expanding access indicating a high degree of potive, sustainable behaviour change

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.



Enhanced existing impact through addition of complementary services


Leveraged technology

Please describe which of your growth activities are current or planned for the immediate future.

E HealthPoint has planned for rapidly improving the performance of its health services, so thatit contributes to scale clinics and continuing to scale water program.Accordingly, E HealthPoint has planned to expand the model in atleast two new states in India in next six months. It has also planned to initiate pilots in one country each in South Asia and in Latin America in collaboration with local partners in those countries. E HealthPoint has planned to introduce complementary services in the areas of mother and child health, chronic diseases' management and care , opthalmology mobile diagnostics, and expanding the rangef wellness products and services.E HealthPoint is actively piloting several new technology-based solutions which shall improve efficiency and customer service standards.

Do you collaborate with any of the following: (Check all that apply)

Government, Technology providers, NGOs/Nonprofits, For profit companies, Academia/universities.

If yes, how have these collaborations helped your innovation to succeed?

Collaboration with the diverse set of partners has enabled the E HealthPoint Innovation to succeed. While partnering with Government provided a unique PPP model opprtunity to be showcased , collaborations with the technology partners provided access to the latest and most efficient tools in EMR and application software thereby increasing efficiencies and in cost management . Collaboration with NGOs has helped in terms of designing community engagement strategies and also in capacity building of E HealthPoint team memebers. Collaboration with For Profit companies resulted in investment and business guidance and with Academia in devising the social metrics and output/outcome related indicators being factored in the program delivery.