ReMeDi - Enabling Access to Rural Healthcare

Sameer Sawarkar has recently been elected as "Ashoka Fellow" by the Ashoka Foundation as a recognition for the work in the area of telemedicine for primary healthcare. Congratulations for this recognition!!! - Neurosynaptic Team

http://www.moneycontrol.com/news/special-videos/neurosynaptic-communicat...

Excuse us for being verbose, but it is important to set a little bit of context.

With the rural telemedicine network spanning over 4.5 Crore population in the villages over 20 districts through more than 650 e-healthcare centers, Neurosynaptic’s ReMeDi today is the largest rural e-healthcare platform in India. Neurosynaptic is also possibly the only company that has shown sustainability and profitability while exclusively working for rural e-healthcare segment. This growth has been consistent year-on-year for the past five years. It is a result of consolidation and absorption of learnings from a lot of failures prior to 2008.

Lack of access to rural health & healthcare is a well recognized problem in India, and all attempts to carry doctors to villages have yielded very little results. While it is quite clear that technology with local capacity building is the way ahead, very little is understood on the ground level channels to deliver the required services.

Neurosynaptic, at its inception in 2002, had a very naïve (as realized today) view about addressing this huge untapped market, representing a large need of 70% of the population. We assumed that creating devices, software and technology would address it. Accordingly, technology was developed with existing infrastructure, skillsets into considerations, as well as with inputs from the medical community. We created the best of the technology that works on 32 Kbps with audio, video and medical data transfer in real time (and also store-and-forward), and a medical device that works on just 2 watts of power, and could set-up a tele-consultation just about anywhere with any kind of connectivity.

However, as we went in the field with this technology, we realized that not only the technology, but the whole ecosystem required for healthcare delivery is missing! There is a need to re-create the ecosystem. This is when Neurosynaptic went ahead to explore various components of the ecosystem between 2005 to 2007, with various partners, channels, economic, training & awareness, service delivery, charging structures, geographic variations in the needs and solutions, infrastructures, components of ecosystem, etc. The ReMeDi technology, also, during this period, went through quite a few alterations, and became capable of bringing together medicines, diagnostics, doctors, village centers, specialists, as well as various ground level delivery processes. In fact, we refer to Technology here as defined by Prof. Clayton Christiansen of Harvard Business School as “a set of processes which transforms labor, capital, materials and information into products and services of higher value”.

The largest initiative today with our strong involvement, began in 2008 with World Health Partners, systematically scaled from 5 centers in 2008, to 30 in 2009, to 128 in 2010 and over e-healthcare 510 centers today in the most backward states of Uttar Pradesh and Bihar. This covers over 4.5 Crore rural population through 5,750 trained village health workers today. It is expected to scale to 28 districts with in the next year.

The service delivery model here has a horizontal approach rather than vertical program based approach, thus covering wide range of primary ailments, leverages financial resources from all three: public sector, private sector and grants. It also leverages the existing public infrastructure in terms of linking up to the Government network for communicable diseases program as well as engages the large fragmented private sector resources (entrepreneurs), who invest and earn or enhance their incomes out of providing the e-healthcare services. In the last two years the ReMeDi platform has provided more than 200,000 consultations. Patients are charged fees close to a dollar for the services obtained in a transparent manner (thereby saving 6-7 dollars of spend), with the Internet Technology component providing strong checks and balances in the system. The ReMeDi platform today provides the most robust, scalable and proven solution in both the client-server and cloud based models.

We also worked with the Government in deploying telemedicine at 50 PHCs in a district and linking up to the rural and district hospitals as well as tertiary care centers. We also work with Hospitals in a rural outreach clinics model.

We see a visible increase in the interests from the private sector players, and additional enablers like RSBY, and National Health Mission are slowly and steadily creating the financing and delivery mechanisms on the ground. We expect to cover a large footprint in India through the ReMeDi solution and various partnerships.

We have been recognized as Technology Pioneers in 2008 by the World Economic Forum, for our path-breaking approach, Global Indus Technovators in 2006 by IBC at MIT Boston and have been the runners up at the Social Entrepreneurs of the Year 2012 Award by Schwab Foundation, and a few other important recognitions, for our contribution in this field.

Neurosynaptic’s business model involves closely engaging with the healthcare service delivery partners and modeling the ground level delivery process in the Technology Platform, and making access possible through these channels. We are self-sustainable since last five years.

With this context, the most important innovation Neurosynaptic brings forth, and which differentiates it from similar other initiatives, is the end-to-end linking of various ecosystem components, capturing of processes and entities through its ReMeDi solution, which makes actual affordable service delivery possible on the ground.

Having said that, we are happy to note that there are now several upcoming initiatives for the rural e-healthcare segment. It would also be important at this stage of this nascent and growing segment, to consider commonalities amongst various initiatives like Neurosynaptics’ on the ground, to evolve basic guidelines / accreditations and systematic inclusive policy approaches, so that the 70% of the population gets maximum benefit towards the access of healthcare.