yeah thank you for the introduction if Martin Luther King was alive today and
Martin Luther King was alive today and
Martin Luther King was alive today and he was working in health care he would
he was working in health care he would
he was working in health care he would have probably said something like this
have probably said something like this
have probably said something like this after 69 years of freedom we still don’t
after 69 years of freedom we still don’t
after 69 years of freedom we still don’t have the right to health 69 years later
have the right to health 69 years later
have the right to health 69 years later the lives of 30 million people each year
the lives of 30 million people each year
the lives of 30 million people each year are still sadly crippled by the manacles
are still sadly crippled by the manacles
are still sadly crippled by the manacles of misdiagnosis sixty-nine years later
of misdiagnosis sixty-nine years later
of misdiagnosis sixty-nine years later 100 million people every year are pushed
100 million people every year are pushed
100 million people every year are pushed onto a lonely island of poverty because
onto a lonely island of poverty because
onto a lonely island of poverty because of catastrophic costs associated with
of catastrophic costs associated with
of catastrophic costs associated with illness 69 years later the sick the old
illness 69 years later the sick the old
illness 69 years later the sick the old and the disabled are still languished in
and the disabled are still languished in
and the disabled are still languished in the corners of our society and so we are
the corners of our society and so we are
the corners of our society and so we are here today to dramatize the shameful
here today to dramatize the shameful
here today to dramatize the shameful condition health care in India is broken
condition health care in India is broken
condition health care in India is broken it is inaccessible it is unaffordable
it is inaccessible it is unaffordable
it is inaccessible it is unaffordable and most of the decisions around health
and most of the decisions around health
and most of the decisions around health care are still largely subjective
care are still largely subjective
care are still largely subjective technology is fast changing the way
technology is fast changing the way
technology is fast changing the way health is delivered but there is no
health is delivered but there is no
health is delivered but there is no magic bullet to truly solve this problem
magic bullet to truly solve this problem
magic bullet to truly solve this problem we need to read business innovation with
we need to read business innovation with
we need to read business innovation with technological development in order to
technological development in order to
technological development in order to understand how to fix healthcare we need
understand how to fix healthcare we need
understand how to fix healthcare we need to first understand why the Indian
to first understand why the Indian
to first understand why the Indian healthcare market is so broken in the
healthcare market is so broken in the
healthcare market is so broken in the first place India like most developing
first place India like most developing
first place India like most developing economies is a self-pay market where
economies is a self-pay market where
economies is a self-pay market where majority of the services are paid for by
majority of the services are paid for by
majority of the services are paid for by the individual or the patient themselves
the individual or the patient themselves
the individual or the patient themselves since individuals compared to bulk
since individuals compared to bulk
since individuals compared to bulk buyers like insurance or government have
buyers like insurance or government have
buyers like insurance or government have much less negotiating power and there
much less negotiating power and there
much less negotiating power and there exists a much higher level of
exists a much higher level of
exists a much higher level of information asymmetry these markets are
information asymmetry these markets are
information asymmetry these markets are rife with corruption and inefficiencies
rife with corruption and inefficiencies
rife with corruption and inefficiencies how many of you by the show of hands
how many of you by the show of hands
how many of you by the show of hands have gone to a doctor’s clinic recently
have gone to a doctor’s clinic recently
have gone to a doctor’s clinic recently how many of you have noticed products
how many of you have noticed products
how many of you have noticed products like pens notebooks calendars
like pens notebooks calendars
like pens notebooks calendars Chateau scopes acceptor which have brand
Chateau scopes acceptor which have brand
Chateau scopes acceptor which have brand names of pharmaceutical drugs or
names of pharmaceutical drugs or
names of pharmaceutical drugs or pharmaceutical companies on them a lot
pharmaceutical companies on them a lot
pharmaceutical companies on them a lot of you most doctors take kickbacks in
of you most doctors take kickbacks in
of you most doctors take kickbacks in either cash or kind to market all other
either cash or kind to market all other
either cash or kind to market all other healthcare related services beat other
healthcare related services beat other
healthcare related services beat other doctors hospitals pharmaceutical drugs
doctors hospitals pharmaceutical drugs
doctors hospitals pharmaceutical drugs or diagnostic centers these kickbacks
or diagnostic centers these kickbacks
or diagnostic centers these kickbacks are significant and value and they not
are significant and value and they not
are significant and value and they not only add to the overall cost of the
only add to the overall cost of the
only add to the overall cost of the treatment but also adversely affect the
treatment but also adversely affect the
treatment but also adversely affect the quality by limiting choice it is
quality by limiting choice it is
quality by limiting choice it is difficult to question the authority of
difficult to question the authority of
difficult to question the authority of the doctor and there is no way of
the doctor and there is no way of
the doctor and there is no way of knowing how good or bad their opinion or
knowing how good or bad their opinion or
knowing how good or bad their opinion or intentions are user reviews and
intentions are user reviews and
intentions are user reviews and information available on online
information available on online
information available on online appointment booking portals and on the
appointment booking portals and on the
appointment booking portals and on the Internet in general talks a lot about
Internet in general talks a lot about
Internet in general talks a lot about the user experience but not much about
the user experience but not much about
the user experience but not much about the patient care outcome to give you an
the patient care outcome to give you an
the patient care outcome to give you an example if you go to a doctor and she’s
example if you go to a doctor and she’s
example if you go to a doctor and she’s courteous to you and she doesn’t make
courteous to you and she doesn’t make
courteous to you and she doesn’t make you wait a lot you are likely to give
you wait a lot you are likely to give
you wait a lot you are likely to give her a great review that does not mean
her a great review that does not mean
her a great review that does not mean the three months down the line you would
the three months down the line you would
the three months down the line you would be in a better position because of her
be in a better position because of her
be in a better position because of her treatment than if you would have gone to
treatment than if you would have gone to
treatment than if you would have gone to a lower reviewed grumpier doctor a
a lower reviewed grumpier doctor a
a lower reviewed grumpier doctor a better way to assess would be to measure
better way to assess would be to measure
better way to assess would be to measure and track objective criteria around
and track objective criteria around
and track objective criteria around long-term patient care outcomes compared
long-term patient care outcomes compared
long-term patient care outcomes compared across doctors and hospitals for example
across doctors and hospitals for example
across doctors and hospitals for example mortality rate among similar cases cases
mortality rate among similar cases cases
mortality rate among similar cases cases in april of 2011 my mother started what
in april of 2011 my mother started what
in april of 2011 my mother started what was then the largest super speciality
was then the largest super speciality
was then the largest super speciality reference lab of the state of Madhya
reference lab of the state of Madhya
reference lab of the state of Madhya Pradesh it had facilities ranging from
Pradesh it had facilities ranging from
Pradesh it had facilities ranging from routine biochemistry advanced
routine biochemistry advanced
routine biochemistry advanced immunoassays and microbiology to super
immunoassays and microbiology to super
immunoassays and microbiology to super specialized genetic and molecular
specialized genetic and molecular
specialized genetic and molecular testing in Madhya Pradesh of 2011 even
testing in Madhya Pradesh of 2011 even
testing in Madhya Pradesh of 2011 even for a simple test like vitamin or cancer
for a simple test like vitamin or cancer
for a simple test like vitamin or cancer marker the sample needed to be
marker the sample needed to be
marker the sample needed to be transported to a Metro like Delhi or
transported to a Metro like Delhi or
transported to a Metro like Delhi or Mumbai this local processing not only
Mumbai this local processing not only
Mumbai this local processing not only saved valuable time for the doctors to
saved valuable time for the doctors to
saved valuable time for the doctors to make treatment related decisions but
make treatment related decisions but
make treatment related decisions but also gave more accurate results because
also gave more accurate results because
also gave more accurate results because there was no detoriation of sample
there was no detoriation of sample
there was no detoriation of sample during transit this was also the time I
during transit this was also the time I
during transit this was also the time I got admitted into the undergraduate
got admitted into the undergraduate
got admitted into the undergraduate program at the Union Institute of
program at the Union Institute of
program at the Union Institute of Technology Bombay I had three months
Technology Bombay I had three months
Technology Bombay I had three months between the inauguration of the lab and
between the inauguration of the lab and
between the inauguration of the lab and my joining the college inspired by the
my joining the college inspired by the
my joining the college inspired by the movie The Social Network I desperately
movie The Social Network I desperately
movie The Social Network I desperately wanted to do something real in life in
wanted to do something real in life in
wanted to do something real in life in the first year of operations we were
the first year of operations we were
the first year of operations we were serving five to ten outpatients a day
serving five to ten outpatients a day
serving five to ten outpatients a day with the capacity to process 5000 we
with the capacity to process 5000 we
with the capacity to process 5000 we were getting specialized work from
were getting specialized work from
were getting specialized work from hospitals and government but not all
hospitals and government but not all
hospitals and government but not all from doctors
from doctors
from doctors the problem was economic the doctors
the problem was economic the doctors
the problem was economic the doctors expected a kickback a cut on the
expected a kickback a cut on the
expected a kickback a cut on the earnings of the Diagnostic Center for
earnings of the Diagnostic Center for
earnings of the Diagnostic Center for each patient they referred something
each patient they referred something
each patient they referred something which was morally unacceptable to us
frustrated we put in one last attempt
frustrated we put in one last attempt reducing the price of all tests by up to
reducing the price of all tests by up to
reducing the price of all tests by up to 70% directly for the patients most
70% directly for the patients most
70% directly for the patients most doctors stopped accepting our reports
doctors stopped accepting our reports
doctors stopped accepting our reports despite being the only lab in the state
despite being the only lab in the state
despite being the only lab in the state with both n ABL accreditation and cap
with both n ABL accreditation and cap
with both n ABL accreditation and cap proficiency for quality many honest
proficiency for quality many honest
proficiency for quality many honest doctors over time also started
doctors over time also started
doctors over time also started supporting the cause but things really
supporting the cause but things really
supporting the cause but things really changed when patients started responding
changed when patients started responding
changed when patients started responding to the superior quality lower turnaround
to the superior quality lower turnaround
to the superior quality lower turnaround times and reduced prices by the end of
times and reduced prices by the end of
times and reduced prices by the end of 2014 we were serving over 100,000
2014 we were serving over 100,000
2014 we were serving over 100,000 patients in Indore at this time we
patients in Indore at this time we
patients in Indore at this time we partnered with the Center for urban
partnered with the Center for urban
partnered with the Center for urban science & engineering iit bombay to
science & engineering iit bombay to
science & engineering iit bombay to commissioned a study to measure the
commissioned a study to measure the
commissioned a study to measure the impact of our model on the lives of the
impact of our model on the lives of the
impact of our model on the lives of the people in a country where only the rich
people in a country where only the rich
people in a country where only the rich are insured and 88% of all medical
are insured and 88% of all medical
are insured and 88% of all medical related expenses were out of pocket we
related expenses were out of pocket we
related expenses were out of pocket we went in with the hypothesis that reduce
went in with the hypothesis that reduce
went in with the hypothesis that reduce prices were helping lower-income
prices were helping lower-income
prices were helping lower-income households
households
households reduce their out-of-pocket expenses the
reduce their out-of-pocket expenses the
reduce their out-of-pocket expenses the study was published in the fourteenth
study was published in the fourteenth
study was published in the fourteenth world congress on public health the
world congress on public health the
world congress on public health the results however were counterintuitive on
results however were counterintuitive on
results however were counterintuitive on average patient was educated most being
average patient was educated most being
average patient was educated most being graduates or diploma holders they had
graduates or diploma holders they had
graduates or diploma holders they had access to clean drinking water and
access to clean drinking water and
access to clean drinking water and sanitation facilities these were the
sanitation facilities these were the
sanitation facilities these were the people who could through their education
people who could through their education
people who could through their education make informed decisions and confidently
make informed decisions and confidently
make informed decisions and confidently go against the advice of the doctor on
go against the advice of the doctor on
go against the advice of the doctor on choosing which brand of healthcare
choosing which brand of healthcare
choosing which brand of healthcare related services what they use the
related services what they use the
related services what they use the economic impact was significant patients
economic impact was significant patients
economic impact was significant patients on an average paid 179 rupees to us
on an average paid 179 rupees to us
on an average paid 179 rupees to us versus 903 in an average Diagnostic
versus 903 in an average Diagnostic
versus 903 in an average Diagnostic Center in the city this was a saving of
Center in the city this was a saving of
Center in the city this was a saving of a whooping 81 percent which was both
a whooping 81 percent which was both
a whooping 81 percent which was both because of lower test costs and fewer
because of lower test costs and fewer
because of lower test costs and fewer tests being prescribed the next question
tests being prescribed the next question
tests being prescribed the next question that naturally came to us was how do we
that naturally came to us was how do we
that naturally came to us was how do we scale this up across India and possibly
scale this up across India and possibly
scale this up across India and possibly the developing world without having to
the developing world without having to
the developing world without having to invest capital everywhere in 2015 I
invest capital everywhere in 2015 I
invest capital everywhere in 2015 I launched an online Diagnostics
launched an online Diagnostics
launched an online Diagnostics aggregator where patients could compare
aggregator where patients could compare
aggregator where patients could compare book diagnostic tests from NAB L
book diagnostic tests from NAB L
book diagnostic tests from NAB L accredited labs around them they also
accredited labs around them they also
accredited labs around them they also save twenty to fifty percent on every
save twenty to fifty percent on every
save twenty to fifty percent on every booking and they could maintain the
booking and they could maintain the
booking and they could maintain the electronic health records with it
electronic health records with it
electronic health records with it we chose NAB L as the minimum criteria
we chose NAB L as the minimum criteria
we chose NAB L as the minimum criteria for quality because it was one the most
for quality because it was one the most
for quality because it was one the most comprehensive check available in this
comprehensive check available in this
comprehensive check available in this country – because ISO one five one eight
country – because ISO one five one eight
country – because ISO one five one eight nine on which NAB L is based is accepted
nine on which NAB L is based is accepted
nine on which NAB L is based is accepted in 130 countries and three because it’s
in 130 countries and three because it’s
in 130 countries and three because it’s a government body it’s unbiased relative
a government body it’s unbiased relative
a government body it’s unbiased relative to other organizations which give
to other organizations which give
to other organizations which give accreditations over time we realized
accreditations over time we realized
accreditations over time we realized that the real value lies not in
that the real value lies not in
that the real value lies not in improving the information asymmetry or
improving the information asymmetry or
improving the information asymmetry or in trying to create a comparison portal
in trying to create a comparison portal
in trying to create a comparison portal but in improving three things one
but in improving three things one
but in improving three things one affordability can the care being
affordability can the care being
affordability can the care being provided of reasonably high quality be
provided of reasonably high quality be
provided of reasonably high quality be afforded by the patient in an ideal
afforded by the patient in an ideal
afforded by the patient in an ideal world we like the best and the most
world we like the best and the most
world we like the best and the most comprehensive care for everyone value
comprehensive care for everyone value
comprehensive care for everyone value life equally of rich and poor
life equally of rich and poor
life equally of rich and poor unfortunately this is not that world the
unfortunately this is not that world the
unfortunately this is not that world the rich person can afford regular health
rich person can afford regular health
rich person can afford regular health check-ups while most poor would not even
check-ups while most poor would not even
check-ups while most poor would not even get tested for diabetes in their
get tested for diabetes in their
get tested for diabetes in their lifetime
lifetime
lifetime even if patients are affording most
even if patients are affording most
even if patients are affording most would err in the side of low while
would err in the side of low while
would err in the side of low while investing in health care to
investing in health care to
investing in health care to accessibility is the care being provided
accessibility is the care being provided
accessibility is the care being provided accessible to me is it near where I live
accessible to me is it near where I live
accessible to me is it near where I live or work can I reach there by public or
or work can I reach there by public or
or work can I reach there by public or private transportation facilities
private transportation facilities
private transportation facilities available to me can the care being
available to me can the care being
available to me can the care being provided be provided to me at home now
provided be provided to me at home now
provided be provided to me at home now once we start thinking about the care to
once we start thinking about the care to
once we start thinking about the care to be provided at home we also have to
be provided at home we also have to
be provided at home we also have to think about the cost and the operational
think about the cost and the operational
think about the cost and the operational aspects around it
aspects around it
aspects around it the average cost including salaries rent
the average cost including salaries rent
the average cost including salaries rent transportation etc for delivering
transportation etc for delivering
transportation etc for delivering medicines for most online startups in
medicines for most online startups in
medicines for most online startups in India at home versus delivering them
India at home versus delivering them
India at home versus delivering them through brick-and-mortar stores is
through brick-and-mortar stores is
through brick-and-mortar stores is between three and seven times higher
between three and seven times higher
between three and seven times higher then there are the operational issues if
then there are the operational issues if
then there are the operational issues if a blood sample is drawn at home and is
a blood sample is drawn at home and is
a blood sample is drawn at home and is transported it takes between four to 24
transported it takes between four to 24
transported it takes between four to 24 hours to reach the main processing lab
hours to reach the main processing lab
hours to reach the main processing lab even if coltrane is maintained this
even if coltrane is maintained this
even if coltrane is maintained this sample is likely to detorri it and the
sample is likely to detorri it and the
sample is likely to detorri it and the resolves are less accurate
resolves are less accurate
resolves are less accurate than they would have been if the sample
than they would have been if the sample
than they would have been if the sample was drawn at the main lab third care
was drawn at the main lab third care
was drawn at the main lab third care outcomes the ultimate differentiator in
outcomes the ultimate differentiator in
outcomes the ultimate differentiator in health care is the improvement and care
health care is the improvement and care
health care is the improvement and care outcomes there is no one thing which can
outcomes there is no one thing which can
outcomes there is no one thing which can alone change the face of the healthcare
alone change the face of the healthcare
alone change the face of the healthcare ecosystem in the country Digital is
ecosystem in the country Digital is
ecosystem in the country Digital is great electronic health records and
great electronic health records and
great electronic health records and information availability have little or
information availability have little or
information availability have little or no
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