Online doctor consultation is coming to rural and semi-urban areas, offering a convenience so far limited to urban areas.
At least three healthcare start-ups are in talks with local general physicians, non-governmental organizations and travel agents in villages and small towns to set up kiosks, or so-called health ATMs, in their premises, where patients can drop in to consult specialist doctors over video link. The cost of setting up a kiosk can range from ₹ 10,000 to ₹ 2 lakh.
Angel and seed-funded startups Doctor Insta Pvt. Ltd, iCliniq (Orane Healthcare India Pvt. Ltd) and JustDoc (Godel Technologies Pvt. Ltd) are planning to launch these services in villages across West Bengal, Uttar Pradesh and Bihar, executives at these companies said, targeting villagers and slum-dwellers. These companies may later expand to the outskirts of New Delhi or slums in Mumbai.
Patients in many towns and cities in India can already consult doctors over smartphones and computers via video link provided by technology start-ups but the lack of specialty doctors, poor Internet connectivity and weak adoption of electronic payment methods have prevented villages from benefiting from the technology.
“Under our pilot, in last few days, 20 consultations have been done. Most of these were psychiatric cases besides dermatology and paediatric cases," said Dhruv Suyamprakasam, founder, iCliniq.
iCliniq has tied up with a travel agent, who has set up five monitors for video consultations, in a village near Durgapur in West Bengal.
Doctor Insta is in talks with local general physicians and plans to set up 500 kiosks across the country in phases from the end of this month.
“Only specialty cases will be handled with our health ATMs. There is a lack of specialty doctors in villages. If patients do not get good doctors, they go to quacks or do self-medication. We are trying to address these issues," said Amit Munjal, co-founder of Doctor Insta.
The kiosks will focus on psychiatry, sexology, dermatology, gynaecology, diet and nutrition and chronic diseases such as diabetes.
Under the partnership, the physician will pay a security deposit for the kiosk and earn a commission on the consultation fee. The kiosks will also have devices such as a digital stethoscope and a thermometer. The physician available at the kiosk will do the basic diagnosis.
JustDoc is in talks with Sevamob, an NGO that offers tele-health services in rural areas by conducting periodic visits. According to Jugal Anchalia, co-founder of JustDoc, the start-up will integrate its technology on the latter’s platform to facilitate video consultation with senior doctors.
Currently, the average fee for online consultation costs above ₹ 200. For remote areas, it will be ₹ 50-100.
According to Prashant Tandon, chief executive of 1mg, an online pharmacy, the cost of specialty treatment is quite high and villagers have to visit a city hospital, involving transport, accommodation and food costs on top of treatment costs. They may have to return frequently for follow-up consultations as well.
“However, for a doctor to do a proper consultation, much more is needed than just a video. So, the start-ups should concentrate there," he said, adding fixing the kiosk with ancillary services for basic check-ups will be the key.
The system should also give doctors access to previous prescriptions, data on patient’s medical history etc., he said.
1mg, which currently delivers medicines, itself is evaluating a plan to launch a video consultation platform.
To be sure, small ticket size and high infrastructure costs could make it difficult for start-ups to make money in the near term.
“Monetization will happen gradually. The current plan is to grow the volume," Doctor Insta’s Munjal said, adding he expects 50,000 daily consultations by his company by March 2017. These start-ups currently conduct 400-900 consultations daily.
India has 938,861 registered allopathic doctors or just seven doctors per 1,000 people. The public health system in India remains inadequate despite multiple government initiatives such as the National Rural Health Mission and Janani Suraksha Yojana.
Many of them do not cover the country as extensively as they should and most of them are poorly equipped and understaffed. The few relatively better clinics are overcrowded.
This leaves a lot of room for private companies who want to cater to rural and urban healthcare concerns.
Three-fourth of India’s population lives in villages and small towns and the rest in urban areas, while three-fourth of medical infrastructure is concentrated in urban areas.
Given the high volume, the companies are likely to make money even at low prices in the long run, said Charu Sehgal, national leader for life sciences and healthcare at consulting firm Deloitte.
As the volume rises, even the government can look at buying their services on behalf of patients, Sehgal said, adding that the fees for super specialty consultations will remain expensive.