August 20, 2014


Are you betting on the Top 5 Throughput Multipliers in Healthcare ?

Let's start with the problem statement.

The phenomenon of globalization and urbanization has led to a burgeoning middle class living sedentary lifestyles. The fast pace of life with double incomes has ensured that food is predominantly fast food or pre-processed food. Common ailments are more related to this lifestyle rather than infections (Hypertension, Insomnia, Diabetes, etc.) While the improved standards of living have increased the lifespan of human beings, there is a huge ageing population requiring access to quality healthcare.

Unfortunately, healthcare infrastructure is woefully behind in terms of addressing this growing need. Most hospitals and clinics can handle a few hundred if not a thousand or more in-patients. The only way to handle the growing queues is to make healthcare prohibitively expensive and beyond the reach of the masses. Back of the envelope calculations suggest that we need at least 20 thousand new hospitals, every year, for the next 20 years to catch up to this growing need in an emerging nation like India alone.

All of us know that this is humanely impossible. The amount of capital expenditure needed will be in the trillions of unavailable capital, and even governments cannot address this.

The only option is to think out-of-the-box and re-plan our healthcare systems from the inside out, keeping the current paradigm in mind. We need to use technology, internet of things and other means to dramatically increase the throughput of the existing healthcare infrastructure by 10X and 100X if possible.

Here are some baby steps in diagnostics and out-patient treatment, already present in the market, which if properly nurtured can have a huge business impact in healthcare for the future.

  1. Electronic Heath Records – Health records till date are purely paper-based due to the huge amount of storage required for imaging records (CT Scans, MRIs, etc.). Also, the need for Doctors to address pathology utilization KPPs in exchange for a practicing seat in renowned hospitals has resulted in multiple and unnecessary diagnostic tests for patients in every new hospital.

    Use of cheap public cloud storage (with adequate biometric security measures) along with government policies and certified norms of validity for various diagnostic tests can save time and money for patients and clearly improve throughput of the overall healthcare infrastructure.

  2. Simple and Non-invasive Diagnostics – Often times, the time spent in queues in clinics and hospitals with a multitude of other patients with contagious diseases can be quite traumatic and risky for an ailing patient. Medical device companies have come up with many innovative devices like laser based non-invasive blood glucose meters, compact and portable ECG meters, super cheap paper based blood tests, and more, which can be used by care givers at a substantially lower capex.

    Simple policies for certification of care givers can result in legions of care givers who can perform 90% of the diagnostics (barring a few like MRIs and CT Scans) at a patient's home improving the convenience factor manifold and at a fraction of the current costs (based on competitive market dynamics of Healthcare as a Service). A well-equipped vehicle with low cost equipment would be all that would be required.

  3. Telemedicine – Thanks to the telecom revolution, most households now have broadband connectivity at home and all the necessary infrastructure for video conferencing. The cost of setting up such facilities in clinics has also come down drastically.

    With access to electronic health records over the cloud, video conferencing with patients and access to care givers who can perform rudimentary checks on patients, doctors now can easily handle out patients across the globe. This is extremely amenable for process optimization and service outsourcing with immense benefits to patients.

  4. Early Intervention and Prevention – Lifestyle related ailments which are the bulk of ailments can easily be prevented by changing our sedentary lifestyle and slowly increasing the quantum of exercise through simple measures like walking briskly, taking the stairs instead of the elevator, avoiding the extra helping of dessert, etc.

    IoT Ingestibles and Wearables can easily monitor health parameters of patients and provide early alerts and innovative reports which act as a conscience keeper and ensure a healthy lifestyle. Often times, a simple alert on the calorie count of the extra helping of dessert and the amount of time required to burn it can go a long way in preventing obesity related issues.

  5. Remote Monitoring Systems – There are still quite a few patients who cannot adopt Do-It-Yourself (DIY) methodologies for healthcare especially Infants and Elderly patients. With the advent of low cost sensorization, many companies are developing Assisted Living systems which can monitor all health parameters of patients with real time communication to a command center for proactive action.

    The cost of these systems has come down drastically, thanks to the sub dollar price of most sensors and the presence of a broadband communication system in most houses. These systems can go a long way in constantly monitoring patients and providing lifesaving treatment (in case or cardio or neuro attacks) in the comfort of a home rather than in an ICU.

The only solution to healthcare infrastructure issues is if modern healthcare attempts to move 90% of diagnostic treatment to the patient's home.

I am sure that the scale would provide the business case for such diagnostic treatments, despite the new normal of revenues for Healthcare as a Service.