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Dr D Lavanian CEO HCit Consultant

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Executive Summary (POC)


Healthcare in villages inadequate Pilot to provide 24/7 primary healthcare support in 100+ selected

villages Will cover between 3,00,000 to 7,00,000 people Quick start 1st village in 5th month, 50th village in 12th month, 100th village in 18th month Cost per individual between Rs 4 to 8 per month A text book Pilot requires a grant of Rs 5.8 crore per yr for 2 yrs A low cost Pilot can be realised in less than 66% of the above cost

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While Maharashtra is today the most affluent state in the country . it continues to have high levels of . inequalities which get reflected in health outcomes which are not the best in the country. Thus Maharashtra has to still struggle with malnutrition deaths, child mortality and maternal mortality levels not commensurate with its economic position in the country Dr. Subhash Salunke Director General Directorate of Health Services Maharashtra 31st August, 2005

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Defining the problem


Maharashtra, has as much population as Mexico 66.7 % of the population of Maharashtra is rural Grossly inadequate healthcare in rural areas in spite of a

population with capability to pay Doctors almost 6 times less in rural areas as compared to the cities Nurses almost 4 times less in rural areas as compared to the cities Villagers vie for good healthcare and quality of life No 24/7 healthcare support Problem the same in most states of India
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Maharashtra at a glance 2008-2009*


Total Tahsils 353
Total Villages 41,095 Rural population 5,57,78,000 Total Livestock 3,72,11,000 Hospitals 1,181 Dispensaries 2,072

Ref: http://maharashtra.gov.in/english/ecoSurvey/EcoSurvey2009-10/FINAL_ENGLISH_At_a_Glance.pdf * Provisional

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The opportunity examined


Huge opportunity for innovative health schemes that are 24/7, eco-friendly reasonable in cost and rational. 1st Phase: Healthcare Pilot proposed in 100 villages (proof of concept- POC) to lay down processes for future roll out into 5,000 villages Being a green and social healthcare project, opportunity for publicity and visibility is huge. Phase 1 is important for collection of vital data for analytics The POC within these 100 villages would yield conclusive and validated data

Detailed demographics collected over 2 years in these 100 villages will guide in the selection of villages for the 2nd Phase where there is potential to justify business plans for pharma, insurance, vet and FMCG
Being a private project, govt interference would be minimum, yet being rural, all govt subsidies and grants could be applied for

The favoured partners could then follow up on the rest of the 5,000 proposed villages in almost a monopolistic position, because of the success and rural branding

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Opportunity for Social service


A plum opportunity for a respected and responsible person or organisation This POC requires full financial support from a prominent person (PP) who

(or organisation (org) that) care(s) for rural growth and health care This Project will win the hearts and loyalties of between 3 to 7 lakh rural population in one go Advantages for the PP/org
The villages in Maharashtra will be selected as per the PPs areas of focus Huge publicity of the project will build the brand image of the PP/org The population will be covered by 24/7 primary healthcare services within 2 years Gaps in governmental healthcare schemes will be covered Jobs will be created in these villages Villagers will hugely benefit from the scheme and will be very grateful to the PP/org

for this eco-friendly, social healthcare service Cost for the PP/org to provide 24/7 primary healthcare services could average out to as less as Rs 58.8 per person, per year

One-time grant required from the PP/org , after which it will become self sustaining and profitable. Further growth will require no grants!
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What is the POC?


Our unique Program

It is a unique program that is a symbiosis of the

healthcare persons caring touch and cutting edge healthcare technology

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In a Nutshell
A judicious bundle of eco-friendly, green, cutting edge

Telemedicine technology and local touch-and-feel medical services. Accept total ownership for the complete medical process right from contact to providing advice to provision of medicines. Our medical personnel shall advice our DEvTAs (Doctor Evaluated and Trained Assistants) stationed at every village, to provide 24/7 medical advice and treatment (as per conditions of the contract) to every villager. This would combine the advantages and rich capabilities of telemedicine with the much needed physical presence of medical personnel at each village. Being a complex operation it would be implemented phase wise with each phase being carefully implemented to ensure guaranteed, quality based operations, within agreed to timelines.
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How it works
24/7 link

Women/men living in the villages are Recruited, provided RMedPacs and trained as DEvTAs (Doctor Evaluated and Trained Assistants)

24 hour Telemedicine center With qualified medical staff Rural Areas

DEvTAs are available 24/7 and carry out investigations, diagnosis, treatment, control and prevention activities with support from Telemedicine center
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DEvTA
DEvTA: Doctor Evaluated and Trained Assistant The DEvTA will be a local villager who is selected, based

on a criterion set, and brought to our training center to be trained in providing reliable assistance to the remote doctor. They will be trained based on strict protocols to ensure safety of the patient while providing optimised support to the doctor No legal issues of status as there is already a precedence in the form of Anganwadi workers (since 1975) The DEvTA will be the eyes, ears and hands of the remote doctor
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Software
Enterprise Triage Application
Contact center Application EHR Data Management server applications SMS and Email applications Mobility Applications BI Applications HR and Supply chain Applications

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RMedPacs
Mobile smart phone, solar charger Medical equipment: electronic thermometer, mercury

thermometer, Aneroid Sphygmomanometer, stethoscope, Solar charged torch, hand mirror, etc Diagnostic kits First Aid and dressing material Select medication Training Document Teaching Flip charts Pen, pencils, note books Water proof lockable carry bag
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Activities: Preventive and Promotive


Advice on prevention of
Water borne diseases Vector and arthropod borne diseases Viral and contagious diseases Communicable diseases Environmental factors Accident prevention Chronic diseases and obesity Sexually transmitted diseases

Advice on promoting good health

Convey important governmental information


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Activities : diagnostic
DEvTAs will be trained to measure and convey to the

nurse/clinician:
Temperature, Pulse, BP, respiration, pallor, icterus Level of consciousness, dehydration,

Orientation in time and space

Observations as per instructions of the nurse/clinician Lab tests: at a later stage depending on local needs

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Activities : Curative and palliative


Carry out Triage

DEvTAs will convey to the patient the clinicians advice as per results of

the triage Convey information to the patients attendant Carry out procedures like cleaning and dressing minor wounds, stop bleeding, apply a pressure bandage, splinting, cooling or warming the patient, providing ORS, placing the patient in an appropriate position Providing select oral or intra-muscular medication strictly as per instructions of the clinician Review the patients condition as per physicians instructions Rehabilitative Exercises advice In case hospitalisation or secondary care is required, will be provided information wrt the nearest appropriate healthcare center (public or private as per patients choice)
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Activities : Training, HR & Stats


Hire and train carefully selected villagers as DEvTAs Ensure 100% availability of DEvTAs as per roster Train rural volunteers in basic hygiene and first aid Document the type and incidence of diseases

Document number of patients adviced/treated


Document types of advice/ interventions Document local health issues Document changes in disease patterns in real time and inform

governmental bodies in case of worsening trends

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Planned Benefits :Healthcare


Medical advice to the users 24/7 (conditions apply) Review and monitoring of patients Lab tests, Treatment and follow-up for patients Reduction in deaths due to diarrhoeas, anaemia, fevers and

pneumonias 100% availability of DEvTAs and call doctor services at the peripheral centers during designated timings, throughout the year Premium wellness services, online purchases and transactions (in second phase) Military like discipline and punctuality providing guaranteed services (conditions apply)
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Additional advantages
Eco-friendly project as solar power will also be used
Capable of quick mobility and use in disaster

management like Tsunamis, earthquakes, floods etc Feedback to health authorities of untoward health concerns Early warning of epidemics Collection of statistics Creation of jobs in villages

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Summary Roadmap
Get support for funding

HCitC Implements Telemed-Touch in 100 villages


Monitor Quality of services and other parameters

for 1 year For 18 months, analyse statistical data Based on learnings, tweak program and expand with premium services (CDM, wellness, healthcare products, etc)

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Contact Details
Dr D Lavanian
MBBS,MD

CEO and MD HCIT Consultant www.hcitconsultant.com Certified HL7 Specialist Senior Consultant and Domain Expert - Healthcare Informatics and TeleHealth Former Vice President - Healthcare Products, Bilcare Ltd Former Vice President - Software Division, AxSys Healthtech Ltd Former Co-convener Sub committee on Standards , GOI Task force for Telemedicine Former Vice President - Telemedicine (Technical), Apollo Hospitals Group Former Deputy Director Medical Services, Indian Air Force Executive Member of IAMI Member TSI (Telemedicine Society of India) Member HL7 Australia Member- AMIA (American Medical Informatics Association) HIMSS (Healthcare Information and Management Systems Society) Level 3 Member UKCHIP (UK Council for Health Informatics Professions) Life Member ISAM (Indian Society of Aerospace Medicine) Life Member ISHWM (Indian Society of Hospital Waste Management)

Office: +91 20 32345045 Mobile: +91-9970921266


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Contact 09970921266 ceo@hcitconsultant.com


All information in this presentation could be subject to change

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References
http://maha-arogya.gov.in/programs/nhp/nrhm/default.htm Ravi Duggal, T. R. Dilip and Prashant Raymus. HEALTH AND HEALTHCARE IN MAHARASHTRA - A Status Report . Centre for Enquiry into Health and Allied Themes, Mumbai. E-mail : cehat@vsnl.com . 2005. Srijit Mishra, Ravi Duggal , Lakshmi Lingam and Amita Pitre. A Report on Health Inequities in Maharashtra. SATHI, Pune 411 029, cehatpun@vsnl.com. Jan 2008. Page 4 National Cardiovascular Disease Database, Supported by Ministry of Health & Family Welfare, Government of India and World Health Organization, http://www.whoindia.org/LinkFiles/NMH_Resources_National_CVD_databas e-Final_Report.pdf

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