Is Care Element Missing in Indian Healthcare Startups?

NCDs impact human productivity and increase healthcare costs. It directly impacts the quality of life for the person suffering from it and the entire family. It is not just information or data but a reality affecting directly or indirectly every individual in India. Check within your family & friends circle, and you may notice that 20% to 35% or more people are suffering from one or the other chronic diseases.

Healthcare startups in India have been focused on volume rather than value. Patients are often taken good care in hospitals where the onus is on care providers. But when it comes to self-management toward managing their chronic diseases, they often drop off from the adherence level impacting their long-term health. Although there have been many healthcare startups, is the care element" missing in the Indian Healthcare startups?

In recent years, numerous healthcare startups have emerged, focusing on developing systems to tackle specific diseases, known as "Vertical Programmes". These initiatives aim to address a single ailment through research, intervention, and treatment. Although such programmes have yielded results in tackling certain diseases, they often fail to consider the interrelation between co-morbidities and how multiple treatment therapies interact with each other. Thereby, the current Digital Health landscape's offerings are in silos. Lack of integration leads to ineffective care and overlapping services, leading to extra spending and disconnected experience for patients. The real problem is more profound. Let's understand the issue at the core.

The ratio of doctors to patients in India is low, meaning that conversations with them are brief. Patients often miss capturing all the necessary dos and don'ts. They rely on others with similar conditions in their circle or other sources available to them, which often are inaccurate & incomplete. As a result, they don't fully understand their condition or treatment plan. This leads to medication non-adherence & later, a regretful feeling when the condition has progressed, impacting the quality of life. There are no effective & sustainable solutions with enough care elements that a person with chronic conditions can rely on. To bridge this gap, new solutions are needed that go beyond simply making healthcare accessible and affordable.

The new approach must be patient-centric, providing value-based care for better long-term outcomes. It requires an entirely new system that would combine products & services along with proper guidance & nudge the patient to take the right action to manage their condition. It is imperative that healthcare systems take a broader perspective and consider the interrelatedness of different diseases while developing treatment plans. A more integrated approach that focuses on improving overall health outcomes rather than just treating individual diseases would be beneficial in the long run. It should be effortless for the patients & provide them peace of mind. The need for reprogramming their minds to take proactive care of their health is a must. An empathetic approach is vital in achieving the desired behavioural shift needed. Empathy allows care providers to understand and address patients' emotional and psychological needs, giving them a sense of comfort and reassurance.

A pure digital healthcare startup cannot provide empathy as it lacks the physical presence of healthcare providers. The new approach would need to be phygital (physical-digital), which combines the benefits of both physical and digital mediums, ensuring that patients receive personalized care while leveraging the convenience of technology. Technological advancements like telemedicine and AI-driven data analysis tools will help build new solutions. Empathy remains a crucial component of the healthcare industry, and it is imperative that healthcare providers, including digital startups, prioritize empathy in their services.

Solutions that have worked in Western countries may not be an absolute fit for India. Arriving at optimal solutions would need trials of different approaches and more funding in the space. Unfortunately, startup funding in India for a value-based model focusing on chronic disease management has been insignificant so far despite India being the diabetic and hypertension capital of he world. However, the outlook for the same is very positive. There would be different challenges for the startups trying to solve the burning issue, but the path needs to be walked before it's too late.

Below is an extract from NITI AAYOG Report 2019, November, highlighting the same issue

Managing chronic disease longitudinally over many decades will require new approaches to healthcare delivery. Involving the patient directly in their self-management of their disease may improve patient compliance and may help us avoid some severe complications from their disease by quickly recognizing the first signs of their disease. Most NCD management efforts to-date have focused on systems which impact a single disease called "vertical programmes". This current approach has many downsides. Among these downsides is that they fail to recognize co-morbidities and the interaction between multiple pathologies.

Author - Bandana Kankani, an Investment Banker & growth consultant for startups. She has rich experience in healthcare, especially in pharma supply chain companies/startups.