Future perfect for online healthcare

How convenient it would be if someone hand-holds you when you are sick – takes you to a doctor, provides you with the best medical aid, etc. Sensing the same, there is a slew of start-ups aiming to take all that burden upon themselves through their online healthcare platforms.

When Delhi-based Shekhar Dasgupta looked for a quality yet affordable orthopaedic hospital for his mother’s knee-replacement surgery, no one was there to help him – right from choosing the right hospital offering surgery at a competitive price, finding best orthopaedic surgeons, fixing appointments with the hospital and doctor, and most critical the post surgery homecare service.

Perplexed by the lack of transparency and information asymmetry, Dasgupta came across with an online healthcare platform that helped him with his mother’s pre and post surgery processes. “It proved to be a one-stop shop for me. Most importantly, I didn’t have to deal with the middlemen that otherwise existed in the offline process,” says Dasgupta, a grocery store owner.

User-led Growth

Increased Internet penetration and consumer awareness of maintaining health and hygiene, and consumers’ desire to make better informed choices in terms of doctors, hospitals or diagnostic labs have open up a new window of B2C opportunity for entrepreneurs.

“The healthcare sector is around $150 billion in size, growing at 45 per cent year on year. As our lives are getting busier, instead of first visiting a doctor, people want to check the best-suited doctors for them and then fix an appointment,” says Akash Kapoor, Partner, InfraBuild Venture Partners LLP, a Delhi-based consulting firm.

Similarly, Sushanto Mitra, Founder and CEO, Lead Angels Network, says, “While the demand for healthcare services are growing, there is an ever increasing section of the population that doesn’t want healthcare services through traditional ways. Catering to this market is a fairly large business opportunity.” The Lead Angels along with Hyderabad Angels invested an undisclosed sum in Mumbai-based online diagnostic services start-up MyLabYogi in August last year. “The convenience of healthcare services delivered at home and the ability to choose the service provider led us to invest in MyLabYogi,” adds Mitra.

Started in January 2012, MyLabYogi allows users to check and book various diagnostic lab tests in their vicinity. Post that a phlebotomist visits the patient to collect blood samples and transport them to selected labs. The test report is then sent to the patient through email and courier. The user can either pay online or in cash on home visit. The entire process takes around six-eight hours.

“I spent around eight years in primary healthcare where I realised there was a huge opportunity in providing a convenient interface for diagnostic services for customers,” says Aneesh Khanna, Co-founder and CEO, MyLabYogi. The company offers blood collection, blood pressure monitoring and ECG services at home and boasts of doing over 20,000 transactions.

Doctor/Hospital-led Growth

It is not just users, but doctors, hospitals and diagnostic labs are also benefiting from the digitisation of healthcare – access to patients’ medical records online, getting their feedback online, better communication with patients on the go especially in cases where they miss appointments which saves money and time, customised solutions for billing, payments and reminders and nonetheless increased profits because of growing volume are driving them online.

As per an online report, doctors claimed increase in their revenue by around 25-30 per cent with around 80 per cent drop in the cancellations of appointment. Buoyed by the growth of e-commerce and innovative business models in India, Saurabh Arora, while working with Facebook in the US, saw the emergence of healthcare in India.

Last year when his wife delivered twins in India, Arora tried looking for doctors online but couldn’t find a trusted platform. This led Arora to start Lybrate in 2013, an online platform and Android app that helps doctors to manage medical records, appointments and billings while helping users to connect and book appointments with doctors, see how many patients have recommended that particular doctor, find ambulances and nearby laboratories. The start-up raised $1.23 million for product and technology upgradation in August this year from Nexus Venture Partners.

Revenue Streams

Online healthcare start-ups usually get revenue share from hospitals, doctors or labs that are empanelled with them. This is the primary source of revenue for them. Other than that services offered like homecare add up to their revenue model.

For instance, Gurgaon-based Credihealth charges subscription money of 10-20 per cent per patient from hospitals and diagnostic centres for the tertiary and quaternary care services. The company will soon foray into home care segment by tying up with around seven home care providers. The start-up is currently in talks with investors to raise around $4 million for technology upgradation, marketing and expansion.

Similarly, Bangalore-based DocTree has the annual subscription model with more than 40 hospitals and 15,000 patients registered on its website. On the other hand, MyLabYogi works on a monthly revenue sharing basis or a flat fee basis between 15 and 30 per cent of the total gross billing.

The start-up works with about 15 hospitals. While Lybrate charges only when doctors use their value added services like ability to communicate with patients via message and email in vernacular languages like Hindi, Tamil, Punjabi and Marathi.

Growth Blockades

There aren’t significant challenges in online healthcare space except getting people online to transact. Some other challenges are remaining sensitive to different quality protocols and patient care.

“The number of people seeking information is larger than those who are transacting. It becomes a business model when people begin to transact. We have closely worked with corporate houses to organise camps and conduct local health check-ups for societies. We have also used Just Dial and other classifieds to reach out to patients who want this particular service,” says Khanna.

Credihealth, alternatively, uses radio and social media to reach out to people and build traction. “We get around 150 requests and record about 30 transactions per day,” says Ravi Virmani, Founder and MD, Credihealth, and former COO, Max Healthcare. Credi Health currently has around 1,000 doctors listed for tertiary care.

If India offers cheap medical treatment vis a vis quality healthcare in the West, it is because of the lack of sensitivity in the sector. However as the system evolves, the sensitivity will have to be put in place.
MyLabYogi’s 20-day training programme teaches new techniques of blood collection to all technicians who have a diploma in medical lab technology. Moreover to manage blood samples in transit, the company has an app for monitoring each transaction to avoid misplacing or loss of any sample.

Healthcare Through Facebook

Recent online reports claim Facebook is planning to enter healthcare segment with the creation of ‘online support communities’ on its network. Through this, Facebook users having healthcare issues can connect with each other and doctors.

This will benefit Facebook to increase its users. This however doesn’t sound alarming to online healthcare start-ups; instead they argue that the room is big enough for everyone’s growth.

“This is interesting as the end user will be able to make more informed choices for the type of service they  require as well as make health services market more competitive and lead to transparent pricing practices,” says Mitra. But how Facebook will alleviate privacy concerns of users’ data and health records, for which there has been lot of criticism, will be answered in coming time.

Going Ahead

Start-ups MyLabYogi and Credihealth are seeing expansion in next few months. While the former will be looking at Pune, Ahmedabad, Bangalore, Hyderabad and potentially Delhi by next year, the latter will be foraying into Mumbai with 500 doctors at about 50 hospitals listed on its platform followed by Kolkata, Chandigarh and Bangalore by June next year. Lybrate, being a mobile-first company, will continue to add new products and value added services in its app for doctors.

“There is a long way for online healthcare to go in terms of diagnostics market. We are looking at another round of funding to move to multiple cities,” says Khanna.

“We want to capture the market share of 4-5 per cent by end of next year. We plan to help hospitals increase their revenue through our platform from current 5 per cent to at least 12 per cent in the next two years,” claims Virmani.

With new services and products to be introduced timely, online healthcare start-ups will have to re-align themselves accordingly and would be wise to pick their focus area in one segment. Nonetheless, from five to seven years from now, we can expect consolidation in the segment.