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Interview 2016-09-09

How Dabur’s Healthcare at Home is growing 150x monthly

Having forayed into India’s at-home healthcare category in 2012, Dabur India promoters’ Healthcare at Home India has served patients in over 33 cities in addition to pharmacy delivery services in 15 cities.

How Dabur’s Healthcare at Home is growing 150x monthly

With an aim to extend hospital equivalent services at the comfort of home, promoters of Dabur India, the Burman family, joined hands with UK-based Healthcare at Home in 2012. In four years of the Joint Venture (JV), the firm has successfully provided hospital like services to over 10,000 patients in addition to catering to over 3,00,000 patients via pharma projects.

With clinical scores matching those of hospitals and customer experience, Healthcare at home is backed by a Net Promoter Score (NPS) of over 70 per cent.

“Our success is backed by several years of experience which comes to us through our promoters, The Burmans, with the legacy of over 130 years in India and founders of Healthcare At Home (HAH), UK, with a legacy of operation over 20 years, treating over 1,50,000 patients annually across UK, Switzerland, Ireland, Australia and Germany. Additionally, our leadership team has close to two decades of strong clinical experience,” said Vivek Srivastava, CEO of Health Care at Home India.

IIT alumnus Vivek Srivastava was previously the Director - Investments for Burman Family Holdings. Backed with a strong experience of over 10 years in Project Management and investment with companies like Indian Oil, Ambit, GTI group, PLI Ventures, Srivastava specialises in corporate finance, business strategy and investment banking.

The company has elaborate plans in the at-home healthcare category. Here is the edited excerpt of Wellness India’s exclusive conversation with Srivastava.

What kind of treatments do you offer at Healthcare at Home?

Our treatments adhere to the patient’s own doctor's prescriptions further backed by a Clinical Evaluation team, through a high response technology driven health monitoring system. It is used by our healthcare professionals to prepare a daily chart of the patient’s health and the chart of their observations, closely monitored by both patient’s doctor and our senior clinical team, ensuring that the right treatment is given to the patient.

Additionally, we follow the highest quality and clinical standards, benchmarked against those of Care Quality Commission (CQC), an independent regulator of health and social care in UK.

All this has helped us come close to our target.

Is it an internally funded venture? How much investment is being made into the project? What is your expectation on the ROI?

HCAH is a joint venture between the Burman family, the promoters of Dabur in India and the founders of HAH, UK. The founders have committed around Rs. 200 crore to the project.

What are the challenges you are facing with big projects like these? How do you plan to overcome these challenges?

One of the major challenges we face stems primarily from the view of healthcare sector in Indian community. People find this hard to believe that high-end home healthcare services are possible. They feel that they can get good services only though admittance in hospitals. We attempt to break this myth by showing evidence and experiences of existing consumers. By far, we’ve done over 1000+oncology/immunology procedures at-home and have looked after more than 3,00,000 patients across India and that too, with a high customer satisfaction rate (NPS >70 per cent) since 2012.

Also, the healthcare industry is facing a crunch of not just doctors, but also qualified and trained paramedics. We have overcome this problem by educating people with non-medical background. Depending on the skill set exhibited they are trained to either nursing attendant or a phlebotomist or an ECG technician. This eases out the work pressure on nurses, helping them focus on increased number of patients.

Additionally, several hospitals are reluctant to try the concept of home healthcare. They mistake us for a competitor, instead of viewing us as an extension to their services. We try to partner with such hospitals by explaining to them our role which will help them widen the reach of doctors and physicians, by vacating the beds occupied by bedridden since a long time. Through meetings and seminars, we explain how we help in increasing the horizons of treatment for patients who are in need of immediate medical intervention, as we free up both their resources and trained staff.

With shift in diversification towards healthcare and wellness, innovative start-ups are changing the industry scenario as a whole. How did you conceptualise the idea to start HealthCare at HOME India?

At HealthCare at Home, we know how important it is to be by the side of your loved ones, especially when their good health isn’t by their side. Patients are most comfortable in an environment familiar to them and do not prefer to move from place to place to get treated. This thought compounded with poor healthcare infrastructure in India (hospital bed ratio of just 0.9 bed/1000 population and only 1 doctor per 1,700 people), made the founders conceptualise at-home healthcare service.

Through homecare, we use the existing capacity in patient homes to take care of this huge gap in Indian healthcare, immediately and cost effectively. By shifting load off the hospitals, we can offload the doctors, allowing them to treat more sick patients. India has already leap frogged technologies in the past (mobile penetration over landline etc.) and hence this can also follow the same pattern.

How does HCAH plan to change the current state of healthcare system in India via offering innovative solutions?

HealthCare at HOME is not trying to disrupt the existing healthcare ecosystem nor is trying replacing hospitals. Our aim is to bridge the existing gaps in the healthcare delivery model keeping consumer at the centre. You can think of us as a distributed hospital, we are using the existing capacity in patient homes to take care of infrastructural gaps, immediately and cost effectively. We work with the hospitals to widen their reach, by freeing the beds for new patients, as well as we try to offload the doctors, allowing them to treat more sick patients.

Our aim is to make healthcare affordable as well as accessible.

What is your growth strategy? Is there any other merger or acquisition in the offing?

We have a two pronged strategy, with the first pivot being the consumers. We offer a wide range of services covering around 70 per cent of all healthcare requirements of a patient starting from nominal wound dressing to performing complex procedures at home like chemotherapy and extends to management of lifestyle and chronic diseases like diabetes, hypertension etc. over consumer’s lifetime. Here the strategy is to widen our geographical reach and broaden our width of services so as to be truly seen as a distributed hospital. .

Additionally, we are focusing to build our B2B business. We partner with pharmaceuticals to provide services covering the patient journey starting from disease awareness to disease detection, treatment initiation, drug distribution, disease management, compliance management and showcasing clinical outcomes.With insurance companies we would in pre and post policy checks. Some of our services are getting cashless approved by insurance companies. We also work with corporates to provide all our services which we offer direct to customer. We also conduct ergonomics, stress management and other similar seminars for their employees. We engage with hospitals to help them in achieving Average Length of Stay reduction & extending community reach and engagement.

We recently acquired Health Impetus Pvt. Ltd, to expand our bouquet of services to pharmaceutical companies. Also, we have formed a joint venture with M3, Inc. Japan, a media healthcare company, to improve clinical outcomes and costs for the patients and most importantly will earn their respect.

We are currently evaluating several other opportunities as well.

What is your plan to upgrade or lift the healthcare system in remote areas?

Our full gamut of services is offered in Delhi/NCR, Punjab, Mumbai and Jaipur. But, we have a hub and spoke arrangement and can reach out to a radius of over 200km from these centres for supporting patients. For E.g. via Chandigarh, we serve patients in cities such as Jammu, Shimla Patiala, Pathankot, Bathinda, Nabba, Hoshiarpur, Phagwara etc.

Moreover, we use emerging web-based technology which leads to patient’s empowerment. The ailing individual and his family is more informed and educated about the services and, most importantly, the patient is involved in the process of decision-making.

What are your prime focus areas under healthcare and why?

Our key focus is on the consumers. We aim to offer cost effective healthcare solutions to patients in their home environment. Hence, we have designed a wide range of services covering all healthcare needs of patients with an exception of emergency services, surgery, and radiotherapy.

In line with our business model to become an extended arm for hospitals, we are focusing on services like critical care at home, ICU care and cancer treatments.

How do you see India’s Healthcare business evolving in the years to come?

The overall Indian healthcare market today is worth Rs 6.7 lakh crores and is expected to grow to Rs 18.7 lakh crores by 2020, a CAGR of 22.9 per cent. Globally, home healthcare segment comprises of 3-6 per cent of the total healthcare market, and on extrapolating Indian home healthcare market can reach Rs10 lakh crore by 2020.

As per World Health Statistics (2015), India needs to add at least 6,50,000 beds by 2017, requiring a capital investment of Rs1.6 lakh crores. Home Healthcare can help bridge this gap as it has the potential to transform healthcare delivery in India, reducing the pressure on the hospital infrastructure, ensuring smooth transition from hospital to home, reducing chances of re-admissions, giving quality healthcare in tier I and II cities and reducing treatment cost.

In the years to come, we expect to witness a paradigm shift in the Indian healthcare. The role of consumers is fast changing as their knowledge about various healthcare services is growing. More and more consumers are deciding themselves on which treatment to adopt and where it should be taken. The preference to get home healthcare is also on a rise.

As a result, the health industry is focusing on aligning its services and offerings with the concept of home-based healthcare. Big corporate houses have already started to realise the importance of home-based healthcare. This will help in setting up a robust healthcare infrastructure across India where patients get adequate beds and care.

As you are shifting towards super-speciality therapies like cardiology, metabolic diseases, neurological health and orthopaedics etc., don’t you think logistics will be crucial for you?

When we were incorporated, we knew that logistics would be a big challenge for ensuring seamless home health management. Hence, we have designed our services in a manner to overcome this challenge. Our services are delivered locally through our back end office and hence we can handle local logistics easily. Also, we have been paperless from day1 and all our people carry tablet devices. These help us in scheduling and tracking in a seamless way

Our technology platforms also enable us to closely monitor patient’s condition. This helps us to notice an early onset of variation in patient’s health, triggering an early response to cater to all sorts of situations.

With the establishment of innovative services offered by online start-ups and other existing players like Lybrate (which offers online consultations by experts and doctors over serious diseases), what do you think is the next big thing in the Healthcare services?

We believe that home healthcare services are the next big thing in the Indian Healthcare industry. We are focusing on tapping this market by designing our services to support the full spectrum of home healthcare needs of patients.

Our success in reaching this goal is indicated with the fact that since our inception, revenues have grown by a multiple of 150x on a monthly basis. Additionally, now we are a 600+ people organisation from 5 people when we started operations in 2012. We are also on track for achieving break even at unit levels.

Since you are expanding in major cities across India, do you have plans to take franchise model for expansion? Or would go as a standalone entity?

For us, patient’s health and safety is of paramount importance. Hence, we plan to continue as a standalone entity only as we want to exercise a strict monitoring over the services given.

We take full ownership of the patient’s treatment. We train our own employees to go to the field and support healthcare delivery. This helps us ensure adherence to global safety and quality benchmarks, thereby fulfilling our promise of giving the highest level of hospital like care and treatment to patients in their home.

Share the future of HealthCare at HOME India by 2020.

As of now, HealthCare at HOME is present in Delhi NCR, Punjab, Haryana, Mumbai, Jammu, Himachal Pradesh, Rajasthan and in Bangalore, Hyderabad and Ahmedabad. Over the next year, we aim to have presence across all remaining states in India.

By 2020, our objective is to become the brand which the customer thinks of when they think of healthcare. On the B2B side, we want to become the largest and most respected partner for the pharma companies, insurance and corporates. 

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