Vision India 2020: Doctor On Wire

In Doctor At Hand, we addressed the opportunity of building a network of pharmacies to address the common illnesses that a few hundred million people face in rural India.

While common illnesses could be tackled without trained doctors, there was, of course, a tremendous need for the remote geographies to be able to access doctors capable of diagnosing and treating more complex ailments.

Doctor on Wire was our tele-medicine venture to make doctors accessible to the vast majority of the rural Indian population.

The concept was based on building local diagnostic clinics in villages that could run a battery of tests based on symptoms. Similar to Doctor At Hand, we made available a medical knowledge base accessible from mobile phones that could guide a clinic nurse through what tests were needed on a case-by-case basis.

The diagnostic clinics were Doctor on Wire franchises equipped with medical equipment ranging from basic blood pressure monitors to X-ray and ultrasound machines, ophthalmoscopes, and so on.

We used a similar strategy as Doctor At Hand to finance the venture. Our main investor was GE Capital. GE, as you know, is one of the world’s largest makers of medical diagnostic equipment.

We also used the micro-franchise formula to build a chain of entrepreneurs who owned and ran the clinics. The sum of money and the financing requirements were significantly higher in the case of the clinics than the pharmacies. Therefore, we chose to do one clinic for every ten villages. And of course, the World Bank Guarantee (WBG) came in handy with this greater financing need.

Training was provided to the franchise owners and their staff on how to operate the equipment and what to measure.

Every clinic was linked via high-bandwidth connectivity to a regional hub where a team of doctors were stationed. This team of doctors owned and operated their own franchises, for which we also arranged financing through the banks we partnered with. Each hub supported ten clinics and one hundred villages. We started operating with twenty doctors per hub, with different specializations, and from each hub, supporting a territory of 100,000 people. Over time, we were able to scale the number of doctors per hub, such that the ratio of doctors to patients improved.

Five years into the project, our coverage was shadowing Doctor At Hand, and we distributed medication through their pharmacies. Our doctors also held local ‘chambers’ at Doctor At Hand facilities on a monthly basis.

Surgery, however, had to be done at the hubs. It was something that we started layering on after five years, as a new offering. For the first five years, we partnered with the closest hospital to a hub that had the facilities. This was not easy to scale, and very often we were faced with inadequate facilities.

Eventually, in 2015, we launched regional nursing homes attached to our hubs where doctors could avail of full operating facilities.

Cancer treatment was another sub-segment in the realm of major illnesses that required specialized expertise and treatment centers. We could only start tackling this area around 2017 due to the serious lack of trained talent that we needed to scale such an effort.

Two key questions emerge out of this massive infrastructure building that we undertook: (a) where did we get the doctors, and (b) how did the rural Indian population afford medical services that Doctor On Wire or Doctor At Hand made available?

The doctors came from a medical education franchise à la MIT India that was also created around 2008, which I will talk about in a later column.

The affordability question was also addressed via an innovative medical insurance company that was founded in 2009, and that worked closely with the Indian government. I will talk about that too, in a subsequent column.

So you see, a full-fledged healthcare ecosystem was being built by these four ventures: Doctor At Hand, Doctor On Wire, Doctor For Sure (Medical Insurance) and Harvard Medical School, India (Medical Education).

They all came together by 2020, such that, it was possible to provide comprehensive healthcare to rural India on a dramatically larger scale than ever before.

Note: Vision India 2020 was subsequently published as a book. You can order it from Amazon, Kindle, Amazon.in, etc.

A call to Indian entrepreneurs everywhere, Vision India 2020 challenges and inspires readers to build the future now. In this “futuristic retrospective,” author Sramana Mitra shows how over the next decade, start-up companies in India could be turned into billion-dollar enterprises. Vision India 2020, which encompasses a wide range of sectors from technology to infrastructure, healthcare to education, environmental issues to entertainment, proves how even the most sizeable problems can be solved by exercising bold, ambitious measures. Renowned in the business world, author Sramana Mitra conceived Vision India 2020 from her years of experience as a Silicon Valley strategy consultant and entrepreneur. Well aware of the challenges facing today’s aspiring entrepreneurs, Mitra provides strategies, business models, references, and comparables as a guide to help entrepreneurs manifest their own world-changing ideas. 

This segment is a part in the series : Vision India 2020