Integrated Care Delivery Model: India

In my previous article COVID-19: Crisis and Opportunity, I had highlighted healthcare as a key challenge area that we must address. Affordable Healthcare is a fundamental need across all segments of the population. This article will focus on the state of healthcare in India and what can be done to improve it.

Multiple players in care delivery (Image: https://pixabay.com/)

The second most populated country in the world with a population of 1.38 billion, has 1 doctor for every 10,000 people in rural India. To put this into perspective, the World Health Organization recommends 1 doctor per 1000 residents. However, India has 1 doctor per 1500 people but with 69% of its population living in rural areas it skews the availability of doctors to 1 per 10,000 people.

With this ratio, the quality of care, if provided, is extremely poor and pathetic.

Traditional channels of care delivery are outdated and highly bureaucratic, making a bad situation worse. A hodge-podge of public, private, and public-private partnership services along with a fragmented, disjoint, and non-navigable care delivery system, makes India an ideal market for technologists to provide a scalable care delivery model.

Increasing the number of trained doctors, nurses, paramedics, midwives, and other care delivery professionals is time-consuming and capital intensive. The current scaling model requires setting up institutions, 3–5 years of study, internship opportunities, etc. However, at the moment this traditional way of infusing talent into the care delivery pipeline doesn’t seem to be working. It is producing substandard professionals and graduates are being burdened with huge financial obligations. This is due to most of the new institutes being private and run by organizations designed solely to monetize the need with little regard for the quality of education delivered.

This is a social problem and we will leave it to our political and social leaders to resolve. We will instead focus on technology ideas to effectively scale the care delivery model.

Integrated Care Delivery Model — India (ICDM-I)

India should start with a patient-first approach as opposed to the current provider-centric design and focus on:

1. Consumption of service depends on the economic and literacy state of the consumer. But irrespective of this, the consumer still needs the service. In the US, privacy rules are very strict and healthcare decisions are largely made by the individuals, or trusted family members. However, in rural India and some urban areas too, health care decisions may not be as private as one desires them to be. In many cases, there is a need for a point-of-contact between the patient and the provider due to the combination of lack of technology, poor education, and social practices. We need to utilize technology to maximize the number of people that the point-of-contact can reach. The person with a gadget (most likely a smartphone) that can connect the care provider and the patient, will enable efficient delivery of care.
2. Integration of channels involved in making care a reality is key in delivering a service that best fits the patients’ needs. Seamless integration of the patients’ needs with pharmacists, ambulances, midwives, nurses, doctors, volunteers, and other tertiary services, is the call of the hour. This fundamental concept is the same as Uber or Lyft, but with the multitude of partners involved, it is complex and prone to failures. A machine learning solution to predict the availability of service and identify the most suitable path will provide a rich experience for all parties involved.
3. Last-mile delivery, like retail, is the most critical part of the delivery supply chain. This is also the least tech-enabled leg and is usually done via foot, cycle, motorcycle, and other inexpensive modes of transportation. The reliability of partners is a key challenge, as most partners in the initial stages may not see the value of being part of the integrated delivery cycle. With a feedback loop from the consumer, ground-level campaigning in target markets, and reverse integration of participants will address the last-mile delivery challenge.

In the next three articles (June 2020), we will discuss the “Integrated Care Delivery Model -India(ICDM-I)” with in-depth analysis on: Consumption of service, Integration of channels, and Last-mile delivery.