While India is home to world-class physicians and hospitals, the delivery of quality healthcare is fragmented and inconsistent. Rural areas lack adequate access to physicians, while urban healthcare providers struggle to keep pace with the demands of their high-income customers. Since according to a planning commission report, almost 67 percent of healthcare costs are paid out of pocket, cost is a key consideration.
Providing quality healthcare-with sufficient access across India’s vast population-will require leveraging leading edge technologies like mobile and cloud. But this is easier said than done. Compared to India, countries with more mature digital health markets have struggled to integrate mobile healthcare channels. Since legacy healthcare systems are largely built on closed architectures, and can’t integrate with the latest digital technologies, this limits their ability to save on infrastructure costs and utilize cloud-based shared services.
In India, digital health services will be cloud-based but delivered via mobile channels. While only 3 percent of Indian households have a computer with Internet access, 63 percent have a mobile phone. And while high-speed 3G and 4G data networks have low subscription rates, they can support a wide array of bandwidth-appropriate applications built for all types of mobile services.
Industry analysts project that the mHealth market in India will grow to cross Rs 3,000 crore by 2017; however, these estimates only include direct spending by consumers. As new B2B opportunities emerge and the healthcare market expands, the mHealth market will also expand accordingly.
If telecom providers intend to rollout mHealth services, they need to take a hard look at the mHealth market and develop an effective strategy that adds value to the ecosystem.
A recent survey of India’s top 10 telecom companies shows a strong interest in providing mHealth as a Mobile Value Added Service, or MVAS. Indian telcos typically work with two types of mHealth partners: platform and clinical. mHealth platform providers serve as a content repository and provide the connection between clinical service providers and content delivery.
Clinical partners are either integrated with platform service providers or operate as separate entities, such as hospitals. With the exception of four operators, all major telecom companies provide at least basic mHealth as anMVAS. Here is what mobile providers can offer as mHealth service:
Push-based Information Services
Most mHealth offerings provided byIndian telecom companies involve delivering push-based health and wellness information to subscribers, but not personalized service.
Subscribers tend to use a subscription model of condition-specific healthcare advice. For example, people pay Rs 30 per month to subscribe to Reliance’s Mobile Healthcare Services and then choose to subscribe to content-specific packages, such as those for Diabetes or Skin Care.
Interactive Voice Response (IVR)-driven information services, that offer similar clinical advice as SMS-based models, appeal to a wider audience and provide more personalized clinical information. Services can be delivered in multiple languages and don’t require literacy. Using algorithm-driven questionnaires, services can provide better information based on an individual’s symptoms. IVR is an especially critical mHealth enabler in rural markets where access to healthcare is poor and mobile use is growing.
Moving up the value chain, many Indian telecom providers offer services that enable direct consultation with healthcare providers by leveraging established industry call centre workflows to deliver on-demand medical advice at a low cost. Some telecom providers offer expert advice, like Videocon, which provides Ayurvedic health consultations with specialized panels of physicians.
Mobile Care Enablement
Medical care delivered via voice and SMS provides few data points for providers to make clinical decisions. But care can be enhanced by providing services like access to in-person care and telemedicine via 3G. Only a few Indian telecom companies are participating in mobile care enablement today. Through a tie-up with Apollo hospitals, subscribers can schedule appointments, have video-enabled visits over 3G and even have prescriptions delivered to their door.
M2M: Remote Monitoring
Most useful patient data is generated outside of the hospital. For patients with chronic conditions and the means to pay, health monitoring services leverage M2M technology to deliver round-the-clock monitoring that saves lives. M2M technologies will likely be used in rural areas for remote monitoring as well as aiding in bio-data-driven diagnoses. While Indian telecom companies don’t provide this service today, M2M is likely to become the key driver of mHealth value in the future.
5 mHealth opportunities Indian telcos can pursue
Pursuing B2B opportunities will be essential for telecom operators to develop the mHealth market in India. Macroeconomic megatrends-like the growing use of health insurance and other bundled medical purchasing plans-are creating extremely promising opportunities to deliver mHealth at scale.
Deliver a Platform for M2M Data
Real mHealth value can be delivered via M2M data. Two device-driven models exist today: diagnostic and monitoring. Diagnostic solutions take a snapshot of clinical data, like blood tests or eye scans, at a single point in time. In remote monitoring, patients wear devices that continually send data to a server. Either way, a considerable amount of data is created, which needs to be collected, stored, organized and analyzed.Whether developed in-house or via a partnership, Indian telecom companies could capture a sizable share of the emerging M2M health market by creating a platform that delivers value by supporting remote diagnostic and monitoring systems.
Mobile Enablement of Micropayments for Telecare
Most remote diagnostic devices and health kiosks-key technologies that expand healthcare to rural areas-will deliver their diagnostic data via mobile. Indian telecom companies should consider enabling telecare solution providers to accept payments via their existing mobile payment services offerings at the point of service.
Airtime as a Form of Compensation
For rural health programs, mobile phone service is often too expensive for both service providers and their customers. For example, an innovative program that monitored blood supplies via SMS failed due to the high cost of having nurses send daily SMS updates. In another case, a government public health agency could not get individuals to submit data via mobile because of the cost involved. But there are innovative new solutions in the marketplace that offer promise. Jana, a major provider of airtime rewards, has demonstrated the efficacy of airtime compensation in rural areas. Indian telecom companies need to develop ways to leverage this unique proposition for mHealth.
Health Data Collection via Mobile
Mobile can bridge gaps in the healthcare data collection process because mobile devices are ubiquitous, nearly anyone can submit a response and results are instant.Government public health agencies, NGOs and commercial medical suppliers-all of whom need to collect data-will do so by using mobile technologies like SMS. By providing simple, scalable and affordable data collection capabilities that address this market need, telecom providers can leverage their status as a trusted data steward to deliver value.
Build and Sell an Online Health Platform to Enterprise Customers
Telecom providers have some of the strongest brands in India and they are pervasive in virtually every organization. As risk-based health insurance enrolment increases and employers expand their benefits packages, telecom providers can help enterprises add value to their healthcare programs via mHealth by offering such valuable services as SMS prescriptions or 3G video consultations. Not only do they provide a low-cost alternative to in-person care, they also reduce sick leave by employees. For these reasons, both employers and employees see these services as more convenient and valuable.
Telcos, the Backbone of mHealth India
In a market where access to mobile service is more ubiquitous than electricity (especially in rural India), Indian Telcos have unparalleled reach and opportunity when it comes to mHealth. While healthcare providers have clinical knowledge, they are not technology experts. They therefore lack the resources and infrastructure to provide mHealth services at scale.
While Indian Telcos will play a central role in the mHealth market, what remains to be seen is which telcos will select the right mHealth partners to build a cost-efficient mHealth eco-system that differentiates and maximises their brand equity and service offerings.