Knowledge Session

Online Models of Healthcare Delivery – Do we have a winning format yet?

The article was written by Geet Arora, Sr. Business Analyst, UnitedHealth Group / Moderator of Healthcare SIG at ISB and Isham Goel, Sr. Drug Safety Officer, Apcer Life Sciences / student HMP, Co. 2016. The article was compiled by Pooja Prahlad, Office of Alumni Relations at ISB. 
On August 27, 2016, the ISB Alumni Association (Delhi Chapter) and ISB Healthcare Special Interest Group (SIG), in coordination with the Office of Alumni Relations, organised an event for healthcare professionals in and around Delhi. The event, which was also a webinar, was attended by over 55 participants at the venue, while 40 more were connected remotely via the Internet.

Tarun Bhambra, Business Head, Practo, Prashant Tandon, Founder, 1mg, Gautam Chopra, Co-founder & CEO, BeatO, Sandeep Singh, Head- Digital Business & Products, DrLalpath Labs and Saurabh Arora,Co-Founder & CEO, Lybrate participated in the panel discussion moderated by Prof. Sarang Deo, ISB.

The centrepiece of the session was a panel discussion titled: ‘Online Models of Healthcare Delivery: Do We Have a Winning Format Yet?’ This was a highly anticipated discussion with a panel of eminent healthcare professionals and entrepreneurs from different domains who had ventured beyond conventional healthcare delivery methods to modern-day online platforms.

Though much of the focus of the discussion was on the online versus offline debate and patient versus doctor centred approach, it also provoked other important questions on approaches to differentiate platforms, improve both affordability and quality of healthcare and optimise the feedback mechanism for online healthcare delivery services.

Some of the key ideas discussed during this session are summarised below:

Paradigm shift from doctor-centric to patient-centric healthcare ecosystem

The healthcare ecosystem has traditionally been founded on bricks and mortar, but it is now undergoing a digital makeover to make it more patient-centric. Moderating the discussion, Prof. Sarang Deo (ISB) pointed out that convenience to customers is an obvious advantage that online platforms offer.
Online healthcare ventures seek to empower customers by making them aware of the existing choices and given them the flexibility to choose the attributes that suit their needs, which could be value for money, quality or warranty, backed by genuine user reviews.
Some panelists were of the view that online healthcare providers are now trying to counteract information asymmetry by pursuing strategies to increase transparency and patient engagement. They argued that traditional brick-and-mortar healthcare providers often do not provide complete information to patients such as treatment alternatives, risks, reasons, etc. Another advantage that online healthcare providers have is that they can reach out to a large consumer base, thus incurring lower operational costs per user.
Gautam Chopra, co-founder and CEO of BeatO, observed that their diabetes care solution is more patient focused, simply because general physicians often do not have the right information to treat diabetes, as specialists do. This is where BeatO comes into play by offering comprehensive diabetic care via an online app. For instance, patients can reach out to quality doctors with just a click. For the elderly, particularly those without caregivers close at hand, it is easy to track deviations in health or in post-operative treatment. The panelists also agreed that online pharmacies have been a boon for the common man.

Offline versus online healthcare

Tarun Bhambra, Business Head, Practo, says the trend has seen a zig-zag movement between online and offline modes of operation. Online ventures narrow the demand-supply gap. The idea behind Practo and many other online ventures is to provide every possible healthcare facility to a sick person at his or her doorstep, saving valuable time, money and energy in travelling to and waiting at clinics, hospitals, pharmacies and diagnostics centers and thereby giving people greater independence in taking care of their health. Hospitals, in turn, have caught on to this trend and are moving towards creating an online presence through websites, apps, newsletters and appointment scheduling, to name a few. Saurabh Arora, Founder & CEO at Lybrate, brought up an interesting point, observing that even though the Indian healthcare system is seeing a shortage of doctors, there is still spare capacity during the afternoons when patients rarely visit OPDs; this is the capacity Lybrate utilises. However, a major drawback for online healthcare providers is the treatment of complex medical conditions that require thorough physical examinations. The chances of getting a mislabeled prescription or an incorrect dosage of medication are high in such cases.

Differentiation amidst multiple online healthcare services

Discussing the convergence of existing and new startups in the online healthcare service space, panelists pointed out that the customer will always choose based on past service experience, referrals, cost and the convenience offered. At the same time, the trust that a customer builds with an existing platform is a competitive advantage against a new entrant. Prashant Tandon, Founder at 1mg stressed on cost leadership and brand trust factors as differentiators, whereas Saurabh Arora pointed to quality of service as playing a major role in influencing patients. Niche treatment areas such as diabetes care can be a point of differentiation if strategised according to market needs.
Processes to put a check on negative or fake reviews
Since online businesses often rely on external vendors for customer reviews, it is important for them to trace and verify the authenticity of those reviews and respond quickly to negative feedback to appease unsatisfied customers and prevent a fire from spreading.
Customer feedback and reviews form the main source of goodwill for any online business. Hence, it is absolutely necessary to govern and keep a check on negative or fake reviews online, which play a major role in consumer decision making. Patient experience and health outcomes are also evaluated on subjective and emotional grounds.
Recommendations on electronic medical records (EMR) standards in India
In India, there are multiple EMR vendors who follow different standards, thus creating inefficiency, waste and errors in healthcare information and delivery management. Also, medical information often gets trapped in silos of legacy systems and becomes unshareable. The panelists agreed that one solution to this problem would be to have integrated EMR systems that provide easy and secure access to information, resulting in efficient care and better healthcare decisions.
This will also help enterprises by stretching the horizons of medical research and resulting in new insights from the existing unstructured data.
Concluding Remarks
In concluding, the panel noted that the online healthcare system is still at a nascent or emerging stage, and it is too soon to make a strong statement on one system being a better than the other.
By bridging gaps and answering unmet needs, early entrants such as Practo and Lybrate have gained large market shares. Online healthcare providers have the advantage of capturing large amounts of data for analytics, which results in improved patient outcomes.
Another takeaway from this discussion is that collaboration in the field of EMR maintenance is the key to an uncomplicated healthcare system by facilitating interoperability among multiple providers offering multi-domain services.
A final insight is that the online healthcare service provider’s contribution to Tier II and III towns in India is immense because of low, or rather, non-existent scale-up costs. Hence, online healthcare is here to stay, grow and ultimately empower the end customer — the patient.