The entire system today is well ordered to push people into the hospital rather than keep them out of it: Saurabh Kochhar, Meddo Health

Shahid Akhter, Editor, ETHealthworld spoke to?Saurabh Kochhar, Founder and CEO, Meddo Health to learn more about the Indian Out-patient care and how Meddo Health is delivering One-Stop solution.

Out-patient care: Challenges

India has a sizable health care system, yet there are still significant quality discrepancies between public and private health care, as well as between rural and urban regions. In India, everyone has access to healthcare. Despite this, there remains a significant disparity in the standard and scope of medical care in India.

Healthcare can vary greatly between states, as well as between rural and urban areas. Physician shortages, as well as differences across states, are common problems in rural areas.

Many Indians seek out private healthcare providers due to the health care system's inadequate coverage, despite the fact that the poor typically cannot afford this choice. Insurance is available to assist in covering healthcare costs; it is frequently given by employers. However, the majority of Indians do not have health insurance; therefore, out-of-pocket expenses account for a sizable portion of the cost of medical care in India.

Out-patient care is always your first step to healthcare. Unfortunately, in India this aspect is the most ignored. We tend to delay our health till the point we need extensive measures. Just like in the case of Cancer. Almost 70% cases in India are detected in their last terminal stage which double that of where developed countries are. The biggest reason is we keep ignoring the small signals unless they become too big to even treat sometimes and that while is an output problem of where outpatient care is.

I think structurally it is extremely fragmented. 90% of clinical establishments in India are actually single doctor establishments. There is no traceability, there is no accountability of care. Lastly, I think nobody has focused on the patient per se. It is a very rigid mindset. A doctor is qualified to give prescriptions, that's all his focus is. They say give me a table and chair, I’ll open a clinic and I’ll start writing prescriptions. A pharmacist is opening a chemist shop. Similarly, a radiologist has a radiology center, pathology center and so on and so forth. Nobody is turning the lens around to focus on the patient who is the ultimate consumer of this service. They are not consuming consultation, they are not consuming purely medicines. They have to consume care and I think that is completely missing.

Out-patient care: Insurance

Again, I think the same issue: in India, while overall insurance penetration is now increasing by almost 50%, actually above 50% in many states, outpatient care is less than 1% . The entire system today is well ordered to push people into the hospital rather than keep them out of it. Hospitals earn more, doctors earn more. Patients actually have an incentive to be in the hospital because they will get it covered by insurance, otherwise not. I think with all of these things, it is very very important, even from an insurance point of view or even from a peer perspective, that we kind of bring back the focus to outpatient care and treat ailments well in time and with far more rigour than waiting for them to get to a point where they need hospitalization. Globally, outpatient insurance has been one of the biggest focus points, but in India again, that’s been a missing piece.

Meddo model of care

With Meddo, what we are trying to do is basically organise the entire outpatient care space. Like I said, realising that the bulk of transactions, if you think about the overall healthcare industry, 99% of the time you do not need hospitalization. In India, we actually have more than double the amount of hospitalisation that we require. If we are to reduce it, we must provide trustworthy quality care at the outpatient care development. Given the fragmentation, given the lack of technology that is involved in overall provision, that’s not being done. So what we are doing is actually working with these individual clinics, the neighbourhood clinics, and trying to upgrade them into full-service health centers.

From a patient’s perspective, you can close your eyes and walk into a Meddo centre and rest assured that you will get high quality care conveniently near your doorstep. You don’t have to run through ten different hoops to get back to your feet. Whatever you need to get back on your feet, any service that you need will be provided from that same center. It would be taken care of and hand-held throughout the entire care process, so that’s the first thing we are trying to solve. Like I said, the very way of doing that is by partnering with these individual doctor clinics and upgrading them to be full service centers from a service delivery perspective and a technology perspective. If you have to do telemedicine today, you will log into a website and it will be a completely different set of doctors than if you are walking into a clinic. We are saying that it cannot be here, so whether it is doctors, diagnostics, medicines, nutrition, whatever you need cannot vary in quality by the channel you choose. It's the same doctors that are going to be available to you whether you walk into a clinic or you want to take a consultation from the comfort of your home. It’s about bringing quality and trust back into healthcare, which we have started to lose. When you go to the doctor or go through a health journey, the first question that comes to mind is "am I being duped or is someone just taking my money?" and so on and so forth. We are saying we will take care of that and you, as a patient, can take rest while we take care of the rest.

Meddo build-up

We started in 2018, we started operationalizing clinics only in early 2019, and then, of course, we had COVID in between. What gives me a lot of confidence and a lot of drive is the fact that in those short years and a half and two years, we have got to execute. We have more than 300 centers. We are already the single largest clinic chain in the country, growing at a significantly good rate month on month, year on year. Till now, we have already serviced more than a crore patients through all our centres and our technology, continuing to add another five to six lakh patients and prescriptions. I think we have made some decent progress, but still, these are very early days. We are still scratching the surface. India has five lakh clinics and at least 10% of those are on the platform.

Meddo-doxper collaboration

In the space that we are trying to solve outpatient patient care, there are two parts to the technology. One is the core prescription technology, and then there is the fulfilment technology. With the acquisition of doxper, we have kind of gotten access to one of the finest and most stable, scalable prescription technologies that exists in the country today. It’s no luck or chance that, using that technology and using our tech stack now, we are the single largest data platform in the country as well. We have more than two billion prescriptions in the bank. We have some of the largest hospitals in the country running on our technology, whether it is Manipal Hospital, BLK Hospital, or Nanavati Hospital, just to name a few. All of these hospitals use our technology to feed their outpatient care patients. Bringing together technology with service is the only way we believe that this entire problem can be solved at scale. We are just around the corner from where India has to move to real world evidence to support space practice. All the buzz words we keep talking about, but the underlying important bit for operationalizing this is always having access to deep data. longitudinal patient data, which is something through both doxper and meddo together we are now trying to do more and more of.

Meddo-doxper: future plans

We are live in four cities with the full suite, which is the service centre model that we do. We have more than 4,000 doctors on the platform using our technology across about the top 18 cities in the country. The plan would be to bring more doctors and clinics to partner with us. enabling interventions on a SaaS scale, whether it is OPD insurance or real-world evidence-based practice. The idea is to digitise more and more prescriptions, creating more data and serving more patients. By the end of next year, we should have two thousand clinics that we will be running under the Meddo brand.