Doctor in the House
How Medwell is turning home healthcare into a
professionally run service
One of the sure signs of economic development is the movement of
un organised services to the organised sector, be it retail, restaurants, taxis
or gyms.Once delivered by small, local outfits, these services are increasingly
going over to corporates who have the resources required to build them up to
scale and give them that sheen of professionalism that Indians have now come to
expect from service providers. The latest to join this trend is homecare
services the nurses, physiotherapists and doctors who take over after
patients have been discharged from hospital. “Home care is a $100 billion
market in the USA and a $25 billion market in Japan and it has huge potential
in India,“ says Vishal Bali, chairman of Medwell Ventures, a company he has
co-founded to incubate startups in the field of medicine.
Medwell's first venture is Nightingales Home Health Services, a
company it acquired last year from its founder Dr Radha Murthy.Nightingales is
an 18 year old company, with over 5,000 families in Bangalore subscribing to
its annual home care plans, so it isn't exactly a startup. But over the next
five years, Medwell plans to pump in $50 million into the company and take it
panIndia. Nighingales is not the only company with big plans in this
field.Portea Medical, a company led by serial entrepreneur couple K Ganesh and
Meena Ganesh, also operates in the home care market, bringing in a healthy dose
of competition.
Medwell has already added 2,000 subscribers and expanded
Nightingale's coverage in Bangalore, setting up two new centres in Indira Nagar
and RT Nagar that act as operating hubs for these areas. It has bought a fleet
of 18 new cars six Tata Nanos and 12 Maruti Eecos, eye-catchingly painted
with the Nightingale logo to ferry its staff between the centres and
patient's homes.And it is now leveraging Bangalore's tech expertise to create a
cloud based IT infrastructure.
Nightingale's nurses are equipped with tablet PCs that record the
patient's recovery at home, for presentation to his or her hospital doctor.
“Home care may seem deceptively simple, but building the operation to scale is
anything but,“ says co-founder and CEO Lalit Pai.“Technology and data are going
to be very important for the future of medicine in India. Insurance companies
need detailed records to settle claims. Keeping patient's medical records in
the cloud is a key feature of our operation.“
One of Medwell's earliest patients was an executive of Lenovo's
Bangalore office, who suffered a stroke at the age of 35. He required home care
services of a nurse, a physiotherapist, an occupational therapist and a speech
therapist and the process to full recovery was a long one and continued even
after he rejoined work. At `14,000 a month, care of this kind doesn't come
cheap, but in a city where time is money, Medwell's joint chairman and
co-founder Ferzaan Engineer believes it's an idea whose time has come.“People
are now used to the idea of paying for better healthcare,“ he says.“We're not
for the bottom of the pyramid, though we don't want it to be perceived as too
expensive in this early stage when we are creating a new category. Our strategy
is to start with the middle income segment and then move to the higher and
lower ends of the market.“
Besides being old friends, the founding trio are former veterans
of the pharmaceutical and healthcare sectors and they've been unabashedly using
their corporate contacts to rope in talent for their first entrepreneurial
venture. “The pharma sector has a lot of talent to give,“ says Engineer, who
was the CEO of Quintiles Research India, a pioneer in clinical research
outsourcing. “More than the healthcare industry, it is the pharma industry
which understands what we are trying to do here at Medwell.“
Vishal Bali was previously the CEO of Wockhardt Hospitals and then
Fortis Healthcare and he's happily raided the Fortis hospital chain to recruit
350 nurses, physiotherapists and doctors for Medwell.“Nurses are now more aware
of home care as a career option and it's attracting some of the best talent,“
he says.“A lot of qualified nurses don't want to work in hospitals because it
involves working in shifts. And we've made sure that our qualified nurses all
have assistants who do bed-side care like bathing the patient, so their time is
optimally utilised.“
One of the senior executives to join Medwell from Fortis
Healthcare is the cheery Mohammed Parveez Jameel, who is designated group head,
business development and strategy. He says: “I never dreamed I would work in a
company that provides home care services.Hospitals never thought of it as
something that could be organised and run by professionals.Even now, I
sometimes feel amazed at what we are doing, taking this operation pan-India.“
Medwell has recently opened its first centre outside of Bangalore,
in Begumpet, Hyderabad, and the next city on its strategic map is Mumbai.
Nightingales operates on a subscription system, charging an annual fee of
`1,000 a year for the first person in a family to subscribe and Rs 750 for
every additional member. Its marketing department is now approaching
Bangalore's builders to offer home care packages to entire housing complexes.
In the next five years, it has set itself a target of one million subscribers,
and CEO Lalit Pai says: “The demand side doesn't worry us.It's the supply side
we need to be concerned with. As supply gets going, demand will unlock itself.“
Five kilometers from Medwell's headquarters on MG Road, at the
Nightingales centre in the upmarket residential suburb of Indiranagar, the
tenor of the conversation changes. The doctors and nurses here are not too
concerned about their company's revenue targets and Pai is happy to keep it
that way. “We don't want to bother them with business plans. Their focus is on
patient care,“ he says. The centre focuses on people affected with stroke,
dementia, dia betes, cancer, lung and cardio-vascular disease, which require
home care by their very nature. For those with acute diabetes, for example,
Nightingales provides wound-care services, which involves specialised
dressings. Here it has tied-up with ConvaTec, a European medical supplies
company, for supply of high end dressings at a reduced rate, a prerogative of
corporates that have scale.
Dementia care is a burgeoning field in which Nightingales is
building expertise. Though it is incurable, the effects of dementia can be
mitigated with specialised care that involves getting the patient to participate
in activities that focus their attention. The Indiranagar centre currently has
20 patients with late stage dementia in its care and Pai says demand for this
service is much higher than the company's capacity to supply. “We found it
difficult to get trained people for dementia care, so we've started our own
training program. Dementia patients gener ally require 24 hour care, so it has
the potential to become a high revenue business.“
One of Nighingale's more interesting innovations in the recent past
is its foray into dental care.The Indiranagar Centre has a portable dentist's
chair that is transported to the homes of elderly patients, and the story goes
that the idea came from an elderly lady, a retired school teacher, who had
suffered a stroke and whose dentures no longer fitted as a result.“She was very
conscious of her appearance and wanted us to fix this so she could continue to
receive her friends at home,“ says Pai. Today, home dental care for the elderly
is one of Nightingale's fastest growing businesses.
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By Dibeyendu Ganguly
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CDET15MAY15
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