The Country Teledoctor

What is the problem that your company is responding to?

S. S. : In India, there is a tragic problem of access to healthcare in rural areas, where three quarters of the population live. 60 % of the hospitals and medical offices are concentrated in cities, as well as 80 % of all doctors, since they would rather practice in an urban area. India’s government does run 140,000 medical centers in villages, but this only covers 20 % of the population’s total need. At the end of the day, 700 million Indians do not have access to basic medical care worthy of the name. They have to rely on poorly trained practitioners and sometimes buy their medicine on the black market.


What solutions did you come up with?

S. S. : To bring quality healthcare to the poorest areas in India, our ReMeDi1 technology rests on three pillars. First, we have developed reliable long-dis­tance diagnostic devices. These devices can provide electrocardiograms, mea­sure a patient’s body temperature or blood-pressure and can act as stethos­copes. We have also created videoconfe­rence software that functions even with a quite limited bandwidth. Finally, we centralized the medical files from every single patient in our digital archiving system. Thanks to these three prin­ciples we have succeeded in connecting villagers with qualified doctors who can in turn examine them and pres­cribe treatments from a distance. We have recently launched ReMeDi-Nova, a kit containing a set of instruments for general medical care which fits in a backpack and relies on Bluetooth tech­nology. All of it is connected to our web platform and can easily be carried whe­rever it is needed.


Is this technology alone enough to resolve the problem?

S. S. : No. We realized as early as 2008 that we needed to build an entire ecosystem. If there is no available medication, if there is no lab to per­form tests, a consultation is useless! We had to conceive the supply-chain down to the last mile. We have sup­ported the creation of 2,300 “village centers”, within which doctors can use videoconferencing to perform a diagnosis on their patient, with the help of the local medical personnel. Since then, several telemedicine cli­nics have appeared within cities and slums. Our digital mainframe allows us to assess in real-time each loca­tion’s stock of drugs, and to locate the nearest available supply in case of shortage. More than a million patients have used our facilities and fifty million people live within four kilometers of one of our centers.


What is your business model?

S. S. : At first, we wanted to set up the centers in the villages by ourselves, but we lacked the skills. So we found partners with real experience in the field, such as hospitals or NGOs, and we continue to work closely with them to this day. They are in charge of opening the health centers while we provide the technology. When a patient pays for a medical test or a consultation, we take a commission. The hosting of all these transactions is cloud-based, making our system very easy to adopt. I might add that we do not receive any subven­tion for our activities.


What are you most proud of?

S. S. : Many of our visitors are women or old people that had never seen a doctor in their entire lives! Some of them have shown up with a fracture of the leg and our doctors were able to direct them towards the nearest hospital in order to receive a plaster cast. Thanks to our equipment, some patients have discove­red that they had a serious heart condi­tion. Others have learned that they suffered from diabetes or hypertension.


Do you have an international strategy?

S. S. : Neurosynaptic is present in seven Asian and three African countries, and we hope to expand very soon into eight new countries. Each nation has its own requirements and health standards and we try to get past these discrepan­cies by establishing local partnerships and reinforcing the international certi­fications of our products. We also wish to continue expanding our action in countries where we are already active. In India, we estimate that 20,000 new ReMeDi access centers will appear in the next two years.


Do you think India will be able to generalize access to primary healthcare in the near future?

S. S. : Yes, there are some very encou­raging early signs. The government is acknowledging the necessity for a public health system. Interesting partnerships between public and private institutions have sprung up. In the field, things are evolving rapidly. Infrastructures are being modernized, access to the power grid and Internet coverage are more widespread. The cost of consultations and treatments is going down, while salaries are increasing. In the last five years, health insurance coverage has been on the rise in India: 30 % of the population has a health insurance policy. But this coverage has still to extend to the poor, and the medical standards can still progress. Telemedi­cine alone cannot solve everything.


By Côme Bastin


1. Remote Medical Diagnostics.