Investing in healthcare: Technology as the key to scalable impact

Such inaccessibility of healthcare services, both physical and financial, is mirrored by unsatisfactory progress towards achieving the Sustainable Development Goals (SDGs) of the United Nations (UN). Data reveals that only two of the 20 countries within the scope of Advancing impact: A roadmap for social investing in Asia⁶ are on track to achieve SDG3 by 2030⁷.

The first obstacle that stands between patients in rural India and quality healthcare is the physical distance and high costs. Two-thirds of doctors in India are based in cities, while 70% of the population lives in rural areas⁹. Karma tackles this challenge by opening e-clinics in villages, saving patients from long, taxing trips to the doctor as well as associated expenses. In fact, a visit to a Karma e-clinic can be seven to eight times cheaper than a face-to-face session with a doctor¹⁰.

The next challenge arises from the patients themselves. Rural patients are generally less well-equipped to navigate the healthcare system. This is where Karma’s nurse-assisted model comes into play. Instead of having the patients fumble with a smartphone and attempt to figure out how to set up online calls with doctors, Karma has a trained nurse in each of its e-clinics to take care of all the technical aspects. Additionally, the nurse is usually locally hired and speaks the dialect. This is reassuring for the patients and helpful for the doctors, as the nurse can ensure that the latter understand exactly what is wrong with the former.

As its popularity grows, Karma now runs 30 e-clinics across India, each serving 25,000 patients¹¹. Meanwhile, technology has begun to connect doctors with patients over a distance in other parts of Asia-Pacific as well. In China, where healthcare is predominately public, research shows that at least 16.5% of public hospital doctors now operate dual practices—interacting with patients directly over online platforms in addition to their day jobs. Over 365,000 doctors are active on the country’s four leading online health platforms, where patients can message, call, or video-call doctors¹². The impact of China’s digital health industry has scaled up rapidly. One estimate reveals that the market has grown eightfold to US$5.7 billion in the period from 2015 to 2019¹³.

When the covid-19 pandemic hit, ICMR partnered with DayBest to repurpose their agricultural drones to deliver vaccines to India’s hard-to-reach populations. Although flying drones is subject to a multitude of regulations, in this unusual partnership between a government institution and a start-up, ICMR and DayBest managed to work together to combine the former’s medical expertise with the latter’s drone technology. In October 2021, the team sent 900 doses of covid-19 vaccines on a 31 km flight across Loktak Lake in Manipur. The vaccines reached the destination, the Karang Primary Health Centre on an island in the lake, within 15 minutes. The delivery would otherwise have taken over three hours¹⁴.

Following the successful inaugural flight, the i-DRONE project has expanded to additional areas and delivers not only vaccines but also other essential medical supplies that are often in short supply in numerous primary healthcare centres (PHCs). Thus far, the drones have reached 20 PHCs in Manipur alone and have delivered over 17,000 units of medical supplies. This successful rollout makes i-DRONE the first project of its kind in South Asia.

Devesh Zha, founder of DayBest, believes that as the industry grows, infrastructure improves, and standard operating procedures (SOPs) mature, drones can become a key component of the technological solution to the issue of access to healthcare in Asia-Pacific: "With telemedicine, doctors can now advise patients from far away and drones can deliver the medicine they prescribe, especially when there’s an emergency." Together, these technologies can save lives by bringing medical resources within patients’ reach.

Scale is key to managing the cost of this new delivery method. While drone delivery requires a certain upfront fixed cost, the operating cost is low. As delivery scales up, the cost of drones could come down as well, as it is cheaper to produce 10 drones at a time instead of one. Currently, the size of the demand has already allowed DayBest’s medical drones to be commercially viable. On a larger scale, deliveries by drone can become even cheaper than deliveries by road.

While medical drones remain a nascent business in Asia-Pacific, Africa offers a sneak peek into what such drones can achieve on a large scale. In 2016, the Government of Rwanda partnered with an American drone company, Zipline, to deliver blood products from two hubs to 20 healthcare facilities. Research shows that the agility of drone delivery has helped to reduce blood product expirations by 67%, 12 months into the project¹⁵. The programme has now been rolled out nationwide¹⁶.

Apart from investing in technology, investors will also need to fund research, share knowledge, and break silos—in Mr Gambhir’s words, "that’s when magic happens".