Scientific paradigm is a recognized achievement which provides solution models to be followed by a specific community. That is exactly the role NewDigm is performing in the Indian rural healthcare landscape: by developing mobile-based Clinical Decision Support apps, real-time monitoring & tracking systems or training village health workers (VHW), they aim to be the new solution for democratizing access to quality and affordable healthcare through appropriate technology.
Launched in 2010 by four childhood friends from Stanley Medical College and National Institute of Technology Karnataka, NewDigm’s ultimate goal for the end of this year is to have touched more than a million lives around a couple of districts in Tamil Nadu and Odissa, which has the poorest health indicators in India. This achievement is proven possible particularly due to the company’s first accomplishment, Palm-H. It is basically an assemble of LCD screen, circuit board and battery with a couple of buttons to say “Yes” or “No”, which allows VHWs to enter patient information while interacting with their patients and demands only a short training.
As the health worker completes the question set, Palm-H classifies the patient into a broad diagnosis and generates care recommendations and a checklist of health advice based on the aforementioned protocols, besides tracking missed investigations and immunization appointments, record keeping, and follow-up services. Along with this device, the heart of NewDigm is also Amrita (which means “vitality/immortality in Sanskrit). It is an antenatal, postnatal and childcare protocol app which can run the Indian languages on low-cost, JAVA-based mobile phones and has no connectivity dependance. The technology is used to provide maternal and child care services, reducing mortality rates, and helps VHWs in accurately diagnosing their patients.
This investment in Clinical Decision Support Systems came out after Saurav Das, one of NewDigm’s co-founders, faced the reality during his college years. “I studied in a Government run med-school and have seen the pain and agony of poor patients form a close proximity. I understand how even in the basic of the situations, the health provider may miss things and go wrong. During internships in the USA, I have seen how technology is used to take complex decisions”, says Saurav.
Social companies rise as hope for a contrasting reality
India’s low healthcare penetration and lack of government investments on the grassroots level are widely known. The current scenario shows nearly 600 million poor without access to quality health care that is affordable, and those living in remote areas have to travel more than five kilometers to access a medical facility.
On the other side, social business companies have been sensing the investment opportunity which lies within the healthcare sector and are now rushing to meet the under-served. When it comes for technology and mobile healthcare supply, startups as Mera Doctor and iKure are leading the way next to NewDigm. iKure developed the WHIMS (wireless health incident monitoring system) on rural areas, whereas Mera Doctor set a low-cost medical call-center with doctors available for advisement 24/7.
NewDigm also offers an assessment, training and certification program aimed at VHW, and transfers health knowledge to the community through the Swashiksha project. “Our innovation lies in the use of behavioral tools to improve health workers’ skills and our prime focus on the ‘human’ part of the job, emphasizing on deskilling everything else by training them on mobile based decision-support”, adds Saurav. However, the best business model still needs to be explored. “Working on the public health domain for the rural poor and generating enough apparent value for the end user to pay you has been quite a challenge world-wide. Our focus has been to build a great product and we are, therefore, yet to break-even”.
With a baseline study of general health parameters and disease monetary burden, together with the National Rural Health Mission of Tamil Nadu, they have already registered and monitored 95 per cent of pregnancies, 75 per cent VHW’s number and 20 per cent reduction in outpatient costs, including drugs. Soon, NewDigm intends to implement their system extensively in the state of Orissa and a couple of new districts in Tamil Nadu and launch the final version of the Diabetes and Hypertension Decision Support App, which runs on Android systems.
For the next five years, the company expects to train and certify 40, 000 operators and reduce infant mortality (IMR) and maternal mortality (MMR) rates by 10-50 per cent (for areas with IMR 40 to 75 and MMR 100 to 330) in addition to general decline. By the end of 2013, they shall meet a decrease incidence of common disease in children and general population by 50 per cent and 30 per cent, respectively, and hope to see 30 per cent of reduction in number of households going into poverty trap. NewDigm’s endeavor was recognized by many national and international Social and Business plan competitions, such as: Economic Times Power of Ideas 2011; Echoing Green Fellowship (semi-finalist) 2011; International Business Plan Competition from BITS Pilani (winner) 2010; Piramal Prize for Healthcare (final-five emerging ventures) 2010; Genesis – IIT-Madras for Social Entrepreneurship (winner) 2010.
“Palm-H and Amrita are not alone mobile phones or hand-helds carried by health workers. They are the pipe lines into the rural heartland. There can be a myriad of services which can be provided in days to come. On a larger perspective, NewDigm looks to generate evidences in health care in our circumstances, leave footprints in contrasting geographies across the country and the world, document them extensively and create appropriate Decision Support Systems in resource poor settings – both for the remote villager as well as the policy makers”, concludes Saurav.
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