How one hospital's negligent service led to a healthcare startup

The home care industry in India is worth nearly $2-$4 billion, growing 25% annually. By 2025, it is estimated that nearly 20% of the Indian population would be senior citizens, and 70% of those over 65 would need long-term healthcare services at some point in their life.* The industry being as disorganised and scattered as it is, there is a dire need for good healthcare service providers in India than ever before.

Launched in September 2013, CareAtMyHome (CAMH) is geared towards providing comprehensive and reliable transition and home healthcare for discharged patients. Their primary product 'ENCHARGE' is a transition and home care model aimed at facilitating smooth transition from hospital to home with the goal of reducing hospital re-admissions. CAMH also provides physiotherapy, speech therapy, nursing and health attendant needs.

The target segment, at the moment, for CAMH are at-home patients, patients discharged from hospitals after major surgeries or illnesses, and seniors with difficulties in performing daily activities.

In last 10 months, they've managed to provide healthcare services to more than 100 clients.

Setting Themselves Apart

At the moment, counselling and education are two aspects of home care services that are hugely neglected. CAMH uses a subjective ENCHARGE Tool for assessment to fill this gap. They're currently working to get in touch with high-risk patients before they're discharged.

The exclusive focus on curing and surgeries has left the rehabilitation sector lagging behind its global counterparts. To top it, there seems to be no access to the latest evidences, research, technology or training techniques for home care providers.

'Once a patient is discharged, he and his family are left on their own to address the long term problems related to recovery.'

After a 6-month study of home care models, ecosystems and transition care in other countries, it was noted that these models reduced hospital re-admissions over a 20% rate in high-risk cases.

' The developed nations have saved millions of dollars by adopting such models.'

The Team

CAMH is headed by Dr Yuvraj Singh, a physiotherapist, and Pranav Shirke, who comes from an engineering and management background with an eclectic career history. The organisation is backed by a host of dedicated professionals working to better health care services.

'We have a team of young and highly talented Care Managers, Physiotherapists, Speech Therapists and Health Attendants. This team has undergone training sensitizing them to needs of home care.'

On lessons learnt in this industry Dr Singh feels that 'beyond the glamour, entrepreneurship is actually quiet stressful, yet exciting. Only a few can have an appetite for this way of life.

'It is very important to constantly keep on innovating.'

Shirke feels the start-up continues to be an exercise in patience as things take their own time to develop and materialise.

'Not everything that you aim for would be practically possible given the circumstances. As co-founders, it’s up to us to maintain our motivation levels, which is not always easy.'

In The Making

Soon, CAMH hopes to start collaborating with hospitals, beginning with Mumbai. A new mobile app to enable patients world over to understand rehabilitation needs and track recovery is also underway.

CAMH provides livelihood training to girls who've dropped out from school. These young women generally hail from the lower socioeconomic strata of society with very few opportunities. Over three months, they're made to go through rigorous training in human anatomy, hygiene, personal care and communication. Once completed, they move on to become Health Attendants. With 20 success stories from this programme, CAMH is currently training a third batch of students.

This is besides the events conducted for those over 60 years of age about health, fitness and exercise.

A Personal Story of Inspiration

In essence, CAMH has a uniquely holistic and welfare-driven approach towards home care. Their inspiration to help people cope with recovery, illness and old-age comes from deeply personal experiences.

For Dr Singh, it was a friend who'd lost his father. After a massive stroke, his ability to swallow food was impaired, leaving him dependent on a naso-gastric feeding tube.

'No one at the hospital told them to ensure the patient is propped up at least 45 degrees while feeding him at home. At home, they fed him in flat lying position. This led to aspiration in lungs, leading to infection.'

There is a sense of righteous anger when Dr Singh explains how 'these events literally "work me up", as lives are getting lost just because there is no "process" for ideal discharge.'

He's inspired further by his own daughter, hoping to be someone she looks up to as she grows.

To Shirke, 'stories of how patients with successful surgeries simply deteriorate at home or sometimes even die because they are unaware of simple Do’s and Don’ts' was the primary motivation for being part of CAMH.

Big Problems with Big Challenges

The greatest challenge for Dr Singh was managing finances whilst also continuing his physiotherapy practice part-time simply to meet expenses. There was a risk involved in leaving a secure job to invest in a start-up with a wife close to delivering their first child. It didn't help that there is a lack of start-up readiness and awareness in the healthcare industry. But, relevance overcame these insecurities.

'Between managing CareAtMyHome and Practice, finding time to spend with Anisha (my baby girl) was a challenge.'

On the other hand, Shirke says 'Switching between strategic thinking, which requires a broader outlook, and implementing the strategies, which needs more focus on finer details, has been quite a challenge and an exciting journey at the same time for me.

'Leaving a high paying job for something I truly believe in has been the riskiest act by me so far. Also, the fact that healthcare is an absolutely uncharted area for me, meant that I had to learn a lot about the overall healthcare ecosystem and find my way around quickly.

'To say, it’s been an enriching experience would be an understatement.'

*Sources: Transparency Market Research, Economic Times, Genworth Financial, Harvard School of Public Health