[Startup Bharat] How 4 friends from Bihar are providing people in rural areas access to affordable healthcare

A desire to study took Suman Sourav, Rituraj Swamy, Mohammad Amanullah, and Prince Kumar from various parts of Bihar to Patna in 2014.

Their aim was one: higher studies. They soon became friends at BIT Mesra, Patna Campus, and realised that they had another thing in common: the number of requests from relatives in rural Bihar asking them to book medical appointments in the capital city.

The recurrence of such calls led the four friends to realise that there was a problem that needed to be solved. In 2019, that led to the birth of Patna-based Medishala, an online healthtech platform that aims to bring the best of doctors and medical experts to patients in the hinterlands.

“We aim to become a service that provides the best doctors online in Bihar, especially in rural and urban-rural areas,” Medishala Co-Founder Amanullah says.

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Healthtech startup Medishala offers two solutions: telemedicine facilities, which allow patients to consult doctor online from their homes, and a digital clinic, which enables patients to go to a nearby Medishala centre where attendants can help them connect with doctors online using IoT equipment.

“This is for the first time in the history that people in our state can consult the best doctors online,” Co-founder Suman says.

“The availability and quality of healthcare facilities in Bihar are, regrettably, in a very sorry state. People most affected by this underdeveloped healthcare infrastructure are those residing in the rural regions,” he adds.

There is one doctor for every 17,685 persons in Bihar, the state’s Health Minister Mangal Pandey had revealed in Assembly replying to a query by RJD's Akhtarul Islam Shaheen during Question Hour in 2018.

“Even though healthcare facilities in urban areas are arguably better, they are simply too far to be of much use to the rural population. Availability here does not do much to help accessibility. To make matters worse, rural areas are frequently devastated by floods, leading to scores of sick and even heavily injured, unattended patients,” Sourav says.

The Medishala founders claim the startup aims to help people in rural regions and bridge the great urban-rural gap in healthcare facilities. “What makes Medishala stand out is genuine care for ailing people in rural areas, mirrored by the cost-effective yet high-standard quality of our facilities provided via telemedicine and video conferencing,” Amanullah says.

With a team of 25 people, the Patna-based startup is currently handling 500 Daily Active Users (DAUs) and has more than 350 doctor-partners and two digital clinics in Samastipur and Barahiya, both small districts in Bihar state.

The backstory 

The lack of advanced healthcare in rural Bihar was evident to the four co-founders as they grew up.

Amanullah says there is a lack of awareness about doctors and which ones to consult, with most people turning to medical experts who are either well known or recommended by family and friends.

“In college, it often happened that I would tell friends that I was going to a particular doctor to fix an appointment for my relative, and they would respond that they needed to do the same and tag along,” he recalls.

The four friends observed that all of them were routinely experiencing this pattern and felt that no startup was working to address this divide. This led them to research the health sector in 2017-18.

The results were appalling.

Prince says: “Patients and relatives had to queue up in lines as early as 3 am for a doctor's consultation, sometimes only to discover that the doctor wouldn't be available. We found about 70 percent of patients visiting city hospitals come from rural areas and that majority of the patient base is deprived of essential health-related information and services."

This became the problem statement, and the four friends and they decided to create a healthcare platform that could bridge the gap for the rural population in Bihar. They decided on an app that could help people book doctor appointments, and Medishala went live by October 2019.

 “The problems Medishala wants to address are primarily of the nature of availability of high-quality treatment for individuals in the remotest of areas. It seeks to be able to do away with the norm of rural people having to pause their lives and travel long distances to see doctors.

"Our aim to bring doctors to the people, instead of the other way around, is coupled with our intention to keep the process as simple and inexpensive as it can possibly be,” Rituraj says.

Competition and the challenges 

Medishala competes with the likes of Practo, 1MG, mfine, Docprime, Cure.fit, and Meddo to name a few.

However, Amanullah feels the real competition are “quacks, who are very prominent in rural Bihar”. “They charge Rs 500-600 for a consultation and are risking the lives of patients in rural areas with their malpractices,” he says.

He adds that none of the players currently focus on the rural population, and that Medishala differentiates itself by being a doorstep one-stop healthcare solution available at an affordable fee. “Patients who come to Medishala pay between Rs 60 to Rs 200.”

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In terms of challenges, Amanullah says the biggest one has been to make adopt technology, and make adaptable and accessible. This is what led them to set up Medishala Booking Centres in consultation with pharmacies.

“We collaborated with pharmacies in rural areas. Here, people prefer to go to pharmacies rather than visit a doctor to get medicines. The pharmacies we have tied up with book appointments for people. Medishala now has booking centres in more than 70 panchayats,” he says.

The two dedicated booking hubs in Bihar help provide video-based and IoT-enabled consultations. 

Business model and future plans

Medishala, which was bootstrapped with Rs 20 lakh raised from friends and family, earns its revenue from consultations, transactions for medicines, lab tests, insurance, pathology, checkups, and arrangement of ambulance services.

The startup has clocked revenue to the tune of Rs 1 crore for FY21 and caters to at least 500 daily active users every day.

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The healthtech startup is mentored by ex-Trivago India head Abhinav Kumar, who is currently VP, Product Marketing, at Paytm; social entrepreneur Ranjan Mistry; and industry experts Sanjay Chakravarti, and Abhishek Singh.

Amanullah says the company is now looking for external funding to expand. It aims to set up 100 digital clinics with 10,000-11,000 pharmacy clinics in next 12-18 months, and is targeting revenue of Rs 2 crore in FY22.

The team is also working on developing IoT products that can help people get their vitals at home itself.

“The intention is to provide better and more advanced treatment to all patients, apart from making the entire process of availing healthcare cost-effective and affordable without compromising on treatment quality,” Amanullah says.