1

Executive Summary
This project report is the planning activity for the summer project at Practo Technologies
Private Limited in Bangalore, India. The report provides a comprehensive knowledge
about healthcare industry its scope and weaknesses in healthcare system in India. The
report is focuses Health Information Systems Plan (HISP) and also the awareness of
healthcare system in India.
India being a country with a population over a billion and such a vast population
requires large number of medical services but its not the case. Only a fraction of
Medical service providers are there to serve such a large population and even the
people of the country is also not aware about the healthcare facilities provided by
private players in the market. People living in an area find hard to locate a doctor,
ambulance and other services mainly outsiders, until and unless they are living in that
specified area for a longer period of time. To help under such circumstances, Practo
entered with a solution by building a Healthcare Information System and also started to
create awareness among the people of the country especially in 5 metropolitan cities.
So by seeing this there is multiple opportunities are available in healthcare industry for
employment and future business. As Practo is already in Healthcare and its name they
come with a web portal called Practo.Com to act as middlemen between healthcare
facilities seekers and the healthcare facilities providers.
This Information System not only provides the information about medical service
providers but will also help in monitoring and improvement for the Health of populations.
It will act as a single platform where all medical stakeholders can interact with each
other. As internet is not available at everywhere for the patients to avail the information
about health facilities, so for availing the information they have two more options via
phone call and SMS. It gives outstanding functions such as selecting and searching the
faculty and facility available at various healthcare stakeholders. This service will provide
1

patient a new kind of connectivity with healthcare service providers with an additional
option for maintaining Electronic Health Records for them.
The study is done with the help of primary data given by respondents during survey
and secondary data was collected through the Internet and various magazines to know
the scope of healthcare industry in India. Primary data is collected through personal
interview using structured questionnaire provided by Practo Technologies Private
Limited.
From the findings we came to know that the scope of healthcare industry is
immense and there are so many business opportunities are present for IT industry.

TABLE OF CONTENTS
S.L

CONTENTS

PAGE NO.

CHAPTER I

5-24

INTRODUCTION
I

Healthcare Industry

6-9

II

Scope of Healthcare Industry

10

III

Opportunities in Healthcare Sector

10

IV

Present Healthcare System in India

11-12

Healthcare Industry in India and GDP

12

VI

Indian Pharmaceutical Industry:SWOT analysis

13-14

VII

SWOT analysis of Indian Healthcare Industry

15

VIII

Trends in Health Expenditure In India

15

IX

Share of Healthcare in Revenue Budget of Major States

16-17

Sources of finance in the Healthcare sector in India during 17-18

2001-02

XI

Innovation and Development in Indian Healthcare Industry

19-20

XII

Population Statistics

20

XIII

Suggestion of Changes

21-24

XIV

Steps can be taken to overcome these problems

25-26

XV

The Budget 2011-12 impact in Healthcare

26

CHAPTER II
OBJECTIVE OF THE STUDY
3

CHAPTER III
i

Research Methodology

30

ii

Problem Identification and Problem Formulation

31

iii

Business opportunities for Healthcare Industries

31

iv

Challenges for Healthcare Industries

32

Scope of the study

32

vi

Review of Literature

32

vii

Public and private share of hospital

32

viii

Healthcare Insurance Industry

33-8

ix

Number of people covered by health insurance

Population projection

35

xi

Population by age

36

xii

Healthcare investment and shortage of medical practitioners

36-38

xiii

Supply and demand of medical personnel

38-40

xiv

Increasing demand pf private healthcare

40-41

xv

Personal Disposable Income

41

xvi

IT in healthcare Industry

42-43

xvii

E-Healthcare solution

44-45

xviii

Telemedicine

45-48

xix

Healthcare telemedicine software

49-64

CHAPTER IV
PROFILE OF THE COMPANY

50-53

About Practo Group

54

Key people

55-56

About Practo.Com

57-59

Key events and milestones

60

Practo products and services

61
4

Financial data of the company

63-64

Company name significance

64

SWOT analysis of Practo Technova

65-74

SWOT analysis of competitors

CHAPTER V
ANALYSIS AND INTERPRETATION OF THE DATA

Percentage of Doctors using Computers

76

Percentage of Doctors using Internet

77

Percentage of calls made from customer number and my 78

number

Percentage of people asked for disease or not

81

Percentage o people saved healthline number or not

82

Percentage of people with different remarks

Popularity compare to Just dial

Percentage of people interested and non interested with

respect to age
CHAPTER VI
FINDINGS AND RECOMMENDATIONS

Findings

Recommendations

Limitation of the study

Bibliography

CHAPTER-1
INTRODUCTION

I.

Health care industry:

The health care industry, or medical industry, is the sector of the

economic system that provides goods and services to treat patients with
curative, preventive, rehabilitative, palliative, or, at times, unnecessary care.
6

The modern health care sector is divided into many sub-sectors, and
depends on interdisciplinary teams of trained professionals and
paraprofessionals to meet health needs of individuals and populations.
The health care industry is one of the world's largest and fastest-growing
industries. Consuming over 10 percent of gross domestic product (GDP) of
most developed nations, health care can form an enormous part of a
country's economy.
In the greater India, the hospitals are run by government, charitable trusts
and by private organizations. The government hospitals in rural areas are
called the (PHC)s primary health centre. Major hospitals are located in district
head quarters or major cities. Apart from the modern system of medicine,
traditional and indigenous medicinal systems like Ayurvedic systems are in
practice throughout the country. The Modern System of Medicine is regulated
by the Medical Council of India, whereas the Alternative systems recognised
by Government of India are regulated by the Department of AYUSH (an
acronym for Ayurvedic, Yoga, Unani, Siddha & Homeopathy) under the
Ministry of Health, Government of India. PHCs are non-existent in most
places, due to poor pay and scarcity of resources. Patients generally prefer
private health clinics. These days some of the major corporate hospitals are
attracting patients from neighboring countries such as Pakistan, countries in
the Middle East and some European countries by providing quality treatment
at low cost. In 2005, India spent 5% of GDP on health care, or US$36 per
capita. Of that, approximately 19% was government expenditure.
Healthcare in India features a universal health care system run by the
constituent states and territories of India. The Constitution charges every
state with "raising of the level of nutrition and the standard of living of its
people and the improvement of public health as among its primary duties".
The National Health Policy was endorsed by the Parliament of India in 1983
and updated in 2002.
Malnutrition
47% of Indias children below the age of three are malnourished, almost
twice the statistics of sub-Saharan African region of 28%. World Bank
estimates this figure to be 60 million children out of a global estimated total
of 146 million. Although Indias economy grew 50% from 2001-2006, its
child-malnutrition rate only dropped 1%, lagging behind countries of similar
growth rate. Malnutrition impedes the social and cognitive development of a
7

child, reducing his educational attainment and income as an adult. These

irreversible damages result in lower productivity.
High Infant Mortality Rate
Approximately 1.72 million children die each year before turning one. The
under five mortality rate and infant mortality rate indicators have been
declining comparing years 1970 and 2002 (202 to 90 & 192 to 68 per
thousand live births respectively). However, this rate of decline is slowing.
Reduced funding for immunization leaves only 43.5% of the young fully
immunized. Infrastructures like hospitals, roads, water and sanitation are
lacking in rural areas. Shortages of healthcare providers, poor intra-partum
and newborn care, diarrheal diseases and acute respiratory infections, also
contribute to the high infant mortality rate.
Diseases
Diseases such as dengue fever, hepatitis, tuberculosis, malaria and
pneumonia continue to plague India due to increased resistance to drugs.
India is ranked 3rd among the countries with the most number of HIVinfected. Diarrheal diseases are the primary causes of early childhood
mortality. These diseases can be attributed to poor sanitation and
inadequate safe drinking water in India.
Poor Sanitation
As more than 122 million households have no toilets and 33% lack access to
latrines, over 50% of the population (638 million) defecates in the open. This
is relatively higher than Bangladesh and Brazil (7%) and China (4%).
Although 211 million people gained access to improved sanitation from
1990-2008, only 31% uses them. 11% of the Indian rural families dispose of
child stools safely whereas 80% of the population leave their stools in the
open or throw them into the garbage. Open air defecation leads to the
spreading of diseases and malnutrition through parasitic and bacterial
infections.
Inadequate Safe Drinking Water
Access to protected sources of drinking water has improved from 68% of the
population in 1990 to 88% in 2008. However, only 26% of the slum
population has access to safe drinking water and 25% of the total population
has drinking water on their premises. This problem is exacerbated by falling
8

levels of groundwater, caused mainly by increasing extraction for irrigation.

Insufficient maintenance of the environment around water sources,
groundwater pollution, excessive arsenic and fluoride in drinking water pose
a major threat to Indias health.

Healthcare NGO
The Smile Foundation is one of the top ten NGOs of India. It was formed in
year 2002 with the objective of providing education and health to the
underprivileged. According to the statistics provided by the foundation,
urban population which occupies only 1/4 of Indias poor population has less
than 4% of basic healthcare facilities provided by the government. Therefore
access to healthcare remains a challenge to Indias health sector both in the
urban and rural areas.
In addition, The Smile Foundation believes that the two main reasons for the
poor health conditions of the people in India are the lack of awareness and
the high opportunity cost incurred by the people when they forgo a day of
wages to seek medical consultations. To tackle these issues, the foundation
brings forth a series of initiatives which include bringing healthcare services
to the needy, promoting healthcare awareness and changing the mindset of
the people towards seeking medical aid.
One such initiative would be the introduction of the Mobile Health Van - Smile
on Wheels. These health vans travel into inaccessible places to reach out to
the inhabitants and provide them with primary healthcare. Till date, the
foundation has 10 such mobile vans located in 126 areas that are spread
across 9 states of India. With its wide reach to the population of India, the
program has benefited over 250,000 people.
Another initiative undertaken by the foundation is the Smile Health Camps.
These camps reach out to the underprivileged with the provision of remedial,
precautionary and referral services. The objective of the camps is to offer
extensive healthcare services and promote greater healthcare awareness to
those involved in the camps. One such camp is the Health Awareness Camp
with Barclays. Basic healthcare services such as health and eye checkup
and lessons on health and hygiene were provided in this health camp. In
addition, a number of the camps involve cooperation with reputable

10

institutions such as the Barclays Bank and the Canara Bank which offered
sponsorships for the running of the camps.
Healthcare Infrastructure
The Indian healthcare industry is seen to be growing at a rapid pace and is
expected to become a US$280 billion industry by 2020.
Rising income levels and a growing elderly population are all factors that are
driving this growth. In addition, changing demographics, disease profiles and
the shift from chronic to lifestyle diseases in the country has led to increased
spending on healthcare delivery.
In order to meet manpower shortages and reach world standards India would
require investments of up to $20 billion over the next 5 years.

Healthcare industry trend

Health care industry trends manifest an upward growth but several areas
need to be attended to for enhancing health care services for the common
man.
Different countries like Indonesia, Russia, Mexico, Brazil, India, Turkey and
China comprise approximately 1/5th of the worldwide health care sales.
Health care industry trends also suggest that the medical related conditions
in the developing countries which are chronic in nature will be similar to the
ones existing in the developed countries. In order to meet international
standards, the existing health care industry is required to alter the mode of
operation for generation of higher revenue and greater contribution to the
Gross Domestic Product of the country.
Facts about the health care industry trends:
The cost related to health care was seen to rise in the 90s. Americans
not possessing any health care coverage or any kind of health
insurance attained the 42 million mark.
10

11

It has been anticipated that the elderly sick people will impose
considerable stress on the health care sector of US.
The total number of different health care programs and different health
care insurance coverage are likely to increase in the coming years.
There has been an escalation in the medical plans from 42.5 million in
the year 2006. The health care industry trends also show that it is
likely to attain 70.2 million in the year 2025.
The health care industry trends also indicate that the expenses for
preventive measures is negligible as compared to the amount spent on
treating chronic diseases which accounts for 70% of the fund used for
health care.
Trends suggest that there are very less Americans (around 23%) who
make an effort to prevent any lifestyle diseases by consuming the
optimum level of vegetable and fruits.

Development of Healthcare in India

In mid 80s most of the hospitals in India were owned by the government and
treatment was free of cost. The implementation of the health policy in 1983
had encouraged private sector to participate in healthcare delivery. Therefore,
with private sector participation, various private entities have blossomed in
India of which 97% are in the unorganized sector and some are still not
registered. Such establishment has called for the provisions for regulations,
standards and accreditation. Through 19861996, growth in the private sector
surpassed that in the public sector by a wide margin as the private sector is a

11

12

preferred choice compared to public healthcare due to greater perception of

assurance in minds of the Indian consumer.
The Indian healthcare industry is seen to be growing at a rapid pace and
is expected to become a USD 280 billion industry by 2020. According to the
Investment Commission of India, the healthcare sector has experienced
phenomenal growth of 12% per annum in the last 4 years. Rising income
levels and a growing elderly population are the driving factors of such growth.
In addition, changing demographics, disease profiles and the shift from
chronic to lifestyle diseases in the country has led to the increased spending
on healthcare delivery. Despite having centers of excellence in healthcare
delivery, these facilities are limited and are inadequate.
In order to meet manpower shortages and be on par with the world
standards, India would require up to USD 20 billion investments over the
next 5 years. It has been estimated that 40% of the primary health centers in
India are understaffed. According to WHOs statistics, there are over 250
medical colleges in the modern system of medicine and over 400 in the
Indian system of medicine and homeopathy (ISM&H) and India produces over
250,000 doctors annually in the modern system of medicine and a similar
number of ISM&H practitioners, nurses and para professionals. The existence
of policy regulations and the establishment of public private partnerships are
solutions to the problem of manpower shortage to propel the growing
healthcare industry. India is now looking at establishing academic medical
centers (AMCs) for the delivery of higher quality care with leading examples
such as The Manipal Group, Fortis Hospitals, Appollo Hospitals, & All ndia
Institute of Medical Sciences (AIIMS) which have been set up. In the year of
2011 Practo group has entered in the national healthcare information
exchange process to facilitate the right healthcare information services to
the citizens of India as

12

13

Practo.Com is a comprehensive Voice and web based service powered by

Practo Technologies Pvt Limited. Practo.com has the unique feature of
Search, Compare, Evaluate, and Select. This service in India has started in
the month of February 2011 in the 5 metropolitan cities (Delhi, Mumbai,
Bangalore, Kolkata, and Chennai) of India. Practo is also trying to go down
the line in Tire 2 Cities of India such as Pune, Lucknow, Kanpur, Coimbatore
etc. to provide healthcare information exchange.

II.

Scope of Healthcare Industry

Health care industry focuses on treating patients suffering from any ailment.
The treatment is done by trained professionals. Now lets focus on Indian
scenario.
Although Indian health care system has gradually improved over the years, it
still lags behind our neighboring countries. The poor state of this industry
may be attributed to lack of enough government push, as estimates reveal
that

per

capita

health

care

spending

is

far

below

international

recommendations. It is to be noted that Developed nations spend about 10%

of their GDP in health care, while Indian spending is at meager 5.25% of GDP.
The focus is definitely catching up on this industry and approximately 12% of
the

scope

offered

in

India

has

been

tapped.

Currently

valued

at

approximately $17 billion, it is expected to grow at 13% every year. The

health care spending can reach $53 billion to $73 billion making it 6.2% of
our GDP in next 5 years. Still leaves lot of scope to match up with standards
set by the developed countries
13

14

This industry in India provides employment to about 4 million people in

various categories. So it can be any one's guess on number of positions that
would be created in next 5 years. The vast difference in treatment costs in
India vs Developed countries, and the improving standards and health care
infrastructure as placed India as one of the favorite destinations for
treatment. Several foreign companies are eying this opportunity and willing
to

invest

in

India's

health

care

business.

This would definitely give rise to the medical tourism industry, which would
help in providing a financial push more on Medical tourism some time later.

III.

Opportunities in Health Care Sector

Healthcare opportunities can be categorized broadly under four heads:

1. Medicine
2. Dentistry
3. Nursing
4. Pharmacy
Each of these categories contains multiple job opportunities, including the
support mechanism.
1. Medicine is the science and art of healing. It encompasses a variety of
health care practices evolved to maintain and restore health by the
prevention

and

treatment

of

illness.

Contemporary medicine applies health science, biomedical research, and

medical technology to diagnose and treat injury and disease, typically
through medication, surgery, or some other form of therapy. Though medical
14

15

technology and clinical expertise are pivotal to contemporary medicine,

successful face-to-face relief of actual suffering continues to require the
application of ordinary human feeling and compassion.

2. Dentistry is the branch of medicine that is involved in the study,

diagnosis, prevention, and treatment of diseases, disorders and conditions of
the oral cavity, maxillofacial area and the adjacent and associated structures
and their impact on the human body. Dentistry is widely considered
necessary for complete overall health. Those who practice dentistry are
known as dentists. The dentist's supporting team aids in providing oral
health services, which includes dental assistants, dental hygienists, dental
technicians,

and

dental

therapists.

3. Nursing is a healthcare profession focused on the care of individuals,

families, and communities so they may attain, maintain, or recover optimal
health and quality of life from conception to death. Nurses work in a large
variety of specialties where they work independently and as part of a team
to assess, plan, implement and evaluate care.
Nursing Science is a field of knowledge based on the
contributions of nursing scientist through peer reviewed scholarly journals
and

evidenced-based

practice.

4. Pharmacy is the health profession that links the health sciences with the
chemical sciences and it is charged with ensuring the safe and effective use
of

pharmaceutical

drugs.

The scope of pharmacy practice includes more traditional roles such as

compounding and dispensing medications, and it also includes more modern
services related to health care, including clinical services, reviewing
15

16

medications for safety and efficacy, and providing drug information.

Pharmacists, therefore, are the experts on drug therapy and are the primary
health professionals who optimize medication use to provide patients with
positive

health

outcomes.

5. Allied Health professionals are clinical health care professions distinct

from medicine, dentistry, and nursing. Allied health professionals make up 60
percent of the total health workforce. They work in health care teams to
make the healthcare system function by providing a range of diagnostic,
technical, therapeutic and direct patient care and support services that are
critical to the other health professionals they work with and the patients they
serve.

IV.

Present Health care System in India

Inflation is sky rocketing, and there is nothing new in that. Over the past
couple of years, India has seen a steady rise in Inflation, which is not being
complimented by the rise in salary of majority of the population of India. The
facilities offered by the Public Health Care system is just not enough for the
majority, Private Health care needs to supplement it. The Government
Hospitals are overburdened with long queues of patients and limited staff,
and to add to the worries, most of the high end medical equipments
primarily lie un-utilized due to lack of skilled technicians. So it is no rocket
science to deduce that middle class in India are looking to Private health care
offerings.
Private hospitals in India are comparatively very expensive for treatments.
Patients are required to pay through their nose to get the required treatment.
This should be an eye-opener for the Government to justify the tax payer, by
focusing more on Public Heath care system. Although, lots of initiatives have
been taken, but this has not materialized at the execution level.

16

17

V.

Health care industry in India and the GDP

Expenses incurred by the Indian Government on health care are the highest
amongst developing countries. India's expense on health care sector
comprises 5.25% of the GDP. Chances are that the health care market could
experience a hike and attain a figure ranging between $53-$73 billion five
years from now. This in turn will reflect an increase in the gross domestic
product to 6.2% GDP. The health care industry in India earns revenues
accounting

for

5.2%

of

gross

domestic

product.

Employment opportunities are provided to as many as 4 million people in the

health care segment or other related sectors catering to the health care
industry in India in some way or the other. Owing to the vast differences in
medical expenses in western countries and that of India, India has become
one of the favorites for health care treatments.
Due to the progressive nature of the health care sector in India, several
foreign companies are intending to invest in the country.

VI.

Indian Pharmaceutical Industry: SWOT analysis

It is often said that the pharma sector has no cyclical factor attached to it.
Irrespective of whether the economy is in a downturn or in an upturn, the
general belief is that demand for drugs is likely to grow steadily over the
long-term. True in some sense. But are there risks? This article gives a
perspective of the Indian pharma industry by carrying out a SWOT analysis
(Strength, Weakness, Opportunity, Threat).
Before we start the analysis lets look a little back in the industrys last six
years performance. The Industry is a largely fragmented and highly
competitive with a large number of players having interest in it. The
following

chart

shows

the

breakup

pharmaceutical industry in last six years.

17

of

the

growth

(YoY)

of

Indian

18

Strengths:
1. Indian with a population of over a billion is a largely untapped market.
In fact the penetration of modern medicine is less than 30% in India. To
put things in perspective, per capita expenditure on health care in
India is US$ 93 while the same for countries like Brazil is US$ 453 and
Malaysia US$189.
2. The growth of middle class in the country has resulted in fast changing
lifestyles in urban and to some extent rural centers. This opens a huge
market for lifestyle drugs, which has a very low contribution in the
Indian markets.

3. Indian manufacturers are one of the lowest cost producers of drugs in

the world. With a scalable labor force, Indian manufactures can
produce drugs at 40% to 50% of the cost to the rest of the world. In
some cases, this cost is as low as 90%.
4. Indian pharmaceutical industry posses excellent chemistry and
process reengineering skills. This adds to the competitive advantage of
the Indian companies. The strength in chemistry skill helps Indian
companies to develop processes, which are cost effective.
Weakness:
1. The Indian pharma companies are marred by the price regulation. Over
a period of time, this regulation has reduced the pricing ability of
companies. The NPPA (National Pharma Pricing Authority), which is the
authority to decide the various pricing parameters, sets prices of
different drugs, which leads to lower profitability for the companies.
The companies, which are lowest cost producers, are at advantage
while those who cannot produce have either to stop production or bear
losses.
18

19

2. Indian pharma sector has been marred by lack of product patent,

which prevents global pharma companies to introduce new drugs in
the country and discourages innovation and drug discovery. But this
has provided an upper hand to the Indian pharma companies.
3. Indian pharma market is one of the least penetrated in the world.
However, growth has been slow to come by. As a result, Indian majors
are relying on exports for growth. To put things in to perspective, India
accounts for almost 16% of the world population while the total size of
industry is just 1% of the global pharma industry.
4. Due to very low barriers to entry, Indian pharma industry is highly
fragmented with about 300 large manufacturing units and about
18,000 small units spread across the country. This makes Indian
pharma market increasingly competitive. The industry witnesses price
competition, which reduces the growth of the industry in value term. To
put things in perspective, in the year 2003, the industry actually grew
by 10.4% but due to price competition, the growth in value terms was
8.2% (prices actually declined by 2.2%)

Opportunities
1. The migration into a product patent based regime is likely to transform
industry fortunes in the long term. The new patent product regime will
bring with it new innovative drugs. This will increase the profitability of
MNC pharma companies and will force domestic pharma companies to
focus more on R&D. This migration could result in consolidation as well.
Very small players may not be able to cope up with the challenging
environment and may succumb to giants.

19

20

2. Large number of drugs going off-patent in Europe and in the US

between 2005 -2009 offers a big opportunity for the Indian companies
to capture this market. Since generic drugs are commodities by nature,
Indian producers have the competitive advantage, as they are the
lowest cost producers of drugs in the world.
3. Opening up of health insurance sector and the expected growth in per
capita income are key growth drivers from a long-term perspective.
This leads to the expansion of healthcare industry of which pharma
industry is an integral part.
4. Being the lowest cost producer combined with FDA approved plants,
Indian

companies

can

become

global

outsourcing

hub

for

pharmaceutical products.
Threats:
1. There are certain concerns over the patent regime regarding its current
structure. It might be possible that the new government may change
certain provisions of the patent act formulated by the preceding
government.
2. Threats from other low cost countries like China and Israel exist.
However, on the quality front, India is better placed relative to China.
So, differentiation in the contract manufacturing side may wane.
3. The short-term threat for the pharma industry is the uncertainty
regarding the implementation of VAT. Though this is likely to have a
negative impact in the short-term, the implications over the long-term
are positive for the industry.

20

21

VII.

SWOT Analysis of Indian Healthcare Industry:

Strengths
Low cost of production.
. Large pool of installed capacities

Efficient technologies for large number of Generics.

Large pool of skilled technical manpower.

Increasing liberalization of government policies.

Weakness
Fragmentation of installed capacities.

Low technology level of Capital Goods of this section.

Non-availability of major intermediaries for bulk drugs.

Lack of experience to exploit efficiently the new patent regime.

Very low key R&D.

Low share of India in World Pharmaceutical Production (1.2% of world

production but having 16.1% of world's population).

Very low level of Biotechnology in India and also for New Drug
Discovery Systems.

Lack of experience in International Trade.

21

22

Low level of strategic planning for future and also for technology
forecasting.

Opportunities
Aging of the world population.
Growing incomes.
Growing attention for health.
New diagnoses and new social diseases.
Spreading prophylactic approaches.
Saturation point of market is far away.
New therapy approaches.
New delivery systems.
Spreading attitude for soft medication (OTC drugs).
Spreading use of Generic Drugs.
Globalization
Easier international trading.
New markets are opening.

Threats
Containment of rising health-care cost.
22

23

High Cost of discovering new products and fewer discoveries.

Stricter registration procedures.
High entry cost in newer markets.
High cost of sales and marketing.
Competition, particularly from generic products.
More potential new drugs and more efficient therapies.
Switching over form process patent to product patent.

India has entered a high growth rate trajectory of 9 per cent. This high rate
of

growth,however,

is

not

accompanied

by

high

level

of

social

development. The social sectors particularly health and education have been
accorded a very low priority in terms of the allocation of resources. For
example, public expenditure on health services as a percentage of Gross
Domestic Product (GDP) in India is less than 1 per cent likely to be one of
the lowest across the globe.

VIII.

Trends in Health Expenditure in India

(GDP is at Market Price, with Base Year

1993-94)
Year
1950-51
1955-56
1960-61
1965-66
1970-71

Health Expenditure as % of the GDP

0.22
NA
0.22
0.49
NA
0.49
0.63
NA
0.63
0.61
NA
0.61
0.74
NA
0.74
23

24

1975-76
1980-81
1985-86
1990-91
1995-96
2000-01
2001-02
2002-03
2003-04

0.73
0.83
0.96
0.89
0.82
0.86
0.79
0.82
0.86

0.08
0.09
0.09
0.06
0.06
0.04
0.04
0.04
0.06

0.81
0.91
1.05
0.96
0.88
0.90
0.83
0.86
0.91

Health sector suffered more during post-liberalization period. Economic

Liberalization policy was introduced in India during the middle of 1991. The
major thrust of economic liberalization is to give more leverage to market
forces so far allocation of resources among various sectors of the economy is
concerned. In the pre-liberalization period of independent India, the health
expenditure as percentage of 6 the GDP increased as a whole from 0.22% in
1950-51 to 0.96% in 1990-91. However, it has seen a steady decline ever
since in the Post-Liberalization period from 0.96 % in 1990-91 to 0.91% in
2003-2004. It is not only that India spends very low proportion of its GDP on
public health services, another problem is the wide ranging regional
variations in expenditure on public health services is also reported. A
comparison of inter-state variations in expenditure on health suggests that
Rajasthan spent 5.75 % of its budget on health, whereas it was only 3.63% in
case of Gujarat in 2003-2004 (See Table 2). The State wise expenditure on
health also reveals that the share of health sector in the overall budget has
been declining over time. For example all the States spent 7.02% of their
budget on health in 1985-86, which declined to 5.72% in 1991-92 and further
to 4.97% in 2003-04.

IX.

Share of Health in Revenue Budget of Major States (in

%)

24

25

S.No

States

1
2
3
4
5
6

AP
Assam
Bihar
Gujrat
Haryana
Karnatak

7
8

1985-86

1991-92

1995-96

1999-

2003-

6.41
6.75
5.68
7.45
6.24
6.55

5.77
6.61
5.65
5.42
4.19
5.94

5.70
6.08
7.80
5.34
2.99
5.85

2000
6.09
5.25
6.30
5.21
4.08
5.70

2004
5.21
4.39
4.84
3.68
3.63
4.85

a
Kerala
Maharast

7.69
6.05

6.92
5.25

6.81
5.18

5.95
4.59

5.42
4.39

9
10
11
12

ra
MP
Orissa
Punjab
Rajastha

6.63
7.38
7.19
8.10

5.66
5.94
4.32
6.85

5.07
5.42
4.56
6.18

5.18
5.03
5.34
6.39

4.89
4.47
4.27
5.75

13

n
Tamil

7.47

4.82

6.40

5.51

5.26

14
15
16

Nadu
UP
WB
All states

7.67
8.90
7.02

6.00
7.31
5.72

5.73
7.16
5.70

4.42
6.30
5.48

5.13
5.23
4.97

Low public sector spending on health services results in over-dependence on

private sector for getting health services. In India the share of private sector
on health care expenditure constitutes around 72 % and household sector
being the major constituent of the private sector claims 68.8% of
expenditure on health care (Table 3). In other words out-of-pocket
expenditure comprises major share of expenditure on health care. All the
three layers of governments (federal, state and local) spend only 23.8 per
cent of the total expenditure on health services. NGO sector is almost nonexistent in terms of spending on health services. Its share is only 0.3 per
cent.

25

26

X.

Sources of Finance in the Health Sector in India

during 2001-2002
Private

Govt

Public

NGO

Extern

al
Funds

Househol

Privat Centr

State Loca

Firm

Sect

ds

or

al

Firms
Health

68.8%

3%

Bank
7.2%

Spendi
ng
Total

71.8%

14.4

2.2

23.8%

3%

s
0.2%

3.2%

0.3% 2%

0.3% 2%

It is not only that distribution of health services are skewed across strata,
skewness in their distribution is also found while studying Rural-urban access
to health services in India. For example, in rural India there are 0.2 hospital
beds per thousand population as against 3.0 in urban areas.

Sl. No

Characteristics

Rural (Per 1000

Urban( Per 1000

1
2
3

Hospital Beds
Doctors
Public

Population)
0.2
0.6
Rs.80,000

population)
3.0
3.4
Rs.5,60,000

4
5

Expendetures
Out of pocket
Infant Mortality

Rs.7,50,000
74/1000Live

1,150,000
44/1000Live

Rate

births

Births

26

27

Under Five

133/1000Live

87/1000 Live

7
8

Mortality rate
Birth Attended
Full Immunization

Births
33.5%
37%

Births
73.3%
61%

Similarly in rural areas there are only 0.6 doctors per 1000 population, which
is as high as 3.4 in urban areas. Rural-urban disparities are equally
pronounced on account of outcome of health services. For instance Infant
Mortality Rate (IMR) in rural areas in 74 per one thousand live births which is
about 44 per thousand live births in urban areas. Similarly Under-Five
Mortality Rate (U5MR) is 137 per thousand live births in rural areas and 87
per thousand live births in urban areas (De, 2008). The Government of India
has taken a new massive policy initiative known as National
Rural Health Mission (NRHM) to reduce the divide between urban and rural
areas in the field of health. The major objectives of NRHM are to improve the
availability ofand access to quality health care by people, especially for those
residing in rural areas, 9 the poor, women and children (NRHM, 2005). The
pace of implementation of the Mission is very slow. Garg and Nath have
opined that the progress of the Mission in Uttar Pradesh, one of the most
populous states is very dismal. In NRHM, Accredited Social Health Activist
(ASHA) is the key player, whose role is to work as an interface
between the community and the public health system. In case of Uttar
Pradesh, the performance on account of ASHAs is very discouraging. The
State has selected only 9,548 ASHAs against the target of 65, 000.
Unfortunately, the State has not made any arrangement for their training. In
most of the other States also the progress of NRHM is very tardy. In India as a
whole out of the total 228,327 ASHAs proposed to be selected; only 145,546
ASHAs were selected (Garg and Nath, 2007).
A government-funded review of NRHM also revealed its slow progress. The
major problems in the implementation of the NRHM are: administrative
constraints, governance issues, inadequacies in human resources as well as
27

28

the poor investment in public health services in the recent past (Shrivastava,
2008). Commercialization and privatization of health services and
introduction of users charges in pubic health institutions during postglobalization phase have excluded a
sizeable number of population particularly belonging to socially
disadvantaged groups and poor from the coverage of health services
provided by organised sector. An earlier study by the authors has found that
since the start of economic liberalization, privatization, and globalization in
the 1990s, the Punjab government had introduced two drastic reforms in
health policy. First policy decision was the
significant opening of health-care services to the private corporate sector.
Private sector hospitals were given land and facilities at concessional rates
and were expected in return to provide free treatment to yellow card holders
(people below the poverty line) up to 10 per cent of outpatients and 5 per
cent of inpatients. The second policy decision was that the Punjab
Government set up the Punjab Health Systems Corporation (PHSC) in
October 1995, under the World Bank-sponsored State Health Systems
Development Project II, and transferred more than 150 health-care
institutions run by the government to PHSC. To mobilize more resources, the
hospitals no longer provided free services and instead charged all patients a
user fee, barring few categories of patients including people below the
poverty line. It was 10 revealed in the study that only a negligible proportion
of people below poverty line availed themselves of exemptions from user
charges at government hospitals. According to field survey ignorance among
the poor about free treatment and the complex and cumbersome procedure
were constraining the access of the poor to the health care services
(Ghuman and Mehta, 2006).
The unequal access to health services has succinctly been stated by the 11th
Five Year Plan of India (2007-2012), there is also a divide between those
who have access to essential services such as health, education, drinking
water, sanitation, etc, and those who do not. Groups which have hitherto
28

29

been excluded from our society such as Scheduled Castes (SCs), Scheduled
Tribes (STs) and some minorities and Other Backward Classes (OBCs),
continue to lag behind the rest (Planning Commission, 2006). Gender
disparities in health services are also very acute and deserve special
attention of the policy makers. Gender disparities are found on account of
utilisation of health services both for in-patient and out-patient care. National
Sample Survey Organization (NSSO) data reveal that in the rural areas the
money spent per illness episode for outpatient care was Rs. 151 and Rs. 137
respectively for male and female. The respective amounts for urban areas
were Rs. 187 and Rs. 164. Gender variation is expenditure spent for inpatient care is also reported (Saha and Ravindran, 2002). Glaring spatial
disparities in health services and their outcomes are also found
particularly in rural India (Kathuria and Sankar, 2005). In addition to inequity
in health services, the quality of health services and governance of public
health organizations are also matter of concern. First the infrastructural
facilities are inadequate followed by their poor maintenance. Secondly most
of public health institutions are understaffed accompanied by a high absence
rate among the personnel. Thirdly, medicines are normally not available in
the health institutions (Dreze, 2004).

XI.

Innovation and Development in Indian Healthcare

Industry

According to the United States Central Intelligence Agency (CIA) Indias

current population is estimated to be 1,173,108,018 people.

This makes

India the second largest population in the World behind Chinas estimated
1,330,141,295 people, and ahead of the United States, which comes in third
place at only 310,232,863 people. The CIA estimates the rate of population
growth to be approximately 1.376% as of 2010 compared to only 0.49%
annual population growth in China (CIA July 2010.) This means that by
29

30

2030 India will have surpassed China as the worlds most populous country,
and

will

reach

population

of

1.4

billion

people

by

2050

(PricewaterhouseCoopers LLP 2007.)

This rapid population increase in India is due to several factors, including but
not limited to, a decrease in the infant mortality rate, increased vaccination
at birth, and increased life expectancy. As a result the growing elderly
population in India will place a large burden on Indias Healthcare
infrastructure, with estimates that by 2025 nearly 189 million Indians will be
over age 60 (PricewaterhouseCoopers LLP 2007.)

XII.

Population Statistics

Top Five Countries by Population.

Rank

Country Name

Total Population

1.

China

1,330,141,295

2.

India

1,173,108,018

3.

United States

310,232,863

4.

Indonesia

242,968,342

5.

Brazil

201,103,330

Statistics
Population Growth Rate:

1.376%

Birth Rate (births/1000 pop):

21.34 births

Avg. Life Expectancy:

66.46 years

Median Age:

25.9 years

Pop. Infected with AIDS/HIV:

2.4 million (2007)

30

31

Percentage AIDS/HIV in pop:

0.3% (2007)

(Source: CIA World Fact book 2010)

XIII.

Suggestion for changes

A health care industry trend suggests changes in the following

spheres:

The companys manufacturing medicines provide health care plans

More stress is to be laid on prevention than treatments

Sufficient supply of the essential health care products should be made

available to the consumers to meet the demand of the health care
industry.

Health care industry trends manifest an upward growth but several areas
need to be attended for enhancing health care services for the common
man.
With the invention of latest technological developments, the world
health care industry is catching up with the other leading industries of the
world. World health care industry is one of the largest industries catering to
the medical needs of innumerable people around the globe. Statistics show
that in the year 2004, employment provided by the health care industry
accounted for 13.5 million job opportunities. Out of the 13.5 million jobs,
some of the people opted for self employment while others remained
salaried workers related to the health care. It has been predicted that
between 2004 through 2014, increase in the health care jobs would be by
approximately 19% or as many as 3.6 million job opening would be produced

31

32

The statistics provided above reflect the health care scenario in the
India,Generally, the world health care industry comprises of the following
segments:

Hospitals

Nursing Homes

Physicians

Dentists

Health care services at home.

Medical practitioners

Outpatient departments

Ambulant health care facilities

Diagnostic laboratories and medical services

Health care industry includes any medical institution which includes either a
single medical assistant to the medical practitioner or medical practitioners
attached to different hospitals and other medical establishments.
The rate of growth of the health care industry in India is moving ahead neck
to neck with the pharmaceutical industry and the software industry of the
country. Much has been said and done in the health care sector for bringing
about improvement. Till date, approximately 12% of the scope offered by the
health care industry in India has been tapped. The health care industry in
India is reckoned to be the engine of the economy in the years to come.
Health care industry in India is worth $17 billion and is anticipated to grow by
32

33

13%

every

year.

The

health

care

sector

encompasses

health

care

instruments, health care in the retail market, hospitals enrolled to the

hospital networks etc.

XIV.

Steps can be taken to overcome with these problems

By Government:

Budget 2013 is round the corner, and if section 80D is revised (currently
deductions are allowed to Rs. 15,000) to maybe Rs. 50,000 (this was a wish
list last year also), that would give a sigh of relief to the middle class. The
details of this section are available on Income Tax's website. The
Government can also look at privatizing the hospital management part (for
Government Hospitals), may be on a contractual basis, which would ensure
the finances are well utilized. This should be just a beginning, as in the long
run the health system itself needs to improve. It is true that many initiatives
have been taken by the Government but most of them have been focused on
Rural India, and the transparency of the execution is not available to a great
extent. This should be a focus area. If the public remains healthy, the lack of
medical infrastructure can be overlooked to some extent.
By Common Man:
The best option one can have is to buy a health insurance plan. There are
plenty of offerings by various companies which one can look into. This will
provide them much needed support in case of any emergency. Many health
insurance advisers are already giving guidance to people on what to look for
when buying insurance.

What else can be done In Healthcare Sector:

33

34

Private health care companies should focus on reducing costs of treatments

for various ailments. This can be achieved by channelizing a part of their
profits into Research for advancements. They should also impart trainings to
the patients on how they can stay healthy. The Private companies should just
not focus on "to extract more money from the patients". They should also
offer support for those who are elderly so that they will not be prone to
getting sick caused by negligence and poor health care. It should be clearly
imparted to patients and public to get treated when the symptoms appear
and

before

it

gets

worst

to

full

blown

disease.

Another aspect of our health system that needs overhauling is the large
bureaucracy that needs trimming. This will enable local public hospitals to
make crucial decisions, which it has failed to do so, leaving many people to
doubt the reform proposals of the government to improve health care. The
key is to provide immediate and efficient health care delivery to every
Indian.

XV.

The Budget 2011-12 impact on Healthcare

Union Budget for 2011-12 had its highlights for the health care sector. While
much have been talked about the inclusion of this sector under the service
tax net, there have been other highlights as well, which should not be
ignored.
From the budget speech, I would like to highlight a few points, which
address health care infrastructure improvements. If we cannot add more
hospitals, we can definitely have healthy citizens, who can save their costs
by avoiding the frequent visits to the hospitals.
While we ensure food for all, we must also promote balanced nutrition. Bajra,
jowar, ragi and other millets are highly nutritious and are known to possess
several medicinal properties. The availability and consumption of these
Nutri-cereals is, however, low and has been steadily declining over recent
years. A provision of Rs 300 crore is being made to promote higher
34

35

production of these cereals, upgrade their processing technologies and

create awareness regarding their health benefits. This initiative would
provide market linked production support to ten lakh millet farmers in the
arid and semi-arid regions of the country. The programme would be taken up
in 1000 compact blocks covering about 25,000 villages. This will help
improve nutritional security and increase feed and fodder supply for
livestock.
This step is definitely a boost towards the health care infrastructure. With the
increase in production of these nutritious cereals, these will be easily
available at affordable prices. A positive move indeed!
The consumption of foods rich in animal protein and other nutrients has risen
of late, with demand growing faster than production. The National Mission for
Protein Supplements is being launched in 2011-12 with an allocation of Rs
300 crore. It will take up activities to promote animal based protein
production through livestock development, dairy farming, piggery, goat
rearing

and

fisheries

in

selected

blocks.

Adequate availability of fodder is essential for sustained production of milk. It

is necessary to accelerate the production of fodder through intensive
promotion of technologies to ensure its availability throughout the year. I
propose to provide Rs 300 crore for Accelerated Fodder Development
Programme which will benefit farmers in 25,000 villages.
Over the years, with increase in awareness about animal products, masses
have increased the consumption of milk and milk products, meat, eggs etc.
With the focus on the same, these two initiatives and fund allocation should
encourage more investment, leading to lowering of costs of animal products
and should get better distribution network. A positive move!
For health, I propose to step up the plan allocations in 2011-12 by 20 per
cent to Rs 26,760 crore. The Rashtriya Swasthya Bima Yojana has emerged
35

36

as an effective instrument for providing a basic health cover to poor and

marginal workers. It is now being extended to MGNREGA beneficiaries, beedi
workers and others. In 2011-12, I propose to further extend this scheme to
cover unorganized sector workers in hazardous mining and associated
industries like slate and slate pencil, dolomite, mica and asbestos etc.
This part is totally focused on population below the poverty line and those
who are extremely poor. Increasing the fund allocation and extending the
benefits to more unorganized sectors is a great vision. Hazardous industries
is often ignored by private insurers, and with government taking care of the
workers, the organizations can encourage more workers to join by luring
them with these government benefits. On a health care perspective this is a
positive move!
Environmental pollution has emerged as a serious public health concern
across the country. I propose to allocate Rs 200 crore from the National Clean
Energy Fund as Centre's contribution in 2011-12 for launching environmental
remediation

programmes.

A number of projects under the National Ganga River Basin Authority

have been approved in 2011-12. This momentum will be further stepped up.
There are many rivers and lakes of cultural and historical significance that
need to be cleaned. In the course of the year 2011-12, I propose to provide a
special allocation of Rs 200 crore for the clean-up of some important lakes
and rivers other than the Ganga.
Addressing environmental pollution related issues has always been an
issue surfacing around the developing economies. The "big bosses" of
developed nations, who unfortunately fail to control pollution limits of their
own countries, show their weight and push the developing economies to
control pollution. With this step of our finance minister, at least we can show
the world that we also care for the health of our citizen's and also the world.

36

37

A welcome step, which would help Indians to live in better conditions and get
clean water and hopefully avoid need for hospitals.
Now the most hyped negative for the health care sector, which directly
impacts the majority of the urban population.
I imposed service tax in 2011-12 on health check up or treatment. This levy
has resulted in differential treatment between persons who make payments
themselves and others where payments are made by an insurance company
or a business entity. Thus, I propose to replace it with a tax on all services
provided by hospitals with 25 or more beds that have the facility of central
air-conditioning. Though the tax is on high- end treatment, I propose to
sweeten the pill by an abatement of 50 per cent so that the actual burden is
kept at 5 per cent of the value of service. I also propose to extend the levy to
diagnostic tests of all kinds with the same rate of abatement. However, all
Government hospitals shall be outside this levy.
With the intent of making things transparent, the finance minister might
have tried to address the issues of insurance companies, but this step would
lead to more expensive treatments for individuals who prefer not to have
health insurance (the majority) as well as for those instances where the
insurer does not provide cover on specific ailments. In majority of the cases,
doctors advise to first get n number of tests done before prescribing the
medication... well all gets more expensive from April. Most of the hospitals
are air conditioned, and have more than 25 beds. The infrastructure, facilities
and management at Government hospitals is very poor in spite of having
good doctors. The welcome step would have been adding more Government
hospitals, alas that did not happen!
Though few initiatives have been taken for this sector, but they are not
enough. Especially, inclusion of all services of hospitals under the service tax
net (though giving a 50% discount on service tax). Nothing has been done to
improve the conditions of the government hospitals. The current rough ratio
37

38

of 70 beds per 100,000 people is far too less than the world average of 396
beds per 100,000. Well, we are just dragging the ratio down! Baby steps
could have been taken to reduce this gap. Most of the state governments are
already cash starved, and would have expected investments from the center
to do something in this direction. We can only look forward for the private
sector to do anything in this direction, but that is all taxed for the patients!
Investing in this sector rewards long term players given the fact that the
break-even period lies close to 5 years.
Nothing was done in the budget for medical education. There are plenty of
ideas to encourage students and investors to join hands for Medical
Education.... if that was properly incentivized by the finance minister.
Taxation of services could have been avoided, and instead the services could
have been made less expensive, making the masses to go for preventive
check-ups and treatments. Unfortunately, now people would avoid visiting
health care facilities to save their pockets with the ever increasing inflation.
Specific

target

was

on

air

conditioned

facilities...

most

of

the

hospitals/nursing homes are air conditioned not because of luxury, but

because of necessities. Various equipments would fail if they are not kept in
controlled temperatures. They need air-conditioning for precise and expected
results! This is not for luxury! The rooms need air-conditioning to avoid

Insects flying all over (imagine opening the windows of your hospital
room),

The summer heat (which would nowhere help in treating a patient),

The noise pollution (what would be the impact on heart patients, with
cars honking outside the hospitals?),

The air pollution (can this help in treatment in any way?)

38

39

The import of medical equipments did not get any tax exemptions. How can
we encourage the much hyped medical tourism industry, if our basic cost is
high? We need to have facilities much cheaper than our neighbors, forget the
west. The finance minister definitely missed revenues from this industry.

CHAPTER I
OBJECTIVE OF THE STUDY
The main objectives of the Study are;

Primary Objectives:

To study the market potential of Healthcare sector in Bangalore.

To understand competitive market for the Practo.Com.

To understand people mentality about Practo.Com .

Secondary Objectives:

To understand the present situation of the health sector in India.

39

40

To understand the future business opportunities around Healthcare

industry.

CHAPTER II
i.

Research Methodology

The project was carried out for understanding advertising and sales
promotion straties of Healthcare Business in India Its Future Growth and
opportunities for the industry. Healthcare sector comprises of many
segments, which include hospitals, medical infrastructure, medical devices,
clinical trials, outsourcing, telemedicine, and health insurance. The global
economic slowdown has affected many segments of the economy. However,
as comparison, the healthcare sector has outperformed the broader market.
Health care system runs by the constituent states and territories of India.
The Constitution charges every state with "rising of the level of nutrition and
the standard of living of its people and the improvement of public health as
among its primary duties". The National Health Policy was endorsed by the
Parliament of India in 1983 and updated in 2002. However, the government
sector is understaffed and underfinanced; poor services at state-run
hospitals force many people to visit private medical practitioners.
Indias pharmaceutical market is highly dynamic and presents
significant upsides for both local firms and foreign multinationals. However,
as with all emerging markets, there are under-appreciated risks to
investments. BMI forecasts that combined sales of prescription drugs and
40

41

over-the-counter (OTC) medicines will increase from US$15.7bn in 2009 to

US$54.2bn in 2019 a compound annual growth rate of 13.2%.In our Q410
Business Environment Ratings, India has maintained its status as the eight
most attractive pharmaceutical market in Asia Pacific, ahead of Malaysia but
behind Hong Kong. According to the World Health Organization (WHO),
private per capita expenditures on health increased by more than 15% in the
last 5 years in emerging markets such as Malaysia, Vietnam, Indonesia and
India. Moreover, based on medical claims analysis, premium costs in Asia will
double in the next five years.
The main competitors of Practo.Com (A product of Practo Technologies Pvt
Limited) are Just Dial, HealthCare Magic and yellow pages companies
and they are well established in the existing market.
Just Dial Private Limited, a company incorporated under the
Companies Act 1956 with its registered office at Building M, 501-B, Palm
Court Complex, Besides Goregaon Sports Complex, New Link Road, Malad
(W), Mumbai 400 064, that governs your use of the search services offered
by JustDial through its website www.justdial.com ("Website"), telephone
search, SMS, WAP or any other medium using which JustDial may provide
the search services (collectively "Media"). When you access or use any of the
Media you agree to be bound by these Terms and Conditions.
Yellow Pages refer to a telephone directory of businesses, categorized
according to the product or service provided. As the name suggests, such
directories were originally printed on yellow paper, as opposed to white
pages for non-commercial listings. The traditional term Yellow Pages is now
also applied to online directories of businesses.

ii.

Problem Identification and Problem Formulation:

41

42

The hospital services market represents one of the mt lucrative segments

of the Indian healthcare industry. Various factors such increasing
prevalence of diseases, improving affordability and rising penetration of
health insurance continue t fuel growth in the Indian hospital industry. With
continuous increase in demand, the industry expected t witness growth
of around 8% in 2009 over the previous year.
Government hospitals, some of which are among the best hospitals in
India, provide treatment at taxpayer expense. Most essential drugs are
offered free of charge in these hospitals. Government hospitals provide
treatment either free or at minimal charges. For example, an outpatient card
at AIIMS (one of the best hospitals in India) costs a onetime fee of rupees 10
(around 20 cents US) and thereafter outpatient medical advice is free. Inhospital treatment costs depend on financial condition of the patient and
facilities utilized by him but are usually much less than the private sector. For
instance, a patient is waived treatment costs if he is below poverty line.
Another patient may seek for an air-conditioned room if he is willing to pay
extra for it. The charges for basic in-hospital treatment and investigations
are much less compared to the private sector. The cost for these subsidies
comes from annual allocations from the central and state governments.
By 2014, revenues estimated to reach USD 52-69 billion, 6.2 to 8.5 per cent
of GDP; employment will Double.

The pattern of healthcare spending will also change

The share of outpatient spend will decrease from 61 percent to 53 per

cent

Lifestyle diseases will drive the growth of outpatient spend

Lifestyle diseases will drive the growth of outpatient spend Cancer and
heart diseases will drive most of the growth of inpatient spend

42

43

80,000 additional hospital beds required every year for the next 3 to 4
years to meet growing demands

iii.

Business Opportunities for healthcare industry:

India needs an investment of USD 203 billion to meet the Health for
All target by 2010

Significant requirement in increase in number of beds per 1000

population from 3 beds per 1000 population to 5 beds per 1000
population by 2010 (in both private and public)

This translates to an addition of 2.2 million beds requiring

investment of USD 77.9 billion, majority of which will come from the
private participation

Increasing preference for private medical care amongst the urban

population

High growth domestic market arising from increasing health

awareness

Rapid growth in private sector companies owning and managing

hospitals

Cost of advanced surgeries in India is about 10 per cent of that in

USA

Service Providers: Curative and preventive in primary, secondary

and tertiary care

iv.

Challenges for Healthcare Industry

Various Challenges faced by healthcare industry are:

43

44

Low consumer awareness about differences in quality of care across

different provider types

By 2010, 4,53,785 doctors and 1,290,174 more nurses will be required

by the Indian Healthcare Industry, which is both a big challenge and an
opportunity

Having well organized healthcare system the services provided by

healthcare industry is not up to the mark. The people of the country are
facing the problem for getting right information at right time. The Product of
Practo (Practo.Com) is made with the motive to provide free customer
assistance 24x7.

v.

Scope of the study :

Though the study is limited to the Practo.Com (A product of Practo

technologies Ltd.) within the area of Bangalore , it is very useful for those
coming healthcare industries to take straties of advertisement and sales
promotion for their product . It is also useful to the stakeholders for the
awareness of oresent situation of Indian health services and the need of
healthcare industries.

vi.

Review of Literature

The study of Advertising and sales promotion straties of Practo.Com was

carried out for understanding advertising and sales promotion straties of
Healthcare Business in India and its future growth and opportunities.
Healthcare sector comprises of many segments, which include hospitals,
medical

infrastructure,

medical

devices,
44

clinical

trials,

outsourcing,

45

telemedicine, and health insurance. The global economic slowdown has

affected many segments of the economy, however the healthcare Industry
was one of them was not affected by the economic slowdown. The
healthcare industry is growing rapidly and the industry has lot of scope in the
future. The scope of healthcare industry is not only limited with the
healthcare but also it also providing opportunities to several sectors such as
IT (Information Technology), Insurance, Tourism, etc. In modern world
healthcare is providing several opportunities to IT Industry in term of
electronic medical records (EMR), Appointment Scheduler. The concept of
EMR is getting popularity among the healthcare stake holders. The industry
is providing opportunity to Insurance sector in terms of health insurance.
Healthcare industry is providing scope to the Tourism Field in the form of
Medical Tourism. The main aim of the market research of Practo.com was to
understand the scope of healthcare information exchange because it is
totally innovative concept in India. The secondary objective of this research
was to develop a database for Practo.comabout healthcare service providers
such as their timing of availability, their experience, their expertise, their
charges, etc.

vii.

Public and Private share of Hospitals

45

46

(Source: Ministry of Health and Family Welfare)

viii.

Healthcare Insurance Industry:

46

47

ix.

Number of People Covered By Health Insurance:

Demographic and population growth will support the performance of health

insurance in India. India is home to one-sixth of the worlds population
occupying less than 3% of the worlds area. The population in India stood at
1.17 billion in 2009 and according to the projection by the US Bureau, Indias
population is estimated to reach 1.33 billion in 10 years time. There is ample
47

48

potential in health insurance as population increases in the near future. The

Institute of Economic Growth has expected the age group ranging from15-64
to grow by 11%, which will also support health insurance growth in tandem.
As income rises and the number of available financing options in terms of
health insurance policies increase, consumers become more engaged in
making informed decisions about their health and are well aware of the costs
associated with those decisions. In order to remain competitive, healthcare
providers are now improving their operational efficiency and enhancing
patients experience overall. The increase number of population would also
translate into higher demand of healthcare services and facilities to meet the
needs of its citizens. The government would need to be far sighted to map
out a comprehensive healthcare plan to cater for the growing population in
the near future. Moreover, the rising fraction of the aging population would
also increase the demand for healthcare. As projected, the number of citizen
between 15-64 years old will increase by 10.9% in 2010 compared to year
2005.

48

49

x.

Population Projection

Source :CEIC

xi.

Population by Age:

Year

Under 15 year old

Person

15-64 Old
Person

64+Year old
person

(Million Person)

(million person)

(million person)

2000

361

604

45

1,010

2005

368

673

51

1,080

2010

370

747

58

1,175

2015

373

825

66

1,264

Projected

49

Total
(Million Person)

50

Source: CEIC

xii.

Healthcare Investments and Shortage of Medical

Practitioners:

The rewarding healthcare sector has been attracting huge investments from
domestic players as well as financial investors and private equity (PE) firms.
PE funds are estimated to invest at least USD 1 billion in the healthcare
sector over the next five years.
Health care facilities and personnel increased substantially between the
early 1950s and early 1980s. The number of population has always outpaced
the number of licensed medical practitioners with 3 medical practitioner per
10,000 individuals compared to 1.4 doctors per 1000 people in China. In
1991 there were approximately ten hospital beds per 10,000 individuals.
Realizing the huge need gap in terms of availability of number of hospital
beds per 1000 population and the need of medical practitioners, the
government has embarked on improving the sector.
In India, the current ratio of beds per thousand persons is a mere 1.03
(well below the WHO norms) compared to an average ratio of 4.3 for
developing countries like China, Korea, and Thailand, and in the best
circumstances, it is projected to reach 1.85 per thousand persons by 2012. It
is estimated that over a million beds have to be added to attain this 1.85
ratio, which translates into a total investment of USD 78 billion in health
infrastructure. India will require an estimated investment of USD 74 billion for
additional 1.75 million beds by 2025, compared to its present capacity of
about 1.22 million beds to meet the projected demand and maintain the ratio
of bed-to-population at 1.9:1,000.

50

51

In line with the concern of insufficient manpower, India is now looking

at establishing academic medical centers (AMCs) for the delivery of higher
quality care with leading examples of The Manipal Group & All India Institute
of Medical Sciences (AIIMS) which had been established to laud the
government effort.
The density of doctors per 10,000 populations in India is 6 while the world
average is 13. There could be a shortfall of over 450,000 doctors in the year
2012. While the shortfall of physician is great, the shortfall for nurses is even
more remarkable. Density of nurses per 10,000 population is 13 in India
while world average is 28 and it has been projected that at least 350,000
nurses are required for primary and secondary care by the year of 2015.
Benefits and lucrative monetary returns offered in developed countries
have led to emigration of such healthcare professionals. This phenomenon is
one of the main reasons for domestic shortage. According to official
statistics, 60,000 Indian physicians have been estimated to be working in
developed countries such as USA, UK and Australia.

xiii.

Supply and Demand for Medical Personnel

Category

Physicians
Dental Surgeons

Statics as of 2009-10

Required Person

(Person)

(Person)

660,801

1,200,000

73,000

300,000

51

52

Nurses

1,371,121

2,100,000

(Source: Ministry of Health)

xiv.

Increasing Demand of Private Healthcare

The significant and growing role of the private sector in healthcare delivery
and total healthcare expenditures are the current trends of the healthcare
industry. In 2007-08, public health expenditure in India accounted for less
than 1% of the countrys GDP compared to 3% of GDP for developing
countries and 5% for high income countries.
Private healthcare sector in India had accounted for over 75% of the
total healthcare expenditure in India and is one of the largest in the world. In
the Indians land, it has been estimated that 60% of hospitals, 75% of
dispensaries, and 80% of all qualified doctors are in the private sector.
However, private healthcare delivery is highly fragmented with over 90% of
private healthcare being serviced by the unorganized sector of all the private
hospitals, 2 to 3% of hospitals are 200-bed plus, 6-7% are 100-200 bed size
hospitals, and the majority of 80% of private sector hospitals are very small,
less than 30 beds.
According to the Studies by the Central Bureau of Health Intelligence,
majority of Indians trust and visit private healthcare despite a higher average
cost of USD 4.3 compared to USD 2.7 in government owned healthcare
centers. Only a small portion of 23.5% of urban residents and 30.6% of rural
residents choose government facilities. The low percentage of public
healthcare demand is a reflection of the common lack of confidence and
bureaucracy in the public healthcare system. The setback of public
healthcare has stimulated growth for private healthcare.

52

53

According to the Studies, it was estimated that out of the 1 million beds
to be added into the industry by 2012, the private sector will contribute to
the addition of 896,000 beds while the remainder will be provided by the
government arms, which had implied that government spending on
healthcare infrastructure (excluding land) is projected to rise only marginally,
by 0.12% of GDP. Government investments is expected to meet only 12% of
the huge investment required in the healthcare sector, with the remaining
balance of the investment requirements to be provided by private entities to
conclude the significant role of private sector for future growth of Indias
healthcare sector.
As India advances and improves its socio economy, the overall income of
its population rises. The rise of personal disposable income at large among
the Indians has also served as an influencing factor to stimulate healthcare
spending as it become more affordable. Personal disposable income of
2008/09 had increased drastically by about 71% from the figure in 2004-05.
Moreover, with the increasing number of financing options such as
health insurance policies available, consumers become more engaged and
are well aware of the costs associated in healthcare. The increasing demand
for high quality and efficient healthcare system has urged the players in the
market, being the public or private sector to improve operational and
management efficiency to provide patients with overall better and enhanced
services and experience to remain competitive in the market.

xv.

Personal Disposable Income:

53

54

xvi.

Information Technology in Healthcare Industry

The healthcare industry today after twenty five years, since computers
started influencing our society, is standing at the threshold of a world of
possibilities thrown up by technologies such as Virtual Reality, Cyber surgery,
Micro - robotic Surgery and 3D image modeling. It is said that the Internet
should be used for the benefit of mankind. Internet pundits have always felt
that development and delivery of Medicine will be one area where this
medium is likely to have immense benefit to mankind.
For e-healthcare and telemedicine to emerge as a viable alternative
modality for delivering medical care and expertise there are a few
preconditions that are to be met. Some of these are,

Adaptation of Information technology by hospitals especially in terms

of networking and Hospital Management systems.

Increasing awareness on IT among medical professionals.

54

55

Better Internet access; possibility the mad vent of broadband in India

that can transfer video files faster.

4Standardization of various protocols (like DICOM in teleradiology) and

acceptance

of

these

protocols

by

the

relevant

equipment

manufacturers.
Decline in the cost of telemedicine hardware to make it more
financially viable.
Govt. encourages a Public Private enterprise.
Large Corporate leading in overseas healthcare contracts - TCS,
Cognizant, etc.
At present, the major constraint is in terms of the financial viability of ehealthcare initiatives. However there have been several isolated initiatives
from various organizations and hospitals for implementation of projects. For
example The Indian Space and Research Organization has today 32
telemedicine location in India and is investing heavily to help Indian
healthcare to graduate in this technology and then use it for its own purpose
in the future to monitor Indian astronauts who undertake journeys in space.
Most of the developments in this field are likely to focus around the needs of
ISRO. The answer to make projects financially viable also probably lies in
pooling together resources by various facilities within a geographic locality
and sharing the benefits and revenues thus created. To elaborate on this
point, several
hospitals within a city like e.g. Salem can share a common Tele-pathology
service or Teleradiology service. The benefits of such a pooled service are
obvious.

Investigations can be viewed by a group of expert consultants.

Such a model will reduce the initial project costs and with the patient traffic
from several affiliated hospitals can achieve economy of scale and thus

55

56

reduce costs of trained manpower and material costs and also provide a very
efficient and optimal service to the community.

E-Healthcare Solution:

xvii.

India is well placed and potentially the ideal location for experimenting with
e healthcare solutions for the following reasons:

India has best computer Technocrats India has a very skilled medical
fraternity private healthcare emerging as a key-player in the country
Indian Healthcare spending likely to increase to 200,000 crores by
2012 from present 86,0000 crores. Potentially India a very suitable
location and resources pumped in this sector now are likely to be of
great benefit

Practo is engaged in providing the latest in internationally recognized

medical care to patients with a variety of ailments and medical
conditions.

Practo ensures patient access to expert care for any specialty.

This

unique network architecture provides expert care to our patients and a

level of confidence in receiving the latest medicare to offer.

xviii.

Telemedicine:

Telemedicine in principle is well suited for countries like India, Africa and
South America where there is a large rural based population separated by
large distances and needing access to regular medical care of quality. The
56

57

telephony revolution of nineties of India has linked most of our smaller towns
and villages with rest of the world. The railway also has a vast network of
fibre-optics cables already laid out on many of its routes. The Space scientist
of our country have placed strategic satellites of communication making a
broadband network not too difficult to achieve with expenditure of minimum
resources, These gateways of communications should be all used to help
with the project of telemedicine and hence reduce applications costs. Even
subsidies could be incorporated to facilitate telemedicine projects in our
country.
Practo has built a tele-medicine network, which connects each of its
facilities, so expert care is never out of reach. In addition, Fortis Practo is
working with both private and public partners in the Indian Healthcare
industry to provide Super Speciality and quality healthcare services. Practo
provides

services

covering

ICU

Management,

ER

Management,

OPD

Management, Radiology Reporting, Pathology Reporting as well as Training

and Education Opportunities. Utilising our strong HIS backbone, and PACS
technology, we are able to seamlessly transmit patient information in a
secure and confidential environment. The use of tele-medicine has provided
a much-needed boost to the Indian Healthcare sector. It has also allowed our
network to expand its presence by extending quality healthcare treatment to
the remote areas of Northern India as well as overseas

xix.

Healthcare Tele-medicine Software

Browser based

Built on HL7 and DICOM standards

Open Source Technology Linux

Offers Real time and delayed Access

Streaming without transfer, real-time ECHO, US

57

58

Statistical Reporting

Interface with Legacy Machines

Flexible clinical reporting formats

Some other healthcare softwares:

Electronic Medical Record (EMR)
Appointment Scheduler
Account Management.etc

CHAPTER IV

Profile of the Company

About Practo Group:
During his college days Shashank, co-founder Practo, had his father
undergoing an orthopedic surgery on short notice. Since he couldnt find a
place to search for doctors he struggled to get a second opinion. Soon he
jotted down a few contacts through family friends. But when he just about
got one abroad, he had a tough time getting the medical reports sent across
since they were on paper. A few snap shots on his camera mobile and few
scans later he just about send it across. Go online and you can book flights
and

movie

tickets

but

not

doctors

appointment.

You opt for organized office-documents but still keep your prescriptions filed
in thick-dusty files.You keep reminders on all important conferences but miss
out

on

follow

up

58

with

your

doctor.

59

The solution to all this seemed ridiculously simple to

Shashank and his partner, Abhinav. But the most compelling fact was that no
one in India had tried this before. Thus in May 2008 they went on to found
Practo Technologies Pvt Ltd. An attempt to use emerging technologies to revup clinics across India and thus enhance patient experience.

1. Key People:

59

60

Shashank ND
(Chairman & MD)

Mr.Raksha
Abhinav
Siddharth
Lal
(CTO)
(HR)

Siddharth Agarwal
(Marketing)

Amal Kiran
(CST)

60

61

Practo is currently operating in eight cities including all major metros, as well as smaller cities like
Pune and Nagpur. In each location, it has appointed a couple of resources to reach out to more
people.
With a high local penetration, we hope to triple our sales team this year. Plus, we are looking to go
global. We have opened a branch in Singapore last week and within the next 6-12 months, we will
enter mature markets like the US, details Shashank. Our primary focus is the Indian subcontinent,
though, and by the end of this month, we will be operating in more than 20 states, he adds.
This also means the company is looking to scale up its team and wants to more than double its
headcount by next year. We were just about 10-15 people when we started. We are 100 now and
we will add around 250 more people by next year, says Shashank.
Thanks to its aggressive growth drive, the startup claims to be clocking 3x revenues every year and
targets to double its revenues by the end of the current fiscal. Practo expects to break even by 2014.
Yet, unlike other startups, Practo is not targeting the Indian market alone. We are investing more
money to capture new markets, especially the US market, and gain a good market share, says
Shashank. The company has already raised $4 million (Rs 25 crore) from Sequoia Capital this year
in a Series A funding and the fund is adequate to take the company to the next level, he feels.
But why does the company target more mature markets like the US?
According to Shashank, the US offers highly developed medical technologies but there is ample
scope to explore the healthcare management space and one also gets good pricing. Our market is
a bit tricky as people expect awesome products at cheap prices and keeping them happy is a
tedious task, he says. Shashank also feels that the go-to-market strategy is more physical here in
India. In developed markets, it is more online than offline and theres more scope to scale up,

61

62

Instant Confirmed Appointments

Powered by Practo ABS

Practo Software for Doctors

Practo Groups for Doctors

Appointment Scheduler
Book, cancel and reschedule appointments with ease!!

Total Security
Access and transfer your data securely on Amazon's Virtual Private cloud!!

Digital Health Records

Keeping track of your patient reports and prescriptions was never this easy!!

Great Customer Support

Reach our experts on phone, live chat and email anytime!!

Follow up reminders
Send out automated SMS and Email reminders for follow up and routine check ups.

Access Anywhere, Anytime

On the go or on a vacation? Your practice is now just a click away with our Android app!!

62

63

Never miss patient calls

At a conference or on the go, attend to your patients needs on time.

24x7 Appointment Scheduler

Your patients can now book and confirm appointments over phone- anytime,
anywhere!

No more busy tones

Your patients will always be heard. Call waiting is now history!!

Instant Call Recordings

Keep track of your clinic activities even on the go, with quick access to call
recordings!!

One Number for all your practices

Your patients can now reach you quick and easy at any of your clinics on one
number!

Smart Emergency Caller ID

Be there by your patients, when they need you the most!!

About Practo.Com:

Practo.Com - the one and only place for reliable relevant and complete
health information. HealthLine 24x7 is a one-stop destination for in-depth
and exhaustive patient centric information on healthcare.
At Practo.Com, the consumer can search a comprehensive database of all
the healthcare service providers listed from across the five metros. These
healthcare service providers have been categorized on basis of various
parameters of consumers choice to make things easier. This categorization
will help you to compare and evaluate the healthcare service provider not
only on the criteria of location and specialization but also on other

63

64

benchmarks like- experience level, education details, fee, timing, emergency

handling, home visit, awards won, etc. Our aim is to help you select the
most suitable healthcare service provider. Practo.Com does not end with the
search; we even have the facility to schedule appointment of the healthcare
practitioner for you.
Practo.Com provides robust information on all medicines categorized by
pharmacology - action time, common dosage, what to do in a missed dose,
over dose, precaution during pregnancy, for kids and for old age, side
effects, used to treat diseases, price comparisons by various manufactures,
availability in locations, brands available, substitutes or alternatives, etc.
At Practo.Com the consumer gets access to all this information and more.
Apart from being a credible source of health information, Practo.Com is also
a platform where you can connect to people suffering from similar
diseases/conditions;

take

opinion

and

guidance from expert

medical

professionals, etc. on the various discussion forums.

Life at Practo
We are a bunch of passionate, young (average age 25), creative, quirky,
curious people working out of our offices at Chennai,Bangalore,Mumbai,
Delhi, Kolkata, Hyderabad and Pune.
We stick by our ethics and dont shy away from being bold.
Our culture comes from our people. It is to get things done. We don't crib or
cry over why things don't happen we make them happen. We are the doers.
We work nights at a stretch. We cant procrastinate. We dont compromise.
We create new. We ideate. We have no respect for status quo.
64

65

We are powered by our people, who are carefully selected from diverse
backgrounds, each with a distinctive quirk quotient.
Whats more? - Our work leaves us clueless to the difference between work
and fun.

65

66

Sequoia Capital

In a recent announcement, Sequoia Capital has invested Rs 25 crore in Practo , a

web service startup. Founded by graduates from National Institute of Technology,
Abhinav Lal and Shashank ND , The Bangalore-based startup offers web service
for scheduling appointments with doctors. Practo Ray, the primary product from
Practo provides automated appointment scheduling, storage of healthcare
records, including x-rays, files, prescriptions and billing. Practo will use the
funding to expand its 80-member team to around 350 and launch products in the
US and Europe in next two years. You can discover a good food joint or order
pizza online, but cannot schedule the appointment with a doctor, said Shashank
ND . Our technology significantly improves patient experience and allows better
functioning of clinics, he added. Key Stats: Practos platform currently manages
10,000 appointments per day Associated with 8,000 doctors at 5,000 dental,
wellness and other healthcare centers across India. It serves three million
patients. The service is free for patients, but doctors have to pay Rs 700 per
month. Practo aims to reach one lakh doctors and 50 million patients in the next
three years. The fast adoption by thousands of doctors is what has led Sequoia to
invest in Practo . Doctors and patients can now access their appointments and
health records online or through their mobile device, said Shailendra Singh ,
managing director, Sequoia Capital.

Press Mentions
Healthcare is one sector which has always lacked the full-fledged support of IT. They somehow were
thought of as two entities which wouldnt go hand in hand which was obviously not true. Few
initiatives were taken initially but now were seeing the integration of IT with the healthcare sector.
Practo, a product of Naabo medical solutions, is one such initiative which was launched in May
2009. It was earlier known as turbodoc.in. The service has grown exponentially and they claim to be
serving 500 practices, 5000 doctors and 500,000 patients. Practo is an online practice management
software which helps doctors and clinics to manage their practice from anywhere and anytime to
provide better services to their patients. Practo automatically reminds patients about their
appointments. Practo allows the doctors to store and manage their patient records and photos
related to treatments. It also helps in accounting and billing.

66

67

The only perceivable problem would be the inability of some of the old school doctors and patients to
convert as they would be too well adept into the prevalent system and wouldnt want to change. The
reputation of these doctors over the years would give them a cushion and wouldnt necessitate them
to adapt to changing technologies. Targeting these doctors or clinics would be a challenging task but
Practo would have a large enough market even if it doesnt focus on the members of the old-school
healthcare system.
Practo provides four different plans for doctors and clinics one of which is the free version which has
very limited features. Every plan has a free 14-day trial period which indicates the trust Practo has
on its product. After this trial period, the plan can be activated on a monthly chargeable basis. Practo
also provides a 100% data protection warranty.
Integration of IT with every sector is a must in the current age. With all these features at pretty
reasonable rates, solutions like Practo could be the way forward for any healthcare practice looking
to develop and expand.

Customer relationship

Campaigns Management Telemarketing and Emails

Loyalty Program Management
Frequent Flyer Program (FFP) Management
Customer Surveys
Customer Analytics

Emergencies

Back office

67

68

Supplier Content Loading

Promotions
Accounting Billing, Accounts Receivable
Expense Reporting and Spend Analytics

Infrastructure
At Practo Technologies, they fully understand the CIOs are hard
pressed not just to deliver cost savings on their IT infrastructure but
Optimization,

Transformation

and

efficiencies

.Practos

remote

infrastructure management services streamline the day-to-day event

driven work to be increasingly proactive in nature. Practos remote
infrastructure services offer a range of benefits through state-of the-art
business transformation solutions.

IT Helpdesk/Service Desk
o Level-I Support

Information Capture

Request Qualification

General Enquiries

Functional Usage Support

License Compliance / Warranty Support

Escalation support

Trouble Ticket Management

o Level-II Support

68

69

Software Installation

Troubleshooting

LAN/WAN Connectivity

Support

Utility Support

o Antivirus

Remote Access Support

Navigation Issues

Upgrades and Patch Support

Knowledge Base Creation,

Maintenance and Update

o Multi Channel Support: Phone, Email, Web Chat and Web Support

Stymied by the lack of digital access to critical records, the then-final year engineering
undergraduate student at National Institute of Technology at Surathkal founded Practo
Technologies with fellow student Abhinav Lal.

"At the time, there were no facilities available to a doctor to keep digital records of medical
reports, which in turn, could also be accessed by patients. It was common to see doctors'
appointments get missed, wrong prescriptions filled and reports going missing. Our plan was to
change the existing scenario as it was, through technology," Shashank says.

The four-year old, Bangalore-based venture offers clinic management software solutions to
medical practitioners, helping them to automate appointments with patients, store healthcare
records, including x-rays, files, prescriptions and billing.

69

70

The start-up's flagship product, Practo Ray, is a software-as-a-service (SaaS) tool hosted online,
which helps doctors schedule appointments, track a patient's medical records and send out
follow-up reminders to them.

According to Shashank, the software tool is used by close to 10,000 doctors across the country,
as they look to streamline their practice by going digital.

Practo's platform currently manages 10,000 appointments per day across 5,000 dental, wellness
and other healthcare centres across India. It serves an estimated three million patients, for whom
the service is free.

"Doctors pay a monthly fee to utilise the services provided by Practo Ray, but it goes a long way
in solving their problems, and ensuring that their patient records are free from any damage or
loss," he says. It is a model that has gone on to capture the attention of risk capital in India.

"All things start small. Practo started as a tool for doctors, but has now evolved into something far
bigger and with wider reach," says Shailendra Singh, managing director of Sequoia Capital.

Sequoia, with its investment focus on healthcare and consumer-facing businesses, found Practo
fitting in well in its portfolio.

In July earlier this year, the global venture capital firm invested Rs 25 crore in the start-up "It has
become a multi-dimensional communication platform for doctors and patients," Singh pointed out.

The fact that Practo has managed to straddle three sectors - Healthcare, Consumer and
Information Technology - that have traditionally received a majority of private capital in India,
makes it a unique proposition for investors.

Financial Data of the company:

SHAREHOLDING

Indust IT
ry :

&

ISIN
No :

Related BSE

Services

Group Practo
:

IT

Code :
Technova NSE

Group
INE991C01018

Code :
Marke
t Lot :

Book
526927

Closure 21/12/2010
:

N.A.
1

70

Market

Rs.

Cap :

Cr.

Face
Value :

270.88

Rs. 10.00

71

Share

Holding

Pattern as on :
Face Value :

30/09/2010

30/06/2010

31/03/2010

10.00

10.00

10.00

PROMOTER'S HOLDING

No.

Of

Shares
Indian Promoters
Sub Total

280324

%
Holdin
g
63.90

No.

Of

Shares
247609

%
Holdin
g
61.29

No.

Of

Shares
247609

%
Holdin
g
61.29

62

73

73

280324 63.90

247609 61.29

247609 61.29

62

73

73

NON PROMOTER'S HOLDING

Institutional Investors
FII's

2568000

5.85

3210000

7.95

3210000

7.95

Sub Total

2568000

5.85

3210000

7.95

3210000

7.95

Other Investors
Private

Corporate 8181784

18.65 7744825

19.17 2855502

7.07

1.04

500058

1.24

501108

1.24

528369

1.20

660462

1.63

660462

1.63

208468

0.48

179231

0.44

180535

0.45

Bodies
NRI's/OCB's/Foreig 454066
n Others
Directors/Employe
es
Other

71

72

9372687

Sub Total

21.3

9084576

General Public
GRAND TOTAL

22.4

4197607

10.3
9

3893428

8.88

3341764

8.27

8228733

20.37

4386657

100.

4039731

100.

4039731

100.

7.00

00

3.00

00

3.00

00

BANKERS

Indust IT
ry :

&

IT

Services

Group Practo
:
ISIN
No :

Related BSE
Code :
Technova NSE

Group
INE991C01018

Code :
Marke
t Lot :

Book
526927

Closure 16/09/2006
:

N.A.

Market

Rs.

Cap :

Cr.

Face

Value :

Name of Banker
ABN Amro Bank N.V.
Central Bank of India
HDFC Bank Ltd.
ICICI Bank Ltd.

Other Details
Listings

Incorporation

BSE

23/03/1994

72

333.28

Rs. 10.00

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Practo Group
1. Shanshank ND- CEO & founder
2. Abhinav lal- CTO
3. HR Team- Raksha Siddharth
4. Finance Team, Admin & Operations Team- Kalyan V
5. Region wise Sales Team
North & East India- Manoj Kumar
West India- Aditya Bhat
South India- Vikas kumar
6.Marketing team- Siddharth Agarwal
7.CST team: Amal Kiran (Head)

This are the different key people in practo handling different departments being head of each department
and everyone reports to the CEO

Business Partners

Sequoia Capital
Sequoia Capital in India has invested in more than fifty companies during the
past decade catering to the founders, families and management who have
selected

us

as

their

business

partners.

With

offices

in Bangalore, Mumbai and New Delhi, Sequoia Capital has a mixture of local
experience and global ties that let us work with great entrepreneurs to help
build market leading companies. We have learned that the only way to
develop a fabulous company is one step at a time. This only happens if the
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company makes wonderful products or delivers a service that thrills large

numbers of customers. If that occurs then founders, management, and
employees of these companies prosper. It is only then that the investor
deserves to be rewarded. It has to happen in that order. There are no
shortcuts.
Technology Partners

HP

IBM

Lenovo

Vmware

Acer

Enterprise Messaging and ERP & CRM

Microsoft Gold Certified Partner

Microsoft Dynamic

Microsoft Dynamics CRM

Microsoft Exchange Server

Oracle Partner

Information Security, Storage and Availability

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Trend micro

Internet Security Systems

Citrix

McAfee

Symantec

Check Point

Fortinet

Ironpont

Cyberoam

Websense

Sonicwall

Packeteer

RSA Security

Radware

Barracuda

Infrastructure Management

IBM Business Partner

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Tivoli software

Networking

Cisco

Nortel

Comapy name significance

Name - Practo is a Latin word that translates as 'to bind together'. This name
has been chosen to reflect the integrated nature of the financial services the
company offers.
Symbol - The Practo name is paired with the symbol of a four-leaf clover.
Traditionally, it is considered good fortune to find a four-leaf clover as there is
only one four-leaf clover for every 10,000 three-leaf clovers found.
Each leaf of the clover has a special meaning. It is a symbol of Hope. Trust.
Care. Good Fortune.
Vision
"To build a globally scalable business of excellence in the IT domain" .
Be the leading healthcare exchanger in India.
Mission
To institutionalize and put into place, processes that shall enable the
organization to achieve leadership position in the IT domain and to develop,
build and nurture high quality client relationships backed by diligence, ethics
and values
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Values
The following values are core to Practo Group. The values are rooted in
current reality, but also represent the path we wish to follow tomorrow.

Integrity and fairness to employees and customers

Equal opportunities for all- no discrimination on any ground.

Move ahead together

Deliver value through deep domain expertise

Commitment

to

building

long

term

relationships

SWOT Analysis of Practo

Strengths:

Strong brand name in the Financial services market

Well known in developed countries and being established in developing

countries as well.

Leader of innovations

Success various products in the market

Highly skilled resource pool - 700+ - with diverse skill sets

Loyal satisfied customers

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Affordable prices of various IT solutions and other enterprise solution

in the market

Certifications in various platforms

strong partnerships with some of the worlds most renowned

technology companies

Weaknesses

New in the IT market

Supply chain management is weak

Availability in very few countries

Brand awareness of is low which is also a reason for its low sales.

Opportunities

Broaden its range to capture more market share.

Capture more market share by introducing solutions in new markets

with Improvements and innovations so it will help to establish them in
those markets.

Increase its brand awareness through excessive marketing and better

market communication.

Establish itself in Global market as they are currently present in only 10

countries all over.

Take risk willingly in product innovations to capture more market share

and increase the sales.

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Threats

Dominant competitors of Practo

Promotional activities of competitors are stronger

Brand name of competitors are well known ,for e.g: SAP,

MICROSOFT,etc

SWOT Analysis of Competitors

Strengths:

Support sales activities by understanding your customers businesses

better
Qualify prospective partners and suppliers
Keep fully up to date on your competitors business structure, strategy

and prospects
Obtain the most up to date company information available
Global relationships with all major Techno companies worldwide
Availability all over.
Strong management team.

Weaknesses:

Products are very costly

Very few competitors providing health care solutions.

Opportunities:

Provide products in different areas

Products should be cost effective

Threats:

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Availability of other Enterprise solution vendors

Availability of products at very effective cost by other vendors.

CHAPTER V
Analysis & Interpretation of data

1) Percentage of Doctors using Computers

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Most of the Doctors in Bangalore instead of doing their job manually

use Computers to perform their day to day work.

2) Percentages of Doctors using internet

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66.6% of Doctors in Bangalore use Internet in their Clinics for connecting

with their patients and for other medical purpose.

3) Percentage of calls made from customer number and

my number

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Percentage of calls made from customer number and my number

13%

32%

55%

From his/her
number
From my phone
Didn't call

Most of the people are able to connect with the concerned Doctors
with the help of Practo number.

4) Percentage of people asked for disease or not

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100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%

Column2

Most of the Customers were interested only for registeration in

Practo,rather than disease inquiry.

5) Percentage of people saved healthline number or not

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As a part of promotion percentage of people saved healthline number or not

45%

Saved number
Didn't save

55%

Healthline number is the best way to connect Patient to the

concerned Doctor.

6) Percentage of people with different remarks

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60.00%
50.00%
40.00%
30.00%
20.00%
10.00%

50.66%
33.66%
18.66%

Column2

0.00%

Most of the people are satisfied with the service provided by Practo
Technologies Private Limited.

7) Popularity compare to just dial

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Popularity compare to just dial

5%

Just Dial
Practo.com

95%

When it comes to popularity Just Dial stands one step ahead to

Practo.

8) Percentage of people interested and not interested

with respect to age

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Chart Title
80.00%
70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%

69%
24%

18-30yr

7%
31-45yr 46yr and above
Column2

Now a days people like instant service,and youth is the mouthpiece

of the growing population.

9) Percentage of doctors using Practos software.

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A large number of people are using software from Practo for their
daily work purpose.

10)

Specialty wise distribution

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In Bangalore almost all kind of Doctors with various specialities are

linked with Practo.

CHAPTER VI

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Findings and Recommendations

A. Findings :
Youth generation is more interested about the product as well as this
kinds of healthline. So there is vast opportunities in Indian market as
.% of population is youth .
Just Dial have been made a brand image in the market and the
popularity of Health line 24*7 is very negligible compare with that as it
is very new in the market. Apart from that there are sulekha.com,
yellow pages etc.
I found that when I explained our services then 50% of the people are
just satisfied , 33% are impressed and approximate 20% people told
that it is a helpful service.
As a part of market research, after influencing , approximately 55%
people saved the Practo healthline number but 45% didnt saved the
number.
During demo call to Healthline 24*7 only 10% people asked for their
disease but rest of 90% made the demo call only for resistration.
During market research it was clear that approximately 32% of the
people made demo calls from their own number , 55% dont want to
make any calls as they think they might get problem in future. And
13% people even didnt make any call.

B. Conclusions and Recommendation: As young generation is interested and there is vast market , so
an attractive and effective promotional strategy should be
adopted.
Like Just Dial , Practo.Com also has to focus to make a brand
image in the market .
As people are not interested to tell about their diseases then free
medical camp is recommended to organize for all level of people
on society.
By campaign people awareness about the usefulness of the
health-line is recommended.

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C. Limitations of the study:

Sample size is limited to a particular area.

Accuracy of the information collected .

D. Bibliography:
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Websites and sources:

http://indiabudget.nic.in
http://www.religaretechnova.com/introduction.html
http://www.religare.in/About_us.asp
http://www.scribd.com/search?
cat=redesign&q=mumbai+health+sector&x=0&y=
http://www.slideshare.net
www.ibef.org/industry/healthcare.aspx
www.frost.com
www.investmentcommission.in/healthcare
www.economywatch.com
www.whoindia.org
www.healthcare-india-statistics.blogspot.com
www.pwc.com/.../healthcare/.../emerging-market-report-hc-in-india
www.globalpost.com
en.wikipedia.org/wiki/Healthcare_in_India
India Budget 2009, Ernst & Young 2009
Four years of NHRM, Ministry of Health and Family Welfare, May 2009
Global atlas of the health workforce [online database].
Geneva, World Health Organization, 2008
India Chronicle: 2008, Ernst & Young Analysis
he Business World, Ernst & Young Survey; June 2009
Ten industry trends 2009, Technopak healthcare outlook, 2009, p. 1
Fostering quality healthcare for all, Ernst & Young, 2008
Ministry of External Affairs.

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Annexure
Health care center type: Clinic

Nursing

Home

Hospital

Diagnostic Center

Center Name:

Mobile (Doctor):

Center Owner:

Email ID:

Contact numbers:

Web site:

Address:
Area:

Pin code:

Timings:
Specialities available
Ayurveda

Dentistry

Dermatology

OBG &

Gynecology
Ophthalmology
Homoeopathy

Orthopedis

ENT

Pediatrics

General Physician
Wellness

Physiotherapy
Veterinary

Spa and salon

Diagnostic facility

Others:
Facilities
Receptionist

Computer generated
Treatment Plan

Computer

Prescription

Internet

Bills

Printer

Records

Software

Software name:

..
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Mode of Marketing used

o Advertisements
o Online Listing
o Clinic website/SEO
o No Marketing.
o Others ..
Cost of Consultation
o Upto Rs 100
o Rs 100 - Rs 300
o Rs 301 Rs 500
o Above Rs 500
Marketing Expense per year

o
o
o
o

Rs 0 Rs 10,000
Rs 10,001 Rs 50000
Rs 50,001 Rs 100,000
More than Rs 100,000

Years in practice
o 0 2 Years
o 3 6 Years
o 7 15 Years
o More than 15 years
Name of the consultant
Contact no

Specialization

Established since:
Size of the Team:
of staff:

No. of Doctors:

Notes:
Disclaimer: You are hereby authorizing us to use this information for
internal purposes only.
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Name of the respondent:

Signature (with Seal)
Place:
Date:
Surveyor code:

Clinic

Code:

Geo Location:
Quadrant:

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