1

Executive Summary
This project report is the planning activity for the summer project at SimpleeKare
Technologies Private Limited in Bhubaneswar,Odisha. 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,
SimpleeKare 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 SimpleeKare is already in
Healthcare and its name they come with a web portal called SimpleeKare.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

1
 2

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

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 SimpleeKare 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.

2
 3

TABLE OF CONTENTS

S.L CONTENTS PAGE NO.

CHAPTER I

INTRODUCTION

I Healthcare Industry

II Scope of Healthcare Industry

III Opportunities in Healthcare Sector

IV Present Healthcare System in India

V Healthcare Industry in India and GDP

VI Indian Pharmaceutical Industry:SWOT analysis

VII SWOT analysis of Indian Healthcare Industry

VIII Trends in Health Expenditure In India

IX Share of Healthcare in Revenue Budget of Major States

X Sources of finance in the Healthcare sector in India during 2015-

16

XI Innovation and Development in Indian Healthcare Industry

XII Population Statistics

XIII Suggestion of Changes

XIV Steps can be taken to overcome these problems

XV The Budget 2011-12 impact in Healthcare

CHAPTER II

OBJECTIVE OF THE STUDY

3
 4

CHAPTER III

i Research Methodology

ii Problem Identification and Problem Formulation

iii Business opportunities for Healthcare Industries

iv Challenges for Healthcare Industries

V Scope of the study

vi Review of Literature

Vii IT in healthcare industry

viii E-healthcare solution

viv Software used by simpleekare

CHAPTERIV

PROFILE OF THE COMPANY

About Simpleekare Group

Key people in simpleekare group

ConferDR

Confercare

About Simpleekare.com

SWOT analysis of Simpleekare

SWOT analysis of competitors

CHAPTER V

ANALYSIS AND INTERPRETATION OF THE DATA

1 Percentage of Doctors using Computers

2 Percentage of Doctors using Internet

3 Percentage of calls made from customer number and my no.

4
 5

5 Percentage o people saved healthline number or not

6 Percentage of people with different remarks

7 Popularity compare to Practo.com

8 Percentage of people interested and not interested with respect

to age

9 Percentage of Doctors using simpleekare app

CHAPTER VI

FINDINGS AND RECOMMENDATIONS

A Findings

B Recommendations and conclusion

C Limitation of the study

D Bibliography

Annexure

5
 6

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. 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

6
 7

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 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 HIV-infected. 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 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.

7
 8

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 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.

8
 9

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.
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

9
 10

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 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 SimpleeKare group has entered in the national healthcare
information exchange process to facilitate the right healthcare information services to the
citizens of India as

10
 11

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

Technologies Pvt Limited. SimpleeKare.comhas 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. SimpleeKare 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

11
 12

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 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.

12
 13

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 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

13
 14

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.

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.
14
 15

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 of the growth (YoY) of Indian
pharmaceutical industry in last six years.

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%.

15
 16

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.

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%)

16
 17

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.

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 a 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.

17
 18

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.

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

Opportunities

Aging of the world population.

Growing incomes.

18
 19

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.

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 a high level of social development. The social sectorsparticularly health

19
 20

and education have been accorded a very low priority in terms ofthe allocation of resources.
For example, public expenditure on health services as apercentage 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 Health Expenditure as % of the GDP

1950-51 0.22 NA 0.22
1955-56 0.49 NA 0.49
1960-61 0.63 NA 0.63
1965-66 0.61 NA 0.61
1970-71 0.74 NA 0.74
1975-76 0.73 0.08 0.81
1980-81 0.83 0.09 0.91
1985-86 0.96 0.09 1.05
1990-91 0.89 0.06 0.96
1995-96 0.82 0.06 0.88
2000-01 0.86 0.04 0.90
2001-02 0.79 0.04 0.83
2002-03 0.82 0.04 0.86
2003-04 0.86 0.06 0.91

Health sector suffered more during post-liberalization period. Economic Liberalization policy
was introduced in India during the middle of 1991. The majorthrust of economic liberalization is
to give more leverage to market forces so farallocation of resources among various sectors of
the economy is concerned. In thepre-liberalization period of independent India, the health
expenditure as percentage of6the GDP increased as a whole from 0.22% in 1950-51 to 0.96% in

20
 21

1990-91. However,it has seen a steady decline ever since in the Post-Liberalization period from
0.96 % in1990-91 to 0.91% in 2003-2004.It is not only that India spends very low proportion of
its GDP on public healthservices, another problem is the wide ranging regional variations in
expenditure onpublic health services is also reported.A comparison of inter-state variations in
expenditure on health suggests thatRajasthan spent 5.75 % of its budget on health, whereas it
was only 3.63% in case ofGujarat 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,
whichdeclined 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 %)

S.No States 1985-86 1991-92 1995-96 1999-2000 2003-2004

1 AP 6.41 5.77 5.70 6.09 5.21
2 Assam 6.75 6.61 6.08 5.25 4.39
3 Bihar 5.68 5.65 7.80 6.30 4.84
4 Gujrat 7.45 5.42 5.34 5.21 3.68
5 Haryana 6.24 4.19 2.99 4.08 3.63
6 Karnataka 6.55 5.94 5.85 5.70 4.85
7 Kerala 7.69 6.92 6.81 5.95 5.42
8 Maharastra 6.05 5.25 5.18 4.59 4.39
9 MP 6.63 5.66 5.07 5.18 4.89
10 Odisha 7.38 5.94 5.42 5.03 4.47
11 Punjab 7.19 4.32 4.56 5.34 4.27
12 Rajasthan 8.10 6.85 6.18 6.39 5.75
13 Tamil Nadu 7.47 4.82 6.40 5.51 5.26
14 UP 7.67 6.00 5.73 4.42 5.13
15 WB 8.90 7.31 7.16 6.30 5.23

21
 22

16 All states 7.02 5.72 5.70 5.48 4.97

Low public sector spending on health services results in over-dependence on privatesector for
getting health services. In India the share of private sector on health careexpenditure
constitutes around 72 % and household sector being the major constituentof the private sector
claims 68.8% of expenditure on health care (Table 3). In otherwords 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 centof the total expenditure on health services.
NGO sector is almost non-existent in termsof spending on health services. Its share is only 0.3
per cent.

X. Sources of Finance in the Health Sector in India during 2001-2002

Private Govt Public NGOs External

Households Private Central States Local Firms Sector Funds
Firms Banks
Health 68.8% 3% 7.2% 14.4% 2.2% 3% 0.2% 0.3% 2%
Spending
Total 71.8% 23.8% 3.2% 0.3% 2%

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

22
 23

Sl. No Characteristics Rural (Per 1000 Urban( Per 1000

Population) population)
1 Hospital Beds 0.2 3.0
2 Doctors 0.6 3.4
3 Public Expendetures Rs.80,000 Rs.5,60,000
4 Out of pocket Rs.7,50,000 1,150,000
5 Infant Mortality Rate 74/1000Live births 44/1000Live Births
6 Under Five Mortality 133/1000Live Births 87/1000 Live Births
rate
7 Birth Attended 33.5% 73.3%
8 Full Immunization 37% 61%

Similarly in rural areas there are only 0.6 doctors per 1000 population, which is ashigh as 3.4 in
urban areas. Rural-urban disparities are equally pronounced on accountof outcome of health
services. For instance Infant Mortality Rate (IMR) in rural areasin 74 per one thousand live
births which is about 44 per thousand live births in urbanareas. Similarly Under-Five Mortality
Rate (U5MR) is 137 per thousand live births inrural 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 inthe 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,9the poor, women and
children (NRHM, 2005). The pace of implementation of theMission is very slow. Garg and Nath
have opined that the progress of the Mission inUttar Pradesh, one of the most populous states
is very dismal. In NRHM, AccreditedSocial Health Activist (ASHA) is the key player, whose role is
to work as an interface

23
 24

between the community and the public health system. In case of Uttar Pradesh,
theperformance on account of ASHAs is very discouraging. The State has selected only9,548
ASHAs against the target of 65, 000. Unfortunately, the State has not made anyarrangement for
their training. In most of the other States also the progress of NRHMis very tardy. In India as a
whole out of the total 228,327 ASHAs proposed to beselected; only 145,546 ASHAs were
selected (Garg and Nath, 2007).
A government-funded review of NRHM also revealed its slow progress. The majorproblems in
the implementation of the NRHM are: administrative constraints,governance issues,
inadequacies in human resources as well as the poor investment inpublic health services in the
recent past (Shrivastava, 2008).Commercialization and privatization of health services and
introduction of userscharges in pubic health institutions during post-globalization phase have
excluded a
sizeable number of population particularly belonging to socially disadvantaged groupsand poor
from the coverage of health services provided by organised sector.An earlier study by the
authors has found that since the start of economicliberalization, privatization, and globalization
in the 1990s, the Punjab governmenthad introduced two drastic reforms in health policy. First
policy decision was the
significant opening of health-care services to the private corporate sector. Privatesector
hospitals were given land and facilities at concessional rates and were expectedin return to
provide free treatment to yellow card holders (people below the povertyline) up to 10 per
cent of outpatients and 5 per cent of inpatients. The second policydecision was that the Punjab
Government set up the Punjab Health SystemsCorporation (PHSC) in October 1995, under the
World Bank-sponsored State HealthSystems Development Project II, and transferred more than
150 health-careinstitutions run by the government to PHSC. To mobilize more resources,
thehospitals 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 was10revealed in the
study that only a negligible proportion of people below poverty lineavailed themselves of
exemptions from user charges at government hospitals.According to field survey ignorance

24
 25

among the poor about free treatment and thecomplex and cumbersome procedure were
constraining the access of the poor to thehealth care services (Ghuman and Mehta, 2006).
The unequal access to health services has succinctly been stated by the 11th Five YearPlan of
India (2007-2012), there is also a divide between those who have accessto essential services
such as health, education, drinking water, sanitation, etc, andthose who do not. Groups which
have hitherto been excluded from our society such asScheduled Castes (SCs), Scheduled Tribes
(STs) and some minorities and OtherBackward Classes (OBCs), continue to lag behind the rest
(Planning Commission,2006).Gender disparities in health services are also very acute and
deserve special attentionof the policy makers. Gender disparities are found on account of
utilisation of healthservices both for in-patient and out-patient care. National Sample
SurveyOrganization (NSSO) data reveal that in the rural areas the money spent per
illnessepisode 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 isexpenditure
spent for in-patient 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 andgovernance of public health organizations are also matter of
concern. First theinfrastructural facilities are inadequate followed by their poor maintenance.
Secondlymost of public health institutions are understaffed accompanied by a high absence
rateamong the personnel. Thirdly, medicines are normally not available in the healthinstitutions
(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

25
 26

growth in China (CIA July 2010.) This means that by 2030 India will have surpassed China as
the worlds most populous country, and will reach a 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 NameTotal 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)

26
 27

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

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

27
 28

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 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

28
 29

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:

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 a
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

29
 30

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
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.
30
 31

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 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. A
31
 32

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 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
32
 33

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?)

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.

33
 34

CHAPTER I
OBJECTIVE OF THE STUDY

The main objectives of the Study are;

Primary Objectives:

To study the market potential of Healthcare sector in Odisha.

To understand competitive market for the SimpleeKare.

To understand people mentality about SimpleeKare.

Secondary Objectives:

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

To understand the future business opportunities around Healthcare industry.

34
 35

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 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.

35
 36

The main competitors of SimpleeKare are SimpleeKare and they are well established in the
existing market.

For millions of people, SimpleeKare is the trusted and familiar home where
they know theyll find a healing touch. It connects them with everything they
need to take good care of themselves and their family - assessing health
issues, finding the right doctor, booking diagnostic tests, obtaining medicines,
storing health records or learning new ways to live healthier.

Healthcare providers can also harness the power of SimpleeKare as the

definitive platform that helps them build their presence, grow establishments
and engage patients more deeply than ever.
5 countries with consumer and software business. 10 additional countries with enterprise
software business.

They get around 50million appointment per year.

They have more than 200k health care provider under them.

ii. Problem Identification and Problem Formulation:

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. In-hospital
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.

36
 37

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

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:

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

37
 38

Various Challenges faced by healthcare industry are:

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 Simpleekare is made with the motive to provide free customer
assistance 24x7.

v. Scope of the study :

Though the study is limited to the SimpleeKare.com within Odisha , it is very useful for those
coming healthcare industries to take strategies of advertisement and sales promotion for their
product . It is also useful to the stakeholders for the awareness of present situation of Indian
health services and the need of healthcare industries.

vi. Review of Literature

The study of Advertising and sales promotion strategies of SimpleeKare.Comw as carried out
for understanding advertising and sales promotion strategies of Healthcare Business in
India and its future growth and opportunities. 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 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

38
 39

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 SimpleeKare.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 Simpleekare.com about healthcare service providers such as their
timing of availability, their experience, their expertise, their charges, etc.

vii. 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.
39
 40

Increasing awareness on IT among medical professionals.

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

40
 41

viii. E-Healthcare Solution:

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

Simpleekare is engaged in providing the latest in internationally recognized medical care

to patients with a variety of ailments and medical conditions.

Simpleekare 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.

Xvii. Softwares used by SimpleeKare

Electronic Medical Record (EMR)

Electronic Health Record(EHR)

Appointment Scheduler

Account Management.etc

41
 42

CHAPTER IV
Profile of the Company

Healthcare at your Finger Tips

Introducing Simpleekare, a digital first healthcare start-up working to improve
patient experience via clinics, home based services and digital channels. Our
experts provide diagnosis of critical illnesses and aim to improve healthcare
delivery through use of technology. We provide convenience to the patient by
providing health care services at our clinics as well as at your home. Health
information and interactions can be accessed anytime anywhere through our
digital channels and mobile apps.

SimpleeKare provides doctor consultations, physiotherapy, diagnostics on the

clinical side. It provides mobile product app for consumers to book appointment,
e-prescriptions, book home based physiotherapy & pathology, make online
payments. Our health provider app facilitates practice management with
appointment scheduling, generating e-prescriptions, uploading patient
records/diagnostic test results and managing multiple clinical practices. The apps
help the consultant doctors to spend more time on patient diagnosis and care
management. Home based services gives consumers the power to decide when
and how to get the care they deserve without visiting hospitals. The digital
records available within the app gives the freedom to interact with their doctors
easily irrespective of location constraints. We are experiencing huge demand
from consumers who are helping their family members in ordering home based
services or tests, making online payments and staying involved with family care.
Many consumers who are staying abroad also take second opinions from our
experienced doctors by utilizing our digital health initiatives. Most of these
services can also be availed from their website.

42
 43

Vision

"Simplify healthcare processes by creating trustworthy patient care models"

Mission
"Transform healthcare by developing intelligent applications connecting doctors,
care providers and patients to improve patient experience via clinics, home based
services and digital channels."

We are pleased to introduce you our SimpleeKare App to change the way
you avail healthcare services.

Book appointment and manage your records online

Find your Doctor for multiple specialties
Search & book pathology tests
Home Care services are available

"Carry the care you deserve"

Quality service with professional & well trained medical staff

Well located, easy to reach facilities added with Home Services

Good Ambience keeping safety and hygiene aspects in mind

Health Screening Packages for all age groups and needs

Doctor Consultations for multiple specializations

Health Records available online and through mobile app

43
 44

About SimpleeKare Group:

SimpleeKare was founded by Mr.N.C Parija and Mr.Lagna Parija.

Chairman- Mr.N.C Parija
Managing Director-Mr.Lagna Parija
Business Operation Head-Mr.Jyotishman Sahu
Own IT team- Mr.Lagna Parija
Mr.Jyotishman Sahu
Mr.Anshul Pattanayak
1. Key People:

Mr.N.C Parija

(Chairman)

Miss.Suman sarita Mr.Jyotishman Sahu

Mr. Lagna Parija
Rout
(MD) (Head Business
(HR) Operation)

44
 45

SimpleeKare is currently operating in 2 cities in Odisha those are Bhubaneswar and Odisha, as well
as smaller cities like Berhampur and Rourkela. In each location, it has appointed a couple of
resources to reach out to more people.

With local penetration, they hope to increase their sales team this year. Plus,they are looking to go
global. This also means the company is looking to scale up its team and wants to more than double
its headcount by next year.

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. SimpleeKare expects to break even by
2020.

Yet, unlike other startups, SimpleeKare is not targeting the Indian market alone. They are investing
more money to capture new markets, especially the Indian market.

Instant Confirmed Appointments

Powered by Confercare Application for patients
ConferDR for Doctors

ConferDR
45
 46

Appointment Management Schedule App for Doctors/Clinic

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!!

Customer Care Helpline:

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 Simpleekare.com:

46
 47

Simpleekare.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 Simpleekare.com, the consumer can search a comprehensive database of all the healthcare
service providers listed from across the 5 cities of Odisha. 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 benchmarks
like- experience level, education details, fee, timing, emergency handling, home visit, awards
won, etc. Their aim is to help you select the most suitable healthcare service provider.
SimpleeKare.Com does not end with the search; They even have the facility to schedule
appointment of the healthcare practitioner for you.

SimpleeKare.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 SimpleeKare.Com the consumer gets access to all this information and more. Apart from
being a credible source of health information, SimpleeKare.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.

47
 48

Life at SimpleeKare

We are a bunch of passionate, young , creative, quirky, curious people

working out of our offices

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.

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.

48
 49

SWOT Analysis of SimpleeKare

Strengths:

Strong base at Cuttack and Bhubaneswar.

Well known in cities like Bhubaneswar,Cuttack,Berhampur,Rourkela.
Leader of innovations
Success various products in the market
Loyal satisfied customers
Affordable prices of various IT solutions and other enterprise solution in the market
Certifications in various platforms

Weaknesses

New in the IT market

Supply chain management is weak
Availability in very few Parts of the State.
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.

49
 50

Take risk willingly in product innovations to capture more market share and increase the
sales.

Threats

Dominant competitors of SimpleeKare.

Promotional activities of competitors are stronger
Brand name of competitors are well known ,for e.g: SimpleeKare,Lybrate

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

50
 51

Threats:

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

Most of the Doctors in Odisha instead of doing their job manually use Computers to perform
their day to day work.

51
 52

2) Percentages of Doctors using internet

66.6% of Doctors in Odisha use Internet in their Clinics for connecting with their patients and
for other medical purpose.

52
 53

3) Percentage of calls made from customer number and my number

Percentage of calls made from customer

number and my number
13.34% 0
From his/her
32% number
From my phone
55.66%
Didn't call

Most of the people are able to connect with the concernedDoctors with the help of
SimpleeKare number.

53
 54

4) Percentage of people saved healthline number or not

As a part of promotion percentage of

people saved healthline number or not
00

45.34% Saved number

54.66% Didn't save

Healthline number is the best way to connect Patient to the concerned Doctor.

54
 55

5) Percentage of people with different remarks

60.00%

50.00%

40.00%

30.00% Percentage of
50.66% people
20.00%
33.66%
10.00% 18.66%

0.00%
Good service
Satisfied Helpful

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

55
 56

6) Popularity compare to SimpleeKare.com

Popularity compare to Practo

5.34%0

Practo.com
SimpleeKare
94.66%

When it comes to popularity SimpleeKare stands one step ahead to Simpleekare.

56
 57

7) Percentage of people interested and not interested with respect to age

Chart Title
80.00%
60.00%
40.00%
69.33%
20.00%
24%
0.00% 6.67%
18-30yr 31-45yr 46yr and
above
Percentage of people interested and not interested
with respect to age

Now a days people like instant service,and youth is the mouthpiece of the growing
population.

57
 58

8) Percentage of doctors using SimpleeKare application software.

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

58
 59

CHAPTER VI
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 highest % of population is
youth .
SimpleeKare 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 is Lybrate 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
Simpleekare health line 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 registration.
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 Simpleekare.com,SimpleeKare.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.
By opening more branches through out Odisha and focusing more on the areas
with hazardous healthcare conditions would give SimpleeKare a great popularity
and focus around the state.

C. Limitations of the study:

Sample size is limited to a particular area.
Accuracy of the information collected .

59
 60

D. Bibliography:
Websites and sources:
www.whoindia.org
www.healthcare-india-statistics.blogspot.com
www.pwc.com/.../healthcare/.../emerging-market-report-hc-in-india
www.globalpost.com
www.simpleekare.com
www.SimpleeKare.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].
Ministry of External Affairs.

60
 61

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
Dentistry Dermatology OBG & Gynecology
Ophthalmology Orthopedis ENT General Physician
Homoeopathy Pediatrics Wellness Physiotherapy
Veterinary Consulation Diagnostic facility Pathology
Radiology wound management
Others:

Facilities Computer generated

Receptionist YES NO Treatment Plan YES NO

Computer YES NO Prescription YES NO

Internet YES NO Bills YES NO

Printer YES NO Records YES NO

Software YES NO Software name: ..

61
 62

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 Rs 0 Rs 10,000
o Rs 10,001 Rs 50000
o Rs 50,001 Rs 100,000
o 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 Specialization Contact no

Established since:

Size of the Team: No. of Doctors: No of staff:

Notes:

Disclaimer: You are hereby authorizing us to use this information for internal purposes only.

Name of the respondent:

Signature (with Seal)
Place: Clinic Code:
Date: Geo Location:
Surveyor code: Quadrant:

62