Outcome Report SCALE Healthcare Innovations SummitNovember 19, 2014, New Delhi

enesis of Building a Healthcare Ecosystem

The Wadhwani Ini�a�ve for Sustainable Healthcare,

WISH Founda�on, organized the first of its Healthcare

Innova�ons Summit towards building a pla�orm for

fostering healthcare innova�on ecosystem in India.

The Summit, for the first �me, showcased live

demonstra�on of the healthcare ecosystem in

progress; brought together around 300 thought

leaders and prac��oners from the healthcare

ecosystem; and exhibited the low cost devices and

models of primary healthcare on one pla�orm. An

important outcome was the high interest and

commitment between government and private sector,

shown by senior representa�ves of both sectors, with the

common goal to strengthen primary healthcare and

commitment to set up a mul�-stakeholder fund to the tune of

$100 million for scaling up health innova�on, with special focus

on early stage funding.

WISH Founda�on, supports scale up innova�ons to transform healthcare.

Mission: To improve the health of poor families across the world by building a demand driven ecosystem that can deliver scaled up approaches to healthcare.

Vision: By 2020, reach 10 million underserved people with quality healthcare services and scale up 20 high impact healthcare innova�ons.

Key areas of focus are:-

Mining of Promising Innova�ons

Accelera�on of promising innova�ons to be scale-ready

On-ground demonstra�on of scalable innova�ons

Replica�on and scaling up of successful innova�ons

Scaling up innovations Transforming healthcare

Wadhwani Initiative for Sustainable Healthcare

Soumitro GhoshCEO, WISH Founda�on

Opening the Healthcare Innovation SummitA five point ac�on plan to create an ecosystem to scale up Innova�ons by Sunil Wadhwani, Founding Donor, WISH Founda�on

1. Iden�fying 300-500 most promising innova�ons and suppor�ng them for incuba�on and scale-up

2. Se�ng up a $100 million mul�-stakeholder fund for scaling up innova�ons and ensuring technical know-how for scale-up through appropriate public-private service delivery mechanisms

3. Proac�ve engagement with state governments to demonstrate innova�ons that will strengthen the health care delivery system at an early stage

4. Crea�on of an enabling ecosystem for healthcare innova�ons, through accelerators and drivers, like health awards, grant challenge and university engagement

5. Crea�on of a knowledge hub, for innovators and incubators to connect and collaborate

Need for building an ecosystem that encourages innova�ons,

Dr. Vishwa Mohan Katoch, Secretary, Department of Health Research &

Director General Indian Council for Medical Research, highlighted the

need to work with larger set of innova�ons, especially building

technologies that support last mile providers. He shared that the

government, through Medical Technology Assessment Board, is

establishing mandate to approve innova�ons that will benefit most

people. He emphasized, “We must ensure that affordable technologies

benefit a large number of people. As a representa�ve of the government, we

assure you of our partnership”.

Urgent need to develop win-win proposi�ons for

public private partnerships, Niraj Kumar Pawan,

Addi�onal Mission Director Na�onal Health Mission,

Director IEC, Ministry of Health & Family Welfare, Rajasthan, highlighted that

the Government is recognising the importance of innova�ons that provide

affordable, efficient ways of delivering primary healthcare services to the

under-served popula�ons. While sharing his experiences on implemen�ng

schemes at the grassroots, he stressed on the need to contemporize age

old approaches. He informed the audience about social and cultural

prejudices that affect the girl child and the need to tackle these issues

crea�vely. Sharing the innova�ons from Rajasthan, he said every �me a girl

child is born to a family, a gree�ng signed by the Chief Minister of Rajasthan is

despatched to the home of the new-born. Another one of Rajasthan's

ini�a�ves, a mother and child tracking system, which started out on a simple

Excel spreadsheet, has been scaled up and undertaken by the Na�onal Health

Mission. The model, now popular as Mother and Child Tracking System (MCTS), is

being replicated across the country.

Niraj Kumar PawanAddi�onal Mission Director

Na�onal Health Mission, Director IECMinistry of Health & Family Welfare

Rajasthan

“I have been a 'serial' entrepreneur, having supported and founded over 40 companies and want to use my

experience to contribute to reaching the poor with quality healthcare services.”

- Sunil Wadhwani

Dr V.M. KatochSecretary, Department of Health Research

and Director General ICMR

Thought Leadership Analysis by WISHFounda�on and Partners

WISH presented two insigh�ul thought leadership presenta�ons undertaken in collabora�on with Interna�onal Finance Corpora�on, The World Bank Group and Access Health Interna�onal on opportuni�es and challenges in scaling up of healthcare innova�ons and fostering private sector engagement in Rajasthan to set the context for the discussion.

The first ever mapping of Inclusive Business Models (IBMs) in healthcare plo�ed 165 models which have a high poten�al for scale and commercial sustainability, however these do not necessarily target the base of the pyramid popula�on. The analysis presented 14 opportuni�es for ecosystem stakeholders for scale; (i) direct pa�ent capital funding; (ii) support research and development on new IBMs (especially in low returns / high risk areas); (iii) health awareness and health seeking behavior ini�a�ves; (iv) proac�ve advocacy for cri�cal reforms; (v) promote best prac�ces and disseminate industry know-how; (vi) build partnerships between different categories of healthcare IBMs; (vii) facilitate early stage real-world product tes�ng; (viii) invest in early-stage IBMs and help them refine their models; (ix) provide investment readiness support to early-stage IBMs; (x) enabling environment for procurement; (xi) independent accredita�on agencies for new solu�ons; (xii) demand-side financing for greater coverage, protec�on and inclusion (e.g. outpa�ent ); (xiii) s�mulate improved health-seeking behavior of the poor and facilitate and explore reforms for para-skilling / task-shi�ing.

The second study on “Public Private Collabora�on for Health: Perspec�ves from Rajasthan” highlighted key barriers which include lack of informa�on on private sector ini�a�ves and players, trust deficit, lack of skills to facilitate public-private partnership and pla�orms for structured dialogue. However there is commitment from public officials to engage the private sector, iden�fy barriers to engage private sector and the way ahead. WISH

Founda�on is working through its project SCALE Rajasthan to build policy framework for PPPs in the state.

Challenges and diverse needs of the healthcare innovators:

A group of 7 innovators represen�ng diverse 1set of innova�ons such as health ATMs and

low cost devices presented their cases and cited lack of business acumen, skill development for scale-ups, linkages to secondary and ter�ary care services, and se�ng up of logis�cal channel for smooth supply as the main challenges in growth. The private sector's interest and efficiency in helping scale-up, the issue of trust between private and public sectors, the percep�on of low cost services being low quality, and the importance of skilled nurses and midwives at primary healthcare clinics was discussed.

1Biosense Technologies Pvt. Ltd., Mumbai; McHealth Grid Corporate Pvt. Ltd, Hyderabad; ZMQ So�ware Systems, Gurgaon; GE Health, Bangalore; Basic HealthCare Services, Udaipur; CHMI/ACCESS Health Interna�onal, Hyderabad; and Karuna Trust, Karnataka.

Primary healthcare delivery is very complex and the exper�se to manage PPPs in health is rela�vely non-existent and hence very limited scale-ups. Na�onal Health Assurance Mission (NHAM) focuses on PPPs and se�ng up pla�orms to iden�fy and approve innova�ons (especially devices). Government is building exper�se and guidance to states to plan and execute PPPs. Cri�cal to success will be risk sharing and complemen�ng each other

“

“Manoj Jhalani

Joint Secretary, Policy, MoHFW

Government and Policymakers

Manoj Jhalani, MoHFW

Niraj.K.Pawan, Govt of Rajasthan

M.L. Jain, SIHFW Rajasthan

T. Sundraraman, Public Health Expert

Donors and Development Partners

Sheena Chhabra, USAID

Aparajita Ramakrishnan, BMGF

Anil Sinha, World Bank

Shirshendu Mukherjee, Wellcome Trust

Facilitators

Mark Allan, Max Ins�tute of Healthcare Management

Dheeraj Batra, D-Labs, Indian School of Business

Anurag Agrawal, Intellecap

Hindol Sengupta, Fortune India

Thought Leadership Presenters

Tom Blathwayt Monitor-Deloi�e

Rohini Rao, Access Health Interna�onal

Innovators

H.Sudarshan, Karuna Trust

Sanjeev Chaudhry, SRL Limited

Ravichandran Natarajan, Narayana Health

Pavitra Mohan, Basic Healthcare Services

Ji�n Chandna, McHealth Grid

Yogesh Pa�l, Biosense Technologies

Hilmi Quraishi, ZMQ

Expert Panel

Summary of Panel Discussions

Innova�ons should be quicker to adapt, cost-effec�ve manner to facilitate adop�on into the health systems

Need for building quality evidence, especially impact of innova�ons on health to increase investment and support

Innova�ons should be supported by affordability, monitoring and opera�onal guidelines and frameworks.

Urgent need for incuba�on and disciplined partnership rather than quick fixes

Successful scale up will require working closely with the innovator, organiza�on opera�ng and co-create from early stage

Delivery of innova�ons face challenges from lack of regulatory framework

The innova�ons need to be socially sustainable even if they are commercially sustainable for them to scale up. Tradi�onal PPP models are cri�cal

Genera�ng for wider media coverage

Experts also called for be�er media coverage

More investors and incubators who support innova�ons that require handholding, and the exper�se to determine the sustainability of the idea. Experts represen�ng the funders and investors spoke about affordability v/s scalability, disciplined partnerships, and iden�fica�on of low-cost, effec�ve innova�ve ideas

Ac�on Agenda from Healthcare Ecosystem

Government as the central stakeholder expressed high intent of priori�zing partnerships between public and private and making space for adop�on of innova�ons

SCALE Rajasthan, a partnership between the government of Rajasthan and WISH Founda�on formalized to demonstrate the impact of scalable healthcare innova�ons and enterprises for primary healthcare

Facilitators extended their exper�se in the development of incubator, crea�ng necessary frameworks to classify and rank innova�ons, provide monitoring support easing out the regulatory framework towards building an enabling environment for innova�ons to nurture

Donors and Development Partners pledged to leverage financial resources and expressed their ability to invest in sustainable ideas and innova�ons that can be scaled-up

Private Sector is a partner to the government and not a contractor“

“

Dr H.SudarshanKaruna Trust

We need to add a fourth pillar to the PPP model, that is, Philanthropy. It is important to provide cost-effec�ve and quality healthcare to the poor

“ “

Dr Sanjeev ChaudhrySRL Limited

WISH invited innovators to display and showcase their innova�ons and models which form part of high poten�al solu�ons that can make primary healthcare more affordable and accessible for Base of Pyramid popula�on. Four categories (i) Stand-alone and networked diagnos�c devices (ii) Low cost models of primary healthcare; (iii) primary healthcare delivery using public private partnerships and telemedicine (iv) health informa�cs, suppor�ve supervision and standardized IEC using mHealth. These innova�ons will be piloted and demonstrated in Rajasthan within the government service delivery system by WISH Founda�on.

Innova�on for affordable medical devices for anemia, diabetes and urine test with cloud based data integra�on provides for early tes�ng and diagnosis at the community level will reduce workload on ter�ary hospitals and will reduce the burden of chronic diseases. Point of care devices like ToucHb, uChek etc have a vital role in ensuring “Healthcare for All”

MIRA - Mobile Channel on RMNCH+A for Rural Women is a holis�c channel which provides health informa�on to rural women on their mobile phones and connects them with health services and frontline workers

GE Healthcare devices for maternal and child health provides Lullaby Warmer etc for facili�es improves clinical performance and ease of use while being highly affordable

Health –ATM is an IT enabled, automated, 3-in-1 Healthcare Kiosk offering doctor consulta�on through telemedicine, basic diagnos�cs tests and medicine vending – all under one roof

Karuna Trust, is a pioneer in successfully implemen�ng PPP models and reaches out to over one million people through direct management of 67 PHCs in seven states of India, eight Mobile Health Units, 2 Ci�zen Desks, 1 Eye Hospital and 1 First Referral Unit and with over 1100 dedicated healthcare professionals

Kavin Corpora�on on Prasak – TB Drug Adherence and Monitoring System Prasak TB Drug Adherence and Monitoring Concept aims at infusing innova�ve technology and integra�ng it into the health care system to emphasize on adherence

Center for Health Market Innova�ons CHMI is a digital pla�orm that provides a way for innovators to learn about and connect with programs striving to improve the health of the world's poor

Food for�fica�on is an appropriate medium-to-long term strategy to reduce the high burden of micronutrient malnutri�on. Global Alliance for Improved Nutri�on and IIHMR support staple food for�fica�on in the State of Rajasthan by working with the state government counterparts and the food industry

Innovation ShowcasePutting Innovations in Action