Saturday, November 21, 2015

The digital platform opportunity

This report advocates digital platforms in fostering innovations. The example of Aadhaar is the most obvious and successful. It talks about other similar platforms. I think this is one idea that has great potential, far beyond what is outlined in the report.

Consider two examples - healthcare and schooling. In health care, the value chain of activities range from informational (where are the nearest hospital or diagnostic facility or specialist and their respective quality) to medical (outpatient consultations or immunization or treatment follow-up or disease surveillance) to logistical (ambulance or drugs supply chain management or fake drugs testing) services. Similarly, in school education, the activities include informational (nearest school and quality or student's report card), pedagogical (learning content and teaching support materials), and administrative (management of student records or on-line access to school transfer and conduct certificates, mark-sheets, degrees etc) services. 

In each of the specific interventions, while there are enormous opportunities, there are also critical regulatory and other challenges. While on the one hand hospitals, public and private, would find great value in having access to electronic health records, there are issues of data protection and portability. In all these cases, if data ownership and privacy concerns are satisfactorily addressed, then the possibilities from mobile and other software applications (apps) are enormous. Only governments, through enabling policy frameworks and proactive market opening interventions, can be impartial administrators in these areas. 

The most important enabling policy framework would be one on data protection protocols that would allow app developers to offer services - medical history tracking, drugs verification, antenatal and immunization interventions etc. Many of these services can be offered through a fee-for-service model, with data remaining protected and with the patient and the respective hospital, or leverage alternative revenue streams. The other critical enabler would be standardization of protocols. This would facilitate dual inter-operability - use of the same app by different service providers and different apps delivering the same service by the same client (hospital/school and patient/student/teacher). Market opening services would include some large government hospital taking the lead in commissioning an electronic health records management system for its patients and then letting the network expand to include the other public and private hospitals in its vicinity. 

A doctor in a private clinic treating a patient covered under a state government health insurance program, say Aarogyasri, could through a software application access the patient's primary care records from the PHC database, and see diagnostic reports retrieved from the diagnostic center's database. Instead of visiting the far-away hospital, the patient can then follow-up on whether the patient is adhering to the treatment protocol. Another app would help the patient find the nearest medical store where the drug is available and check whether the drugs purchased are fake or not by scanning the QR code. 

The state medical and health department could put out standardized maternal and child health treatment protocols for developers to create apps. PHCs could download and subscribe to such apps on a fee-for-use model, on a range of differentially priced services. While the basic services may be available for a very negligible fee, the more value-added ones could be priced higher and would be subscribed by PHCs and other clients only if they find significant value proposition in them. This would also foster competition among PHCs and different other health units. Much the same dynamics would be generated with education, where schools could choose from the menu of services that are catalyzed and those which they find valuable.  

In both these cases, the hospital records and school records can be the respective platforms to catalyze entrepreneurship and create an eco-system of services which significantly impact health and education sectors.

1 comment:

Kailash said...


Very interesting read. Coincidentally Nandan Nilekani talks about similar platform opportunities in his latest book Rebooting India. For Health, he recommends a Centralized Electronic Medical Record System with Aadhar as the patient identifier, data on the cloud, accessible anytime, anywhere. Likewise for Education, he suggests a Khan Academy equivalent, in fact he's testing it with The book is a highly recommended read Sir.


Kailash Karthik N