In the second part of the IRD-CHMI Working Group Blog Series, we evaluate the health market through the lens of disruptive innovations and highlight programs that are influencing markets in Karachi. The first part of the blog series can be found here.
The aim of the final session of the working group meeting was to crystalize participants’ ideas and provide key messages that can help organizations scale.
The group discussed that public health programs appear to follow a path that is similar to disruptive innovations described in other industries. A disruptive innovation creates new markets that displace an earlier technology in unexpected ways.. A key feature of the programs discussed was a focus on non-users or customer segments on the lower-tier of the market. Public health programs typically focus on individuals that do not utilize existing healthcare facilities due to high costs and difficult access. These programs do not initially pose a challenge to incumbents that dominate the market such as large hospitals and health insurers. However, given new innovative features such as new diagnostic tools or novel operational processes, these programs have the potential to disrupt existing markets and evolve into the new standard of care.
It remains to be seen whether health market innovations in Pakistan will confirm this hypothesis. Private sector-led healthcare has yet to fully evolve in Pakistan . However, this framework does provide some important practical applications to programs. Recent evidence suggests the need to build strong partnerships with the public sector and other development organizations to enable disruptive innovations to truly scale. Finally, it underscores the need for experimentation with innovations due to their capacity to bring about improved quality of care and reduced costs—a phenomena widely observed in other industries but sorely lacking in public health. Two public health programs that are potentially disrupting markets in Pakistan that were part of the IRD-CHMI Hub are described below.
Indus Hospital Blood Center
Indus Hospital Blood Centre (IHBC) is revolutionizing blood banking in Pakistan by using its own proprietary software and technology to develop the first barcoded blood banking system in South-Asia.
IHBC uses its own software and other innovative technologies to procure, hold, track and deliver blood and blood-products. Donors are verbally screened with Android devices that are linked to the Centre’s database, a practice that reduces costs by identifying individuals at risk of transmitting infections, and prevents unnecessary testing. Each donation is assigned a barcode to track the container at every step of the blood storage journey. IHBC has developed an efficient system to test for contaminants that would render the blood unusable. Rather than carry out simultaneous screening of all antigens, the most prevalent diseases are tested first. This sequential testing enables IHBC to conserve expensive testing reagents.
Using these approaches, the Indus Hospital Blood Center is rapidly building its reputation as a provider of safe and quality-assured blood and blood products. The Centre’s business model involves forming networks with hospitals in Karachi. Partnering hospitals use an online portal linked to the Centre’s database to request blood products, delivered for a fee. The IHBC helps ensure cold-chain and other necessary supply requirements, and ensures adequate storage facilities at the partnering hospital. As the first centralized blood center in Pakistan, patients no longer need to search for appropriate donors after emergencies or during complications. The center adds great value to patients by removing the stress involved in searching for donors. Hospitals are increasingly seeing this benefit and are signing on to the center allowing it to scale its operations as well as to become sustainable.
Ultimately the IHBC aims to become the standard with which blood banking is carried out in the country.
Community Health Solutions (CHS)
Community Health Solutions has multiple facilities, known as Sehatmand Zindagi (or Healthy Life) Centers in Karachi that treat pulmonary diseases and diabetes. The initiative received initial funding via the Stop TB Partnership and UNITAID to scale up tuberculosis case-detection and treatment in the private sector through mass-screening and testing via a molecular-based rapid TB diagnostic (GeneXpert MTB/Rif). Whilst GeneXpert testing for TB takes place free of charge, the program creates revenue by first screening patients via a digital Xray that is provided at a low cost. The program recovers costs by charging for diagnostics and treatment for conditions associated with increased risk for development of TB including COPD, asthma and diabetes.
CHS employs a number of innovative technologies such as a new digital Xray and rapid diagnostics. The screening processes allowing doctors to diagnose and treat patients sooner. Low-income patients benefit by not only receiving high-quality care but also by missing fewer hours of work with only one visit required to reach a diagnosis. Public sector providers and large tertiary hospitals detect greater number of TB cases in Karachi, thus CHS collaborates with government hospitals to introduce GeneXpert testing at these sites. CHS uses revenue to cover operational costs, and is also aiming to receive funding from the government to scale-up its operations in Pakistan. This initiative is providing important lessons for the role of partnerships in improving quality of medical care and developing new markets through disruptive innovations.
Photo: A breakout session from the IRD-CHMI Hub Meetings ©IRD 2014