When K. Ganesh, a serial entrepreneur who has built four successful green field ventures, exited his recent venture TutorVista (which was sold to Pearson for Rs. 1,329 crore), he was looking for various business opportunities to turn to next. A personal incident led him to his next venture – Portea Medical (Portea).
The genesis for the home healthcare business started when a close relative was diagnosed with cancer and treated at Manipal Hospital, Bengaluru. Subsequently, the family found it hard to get post-hospitalisation care at home. “Doctors in India never come home. We had to take our relative to and fro the hospital in this traffic. We also could not get a reliable nurse to take care of him at home,” recalls Ganesh. He then researched this market and understood that in the U.S.it is a US $80 billion industry driven primarily by insurance companies. But, in India, the home healthcare market just did not exist. What justifies the need for a service in this space is the demand as everyone has elderly at home to take care of.
Sensing an opportunity, Meena Ganesh and Ganesh established Health Vista India (parent of Portea) in July 2013 along with Dr. Manjusha Anumolu, a doctor (U.S. Board Certified) of internal medicine with 20 years of practice in the U.S. and India. Explaining the business further, Ganesh says, “I came across a New Delhi-based start up, Portea Medical, which offered home healthcare in association with hospitals. They had done some pilots and had a one-year head start. So we brought them into the company (gave them equity in our holding company and they are part of the management team),” recalls Ganesh. He decided to retain the brand name Portea Medical which later became a 100 per cent subsidiary of Health Vista India.
Today, Portea is India’s home healthcare pioneer with a network across 18 Indian cities. “When it comes to healthcare, while 30 per cent of the medical work is in the hospital like diagnostics and surgery, the balance can be done at home without the patient moving out. We are addressing the remaining 70 per cent,” says Ganesh. The company offers home visits from doctors, nurses, physiotherapists, nutritionists, counselors and trained attendants and focuses on geriatric, chronic and post-operative care patients using latest technology that makes healthcare delivery convenient and affordable. The company also offers medical equipment on rent for home use purposes. It has a team size of around 1,000 people, 100 of whom are doctors and does close to 22,000 visits every month. The company received a Series A round of funding to the tune of Rs. 48 crore from venture capital firms, Accel Partners and Ventureast, in December 2013. It plans to use these funds to build a technology platform and focus on hiring, training and building its team. “We have to hire people and deploy them ahead of the curve,” says Ganesh.
Understanding the market
Due to advancement in medical sciences, many diseases are getting detected early and people are living longer – the average life expectancy which used to be 62 years has gone up to 68 years in the last 10 years. Hence, the duration for disease management has become longer and a major portion of this cannot be done in hospitals. “People go to hospitals for emergencies whereas this is lifestyle management,” says Ganesh. And this is where Portea has a role to play. It has four target areas: One, the entire geriatric population. Next to China, India has got the largest elderly population of 144 million people. “Unlike in the U.S., we do not have the concept of elder care homes. Socially, it is still unacceptable for us to send old people to these homes,” states Ganesh.
The second focus area is the chronic segment where the company is focused on three chronic diseases – cancer, diabetes and cardiovascular diseases. Third comes post operative care like physiotherapy, nursing, sutures and finally, the family doctor or general physician visits. Currently, 80 per cent of its revenues are from the B2C segment while the remainder is from post hospital discharge patients.
As far as the revenue model goes, a customer can avail just a single transaction. For instance, if you are from another city and want a doctor to visit you, then it can be a single transaction. However, for disease management, physiotherapy, elderly care and so on, Portea offers packages. At present, 80 per cent of its business comes from these packages.
To reach its target audience, Portea depends a lot on word-of-mouth and digital and social media. “Facebook has worked out very well. It is a high engagement category,” says Ganesh. The company also has on-ground events in residential complexes and conducts physiotherapy workshops.
Banking on technology
To manage its services efficiently, the company has built a technology platform, which is used in all aspects of its business. Its platform is on a geo fencing network that divides each city into geo fences and helps the company manage and co-ordinate clinician visits. Its back-end algorithm helps to identify clinicians who are best suited for a particular patient. Factors taken into account include the geo-location of customer, preferred timeslot, type of service request and clinician calendar. Based on these, the best available clinician is assigned. All patient requests and clinician locations can be viewed from a central location. Real-time updates can be obtained including information such as when a clinician is running late for any reason.
Portea clinicians have access to the Portea app, through which they can access the patient’s medical history, check for specific instructions from the patient’s consulting specialist and provide real-time updates of the patient’s vital parameters and patient’s health record (PHR).
The company is also in the process of integrating Bluetooth capability with medical equipment; vitals such as BP, temperature, blood glucose levels are automatically captured in the Portea app.
Currently, Portea is evaluating the entire monitoring devices area. “We are evaluating 22 different kinds of devices which people can use on a continuous basis to monitor their health. The idea is to monitor instead of intervene after the problem has cropped up,” shares Ganesh.
Training holds the key
The company is operating in a new category where there are no established practices. “Lack of best practices and experienced people in this space are our biggest challenges,” says Ganesh.
Unlike a hospital, in this business, the healthcare worker pays a visit to the patient at his or her home. Hence, the training of the worker in all aspects – grooming, behaviour, consistency in delivering the service, ability to handle emotionally charged patients – is very important. “This is one of the few places where the person calls you when he or she is in trouble. Logic is not always applied. The caregiver needs to have immense patience and empathy to handle such situations,” says Ganesh. So, Portea’s focus is on training, maintaining quality and consistency in a distributed set up which is remote and where no one is watching. At an organisational level, the challenge is in scaling as the company needs a lot of qualified people.
Since this a manpower intensive business, having good real estate is not important. A company should be able to hire, train, deploy, quality check and scale up its team remotely. With such an operational structure, in the coming years, Ganesh wants Portea to own the entire space of home healthcare. He is confident of taking Portea to the top 50 cities in India, which have a population of more than a million in the next one year.
CONCEPT IN BRIEF
Meena Ganesh and Ganesh established Health Vista India (parent of Portea Medical) in July 2013 to offer home healthcare services to the Indian population. Portea has a network across 18 Indian cities where it offers home visits from doctors, nurses, physiotherapists, nutritionists, counselors and trained attendants and focuses on geriatric, chronic and post-operative care patients using latest technology and tools that make healthcare delivery convenient and affordable. The company also offers medical equipment on a rental basis. It has a staff of around 1,000 people, 100 of whom are doctors and does close to 22,000 visits every month. The company received Rs. 48 crore in Series A funding from venture capital firms, Accel Partners and Ventureast, in December last year. It plans to use these funds to build a technology platform, hire and train people.
Founder: K Ganesh and Meena Ganesh, Dr. Manjusha Anumolu
Funding: Series A of Rs. 48 crore from venture capital firms, Accel Partners and Ventureast, in December 2013