New Delhi: Everyone takes care of their health, very few people take care of their health records. Harsh Parikh and Sohit Kapoor have had personal experiences of dealing with missing health records that created a lot of avoidable issues and stress for their families. Unlike in the US, where the network of the health insurance provider maintains the medical records of patients, in India, the only aggregator of medical records is the patient herself.
Given their personal experiences and the desire to help digitise healthcare in India, the duo decided to build a user-centric personal health locker, DRiefcase, in late 2015 and launched it in early 2017. This was after careers as investment bankers at Bank of America-Merrill Lynch where each spent nearly a decade.
Kapoor is a computer engineer from Mumbai University and an MBA from IIM-Bangalore. At Bank of America-Merrill Lynch, he led the corporate finance, M&A & financial sponsors coverage teams. Parikh is a chartered accountant and an MBA from IIM-Bangalore. His role at BoA-ML involved covering clients across consumer goods, building materials, metals & mining sectors. Apart from being colleagues, they had studied and worked together. So their relationship of nearly two decades was a natural bond to their entrepreneurial association also.
Parikh says DRiefcase is a complete health-tech platform anchored on the Ayushman Bharat Digital Mission (ABDM). “The ABDM, a key project of PM Narendra Modi, is a health information superhighway that connects everyone associated with patient care, with explicit patient consent. So, if you are consulting a doctor at a hospital and the doctor wants to access a health check-up done at any other lab, it can be done with a click,” Parikh says.
DRiefcase has built ABDM-focused solutions for patients, doctors, and healthcare as well as insurance enterprises.
“Firstly, DRiefcase is India’s first ABDM approved PHR (personal health records) app. Users can manage their entire ABDM journey through DRiefcase – create ABHA, register with hospitals through QR code, consent handling and health records management. If ABDM is the UPI of healthcare, then DRiefcase is the Google Pay,” says Kapoor.
Then there is DRiefcase Connect, an ABDM integrated practice management solution for doctors. This platform acts as an ABDM gateway for individual doctors, polyclinics and small hospitals and helps them improve productivity and manage their practice.
Parikh says the implications of truly connected digital healthcare are immense. Better quality of care, superior patient experience, cheaper and faster insurance processing, and ultimately universal health coverage.
“We have seen the transformative effect of UPI over the last few years. We believe ABDM will be even more transformative than UPI. The success of ABDM depends on adoption by various stakeholders, with patients being the key element here. PHR apps (like DRiefcase) have a tremendous opportunity as they will play a critical role in connecting the patient to the ABDM,” he says.
Kapoor says numerous healthcare apps provide users the functionality to store their medical records. But they expect the user to put in all the hard work. So those apps never take off.
“We provided users with multiple easy options to upload their records (email, WhatsApp, courier pickup and physical scanning at home). Further, with our proprietary indexing feature, users could find any record in their account in less than 10 seconds. Given our understanding of the space, the architects of ABDM invited us to help them design parts of the ABDM framework,” says Kapoor.
What also helps users is that DRiefcase has developed a proprietary method of scanning X-Ray and MRI films in a low-cost manner. This allows users to store not only the reports but also the films in their DRiefcase health locker.
Refusing to disclose the numbers, Parikh says DRiefcase had minimal revenues last year. According to Tofler, the company clocked about Rs 4 lakh in revenues in the year ended March 31, 2022 — a 65% rise from a year ago.
Ease of use for subscribers
Waiting in a queue to get the doctor’s appointment at a Navi Mumbai Hospital recently for her relative’s checkup, Kavita Kelkar noticed a board that read “scan-and-share” for fast-track OPD registration. “I was curious to know about it so enquired at the desk and that’s when I happened to know about DRiefcase. I installed it and realised it’s time saving, as you need not stand in the long OPD queue. You can just scan the QR code at the hospital and it’s done,” says Kelkar.
Kelkar, who suffers from thyroid for many years, says managing her health records was a real challenge. “With multiple doctor visits, lab reports, and medication changes every few months, it was difficult to keep all my health records organised. But the DRiefcase app made life easy for me. I have been using the app for some time now and I find it very helpful because all my family’s health records are now stored on DRiefcase and can be easily accessed with just a few taps on my phone,” she says.
Bullish on Ayushman Bharat
DRiefcase is a free app and is available on PlayStore and AppStore. Users can create their ABHA in three quick steps. DRiefcase also has an on-ground team in some of the largest hospitals across India. This team helps patients get onboarded on ABDM and use the QR code-based fast OPD registration service that has been launched in around 500 hospitals across India.
The founders are confident ABDM will transform healthcare in India and have aligned the business towards India’s digital health mission. “The first public use case of ABDM, the QR code-based fast OPD registration, was launched around November 2022 and in a brief span of six months, DRiefcase has onboarded more than a million users. Further, our ABDM Connector is getting a very positive response and various large and small enterprises have shown a strong interest in it,” says Parikh.
Sandip K Rane, Interventional Cardiologist, Founder Mumbai Heart Clinic, and Promoter-Director Asian Heart Institute, says he was particularly impressed with the way DRiefcase Connect can help improve patient care and manage hospital workflow. “For example, the platform allows doctors to easily access patient records, which can help them make better diagnoses and treatment decisions. Additionally, DRiefcase Connect can help doctors communicate more effectively with patients, which can lead to improved patient satisfaction.”
Rane says he has seen a significant impact on his work where workflow has not only been streamlined, but has also ensured that the hospital has a digital record of all documents and videos. “We have a vision of being India’s first paperless hospital, and DRiefcase is helping us achieve that goal,” says Rane.
Digitisation of healthcare in India is not a new phenomenon. Various companies have tried to digitise aspects of healthcare. There have been good results in some aspects–doctor discovery, e-pharmacy, teleconsulting. Some other aspects have not shown much improvement.
“All the past efforts have largely been siloed and driven by individual companies. ABDM is changing that. Healthcare digitisation is now a national mission backed by the government. We believe that this augurs well for the ecosystem and we will see rapid developments in the digital healthcare space in India,” says Kapoor.
Electronic medical records and quality of care
The founders say better access to a patient’s medical history helps health care professionals across disciplines prescribe more appropriate and effective interventions. Further, remote monitoring of patient health and continuity of care can lead to significant improvement in productivity of doctors and nurses–important for a country like India where many regions have extremely low per capita availability of healthcare professionals.
According to Parikh, the most gains that healthcare professionals can make from health data is in the development of artificial intelligence to assist doctors in better decision making. “The biggest challenge yet to be overcome in large-scale implementation of AI in healthcare is the availability of statistically relevant data in each potential outcome to arrive at any prognosis scientifically. While use of AI as a decision-making tool has made some head-way in certain therapeutic areas, we have only scratched the surface on its potential to help predict outcomes and increase the effectiveness of treatments,” he says.
Business of health
DRiefcase says the first 3-4 years of its journey was spent in building the market for health lockers. “For the last 3 years, we have been focused on ABDM. In this period, we have integrated three solutions in ABDM. Today, DRiefcase PHR app has over 1.2 million users. Further, our ABDM connector has powered two enterprises in their ABDM journey,” says Parikh.
DRiefcase has three primary revenue streams right now: the PHR app that provides healthcare services for users, DRiefcase Connect that has a subscription fee from doctors and the ABDM Connector, which charges a licensing fee from enterprises.
Parikh says there is strong interest in the ABDM Connector. With the company planning to launch healthcare services like e-pharmacy and labs by integrating partners on DRiefcase, it is targeting a robust revenue build-up in the current year.