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Running a healthtech startup-Challenges, learnings and triumphs

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The Indian healthcare sector is largely unorganised and the market is mostly out-of-pocket expenditure (unlike developed markets where insurance companies and the government fund healthcare).

Running a healthtech startup-Challenges, learnings and triumphs
Written by: Dr Manjiri Bakre
Entering the healthcare industry isn’t the same as starting an IT or technology company. There has been great progress in India the past decade in logistics, e-commerce and online consumer services, but one area that’s lagging behind considerably is healthcare. The Indian healthcare sector is largely unorganised and the market is mostly out-of-pocket expenditure (unlike developed markets where insurance companies and the government fund healthcare). This can throw up a lot of challenges for health-tech startups.
Some of these challenges are:
Fundraising
: Product-focused startups in healthcare have a long gestation period, it takes years for the final product to see the light of day.  Unlike IT/tech companies, in healthcare the upfront investments are high and product cycles are long. Thus,  the path to revenues is longer. The start-up ecosystem is young in India and primarily IT-driven; in contrast to the West, India lacks “patient capital” which poses a significant challenge for life science entrepreneurs in India. Choosing the right investor is also key. Investors can be great partners in helping you grow, so they must share your medium and long term vision, and their goals should be aligned to that.
Collaboration: Working with hospitals can be a huge challenge. It makes it even harder when the company has no track record. Convincing doctors about the science and technology behind your product is the key to get them interested in working with your startup.
Unlike developed countries, conducting research studies in India can be challenging since clinical trial frameworks are not as well established. In India, you may have to approach many hospitals before seeing any success.
Some of the reasons for this are:
  • The doctor-patient ratio in India is well below the developed world leaving them with little time to focus on research studies.
  • Lack of documented and electronic patient records and follow-up makes it difficult to conduct studies that require longitudinal data. Patients often move back to their hometowns after treatment and are lost to follow-up as historically there is no insurance tie up to keep track of them. Robust data makes for a robust AI/ML algorithms, otherwise, its garbage in, garbage out.
  • Lack of enforcement and encouragement of the importance of research studies, clinical trials, detailed documentation from government and regulatory authorities.
  • Navigating regulations: Healthcare is also a highly regulated market to ensure that patients get the best possible outcome and in today’s times, their privacy is protected. The amount of verification and validation that healthcare products need to undergo can be a massive and prohibitively expensive undertaking for a startup. The quality and regulatory approvals needed not only to run your business but also to give you a competitive edge, can spell difficulty for many startups. The process of knowing, navigating, and abiding by these regulations is challenging and expensive. The Indian medical device regulations have undergone a lot of changes over the last couple of years and this has not been easy for start-ups to navigate.
    While there are a number of challenges to overcome, the whole experience of building a healthcare startup leaves you with important learnings and life lessons
    Some key learnings are:
    1. Keep “updating” your product/offering: Other than continuing to improve the robustness of your product, keep working on how you can continue to value-add with your product. In healthcare, it is not enough to have a great product. You need to create awareness and reduce the friction of payments by working on things like insurance coverage or other forms of financial assistance.
    2. Be patient and persevere: As a start-up founder, you’ll find that you need to work with established companies/institutions from the get-go. Just like no man is an island, no startup can function like one. It does take time in the healthcare sector to build a successful business but perseverance always pays.
    3. Build the right team: Building the best team is imperative. Given the complexity of building and implementing healthcare innovations, you will need to build a team that understands the ins and outs of healthcare and its regulations at every stage of the company. An experienced strong team can give you exponential growth.
    4. Get the right advisors and consultants: Have the right mentors. Having a mentor from the same industry translates to having a ready reckoner of what lies ahead in terms of business problems, difficulties and challenges. This type of mentor can ideally give you the best possible solutions to avoid or overcome them.
    5. The triumphs are multifold—going where no one has gone before, building a product that fills a gap in the market and has a big impact on the lives of patients is very rewarding. The right technologies can not only save the lives of patients but also really help improve the quality of their life. Health-tech can be a game-changer which directly touches the lives of people.
      —Dr Manjiri Bakre is the CEO and Founder, OncoStem Diagnostics. The views expressed are personal
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