Towards An Untraded Mission - EHEALTH

Towards an Untraded Mission - eHEALTH
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Towards an Untraded Mission eHEALTH

Read more on:Bhagat Chandra Hospital | chronic kidney disease |
delhi | Ganga Ram Hospital | incubation | India | kidney disease |
MD | NCR | Sharmila Das
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Aseem Garg,
MD, DCDC
Aseem Garg, MD, DCDC Kidney Care could not resist himself from
venturing into the unknown when he was well placed in a cushy
job. Inspired by the demand-supply gap in the dialysis scenario of
Indian healthcare, he envisioned DCDC Kidney Care. He shares
his thoughts on the dialysis care in India with Sharmila Das, ENN.
What was your eureka moment to launch DCDC Kidney Care?
I was very clear of my intention when I was pursuing studies in
IIM-Bangalore that I wanted to do something in the social space
that too either in education or in healthcare. I wanted to be an
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entrepreneur; reason being never took any bank jobs or

employment with any consulting firm. During the second year of
my management studies I was making business plans. I enrolled
myself in social entrepreneurship course in the second year of the
course. Around this time two things happened, one: I took this
course and second: Professor CK Praladh came to campus and
gave a very rewarding speech on bottom of the pyramid. These
are couple of factors that really moved me. Accordingly, I made
some business plans both in education and healthcare. In
healthcare, dialysis as a concept struck me. It was a fairly
established method of treatment outside India. Here you can
probably count the number of dialysis centers on the finger tips.
So there was an opportunity that nobody was tapping into and the
concept could save many lives National Kidney Foundation, having
a chain of 24 dialysis centers in Singapore, visited our campus
and I apprised them of my objective and business plan. I joined
them for professional experience and thats how this transition took
place.
Did you get any incubation help from IIM Bangalore?
No incubation help per say. We had a strategic teaching course
with a faculty there. When I made this business plan back in 2005, I
discussed it with him and he encouraged me saying it is a good
concept and a lot of companies in US are looking for it. So
probably the discussion helped me, but I have not leveraged the
incubation facilities of IIM- Bangalore for this.
Tell us about DCDC Kidney Care? What are the exclusive
medical services you offer?
We offer a normal, peaceful environment in which we provide
dialysis services. One dialysis session takes four hours and 2-3
sessions in a week are recommended for a kidney patient.
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Naturally, getting dialysis done in a hospital environment can be a

bit taxing psychologically for the patient so we need to create a
homely environment. Therefore at DCDC, we have beds, we have
entertainment facilities like individual LCDs, video
programs, movies, play stations, WIFI connectivity and the like. The
idea is to make and feel the patient that they are not in a hospital
but settled in a very homely environment. If the patients want they
can watch movies, they can work on the laptops and most of
our patients work on the laptops during their stay at the center.
What is the fee you charge for each session?
On average, it works out only to be Rs 1500 which is much cheaper
than the corporate rates available. If you compare it with the
corporate set-ups like in Fortis, the average dialysis fees is Rs
3000, in Apollo it is again Rs 3000, even a charitable trust like
Ganga Ram Hospital is doing it at Rs 2400. So we are almost 40 to
50 percent cheaper than the regular corporate worlds and providing
the same quality.
How many dialysis sessions you have in a month?
We are doing close to 5,000 dialysis sessions in a month that
makes us one of the biggest player in this field.
Are all of your centers located in Delhi?
Yes, we have presence all over Delhi, NCR and we have one
centre in Panipat, Haryana. In next 20 days we are opening two
centers in Jaipur and one in Ludhiana and one in Hissar. So we will
have 12 centers by the end of this month. What are your views on
the current state of kidney disease in India or kidney related
problems in India. Kidney related disease has been a neglected
field till now mainly due to the lack of awareness and poor
affordability but the scenario is changing now and more and more
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people are getting aware. Kidney disease is purely a lifestyle

disease. People come to End-Stage Renal Disease (ESDR) and
for dialysis because of their lifestyle hazards. If they had adjusted
their lifestyle and had they taken proper precautions then this
thing would have never ever happened. Almost 85 -90 percent of
the cases are due to blood pressure and sugar related issues.
These days, diabetic and hypertension related problems are
increasing. However, as more and more centers are emerging
naturally the numbers of doctors are also going up and they are
spreading more awareness. Due to this people now are able to
take better care of themselves. Lately, health insurance have
started covering kidney diseases, so the affordability factor is also
slowly and steadily started getting resolved. We are hoping that all
regulatory factors would come in to play and will have much better
service offerings going on.
How a kidney patient should take care of himself or herself?
A kidney patient shows some symptoms of this disease. If
somebody is in stage one or stage two the body does not show
enough symptoms and whenever little symptoms are shown
patients tend to ignore them. Ultimately prevention is the best cure.
A patient should be able to detect the symptoms at the beginning
itself so that they can adjust their lifestyle accordingly. The way to
do is getting blood test done once in a year so that they can find out
if there is something wrong with the body or not. Once it is clear
that a person is into Chronic Kidney Disease (CKD) and going to
get into dialysis, he needs to adjust his lifestyle. A proper diet
control needs to be taken care of along with proper psychological
sessions so that his mind is happy. Proper consultation with
physicians and nephrologists should always be in place. We have
designed a program to encourage our patients to take employment
because after sometime kidney patients get depressed. We
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have seen family members discouraging patients by saying you are

sick and you dont need to work you just lie down etc which is a
wrong approach to heal the disease. We encourage our patients to
get out and get a job and we offer them discounted treatment fee if
they get a job. So its like a double benefit for you. Firstly you will
be contributing to the family, your family will start respecting you
more and that will boost your self esteem and you will also feel you
are not a burden on any one and you will live a life with dignity.
The center which you have started is exclusively a dialysis
center or you provide some other services too?
We provide certain support functions like psychiatric care to help
cure the depressed minds and dieticians are here to give balance
diet plan also.Apart from these, do you cover diagnostic part also
like MRI? No, we dont. However, we have regular blood tests
facilities. Normally, we outsource other diagnostics services or for
five centers we make a central hub wherein we provide a lab but for
other centers we are mainly 90 percent in dialysis.
Kidney disease is purely a lifestyle disease. People come to
End-Stage Renal Disease (ESDR) and for dialysis because of
their lifestyle hazards
How do you get your patients from hospitals?
We organise a host of on-field activities. In the recent past, we
organized a lot of seminars, kidney care camps etc. We tried
advertising, but I think healthcare is not suitable for newspaper
advertising. So I think for us, its the on- field activity to engage
patients, educating them about the disease, holding a lot of
preventive camps etc help us to get patients from different
hospitals. Like the radiology companies outsourcing their
radiologist, complete MRI setup to different hospitals, are you also
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in touch with the hospitals? We are already doing that. We have

taken over entire dialysis department of different hospitals and a lot
of hospitals are outsourcing their dialysis need to us. For example,
we have our dialysis set up in National Heart Institute, they did not
have dialysis department earlier. Also, we have our set up in Kalra
Hospital and in Bhagat Chandra Hospital. Actually out of our total
eight centers in Delhi, six are outsourced departments to hospitals.
What are the technology advancement happening in this
field?
From technology point of view, we have the latest machines that
are available overseas. Dialyses are getting much safer and it has
started getting more acceptances. There is no breakthrough
technology till now because dialysis as a process is made to be as
peaceful and painless as possible. I think the most successful
innovation would be the artificial kidney transplant which will take
away the need of dialysis completely. We are now also providing
home dialysis to the patients. If the patient opts for home dialysis,
we reach their home with our machines, technical supports etc. We
are actually innovative in our service delivery. We are
offering mobile dialysis for the patient who is not able to commute.
We fit one ambulance with the requisite machines, doctors and
technicians; they visit the patient at his place or any other
place and provide the dialysis. What are the challenges you
have faced to setup DCDC Kidney Care? The biggest challenge
was from the fraternity itself as we are not doctors but outside
people and getting into dialysis and bringing a lot of disruptive
innovations. There was a lot of resistance from nephrologists,
from established doctors, they were very skeptical about how this
process can work both in a standalone setting and in a hospital
setting, because any kind of change is scary specially for
the people who are involved in it. It was mainly the fear of the
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unknown, how the market will approach; whether their role

becomes less important etc many doctors opposed us. We fought
those challenges and ensured that the We faced some regulatory
hurdles too.
On issues like how you can start a standalone dialysis center etc.
We tried to liaison with the Government to make them understand
that there should be regulations to govern this. Fund raising was
always a problem, getting patients to the dialysis center was also a
problem as patients used to think that it was a specialty
treatment and they need to go to a hospital only not to a standalone
enter. Now we observe the level of acceptance that hasbeen on
the increase. model works.
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