The Great Reset: Transforming Public Healthcare with Technology
“The Great Reset” by Parikshit Jahoorkar, Founder & CEO of Trawely
It was still 6:00 am in London when the phone rang. Half-awake, rubbing my eyes I said, “Hello?” The voice on the other end came in after a pause, “I have COVID.” I instantly recognized the voice and as I sprung on the bed I replied with a deeply concerning tone, “Oh! When did you find out?” I could hear a gulp on the other end fill up the silence like the first thunder of monsoon, trying to find a voice before I heard, “This morning.” The voice was that of my brother in India. Little did we and our family know that the real ordeal was about to come a little more than a week later.
The world went through an immense exercise of throwing out conventional wisdom on how we went about with most routines from washing hands to meeting and greeting others without physical contact to seeing kids have their play dates on zoom. Who would have thought that something very human that had been an essential element of social norm—a simple touch, would become a touchy (pun intended) subject and turn into a weapon of mass destruction. A lot of us woke up hoping it would be a long Steven Spielberg movie that would fade out of our memory with a nice good sleep and everything would go back to normal. With every morning passing by, what seemed like a good Sci-Fi movie started to look like a reality—you look out the window and nothing has visibly changed but deep down you know everything had changed. We went through the Great Reset. And so did my brother battling with COVID.
My Personal Experience Helped Me to Define a Pain Point
A week passed by but the high fever wouldn’t go down. The doctor suggested we wait for three more days to see if it came down before admitting him into a hospital and getting him 24/7 care to contain the COVID infection in his lungs. Three days go by, but the fever had been persistent without any signs of abating. My brother drove himself to the hospital with the fever just to make sure other family members did not contract the infection from him or at the hospital. This was just the beginning of his struggles. After he was admitted into the hospital, he was told there was a severe shortage of Remdesivir—the injection needed to contain his infection that had spread to his lungs. And they needed it in the next two days else it would be too late.
As a HealthTech entrepreneur, I know I am supposed to have a quick techie solution that would solve any health problem, help people in need to cross the proverbial “bridge” and get to the other side, but given the current state of the healthcare industry, there’s just one problem—there’s no bridge! The technology works when the user and the provider both are on either end of it and the technology creates a passageway so either of them can easily cross over to the other depending on the need for a timely resolution of the problem. So, technology is the bridge! And bridges require both ends to have a solid foundation upon which they can mount. Most users have that foundation on their end, it’s called a smartphone with an internet connection.
The problem is the other end, one that the healthcare provider cannot easily fix and understandably so—precisely because having a smartphone is not enough on this end. It requires a network of foundations. And this is the current state of affairs in the healthcare industry that Coronavirus, very promptly exploited and laid bare the lack of foundations for all of us to try and fix.
What We Needed to Cross the Bridge
We had less than 24 hours to procure, ship, and deliver the Remdesivir injections to my brother. We were looking up every doctor we could think of to contact until a dear doctor friend of mine came to my mind that helped us procure 6 vails in less than two hours. We found a human courier, who was preparing for the civil services exam, a prestigious exam in India for a position of high stature and potential to have great societal impact, was kind enough to agree to take a 14-hour train ride from another state, take the rapid COVID test required to show at the border of the state to be allowed to cross over. Taking a plane would have been faster but the airport checks could have created admin bottlenecks in transporting a biological, liquid substance in the air that carried its own risk from the airport authorities’ point of view. Moreover, our kind gentleman wanted to use the time on the train to study on the way. 14 hours later, the vials were delivered to the hospital and administered. Talk about medical tourism in its strangest form!
We created a make-shift human bridge, from our analogy earlier, so people in need could cross over to the other side.
The world has seen several such anecdotes, unfortunately, a lot of them without much of a happy ending regardless of their financial status. Coronavirus like other ransomware does not attack for ransom, making money worthless in times of crisis highlighting that money is not the real currency, health is.
Inducing to a General Solution from a Specific Problem
Sure, we can vaccinate huge swathes of the population around the world until the pandemic is largely contained. But what if there’s another pandemic in a few decades or sooner. This fight is not over yet. Not until there are enough bridges that an elderly lady with a health condition can comfortably cross on her own. Not until somebody without the financial capability can make it to the other side without selling an arm and a leg. Not until there are several more choices than death or bankruptcy.
We, the community of start-ups, VCs, policy makers, governments, healthcare providers can work together to create those bridges so people can preserve their real currency—the health currency. Public healthcare systems in countries like the UK were inundated with COVID-related cases creating a huge backlog of elective procedures with people waiting for more than a year to be treated. The number of people waiting for more than a year has gone up 141 times compared to the same time last year.
With Cleveland Clinic already in the UK, more and more American healthcare companies are eyeing the UK healthcare market poaching NHS healthcare professionals. As more healthcare workers quit NHS to work in private healthcare for higher pay, the wait times will further increase because of the shortage of healthcare workers in NHS. Either the NHS funding will have to be increased which means more pressure on already weak public finances given the pandemic costs to the economy or the supply of healthcare workers will have to be increased which is looking difficult given the “Brexodus” of EU citizens working in NHS. All these woes point to only one thing, public healthcare systems by themselves are not sustainable anymore.
There are rumours that NHS is quietly being privatised. We at Trawely are seeing more and more people opt for private fertility treatments because they have been waiting for an inordinate amount of time, some more than a year, to be treated with no clarity in sight as to when their turn will arrive and so they are willing to pay from their own pocket if they can get private healthcare without any wait times.
What Are the Responsibilities of Healthtech Startups?
There is a solution to this big problem—Public Private Partnerships (“P3”s) in the delivery of care models. Just to clarify, I am not talking about the construction of healthcare facilities using the P3 model. I am talking about delivering quality care not just through NHS and its affiliates, but through a combination of NHS, private players, tech start-ups, venture capital investors, governments, policymakers, bankers, private equity shops, etc through a consortium.
As an ex-infrastructure banker, P3s are tried and tested models in the construction of large-scale public infrastructure projects like dams, roads, public transport systems, even healthcare facilities using the DBFOM model—Design Build Finance Operate Maintain where the public sector assumes the relevant risks and leverages on the private sector’s expertise to bring operating and cost efficiencies.
Healthcare delivery models, on the other hand, either have been largely in the hands of the private sector in countries like the US, giving rise to price gouging, or largely been in the hands of the public sector in countries like the UK, Canada giving rise to waiting lists and backlogs.
DBFOM models can work in Population Health as well with some slight adjustments. The NHS/Government can assume Design function ensuring all the players are aligned with public interests; HealthTech platforms, and startups can assume the Build responsibilities; Health providers assume Operate responsibility; VC, PE funds and investors can assume the Finance responsibility; Health providers, HealthTech platforms, VCs assume Maintain responsibility. This way right incentives are in place at the same time accountability is ensured without any single party taking undue risks (such as the pandemic, where the government takes all the tail risk).
This will make sure the relevant responsibilities lie with entities with appropriate skills, and the participants taking risks are adequately rewarded, aligning every participant’s interests with just one goal—improving population health.
VC, PE funds, and other equity investors get good risk-adjusted returns because some of the tail risks are now borne by the government as opposed to traditionally with their portfolio companies and in turn, by themselves. This can attract more non-traditional risk-averse investors to the start-up space like pension, retirement funds to invest in the consortium through an SPV with a dividend provision that can generate a steady stream of cash flows more appropriate to their mandates and LPs.
Pension and retirement funds get diversification into their portfolio by way of increased access into the tech start-up space but with an investment vehicle aligned with their investment mandate at the same time tapping into the expertise of the VC funds to pick the right tech start-ups to be included in the consortium.
Bankers can get a good return on their loan portfolio. The risk-adjusted returns will incentivize more and more risk capital to flow back into the ecosystem. This unlocks smart capital for the starving tech start-ups opening a huge potential for scaling up and innovation. This alleviates the tremendous amount of pressure currently borne only by the healthcare professionals and transfers the responsibility of Population Health to several other players.
More importantly, the end consumers get a superior experience and pro-active management of their health managed and operated by the entire consortium. Everybody wins!
Providing a Better Public Healthcare with Technological Transformation
As this care model catches on globally, we will have a more inter-connected world from a population health standpoint, and we will be able to spot and nip future pandemics in the bud before they grow into full-blown pandemics.
Trawely is taking steps in this direction with operations in the entire EEA and hopes to alert the authorities of a potential surge in cases, if any, as we continue to grow and strive towards improving customer outcomes with innovation. Recognizing our painstaking efforts, Trawely is being featured on CNBC helping us bring our revolutionary technology to millions of its viewers in the US and 100+ other countries in the world. Let’s use the current pandemic as a wake-up call.
Like the funny saying goes—
Fool me once shame on you, fool me twice shame on me.
First pandemic (in several decades) shame on the virus, second pandemic (in the next few decades) shame on all of us (for not embracing technology to prevent the subsequent pandemics)!
About the Author:
Parikshit Jahoorkar, an ex-Investment banker on Wall Street turned HealthTech entrepreneur having worked in New York, Chicago, Toronto, and London, is passionate about disruptive technologies and leveraging technology to make the world a better place.
About Trawely:
Trawely is revolutionizing the healthcare industry by democratizing access to world-class medical care using Artificial Intelligence through borderless and equitable options. Its innovative artificial intelligence is making futuristic technologies a reality with its virtual personal assistant, ALISA™ — Artificial Linguistic Intelligent Semantic Application. ALISA is a friendly personal caretaker that stays with the patient from illness to wellness.
Trawely’s mission is to bring the best healthcare to every corner of the world regardless of location or financial status, one ailment at a time, starting with fertility – bringing IVF solutions to people that have trouble having babies.
For more information, visit http://www.trawely.com.
