Last week, four UC Berkeley MBAs flew 8,700 miles to Bangalore, India, to innovate mHealth business models for the country’s remote hinterland. As part of a course in international business development, the Berkeley team is consulting with Foundation Research on Health Systems (FRHS), a not-for-profit NGO operating in Dehli, Ahmedabad and Bangalore. In operation since 1989, FRHS has been developing surveillance programs leveraging health information systems to monitor and care for women and children in rural India, focusing on strengthening the existing health system across the country. It seems intuitive that mHealth could augment the effectiveness of India’s healthcare given the rapid penetration of mobile devices and infrastructure disparities between densely populated cities and the rural countryside. Equally salient are the significant opportunities for business and social change if mobile app developers can meet the needs of hundreds of millions of rural inhabitants. Thus, it is in this promise for better patient access to care that the developing world holds valuable lessons about bringing health innovations to new markets.
The first lesson from the FHRS effort is the need for sufficient access to financial and intellectual startup capital – a must for entrepreneurs operating even in the wealthiest economies. With a grant from the Welcome Trust and partnerships with the World Health Organization and the Columbia Earth Institute, FRHS has the resources necessary to pilot these programs in a challenging environment. The Earth Institute, for example, had successfully piloted similar programs in Kenya, and lent considerable expertise to the program in India. These resources are made all the more critical by the fact that although consensus opinion perceives vast potential for NGO mHealth initiatives, many such programs die within two years. Shut down is often due to a lack of infrastructure to measure and evaluate performance, leading to funding shortages before a sustainable business model can be implemented around real world results. Sound familiar? A similar story could be told about many healthcare ventures in mature markets, whether as part of VC-funded start-ups or growth business units in market leaders.
As such, the second lesson that may be observed from the FRHS effort is that start-up capital for innovative technology is not enough. A realistic business model must be in place from day one for a new commercial offering or not-for-profit program to thrive. In the case of FRHS, while management hails from some of the foremost public health and technology organizations, little consideration was historically given to effective models for sustaining and scaling their operation. Management wisely recognized this gap, and reached out to partner organizations, including the Berkeley-Haas School of Business, to help develop a market sustainability model. To accomplish this, the Berkeley team first characterized the drivers of FRHS’ value proposition by leveraging a suite of innovation concepts, such as design guru Alexander Osterwilder’s business model canvas. By examining opportunities for partnerships, supply chain efficiencies, and feature set development, the team is working to help FRHS realize self-sufficiency as it engages with donors and government in one of the world’s most populous and rapidly growing nations.
In this process of engaging FRHS and their customers is the third lesson of the FRHS effort. The creation of applications that customers not only realize they benefit from, but also are customized to their specific culture, socioeconomics and health needs must be the singular focus of any HIT app developer. Regardless of what patients or markets they serve, if customers can’t seamlessly integrate a new tool or toy into their daily lives, precious innovation is wasted. And so, after arriving in Bangalore, the team traveled 150 kilometers to Mysore, to meet with physicians and community health workers far outside the city. For three weeks, they will perform a detailed customer needs assessment for rural communities that rank among the world’s most dispossessed.
To be sure, many aspects of Indian healthcare are vastly different than in the US, but in this sense, healthcare ventures in the Indian interior operate in a strikingly similar way to those in Silicon Valley. Even where low literacy rates and sporadic access to health services hinders care for countless millions, the process of translating a technically adept application into an intuitive, patient-friendly product requires forethought, resources and time. Sometimes, strategies for serving the top of the pyramid can also be applied to the base. Savvy commercial innovators realize that rich or poor, the same basic biological and social pressures mold our behavior. People are people, and as such, it shouldn’t be surprising if business models launched halfway around the world to increasingly find new markets close to home.
MBA/MPH Candidate 2012
Haas School of Business
University of California, Berkeley