With its innovative approach, this startup has introduced a new way to provide healthcare services to the people.

At a time when people are virtually locked up in their homes due to the restrictions in place to stop the possible spread of coronavirus, accessing healthcare services has become problematic for many. To relieve people from such problems, a startup is working to provide healthcare services at homes. In association with the Ncell, Health At Home has been running telephone triages to assess the health inquiries of people across the country. “People get free counselling from medical professionals about their symptoms of coronavirus. We want to reach rural areas with no direct access to doctors. For this reason, we started telephone service instead of an app,” says Dr Bishal Dhakal, founder and Director of Health At Home.

The company is also handling the ‘consultant on-call’ service through which people can consult them on dermatology, psychiatry and other problem areas via telephone. The venture is collaborating with around 20 doctors from various hospitals.

Inception
“Back in 2009, the idea of home-based care was completely new in South Asia as medicine was considered a service rather than an enterprise,” remembers Dhakal. He had completed his MBBS from Saint Petersburg Medical Academy in Russia. After that, he went to Lahore, Pakistan for his cardiac surgery residency. During the residency, he realised that many patients needed prolonged treatment and care even after treatment, for which they had to visit hospitals frequently. He researched and studied how such services could be taken forward. Coming back, he started approaching people to bootstrap his project. With time he also realised the need for social entrepreneurship in the health sector.

Currently, Health At Home has 150 clients. The clients consist of people who are bed-bound, are in a terminal state, dependent and with long term diseases like Alzheimer's and Parkinson's.  

Health at Home has received recognition with the Surya Nepal Asha Social Entrepreneurship Award 2012 for institutionalising professional home-based healthcare services that need frequent health attention.  

Mobilising Social Media
From mobilising immediate relief groups during the 2015 earthquake to spinning up campaigns for emergency collection of N95 masks and ventilators, Dr Dhakal has been embracing social media during the recent crises in Nepal.

As social media has metamorphosed into a viable communication tool for everyone over the years, Dhakal strongly believes in the power of social media, especially during the time of emergencies. “Running a social enterprise, we have some responsibilities in society. So, I have been continuously expressing those concerns on social media. And many such challenges have been solved,” says Dhakal.

Dhakal has been raising issues on doctor’s safety and collaborating with acquaintances to provide emergency shelters to the health professionals on the frontline of the coronavirus fight. In collaboration with Nepal Critical Care Development Foundation, Dhakal has also been fundraising equipment to establish ‘Nepal Ventilator Bank’. “Nepal currently has around 700 ventilators and we need 5000 ventilators to ensure that all Nepali have access to critical care,” says Dhakal.

“We are a for-profit impact organisation. We do profit-making and redistribute it to society in different ways,” states Dhakal.  

Modus Operandi
Apart from all COVID-19 centric volunteer activities, Health At Home has been continuing home visits of patients. “We haven’t done vigorous marketing, but have been managing the home care service,” informs Dhakal.  

The healthcare startup facilitates a range of personal care and support service including doctors on call, nursing care, vaccinations, pharmaceutical equipment, medicines, lab on call, equipment on rent, physiotherapy, counselling and therapy, appointment management with doctors, and travel and escorting. The health enterprise provides generalised care in areas including neurology, orthopaedics, pregnancy, child, old age, critical care with limitation in emergency service and hospital surgery. “Being more human resource-driven, we are agile and scalable,” says Dhakal. Once a patient is enrolled, they get 24/7 health care facilities at their home. The company has employed around 200 staff including health professionals. Apart from Kathmandu, Health at Home also provides its services in Pokhara, Itahari and Biratnagar and is soon planning to extend services in the western part of Nepal as well.  

Growth and Investment                      
It took Dhakal three years to stabilise the idea and three years to make an enterprise model. Also, he was unfamiliar with concepts such as a balance sheet, taxation, invoices and other aspects of a business. “I studied entrepreneurship and adapted the entrepreneurship ecosystem. This way, it took more than five years to realise that I am a business guy,” he shares.

Recently, Health at Home signed an investment agreement with Business Oxygen Pvt Ltd (BO2), a private equity fund. “Health at Home is a social enterprise with a holistic approach in the health industry as it provides most services from one platform. We invested in this company so that it can scale up and make more impact,” says Siddhant Pandey, CEO of BO2.

According to Pandey, the shareholders agreement was signed around two months ago and the investment is yet to be realised. “We are waiting for FDI approval,” he says. According to him, BO2 has a 45 percent stake in the enterprise now. BO2 has already started providing technical assistance to Health At Home. With BO2’s investment, the enterprise will add ambulance services, set up a pathological lab, diagnostic centre and invest in more health professionals. “We are looking forward to making the platform stronger with technology,” says Pandey.

Dhakal shares that one of the reasons behind the success of Health at Home is that it has been consistent in what it has been delivering. “Because you can’t experiment much in the health care sector, we keep adding service lines,” says Dhakal. He believes that as a founder of a startup one must be able to understand the hustle in the industry and also should have the individual capacity to transform the industry. Being a pioneer of home healthcare service, now Dhakal sees an exemplary growth in the industry. “There are around 50 similar institutions. And 30 percent of the founders have worked with Health at Home earlier,” he says. According to him, there are currently 5,000 jobs in the home health care industry in Nepal.

The company is planning to add more verticals to the service, especially to access the rural areas, while also focusing on its own institutional restructuring. Dhakal says that the service model of Health At Home will gain more appreciation with the risk being there for the next few months or years. “This will be especially crucial for elderly people who are not immune to the virus but also face other health risks,” he adds.