Market potential analysis of Healthcare Information Service in Kolkata

(A Report Submitted in Partial Fulfillment of the Requirements for the Post Graduate Diploma in Business Management in, Kolkata)

Prepared by: Roll No: PGDBM:

PRADIP MUKHERJEE.

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INSTITUTE GUIDE

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CONTENTS
Table of Contents

EXECUTIVE SUMMARY .......................................................................................................... 5 INDIAN HEALTHCARE SECTOR ............................................................................. 6-10

OVERVIEW & TRENDS Structure / Market size KEY DRIVERS RESPONSIBLE FOR THE GROWTH
. Healthcare Trends and Investments
6

7-8 11-14

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EXECUTIVE SUMMARY

This report is prepared for Industry internship project at Religare Technology in Kolkata, India. This report is a Healthcare information service plan . This project is about the market research on Healthcare Facilities in Kolkata and scope of healthcare business in the market. It is also about the study of awareness creation of HealthLine 24x7 in both business and consumer markets. It is no secret. Healthcare is in crisis - high costs, poor or inconsistent quality, and inaccessibility are potentially catastrophic. In virtually every country, the growth in healthcare demand is increasing more rapidly than the willingness and, more ominously, the ability to pay for it. If left unaddressed, financial pressure, service demands driven by aging populations and other demographic shifts, consumerism, expensive new technologies and treatments, and the increased burden of chronic and infectious diseases will cause most countries to reach a breakpoint. . People living in Kolkata find difficulties in locating & consulting a doctor,ambulance,bloodbanks & other healthcare service provider mainly outsiders, until and unless they are living in that specified area for a longer period of time. To cater those problems,Religare Technology came up with a solution by building a Healthcare Information Exchange System. Therefore there is a need to make both the healthcare service providers and the common people aware of the platform which HealthLine 24x7 provides to bring them closer with just a web search or a voice telephonic call. This Information System not only provides the information about medical service providers but will also help in monitoring and improving the health of people. Awareness in the business markets is all about making all the healthcare service provider know what Healthline 24x7 is all about and what they expect from Healthline24x7 therefore a corresponding analysis is done on the basis of the indepth interviews with the healthcare service providers and also the data collected by filling up the questionnaire similarly in consumer markets awareness is done in society and schools to make people aware that there is a one stop health care solution available to them for various health related problems.

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INDIAN HEALTHCARE SECTOR I. OVERVIEW & TRENDS

The Indian healthcare industry, unlike other industries, stands untouched by recession. There had been a steady growth in this sector, revenues from the healthcare sector accounts for 5.2% of the GDP, making it the third largest growing sector in India, and further the healthcare sector is projected to grow to nearly 1,80,000 crores by year 2012 and a compounded annual growth rate (CAGR) of 15-17 percent for at least the next 7-10 years. In India healthcare is delivered through both the public sector and private sector. The public healthcare system consists of healthcare facilities run by central and state government which provide services free of cost or at a subsidized rates to low income group in rural and urban areas. With the Indian economy enjoying a steady growth, the industry is heading towards growth phase. The introduction of product patents in India is expected to boost the industry by encouraging multinational companies to launch specialized life-saving drugs. Attracted by the advantages such as lower costs of production and skilled workforce that India offers, these companies are looking to set up research and development as well as production centers there. There are some economic factors which make India such an exciting market. Since healthcare is dependent on the people served, Indias huge population of a billion people represents a big opportunity. The middle income group in this vast base is also a large above 300 million and the Demographics of Middle Income Class in India is expected to grow to 400 to 500 Million by 2015. India spends only 1% of its GDP on health, translating into $55 per capita. France spends 10.4% and Japan 8%. A significant portion of the population receives inadequate or no health care, specifically 25.7% living below the poverty line and those who have only the public health system to rely on. National Family Health Survey estimates 473 deaths per 100,000 women; higher than Cambodia, Bolivia and Botswana. India accounts for 20% of the world's maternal deaths, with a woman dying every five minutes. 20% of deaths of children worldwide under the age of 5 occur in India. The private healthcare sector in India accounts for major percent of total healthcare expenditure in the country
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and is one of the largest in the world. Indias healthcare sector, however, falls well below international benchmarks for physical infrastructure and manpower, and even falls below the standards existing in comparable developing countries.

II.

Structure / Market size

The sector comprises hospital and allied sectors that include: (a) Medical care providers that includes physicians, specialist clinics, nursing homes and hospitals (b) Diagnostic service centers and pathology laboratories (c) Medical equipment manufacturers (d) Contract research organizations and pharmaceutical manufacturers (e) Third party support service providers

In India, 80% of all the healthcare expenditure is borne by the patients. Expenditure borne by the state is 12%. The expenditure covered by insurance claims is 3%. As a result the price sensitivity is quite high. The high level healthcare facilities are out of reach for the patients. Among the top five therapeutic segments, gastro-intestinal and cardiac are experiencing both high volume and value growth. Opthologicals, cardiovascular, anti-diabetic and neurological drugs continue to top the growth list. The anti-infective, neurology, cardiovascular and anti-diabetic segments have witnessed a high number of new product launches in recent years.

Current Healthcare Landscape

Amount spent on healthcare - 103,000 crores / annum 86,000 crores is the Healthcare delivery market 17,000 crores is the Retail pharma market

Key findings of current private spending

Private spending on healthcare delivery 69,000 crores

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61 % of this is spent on OPD services, 44,000 crores Indicates low levels of affordability and a disease pattern dominated by infections 39 % on IPD services = 25,000 crores 85 % of IPD spend is in 5 areas : cardio, cancer, accidents, infections and maternity

Road Ahead 2012

Private spending on healthcare delivery 156,000 crores because of an increase in population will lead to increase treatments Change in socio-economic mix will lead to 8 % increase in treatment rate and 30 % increase in avg. price paid Change in prices 26 % increase in price per treatment Change in mix of diseases 50 % increase in prevalence of lifestyle diseases will lead to 12% increase in treatment rate & 7 % in price and this would lead to a change in GDP from 5.2%to 6.2% Richest 15% will account for 50% of all private healthcare spending & 60% of inpatient spend Private spending would increase by another 39,000 crores if the insurance is likely to impact on middle-income households approx. 350 million in 2012, leading to achieving GDP spending to 7.5% and private spending on healthcare delivery to 195,000 cr.

Given the growing demand, the emergence of reputed private players, and the huge investment needs in the healthcare sector, in recent years, there has been growing interest among foreign players and non resident Indians to enter the Indian healthcare market. There is also growing interest among domestic and international financial institutions, private equity funds, venture capitalists, and banks to explore investment opportunities across a wide range of segments.

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Healthcare Fact File

Parameters No. Of Beds No. Of Doctors No. Of Nurses Infant Mortality Rate Current 1.2 beds per 1000 50,00,000 doctors 0.8 per 1000 34:1000 By 2012 9,14,543 In addition 6,25,130 In addition 8,36,000 In addition 10:1000 1 :1000 50.00% 156,000 Crores 82,000 Crores

Maternal Mortality Rate 4:1000 % of population Insured 12.00% Total Private Spending OPD Spending Hospitals 69,000 Crores 44,000 Crores

30,000 hospitals approx 17300 In addition 1,64,000 In addition

Primary Health Centres / 1,50,000 approx Community Health Centres Retails chemist outlets Medical Colleges Current market size 3,50,000 229 103,000 Crores

24,000 In addition 179 New 1,80,000 Crores 74 years

Average life Expectancy 63.3 years

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350

300

250

200

150

100

50

0 2008 2013 2018 2023

Figure 3.1 Indian Healthcare Market Sources: 1: Ten industry trends 2009, Technopak healthcare outlook, 2009, p. 1 2: Fostering quality healthcare for all, Ernst & Young, 2008 3: Ministry of External Affairs India.

The Indian healthcare industry is set to grow rapidly this decade due to following reasons: i. ii. iii. iv. Rising life expectancy Higher Income levels Health Insurance proliferation Growing incidence of lifestyle-related diseases

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III.

KEY DRIVERS RESPONSIBLE FOR THE GROWTH

The key issues driving growth in the healthcare industry have been identified as follows: 1) Population Growth- This is the prime driver of growth in the healthcare sector. With the population currently at 1.1 billion and increasing at the rate of 2% p.a., it is estimated that by 2050 the population will reach 1.6 billion.1 This massive population is due in part to a decrease in infant mortality (in turn a result of better medical facilities and government emphasis on eradicating diseases such as hepatitis and polio among infants), a general increase in life expectancy, greater affluence among people and better hygiene. This way a growing elderly population will soon place an enormous burden on Indias healthcare infrastructure. 2) Expanding Middle Class- Parallel to Indias thriving economy is rapid urbanization and creation of an expanding middle class with more disposable income to spend on healthcare. With women entering workforce, purchasing power and thus affordability has increased and people can buy western medicines. 3) Rise of Diseases- Two kinds of diseases are largely prominent among people these days-one is communicable diseases and the other chronic degenerative diseases. While infectious/communicable diseases such as polio, hepatitis, tuberculosis, pneumonia were thought to have been brought under control via the extensive government programmes however now they seem to have resurfaced or have developed a rather stubborn resistance to drugs. Another problem that seems to be on the rise these days is AIDS. Among the urban population there have been a significant number of health problems which may be called lifestyle diseases. Unhealthy diets, sedentary work and affluent lifestyle has given rise to hypertension, cancer, diabetes, obesity etc. Lifestyle disorders are expected to grow in the future at a faster rate than infectious diseases in India and to result in an increase in cost per treatment. 4) Medical Tourism- With specialty and super specialty hospitals equipped with the latest equipment and the best surgical procedures at relatively inexpensive charges on the rise has made India a hub for people from the west to get treatment here-giving birth to a concept called Medical Tourism. With the healthcare costs increasing in many developed nations and the time for waiting for a procedure also
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increasing, especially in Britain, it is expected that the medical tourism industry will grow. 5) Emerging private sector It is more focused on tertiary-level as wells as preventive and diagnostic healthcare and is sensing a huge untapped opportunity in delivery of quality healthcare to the Indian masses.

6) Global Private Equity and Venture Capitals They are playing a vital and varied role in Indian healthcare delivery to increasing the global footprint of local pharmaceutical companies to aiding the rapidly growing contract research outsourcing industry. 7) Favourable demographics Indias rising population and income levels, along with a growing preference for private health services over public services, is augmenting the growth of the healthcare delivery market. 8) Changing disease pattern India is witnessing a shift in disease patterns from communicable diseases to the high incidence of non-communicable and lifestyle-related diseases, which is driving the need for tertiary-and quaternary-care hospitals and clinics. 9) Availability of quality and affordable healthcare Among countries outside the US, India has one of the largest numbers of Joint Commission International (JCI)-approved hospitals. The country has 0.5 million doctors, 0.9 million nurses and around 1.37 million beds. India holds the top position in the number of medical and nursing colleges 303 and 3,904, respectively. The cost of surgery in India is nearly one-tenth of the cost in the US and European countries.
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10) The changing nature of disease We believe one of the most profound drivers of healthcare change is the growing incidence and impact of chronic illness. Chronic diseases now account for 60 percent of the 58 million deaths globally each year and represent a significant economic burden on societies worldwide. As much as 75 percent of the healthcare resources of developed countries are consumed by the needs of those with chronic conditions.

11) Increased expenditure on healthcare Population growth and increased disposable income are expected to result in better healthcare awareness and more expenditure on healthcare. Healthcare expenditure in India is expected to increase by 15 per cent per annum. India has the potential to add nearly 1.74 million beds between 2008 and 2027 with an investment of about US$ 104 billion during the same period to fulfill the unmet needs. Healthcare expenditure in India is expected to increase by 15 per cent per annum.

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12) Globalization Healthcare, which has remained largely regional and local to date, has not escaped globalization unscathed. The financial pressure arising from globalization is having the greatest and most obvious impact on healthcare systems. In many countries, competing on a worldwide basis is causing substantial shifts in their revenue bases and forcing alterations in their funding choices and spending patterns. Globalization is also laying the foundation for healthcare without borders. Further, as this driver gives rise to new social and political models, it will also irrevocably alter the environment in which healthcare operates and the key stakeholders who determine its course. 13) Consumerism Consumerism in healthcare is part of a broader movement promoting consumer interests and placing more power and control in the hands of individuals. In healthcare, consumerism is producing increasingly assertive buyers who are willing and able to promote and defend their interests. 14) New medical technologies and treatments We believe innovative new medical technologies will continue to drive change in healthcare. They promise improved population health and higher quality care. But this promise will often include higher unit costs and greater overall demand, which may well result in higher aggregate costs, particularly during the early phases of their development and growth. Genomics, regenerative medicine, and information-based medicine are three rapidly emerging technologies that will be major drivers of healthcare change.

In summary, we believe these five change drivers - globalization, consumerism, demographics, chronic and infectious diseases, and new, expensive technologies and treatments - are and will continue to upset the status quo of healthcare systems throughout the world. Crises in healthcare systems are not new per se, but these drivers are creating a healthcare environment that is fundamentally different from past periods of crisis. These drivers are creating higher costs, burgeoning demand, and increasing regulation.
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IV. Healthcare Trends and Investments

The rural healthcare sector is also on an upsurge. The Rural Health Survey Report 2010, released by the Ministry of Health, stated that the number of Sub Centres existing as on March 2010 increased from 146,026 in 2005 to 147,069 in 2010. The report further stated that there is an increase of 437 primary health centres (PHCs) in 2010. Moreover, Number of nurses at PHCs and community health centres (CHCs) has increased from 28,930 in 2005 to 58,450 in 2010. Leading international clinic chain Asklepios International is gearing up for a foray into the Indian healthcare market. As part of the 2.3 billion euro groups strategy to enter the sub-continent, Asklepios is mulling the launch of a US$ 100 to US$ 200 million fund.

The Ajay Piramal Group-owned private equity (PE) firm, India Venture Advisers, will launch its second US$ 150 million healthcare fund next year . The government, along with participation from the private sector, is planning to invest US$ 1 billion to US $2 billion in an effort to make India one of the top five global pharmaceutical innovation hubs by 2020. According to a Venture Intelligence study, 12 per cent of the US$ 77 million venture capital investments in the July-September 2009 quarter were in the healthcare sector. As part of its Healthymagination initiative, GE will spend US$ 3 billion over the next six years on research and development, provide US $2 billion of financing over the next six years to drive healthcare information technology and health in rural and underserved areas, and invest US$ 1 billion in partnerships, content and services. As per the data released by the Department of Industrial Policy and Promotion (DIPP), the drugs and pharmaceuticals sector has attracted foreign direct investment (FDI) worth US$ 2.4 billion between April 2000 and April 2011, while hospitals and diagnostic centres have received FDI worth US$ 1.03 billion in the same period. Wipro Technologies has launched a service that aims at helping drug development owners (DDOs), clinical research organizations (CROs) and regulators to improve collaboration for multi-region clinical trials. The
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service, Wipro Clinical Collaboration Portal is a secure cloud-based productized solution. With an intention to revolutionize the critical care segment, Philips Electronics India is ready to develop the countrys first virtual ICU soon. The company is already having discussions with major multi-specialty tertiary care hospital groups to launch a technology called eICU by 2012. Apollo Hospitals Enterprise Ltd and University College London (UCL) have signed a memorandum of understanding (MoU) to collaborate their efforts in training and clinical research. The strategic partnership would aim to promote and conduct educational and research initiatives in health sciences. Fortis Healthcare plans to launch low cost hospitals in smaller towns under a new brand and has set a target of 25 hospitals in three years. Foraying into the healthcare sector, Manappuram Health Care Ltd plans to invest US$ 222.27 million over 2011-16 to set up a chain of medical, dental clinics and diagnostics centres across South India. The entity is a venture of the Manappuram Group of companies.

V. Indian healthcare industry poised for rapid growth

The Indian healthcare industry is undergoing a rapid expansion phase with 12 percent CGPA (cumulative growth per annum) since 2008 and its market is poised to gross Rs.1.3 trillion (Rs.12,60,000 crore) in revenue by 2020. Government initiatives and public-private partnerships will help create better opportunities for nurses, paramedics, emergency medical technicians and specialized doctors across the country. According to the Investment Commission of India, the market size of hospitals and nursing homes will be Rs.54,000 crore with 20 percent growth rate per annum; medical equipment Rs.9,000 crore with 15 percent growth; clinical lab diagnostics Rs.4,500 crore with 30 percent growth; imaging diagnostics Rs.4,500 crore with 30 percent growth and other services, including training & education, aesthetics & weight loss and retail pharmacy Rs.9,000 crore. Health Insurance has the potential to show top line growth, as a study by global advisory McKinsey-CII (Confederation of Indian industry) estimates the number of insurable lives at 315 million, with a potential of generating Rs.34,650 crore in premium by 2015. Importing customers into India for medical tourism, educational services, and leisure tourism is expected to generate an additional $6-50 billion in revenue and create 10-48 million direct and indirect jobs by 2020.
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VI. Areas of Opportunity Our analysis here tries to highlight various pockets of opportunity within the Indian healthcare sector. The key areas of opportunity within the Indian Healthcare sector are: \ Medical Infrastructure Telemedicine Medical Equipment Medical textiles Health Insurance Clinical Trials Health services outsourcing Medical value travel Training and Education

I.

Medical infrastructure

It forms the largest portion of the healthcare pie. As per the current statistics (2006) bed per thousand population ratio for India stands at 1.03 as against an average 4.3 of comparable countries like China, Korea and Thailand (2002 data). Hence in spite of the phenomenal growth in the healthcare infrastructure, we are likely to reach a bed to thousand-population ratio of 1.85 and in a best-case scenario, a ratio of 2 by 2012. Beds in excess of 1 million need to be added to reach a ratio
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of 1.85 per thousand, out of which about 896,500 beds will be added by the private sector with a total investment of 51 Billion over the next six years. However, the gains are commensurate in this capital intensive industry, since the revenues generated by private hospitals in the year 2012 will be to the tune of 26.5 billion growing at a CAGR of 15%. Despite this investment, the bed to thousand population ratio would be far from comparison with other similar developing countries.

II.

Telemedicine

It allows even the interiors to access quality healthcare and at the same time, according to the model proposed by us, significantly improves the productivity of medical personnel. In a country of over 1.1 Billion people, the Healthcare system will have to innovate to double the utilization of its existing resources just to reach a stage at which comparable developing countries were in 2002. Telemedicine is one such innovative technology, if used effectively can double utilization of scarce human resources. Standalone telemedicine models may not be feasible, but if telemedicine models are integrated in a Healthcare model, such models can become viable. One important reason is that Telemedicine shall increase the patient base, which in turn will increase occupancy rates of hospitals in the integrated telemedicine model. The biggest challenge for the healthcare industry today is an acute shortage of trained personnel, ranging from doctors, nurses, technicians and even healthcare administrators. There could be a shortfall of over 450,000 doctors in the year 2012. Such challenges present an opportunity for both domestic and foreign players in the form of training & education. Foreign players can enter the market to take a twofold advantage. One, they get a piece of the booming education sector and two, they can source some of the talent for their own countries as human resources shortage in healthcare will be a global phenomenon.

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III.

Medical equipment

This is another promising opportunity within healthcare. Analysis pegged the medical equipment industry at 1.6 billion in 2006 growing at 15% per year and estimated that it would reach 3.6 billion by 2012. Currently over 65% of the medical equipments are imported and thus lies a key area for forging partnerships across borders. Engineering excellence, cost-effective labor, increasing emphasis on intellectual property rights and most importantly a fast growing domestic market makes India an ideal manufacturing base. According to official statistics, the number of clinics and hospitals have increased almost four times than in the 1950s. This has also increased the demand for medical equipments which has made the medical device sector as one of the most promising markets in India. Even more alluring than the size of the market is its projected growth. The demand for medical equipments is rising annually at an impressive rate of 15 %. The Indian Healthcare sector has seen progressive increase in investments in healthcare infrastructure and facilities, especially hi-tech medical devices. The Medical Device Market is becoming too big to ignore. It is full of opportunities for investment in high quality, specialized medical equipments. Foreign participation is required, especially in high-tech devices that account for roughly 45-55 % of the entire market. Most Indian healthcare institutes use foreign medical equipments for the purpose of surgery, diagnosis of cancer and medical imaging.

IV. Health Insurance This has the potential to show fantastic top line growth. Premiums grew 133% for private players and for the overall industry premiums grew at 47% in Q1 of 2006. The Health insurance sector will grow to 2.8 billion in collected premiums by 2012 as compared to 526 million in 2006. Clinical trials has the potential of becoming a 740 million industry by 2010, even though the advantages of trials in India is well known, the industry needs a boost in terms of effective government policies and active interest by the government
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including effective utilization of established government infrastructure.

V. Services outsourcing

This sector has real potential as most of the key components needed for success are present in India and the total size of the industry is set to grow to 5.4 billion by 2012 growing at 11% per year. In the end there is a need for stronger partnerships in healthcare, between the government and private sector. Even a realistic targets of 1.85 beds per thousand population by 2012 needs an investment of 57.6 billion and hence the government and private players need to focus on their core competencies/responsibilities and work together to reduce inefficiencies and complement each others effort.

VII. DEMAND AND SUPPLY GAP: There is a growing demand for improved public health infrastructure due to the countrys high population and increasing disease profile.
This highlights the need for better healthcare delivery, which addresses

accessibility and affordability issues.

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Health Infrastructure Source: Ernst & Young research 2010 Note: DALY: Disability Adjusted Life Years; DALY rate per 1,00,000 population is a universally accepted indicator of burden of disease. It is a measurement of the gap between current health status and an ideal situation where everyone lives into old age free of disease and disability.

VIII. PREFERENCE FOR PRIVATE TREATMENT

In India, private healthcare accounts for nearly 80 per cent of the countrys total healthcare expenditure, although it is more expensive than public healthcare services. The preference for private healthcare can be attributed to better perceived quality and accessibility. Close to 80 per cent of the required investment should come from the private sector. The government's spending on healthcare is around 0.9 per cent of the total GDP, which limits the extent and effectiveness of the coverage it can provide. Private healthcare will continue to be the largest component in 2012 and is likely to double to Rs 156,000 crore. It could rise by an additional Rs 39,000 crore if health insurance cover is extended to the rich and middle class. The public spending could double if the government reaches its target spending level of 2 per cent of GDP, up from the current 0.9 per cent, according to the report. Coupled with the expected increase in the pharmaceutical sector, the total healthcare market in the country could increase to Rs 232,000-Rs 320,000 crore (6.2-8.5 per cent of GDP) in the next five years.

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 Outpatient care accounts for 61 per cent of private healthcare spending, of which maximum is on acute infections like fever, diarrhoea and gastrointestinal disease. Inpatient spend is concentrated on groups like cancer, heart disease, accidents, acute infections and injuries that account for 85 per cent of private spending. Of the expected Rs 156,000 crore private healthcare spending in 2012, inpatient spending will account for 47 per cent. The growth will be driven by rise in diseases, especially cancer and cardiovascular disease. Outpatient spend will decrease in terms of share but increase in absolute terms to Rs 74,000 crore, the report added. Private healthcare will continue to be the largest component in 2012 and is likely to double to Rs 156,000 crore. It could rise by an additional Rs 39,000 crore if health insurance cover is extended to the rich and middle class. The public spending could double if the government reaches its target spending level of 2 per cent of GDP, up from the current 0.9 per cent, according to the report.

IX.

KEY OPPURTUNITIES

BUILDING HEALTHCARE INFRASTRUCTURE

An additional 1.75 million beds are needed for India to achieve the target of two beds per 1,000 populations by 2025. An additional 7,00,000 doctors will be required by 2025 to reach a ratio of one medical doctor per 1,000 individuals. To maintain the current doctor-to-nurse ratio of 2.2, an additional 1,600,000 nurses will have to be trained by 2025.
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 Achieving these targets will require a total investment of US$ 77.9 billion.

Health Infrastructure

DEVELOPING TERTIARY CARE UNIT

The market for tertiary care is expected to grow exponentially due to the rise in complex ailments such as heart diseases and cancer. Indias changing demographics and the increasing incidence of noncommunicable and lifestyle-related diseases is expected to trigger the need for more tertiary care hospitals to cater to this demand. The share of tertiary care in the total healthcare market was around 11 per cent in 2008.

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Health Care Infrastructure-Types of Services

4th Qtr Primary 0% 11% Secondary 11%

Tertiary 78%

Figure - Healthcare Infrastructure-Types of sevices

HEALTH INSURANCE
Around 14 per cent of the Indian population is health-insured. The health insurance industry is growing at 25 per cent annually and is expected to reach US$ 5.75 billion in 2010. Several private insurance companies have entered the market and have empanelled hospitals to provide cashless treatment to subscribers of insurance companies. With the launch of Rashtriya Swasthya Bima Yojana(RSBY) in 2008, the goal is currently providing annual medical care cover worth US$ 625 (INR 30,000) to close to 20 million families across 27 states, which enhanced the market presence of health insurance. The potential increase in the penetration rate of medical insurance and employer plans could result in a higher demand for premium healthcare services in India and consequently increase the demand for hospital beds and medical equipment.

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Health Insurance- Penetration in India

Current market 0% 14%

Untapped market 86%

Figure - Health Insurance- Penetration in India

Source: Ernst & Young research; Govt widens ambit of rural health cover, The EconomicTimeswebsite,http://economictimes.indiatimes.com/personalfinance/insurance/ins urance-news/Govt-widens-ambit-of-rural-health-cover/articleshow/6661701.cms, accessed1 October 2010.

MEDICAL TOURISM
The Indian medical tourism industry is poised to grow at 30 per cent annually, primarily driven by world-class healthcare services that are offered at a fraction of the overall cost, compared with western countries. According to the Associated Chambers of Commerce and Industry of India (ASSOCHAM), the cost of surgery in India is nearly one-tenth of the cost in US and European countries. Approximately 180,000 patients visited Indias medical centers during the first eight months of the 200809.

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 The boom in medical tourism industry is expected to complement the growth of the domestic healthcare delivery market.

Figure - Medical tourism industry in India

Source: Ernst & Young research; Indian medical tourism to touch Rs 9,500 crore by 2015:Assocham,TheEconomicTimes.

Manufacturing
India has emerged as a major supplier of several bulk drugs, producing these at lower prices compared to formulation producers worldwide. The US Food and Drug Administration (FDA) already has approved 85 Active Pharmaceutical Ingredient (API) and formulation plants in India, the highest such number outside the US. India is poised to become a major exporter of pharmaceuticals, particularly generic and OTC drugs, to global markets. By 2010, India could be producing 15% of the worlds bulk pharmaceuticals and drug intermediates. However, achieving that level of growth will require an estimated $1.2 billion investment in production capacity. 9
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Many multinational generics companies have been sourcing products from Indian manufacturers for some years. Some also use Indian contract manufacturers to manufacture the finished product. Contract manufacturing, currently estimated at $350 million, is expected to reach $1billion by 2010, according to CRISIL. Some companiesencouraged by the relaxation of the rules on foreign ownership and a favorable tax regimehave gone beyond contract manufacturing, setting up their own local manufacturing facilities. The financial incentive is compelling: Goldman Sachs estimates that the cost of setting up and running a new manufacturing facility in India is one-fifth of the cost of doing so in the West.

Pharmaceutical research
Pharmaceutical research is one area that is expected to achieve tremendous growth in the coming decade, due to Indias huge and growing population, low per capita drug usage, and increasing incidence of disease. Global pharmaceutical alliances with Indian drug firms are finally beginning to look like a two-way street, with major R&D deals being struck.

Clinical trials
India historically lacked the expertise to perform clinical trials, because most companies only tested different processes for producing copycat versions of Western products, and the rules were quite lenient. Several drug makers have also been caught behaving unethically or even illegally. However, in recent years, India has become a more attractive market for clinical testing. One reason is that in November 2004, the federal government amended Schedule Y of the Drugs and Cosmetics Act to make the rules on clinical trials more consistent with international
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practice. In addition, in January 2005 India became compliant with the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement and formally recognized product patents. This triggered growth in Indian clinical trial activity by contract research organizations, such as Quintiles, Omnicare, PharmaNet and Pharm-Olam, and by multinational corporations such as Novo Nordisk, Sanofi-Aventis, Novartis and GSK. Some multinationals, such as Pfizer and Eli Lilly, have been conducting tests locally for a while. Government taxation incentives are further boosting R&D in India. As a market for clinical testing, India holds other attractions as well. According to a study by Rabo India Finance, a subsidiary of the Netherlands-based Rabo Bank, the huge patient population offers vast genetic diversity, making the country an ideal site for clinical trials. It has the largest pool of diabetic patients, the population is relatively easy to access, and many people are treatment-nave; they have not been treated with medications being tested, which potentially could distort test results. As a result of these favorable factors, the Indian clinical trials market, currently estimated at $120 million, is expected to reach $1 billion by 2010, according to Infomedia. To achieve that level of growth, India will have to address a lack of skilled workers, high wage inflation, and inadequate infrastructure.

COMPETITION RELATED ISSUES IN THE HEALTHCARE SECTOR

In theory, competition ensures provision of best possible goods and services at the lowest possible prices. It is in the absence of effective competition that efficiency of markets is hampered. Different government policies may encourage or adversely affect competition, and hence consumer welfare, particularly in the context of the present globalising environment.10In addition, sector specific policies in various
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areas such as health, electricity, telecommunications, financial services etc., also affect competition in the economy. The market for healthcare services is quite distinct in its functioning with asymmetries of information and market power prevailing in the industry .The complexity of the market for health services arises because of three reasons: Asymmetry of Information Complexity of production since each patient requires different treatment procedures and standardization of such procedures is not feasible. Local market power due to economies of scale and costs of travel-In urban areas there are economies of scale since they cater to a larger segment of the population compared to the rural segment and hence have significant local market power.

It is such complexity of market for health services that makes it even more difficult yet essential to ensure free and fair competition and thus efficiency in the market. Competition issues in the healthcare sector can be looked upon by segregating them into issues at domestic level and those at international level.

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C. RESEARCH METHODOLOGY
1) RESEARCH OBJECTIVE: Comparative study of different key players in Indian Healthcare sector and what are the challenges faced by them in the market. To study the market potential of Healthcare sector in Kolkata (south) & the opportunities existing. To provide technical support to strengthen data analysis and use of information at all levels of health care delivery. Promotion of Healthline 24x7 information service.

2) SCOPE OF STUDY Increasing the awareness level of technology in healthcare sector Making: Medical stakeholders aware about this new healthcare information system & bringing them to single healthcare platform A personalized website as a catalyst to doctors practice Need for better connectivity among same background doctors Need for constant updating on the latest medical facts and the intent to spend time and resources on it. Awareness creation in the consumer markets with free medical camps in schools,residential complex & door to door awareness.

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3) SURVEY:
Survey was made in Kolkata region to get primary data,since our project was divided into 2 parts i.e 10 weeks for B TO B & 10 weeks for B to C,the areas specified to us were different. SaltLake,Tangra,Phoolbagan,Narkeldanga was my area for B TO B project & Jadavpur,Santoshpur & Bengal ambuja for B TO C. 4) RESEARCH DESIGN The study is an exploratory research study and I used Strata Sampling (NonProbability Sampling) to serve the purpose. For the purpose of present study a related sample of population was selected on the basis of convenience. 5) RESEARCH PERIOD Research Work was carried for 10 Weeks. 6) RESEARCH INSTRUMENT This work is carried out through questionnaires. The questions included were:Dichotomous questions, Closed ended questions, multiple choice questions. 7) CONTACT METHOD Personal Interview 8) DATA COLLECTION TECHNIQUE Primary Source: The data has been collected directly from respondent with the help of
structured questionnaires. Secondary Source: The secondary data was collected from internet.

9) DATA ANALYSIS The data is analyzed on the basis of suitable tables by using mathematical techniques. TheTechniques that we have used is bar graphs, pie charts etc. 10) HYPOTHESIS: The primary data was collected in limited area. The sources of data collection was limited in this research. Time limitation will be there. The respondent may be biased
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D. RELIGARE AN OVERVIEW

1.

ABOUT RELIGARE ENTERPRISE LTD

Religare Enterprises Limited (REL) is a global financial services group with a presence across Asia, Africa, Middle East, Europe and the Americas. In India, RELs largest market, the group offers a wide array of products and services ranging from insurance, asset management, broking and lending solutions to investment banking and wealth management. The group has also pioneered the concept of investments in alternative asset classes such as arts and films .With 10,000 plus employees across multiple geographies, REL serves over a million clients, including corporate and institutions, high net worth families and individuals, and retail investors. Religare is a Latin word that translates as 'to bind together'. This name has been chosen to reflect the integrated nature of the financial services the company offers. 2. BACKGROUND OF RELIGARE ENTERPRISE LTD. The Company was originally incorporated as Vajreshwari Cosmetics Private Limited on January 30, 1984.The name of the Company was subsequently changed to Religare Enterprises Private Limited pursuant to a special resolution of our shareholders dated January 10, 2006. The fresh certificate of incorporation consequent to the change of name was granted to the Company on January 31, 2006, by the Registrar of Companies, Punjab, Himachal Pradesh & Chandigarh at Jalandhar. The status of the Company was changed to a public limited company by a special resolution of the members dated July 14, 2006. The fresh certificate of incorporation consequent to the change of name was granted to the Company on August 11, 2006, by the Registrar of Companies, NCT at New Delhi.

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At the time of incorporation, the main objective of the Company was to purchase, sell, import, export, manufacture, pack, replace or otherwise deal in all types of tooth paste, tooth brush, face powder, face cream and other cosmetics. The companies mentioned below have been recently acquired by the Company and have become its subsidiaries. (a) Religare Securities Limited (b) Religare Finvest Limited (c) Religare Commodities Limited (d) Religare Insurance Broking Limited (e) Religare Venture Capital Private Limited. (f) Super Religare Laboratories Limited (g) Religare Wellness Limited (h) Religare Technova Limited (i) Fortis Healthcare Limited (j) Religare Voyages Limited

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3. ABOUT RELIGARE TECHNOLOGY

INTRODUCTION Religare Technology Limited is the holding company for the IT business of a large diversified Indian transnational business group. The group pursues aggressive business interests globally in Financial Services (Religare Enterprises), Health Care (Fortis HealthCare), Wellness (Religare Wellness, formerly Fortis HealthWorld), Diagnostics (Super Religare Laboratories, formerly SRL Ranbaxy) and Aviation and Travel (Religare Voyages). The offerings of the company are divided into Products and Services. The Religare Technova umbrella includes Religare Technova Global Solutions (formerly Asian CERC Information Technology Ltd and Capital Market Solutions Pty Ltd), a global leader in providing Enterprise Software Solutions to the Capital and Financial markets; Religare Technova IT Services Limited, which provides Enterprise IT Solutions and Religare Technova Business Intellect Ltd, which provides Knowledge Management Solutions. Currently with over 2000 employees and presence in over 10 countries, Religare Technology is poised to be a leader in the global IT space. Religare Technology focuses on clients in key verticals such as Banking and Financial Services, Insurance, Capital Markets and Health Sciences (Healthcare and Pharmaceuticals).

PROMOTER GROUP:

Fortis Healthcare Limited, established in 1996 was founded on the vision of creating an integrated healthcare delivery system. With 22 hospitals in India,
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including multi-specialty & super specialty centers, the management is aggressively working towards taking this number to a significant level in the next few years to provide quality healthcare facilities and services across the nation.

Religare is a global financial services group with a presence across Asia, Africa, Middle East, Europe and the Americas. In India, Religares largest market, the group offers a wide array of products and services ranging from insurance, asset management, broking and lending solutions to investment banking and wealth management. The group has also pioneered the concept of investments in alternative asset classes such as arts and films. With over 10,000 employees across multiple geographies, Religare serves over a million clients, including corporate and institutions, high net worth families and individuals, and retail investors.

Super Religare Laboratories Limited (formerly SRL Ranbaxy) within 11 years of inception has become the largest Pathological Laboratory network in South Asia. It started a revolution in diagnostic services in India by ushering in the most specialized technologies, backed by innovation and diligence. The current footprint extends well beyond India in the Middle East and parts of Europe.

Religare Wellness Limited (formerly Fortis HealthWorld) is one of the leading players in the wellness retail space with a footprint of 100 stores across India. The group envisages setting up a pan India world class retail network of wellness stores that would provide comprehensive solutions under one roof.
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The group also operates in the domain of integrated Air Charter and Travel, anchored under the holding company Religare Voyages Ltd. The Air Charter business is one of the largest in the non-scheduled space in the country with its own top-of-the-line fleet that comprises jets, helicopters and turbo props. The travel business is duly accredited for complete management of both in-bound and out-bound domestic and international travel.

4. PHILOSOPHY
VISION "To build a globally scalable business of excellence in the IT domain".

MISSION To institutionalize and put into place, processes that shall enable the organization to achieve leadership position in the IT domain and to develop, build and nurture high quality client relationships backed by diligence, ethics and values

TECHNOLOGY IDENTITY Technology has been chosen to represent the companys commitment to innovation and excellence in the technology business. This name has been chosen to reflect the integrated nature of the services that the company offers as well as the partnership model it follows. The symbol of Religare Technology circle stands for balance and synchronization and our commitment to quality and wholeness. It represents the tradition of
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incorporating different ideas and solving complex problems. The symbol represents complete customer centricity and our aim of insulating our customers from environmental risks.

VALUES The following values are core to Religare Technology. The values are rooted in current reality, but also represent the path we wish to follow tomorrow

Integrity and fairness to employees and customers Equal opportunities for all- no discrimination on any ground Move ahead together Deliver value through deep domain expertise Commitment to building long term relationships

ENTITIES UNDER THE RELIGARE TECHNOVA UMBRELLA The companies under Religare Technologys umbrella are Religare Technova Global Solutions Ltd (formerly Asian CERC Information Technology Ltd) and Capital Market Solutions Pty Ltd (being renamed as Religare Technova Global Solutions Pty Ltd); Religare Technova IT Services Limited, which provides Enterprise IT Solutions and Religare Technova Business Intellect Ltd, which provides Knowledge Management Solutions. GLOBAL REACH Currently with over 2000 employees and presence in over 10 countries, Religare Technology is in the global IT space. The group entities provide IT services, products and solutions. Religare Technology sells information technology and business process outsourcing to clients in verticals such as Banking and Financial Services, Insurance, Capital Markets and Health Sciences.

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ACQUISITIONS The holding company Fortis Financial entered into a share-purchase and subscription agreement with ACERC Information Technology for acquiring 23.52 lakh equity shares. Religare Technology Ltd. ("RTL")(formerly Fortis Financial Services Ltd), which is a substantial stakeholder of Asian CERC Information Technology Ltd (ACERC) a leading capital market software provider acquired Capital Market Solutions Pty Ltd (CMS) an Australian software major providing Fsolutions and services to financial markets in Asia Pacific and UK. RTL acquired 76 per cent equity of CMS through Regius Infotech Private and Regius Overseas Holding Company, Mauritius a special purpose vehicle formed by it. AWARDS AND RECOGNITION Religare Technology, a Microsoft Gold Certified Partner, has been awarded membership of the elite Microsoft Dynamics Presidents Club 2008. The Presidents Club consists of only 13 members across India. Religare Technology was also honored with the Star Emerging SI Sales Award by Microsoft in 2008. The prestigious Amity HR Excellence Award was awarded to Religare Technology at the Fifth Global HR Summit 2008. Religare Technology has been appointed ASP for Lenovo. The relationship is for a pan-India footprint and pertains to Lenovo PCs and Laptops. Religare Technology has been awarded the mantle of Cisco Premier Certified Partner in India Sub-Continent.

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E. HEALTHLINE 24X7 The Any Time Anywhere Health Assistance

HealthLine 247 is a Health Information Helpline and Assistance platform that offers identical yet complementary service over two channels voice media through phone and digital media through the internet. The service is absolutely free and is available 24x7x365. The unique SCES platform enables customers to Search for the right information, Compare the available options, Evaluate all possible alternatives and finally Select the best option. Healthline 247 empowers people with reliable, relevant and in-depth health information. The helpline is just a click away on www.healthline24x7.com from most browsers or just a call away at 33006666 from any phone landline or mobile, from any telecom provider. The service blends healthcare information & technology in a way that it not only acts as a trusted guide to the right specialist near you based on your symptoms, but can also answer your queries related to information about the medicines that have been prescribed to you. Questions like side effects of medicines, alternate medicines and the cost comparison are also answered through HealthLine24x7 HealthLine 247is useful in providing information about diseases, its symptoms, possible treatments, alternative treatments, medicines, probable side effects of medicines and most importantly, it helps in identifying the right specialist in and around any given locality. Healthline 247 is Indias first free round the clock Healthcare Information Assistance service. Fuelled with comprehensive knowledge and exhaustive intelligent Search- Compare- Evaluate- Select platform, Healthline 247 service fuses health information and technology to produce countrys first 24 hour service that will not only act as trusted guide to the right specialist doctor, but will also let you know your disease, locate the nearest doctor, Pathological labs, Nursing homes and Emergency Services that meet your medical requirements. It empowers all to have the power of knowledge at fingertips when it comes to healthcare. Absolutely free Healthcare Assistance round the clock from advisors with a medical background Healthline 247 is a one- stop shop for all the healthcare information needs.
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HealthLine 24x7, a healthcare information service available around the clock for finding doctors and getting disease data in India, has announced two new services, Teleconsult & e-PHR (an electronic personal health record). Teleconsults goal is to connect patients with doctors over the phone so that visits to the office for common ailments are not necessary. e-PHR will enable people to store and access their medical records free of cost. Healthline 24x7 has a database of over 150,000 physicians and is currently available in Delhi/NCR, Mumbai, Bengaluru, Chennai, Kolkata and Pune, according to indiatimes.com. The company plans to expand its presence into more cities across India. ePHR enables customers to access their personal medical records anywhere, anytime. Patients can maintain a timely record of their medical appointments, gain access to significant medical alerts, conveniently book appointments with physicians and specialists, obtain faster and more efficient diagnosis and treatments, and improve quality of care and treatment by creating an ID on the website www.healthline24x7.com

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F. Business to Business Project

This study was conducted in various parts of Kolkata city with a time frame of 10 weeks ,which started from April 18th 2011 & continued till June 25th 2011. RESEARCH INSTRUMENT: This work is carried out through questionnaires which was given to us by the company. The questions included were:Dichotomous questions, Closed ended questions, multiple choice questions. CONTACT METHOD: Personal Interview DATA COLLECTION TECHNIQUE Primary Source: The data has been collected directly from respondent with the help of structured questionnaires. Secondary Source: The secondary data was collected from internet and magazines. THE RESPONDENTS: All the health care service providers which included Doctors,Hospitals,Clinics,Diagnostic Centres,Chemists,Opticians,Ambulance services,Blood bank, Medical Equipment sellers etc.

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Healthcare marketing is a relatively new concept in the healthcare industry. This field within the healthcare industry deals with the establishment of connections between physicians, patients and healthcare organizations, and thus forming mutual relationships. At the core of marketing healthcare organizations and their services lies the consumer focus. The focus of the marketing effort is based on trying to understand the needs of healthcare consumers and their preferences so as to tailor needs that can meet their needs, satisfactorily. However, the main concern in establishing healthcare marketing campaigns lies in determining how to establish loyalty. Consumer loyalty constitutes the totality of attitudes and dealings that incline a consumer to make a re-purchase of a certain service, product or re-visit a certain healthcare organization. Customer loyalty is important to the enhancement of a businesss profitability. Customers may prefer a loyal status to healthcare organizations so as to establish familiarity of services, physicians and follow up because this creates convenience for them-they do not have to make new contacts or re-explain their medical history. "Providing access to reliable health information for health workers in developing countries is potentially the single most cost effective and achievable strategy for sustainable improvement in health care." Community health workers in developing countries are often trained only for a few months before they begin providing health services, and have a great need to access updated and reliable health information. In the Healthline 24x7 project, we're designing an information access system specifically for such health workers, which they can call any time, from any cell phone or landline. Through a spoken conversation with the system in their native language, they would be able to learn more and/or fill in any health information gaps that they may have. This would in turn enable them to provide better health services to their community.

As of January 2009, we have completed a large user study with health workers in rural Sindh comparing two automated information access systems in the Sindhi language. In one system, health workers would use the telephone keypad to select
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menu choices, while in the other they would speak instead. Most users preferred the spoken interface, though there are still significant challenges for the least literate users. Such users had significant difficulty using either system, and we are now looking into ways of streamlining the interaction based on their needs.

As of May 2008, completed a series of user studies with health workers in rural Sindh to understand their preferences with respect to speech-based information access as compared to text-based information access. One major finding is that our initial choice of Urdu (Pakistan's lingua franca) as the target language was suboptimal, as community health workers often are not always fluent in Urdu -- even though they may have attended school up till 5th grade. We are now re-building our prototypes in Sindhi, and will be conducting user studies with health workers of varying literacy levels to evaluate the prototypes through objective metrics (such as task success rate, task completion time) and subjective metrics (user ratings).

As of September 2007, we have completed a series of field-based interviews with various health workers to understand the context in which they work, their literacy and comprehension skills, as well as their baseline health information needs. We have identified appropriate health information texts, and have completed a successful prototype test in August. We are now creating a system with more information, utilizing voice-based search, and will be evaluating it with a wide range of community health workers, with varying literacy levels.

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I. Research questions:
What are the principles of speech interface design for a voice-only information access mechanism that provides large amounts of detailed information? Since low literate users have no other options for automated information access, all details must be provided through the voice channel.

What role can voice-based search play in such interfaces?

How do low-literate users view voice-based search? Can they easily learn how to use it? Most existing content is designed for visual access, and is optimized for reading. How must this content be adapted so that it is optimized for hearing? Further development of customer's document service VTT has developed a secure document service for B2C (Business to Consumer) applications. The concept has been earlier applied for health documents in B2C-MED project. In this follow-up project (B2C-HEALTH) our objective is to improve the integration between the document service and the service provider's information systems. This will be done by providing a HL7/CDA compatible communication adapter and a new generic model for B2C health care data. Furthermore, we aim at automated collection of data - such us blood pressure measurement carried out by the patient at home. Integration of electronic patient contacting in health care processes Electronic information exchange between healthcare service providers and customers have not yet become common, even if several efforts have taken place. One of the reasons is that a secure and user-friendly technical service solution is still missing. VTT has developed and evaluated new document-based and generic solutions in two Finnwell projects: B2C-MED and B2C-HEALTH.

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II. B2C (Businesses to Consumer)

Product driven Maximize the value of the transaction Large target market Single step buying process, shorter sales cycle Brand identity created through repetition and imagery Merchandising and point of purchase activities Emotional buying decision based on status, desire, or price

The ultimate goal of B2C marketing is to convert shoppers into buyers as aggressively and consistently as possible. B2C companies employ more merchandising activities like coupons, displays, store fronts (both real and Internet) and offers to entice the target market to buy. B2C marketing campaigns are concerned with the transaction, are shorter in duration and need to capture the customers interest immediately. These campaigns often offer special deals, discounts, or vouchers that can be used both online and in the store. For example, the goal of an email campaign for a B2C company is to get consumers to buy the product immediately. The email will take the consumer to a landing page on the web site that is designed to sell the product and make purchasing very easy by integrating the shopping cart and checkout page into the flow of the transaction. Any more than a couple of clicks and the customer is likely to abandon the shopping cart. One interesting aspect of B2C marketing, however, is that many companies have realized the importance of loyalty. Amazon, Best Buy, and Staples combine merchandising and education to keep customers coming back. Add great customer service, and you get a winning combination.

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B2C marketing is considered unique for the simple reason that the industry is able to strike geographical barriers and achieve worldwide audience. In addition, businesses are able to get to the client base straightforwardly and slash intermediary distributors when the product needs to be distributed using longestablished ways. B2C marketing also permits companies to cut costs.

B2C marketing permits most businesses liberty and autonomy. The result is that even an undersized home based enterprise is given the chance to go up against bigger retailers. This can be achieved for the reason that the costs implicated in online B2C marketing is not as much as in conventional marketing. Let's say you a small retailer and you're promoting computers using the Internet. Because you are a "small fish in a big pond" it is exceptionally hard for you to establish a marketplace in a conventional way. In case you are wondering why, well the reason is that you are competing with deep pocket, big brand companies. They run hundreds if not thousands of ads online, in newspapers, radio or TV. But don't get too sad yet! Here comes B2C marketing to your rescue. B2C marketing provides each seller a superior chance to prove themselves in the marketplace. Well more or less! B2C marketing is not going away soon, so ultimately businesses are determined to adjust the way they reach out to their client base. The major difference between B2B (Business to Business) and B2C (Business to Customer) in internet terms is the role of the B2B website. B2B concerns itself primarily with supply chain management. These are portals that allow businesses to deal directly with their suppliers and distributors online. Allowing electronic transfer of orders, invoicing and even payments. Wholesalers, distributors and manufacturers fall in this category. Good market research is an essential tool for your e-commerce venture. You will need to know what products sell on the internet, how to study your competitors, how to target the right audience and the effects on your bricks and mortar business.

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III. SWOT ANAYSIS

STRENGTHS

1. 2. 3.

New, skilled and experienced Executive Management Team. Increasing expertise in service redesign improvement. Provision of a broad range of secondary care services.

4. Healthline 24x7 is Indias first free 24x7 patient-centric, health information on web and voice. 5. Facilities like intelligent search platform to Search Compare-EvaluateSelect a healthcare service provider, database of Indian medicines, Health Records Electronically over a web based E.M.R etc. 6. Religare provides holistic information approach-Homeopathic, Allopathic, Ayurvedic even pet care and all health related information. 7. Healthline 24x7 is growing at a rapid rate i.e. the market coverage is increasing day to day as healthcare service providers and consumers are coming to know about it. 8. Increasing urbanization, superior demographics and higher life expectancy has enhanced the demand for quality healthcare and this is where Healthline comes in to close the gap. 9. Upcoming Information Technology in Healthcare i.e. the use of mobile and web. 10. Consciousness among growing population about health related issues.

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WEAKNESS Although the information collected is huge but still it is only 20% of the total data therefore until and unless the healthcare service providers and consumers believe in the technology advancement it would be very difficult for Healthline 24x7.
1.

2. Language problem Healthline is only available in English and Hindi therefore a majority of people in other state are not able to access it. 3. As a part of corporate social responsibility which Helpline pledged that they would help poor people get free treatment is getting tough because no healthcare service provider in ready to do so. 4. A few features are not available which are provided by competitors such as daily alerts, general awareness and customized services. 5. Curative health services not accessible to rural populations i.e. it is only available in the few big cities and is planning to expand in Tier 2 cities. 6. Inadequate availability of skilled doctors and staffs and also beware of quacks. 7. Limited number of quality medical institutions therefore lack of R&D

OPPORTUNITIES
1.

Increased Health Consciousness amongst Middle Class. Incorporation of IT in the Industry. Rising Medical Tourism. Slow Growth of Medical Health Insurance Lack of Uniform Healthcare Services Pricing.
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2. 3. 4. 5.

6. 7. 8. 9.

Increasing Demand for Indian Healthcare Professionals. Medical Tourists to Increase the Demand for Healthcare Facilities. Preventive Healthcare Facilities Demand to Increase. Demand is Exceeding Supply.

THREATS
1.

Rivalry among Competitors. Increasing Competition. Low Competition from Public Sector. Threat of New Entrants. Encouraging Government Reforms. Cost Structure- A Barrier for Foreign Firms. Threat of Substitutes Alternative Medicines

2. 3. 4. 5. 6. 7. 8.

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IV. PEST ANALYSIS

Political Factors
1.

Legislation for Accreditation of Healthcare Institutions. Extension of Visa Period for Medical Tourists. Regulatory & Tax Reforms. Increasing regulatory burden.

2. 3. 4.

Economic Factors
1.

Lack of Government Spending. Reduced levels of NHS growth. High costs of capital. High costs of labor. Reducing costs of some new technologies. Increasing costs of drugs and therapeutics. Increasing costs of litigation.

2. 3. 4. 5. 6. 7.

Social Factors 1. 2. 3. 4. Increasing Elderly Population. Geographical Reach. Increasing Demand for Specialty Services. Epidemiology: increased prevalence and incidence of obesity and diabetes.
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5.

Increased mobility.

6. Demand for local access to services in a rural area with a scattered population. 7. 8. 9. Increasing public expectations. Immigration into Herefordshire by EU migrant workers. Continuing problems in recruiting key staff.

Technological Factors
1.

Use of Information Technology. Role of Telemedicine. Increasing complexity of hospital care.

2. 3.

4. Increased levels of sub specialization within the traditional taxonomy of secondary care services. 5. Changes in clinical practice: shorter lengths of stay; increased levels of day surgery. 6. Increased volumes of care traditionally provided by secondary care providers now provided by primary and community care providers. 7. Increased volumes of hi tech secondary care now being referred to tertiary care providers. 8. Increased use of standard care protocols.

9. Introduction of new technologies (e.g. genetic technologies) resulting in therapeutic rather than surgical interventions, delivery if hi tech care in a lo tech setting. 10. 11. Increased mobility/miniaturization of diagnostic equipment. Continuing advances in IT.
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Promotional Health Campaigns

Health Campaigns were done on -: 1) 2) 3) Schools Residential Complexes. Other places were large number of People gather.

Designated Area was: 1) 2) Dumdum. Belgachia.

Approach was made to: 1) 2) 3) 4) 5) Motijheel Girls School -- 2500 Students + 90 Teachers and Staff. Clubhouse Town {Residential Complex} 400 residents. Kisshore Bharati Boys School 1700 Students. St. Marys Orphanage Day School 1900 Students. Akansha Apartment 250 Residents.

Health Campaign was finalized with: 1) 2) 3) 4) 5) Motijheel Girls School -- 2500 Students + 90 Teachers and Staff. Clubhouse Town {Residential Complex} 400 residents Kisshore Bharati Boys School 1700 Students. St. Marys Orphanage Day School 1900 Students. Akansha Apartment 250 Residents.

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Table 1: Categorization of the drug information queries

Categorization of queries
Speciality General Medicine Gynaecology Paediatrics Hospital Pharmacy Others Status of the enquirer Physician Pharmacist Intern Others Mode of request Direct access During ward rounds Telephone Email Purpose of query Better patient care To update knowledge Educational purpose Time frame to reply Immediately Same day Next day When time permits Mode of reply Verbal Printed Type of query Adverse drug reaction Drug interaction Dosage Drug therapy Indication Others Performance of drug information centre Excellent Very good Good

Number of queries
101 18 8 21 44 41 26 86 39 155 11 20 6 78 93 21 95 23 49 25 111 81 59 9 25 17 24 58

Percentage of queries (%)

52.6 9.3 4.1 10.9 22.9 21.3 13.5 44.7 20.3 80.7 5.7 10.4 3.1 40.6 48.4 10.9 49.4 11.9 25.5 13.02 57.8 42.1 30.7 4.6 13.02 8.8 12.5 30.2

18 134 19

10.4 77.4 10.9 Page 53

Satisfactory Poor References Textbooks Websites Electronic database Medline Others

2 0 72 68 31 15 6

1.1 0 37.5 35.4 16.1 7.8 3.1

% of Queries
60 50 40 30 % of Queries 20 10 0 General Medicine Gynaecology Padaetrics Hospital Pharmacy Others

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Our Learning's
Customer Interaction Directly interaction with the customer on the ground level. Area Management How to organize the daily task keeping in mind various constraints like time, manpower and the target. Market insight First-hand insight into this sector I learnt how to make good relationships with customer, channel partners as well as colleagues. The practical aspects of marketing theories are materialized during the course of this study During this project I worked on my analytical abilities in practical situations where the customer comes to us with problem and we are suppose to give him/her a suitable solution for that problem.

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VII. RECOMMENDATIONS There are two parts one is creating awareness in consumer markets i.e. making people aware and other part is creating awareness in business markets so as to push sales of the different packages which are offered to the healthcare service providers by Healthline therefore until and unless the marketing and advertisement are not high the sales of the packages would not be possible. In India it is mainly word of mouth communication for preferring medical service provider than availing information through internet/website. So HealthLine 24x7 should try and make people aware and should include a community where not only medical stakeholders but a common man can also interact with others, so that the impact of word of mouth should be continued. The follow-up in case of healthcare service providers are very slow it takes almost a few months to upload the information on their websites and therefore both the healthcare service providers and the consumer tend to forget within a week. To avoid this situation fasten up the system of data collection and be in contact whenever possible. Try and concentrate on areas which have been recently built for awareness in society according to the analysis the age group of people living is quite young and therefore the impact would be maximum. Company should not run for profit in its early stages, first it should wait for a positive response from the market and stakeholders, after that, good amount of revenues can be generated through stakeholders website and micro website. For example: Orkut, face book, twitter and many more.

Internet/website not available everywhere and even during emergency this option become invalid and to overcome it, Religare must provide other options such as toll free number with SMS service and something of Echoupal thing for people living in villages.

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VIII. BIBLIOGRAPHY 1. India Budget 2009, Ernst & Young 2009 2. Four years of NHRM, Ministry of Health and Family Welfare, May 2009 3. Global atlas of the health workforce [online database]. 4. Geneva, World Health Organization, 2008 5. India Chronicle: 2010, Ernst & Young Analysis 6. The Business World, Ernst & Young Survey; June 2009 7. Ten industry trends 2010, Technopak healthcare outlook, 2010 8. Fostering quality healthcare for all, Ernst & Young, 2008 9. Health policy & planning Ramesh Bhatt. 10. en.wikipedia.org/wiki/Healthcare_in_India 11. About .religaretechnology.com/introduction.html. 12. An Overview of the Indian Healthcare System: Two Decades of Change, 1980-2000 (Center for Medicare and Medicaid Services). 13. Redefining Competition in Healthcare, Harvard Business Review. 14. IBM Healthcare report 2010. 15. Industry Analysis Healthcare by Brencom

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