Richa Singh, CEO of Philips Homecare, says, "It is a very serious challenge. Manpower is what will ensure the quality you deliver at home. We are reaching out to colleges where we can recruit, train and deploy. The shortage is in terms of quality nurses and paramedics."
Home Healthcare is a $5 billion market opportunity, and is quickly lilely to double, according to Vishal Bali, co-founder and chairman of Medwell Ventures, which runs home healthcare specialist Nightingales.
There are eight to ten major organised players across the country now, including Portea, Medwell Ventures, Care24 and India Home Healthcare, which is in collaboration with Bayada, Healthcare at Home, Apollo Homecare from Apollo Hospitals, Max Healthcare and Philips.
"There wasn't a single organised player in the segment three or four years back," Bali says. "Staffing is a challenge. You are creating a completely a new cadre of staffing and home healthcare as a career option. The quantum of people we need, because we are providing services at home, is a lot more."
"The segment needs a whole spectrum of skilled manpower, such as doctors, nurses, physiotherapists and other staff. One way to address the challenge is to deploy the available skill manpower more efficiently, using technology to help them monitor and serve customers better," says Meena Ganesh, CEO and MD of Portea, the largest player in the space, with a presence in 16 cities.
"At a macro level, there are 120 million elders and assuming they need assistance even in a small way, the size of the market is huge. It is a very large and un-penetrated market, needing a lot of resources. There is a demand supply gap as of now," she said.
Training institutes for nursing aides are few and far between in India and at the pace at which the industry is growing, thousands of people in this segment alone would be required every year. The company is working with National Skill Development Council (NSDC), Karunashraya Trust and others to identify and train nursing attendants.
Portea has also developed a software platform using third-party devices to monitor and collect various health-related data from the patient using wearables. This, in a way reduces the resources required for continuous monitoring of patients. It also uses video call facility, remote diagnostics and other technologies to improve the bandwidth of clinicians and doctors.
The sector is likely to grow at a faster pace, backed by investors in many of these companies, who have engaged in various rounds of funding in the recent past. Around $147 million has been invested in the segment in 13 deals between 2013 and 2017, according to data from alternate investments research firm Venture Intelligence. Investors such as IFC are helping their investee firms in various aspects including getting technology to address staffing and other challenges.
"Backed by the country's largest hospital chain network, Apollo Home Health is facing the same challenge and working on addressing it," says Mahesh Joshi, the company's CEO. "Even hospitals are running short of nurses and doctors. The home healthcare space is not an environment nurses or doctors are trained to work in. We always find a challenge in getting them recruited and even if we recruit, attrition is very high. If you get people, their skill sets are not suitable for home healthcare."
He said that instead of the traditional Indian model of the healthcare professional staying round the clock with the patient, in the evolved markets, the manpower is managed with the professional visiting the home once in a day or a week, while a healthcare aide would take care of the routine work.
"This model would help skilled resources handle four or five patients. Today one person is attending to one patient. If you're able to evolve to that level, your cost of home healthcare delivery will come down," Joshi adds.