Protect, Predict and Practice: Dakshas is redefining Accessibility and Affordability in Healthcare

By auther pic. Faiza Ruksar Arif

August 27, 2020

Protect, Predict and Practice: Dakshas is redefining Accessibility and Affordability in Healthcare

Dakshas’ elderly care training program is bringing care to the bedridden and abandoned

The wellbeing of its citizens is a key priority of any country and India is no different. Although India has been making steady improvements in healthcare, the COVID-19 pandemic has highlighted the need to transform India's healthcare infrastructure. While COVID-19 has left a trail of despair and disruption in its wake, it has also provided us with a rare opportunity to learn a few very important and hard-fought lessons. We can capitalize on these invaluable lessons to identify ways to leapfrog the standard evolutionary patterns and fundamentally re-imagine our healthcare infrastructure. By leveraging the power of innovative thinking and new-age capabilities we can explore the potential to better manage health, build a multi-tiered healthcare delivery system, and significantly augment the capabilities of healthcare professionals.

Dakshas is one such emerging pioneer in the field of healthcare – revolutionizing access to healthcare for marginalized patients. Dakshas, a healthcare nonprofit project, and was set up with the vision to actualize 'Universal Healthcare', sans financial constraints. With the motto "To ensure healthcare is delivered, not denied." Dakshas offers primary care to 90% of the patients and taps into its dynamic network of healthcare providers for secondary and tertiary healthcare who provide their services at a variable cost. Dakshas provides end-to-end Musculoskeletal Medicine and Surgery services to marginalized populations across the city of Hyderabad. It echoes a philosophy of 'collaborative partnership', working with a plethora of NPOs, charitable/government clinics, old age homes, diagnostic centers and various hospitals across Hyderabad. Over the last four years, Dakshas has developed and scaled a unique methodology that delivers health care to marginalized patients at 16% of private primary healthcare cost, while simultaneously enhancing the practice and efficacy of primary care physicians by 50%.

The Dakshas methodology and best practices have incorporated a tech-based transfer of care from specialists to primary, hospital to clinics; match marginalized patients to free healthcare capacity, plugging resource gaps in charitable hospitals at variable cost and bridge funding poor patients. While a patient may enter the healthcare system at any point, the primary path of entry is either through the community-based preventive screening or primary clinics. Primary care at Dakshas is meted out through clinic or telemedicine-based primary care physicians, trained to screen and treat 95% of the patients, real-time support from specialists.

The 'Primary care clinic' is the heart of Dakshas' initiative and has been deployed via telemedicine, rural camps, old age homes, and elderly rescue sites to identify and aid the most vulnerable sections of society. Patients are screened by in-house physiotherapists using a pre-designed and validated electronic questionnaire to separate minor and major complaints. Minor complaints (95%) are advised and treated through the telemedicine platform, while major complaints are taken up by orthopedic surgeons, either online or in clinics. Further plans for investigations and surgical interventions are planned.

After surveying over 55 old age homes, Dakshas set up a preliminary screening, primary care, and Fall Prevention program to support 10 old age homes spread across 4 clusters in Hyderabad. Each home received nurse-caregivers to aid the abandoned and bedridden elderly in matters of nutrition, hygiene, and daily monitoring. Routine visits by physiotherapists were also arranged to screen patients and provide regular treatment. Data submitted were monitored by a medical team on a dashboard that prioritized abnormal findings and aggregated intervention. Seniors with severe ailments were escalated to specialists or hospitals in a cost-effective model. This program is now being replicated in rural areas as an innovative health care delivery mechanism to the rural elderly.

Dakshas' program has been a gamechanger not only for patients, but also for practitioners and hospitals as well. Dakshas' model saves specialists 80% of time spent on the preliminary evaluation and intervention so that health care specialists and centers can focus on complex patient care, counsel patients effectively, and carry out in-patient treatment. The post-discharge follow up has also been taken up by Dakshas and is conducted at the community clinic closest to the patients' home. With an unburdening of specialists and hospitals, they have offered their services at lower prices, often agreeing to treat in public insurance systems like Arogyashri. Dakshas' unique approach has enabled specialists to save on 1500 working days and perform an extra 210 surgeries, resulting in improved capabilities and reduced morbidities. Additionally, patients received 40,000 treatment sessions, while saving over 2.4 crores in 'Out of Pocket Expenses' (OOPE). While internally the average treatment costs Rs. 98/- session and an Rs.256/- per patient, Dakshas hopes its tech platform can be deployed externally at an incremental cost of Rs.50/- per treatment session.


Through its collaborative partnership Dakshas has allowed specialists to increase intensive care and performs a larger number of surgeries.

Dakshas' health model has not only stood the test of time but is COVID resilient and responsive. Dakshas adopted a three-pronged approach to combat the ever-growing pandemic - Protect Vulnerable, Predict Ahead and Practice Online. Dakshas was able to rapidly transfer all its orthopedic services online to its technology platform and accommodates over 250 calls a day. Through its telemedicine platform and remote monitoring system, Dakshas was able to extend its preventive services to 81 shelter homes. Amidst the COVID lockdown, Dakshas was able to train and implement infection control across 306 units including old age homes, shelter homes, temporary migrant camps, ration outlets, government healthcare units, and hospitals. What is perhaps most intriguing among the plethora of services offered, is Dakshas' predictive capabilities. To further optimize supplies, a volunteer Data Scientist group, led by Dr. Durga Bhavani and Dr. Shobha Rani, from CSIS, UoH, published a model that can predict the number of infected cases, in any district, 7 days in advance. This initiative will afford authorities and hospitals a week to prepare for patients who will require treatment.

Dakshas has achieved tremendous impact at scale in 24 months, proving that Universal Healthcare is both attainable and sustainable within the existing healthcare system. Dakshas is now consolidating this unique model onto a tech-based, AI-enabled, medical protocol-driven demand-supply aggregator platform. This will benefit patients, NGOs, and healthcare providers alike, heralding an era of 'collaborative' healthcare. The existing platforms are two telemedicine modules and an elderly monitoring dashboard. Three more innovative technology tools are in the pipeline - one to automate PPE supply and another telemedicine bot for WhatsApp. The third tech model has been envisioned as an online marketplace to ensure migrant citizens get hyperlocal essential industry jobs.

When the going gets tough, the tough get going. COVID-19 has presented India a unique but challenging opportunity to significantly upgrade its healthcare infrastructure. This journey will require bringing together cutting-edge technology capabilities, inspired creative thinking, and relentless execution. Through its unique amalgamation of technology, collaborative partnerships, and a social inclusivity lens, Dakshas has showcased that it can successfully deliver world-class outcomes at highly attractive cost points. By successfully re-imagining its healthcare infrastructure, India has a chance to not only serve its citizens well but also show the world that it is possible to deliver high-quality healthcare at reasonable and affordable costs.

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Impact-Story is a series on development and CSR interventions leading to some impacts on the ground. If you have a project, innovation or intervention that has changed the lives of a few people or a community, please share a brief note at shilpi@csrbox.org. Our Team will get back to you after validating the information for a detailed coverage.

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Faiza Ruksar Arif is a content specialist and researcher based in Bangalore who has worked extensively on curating curriculum and educational programs for adolescents in Telangana. With a Master’s degree in Gender Studies from Tata Institute of Social Sciences, Faiza is on a mission to improve social realities by equipping women and other marginalized sections, with improved access to health, education and livelihood opportunities. She also dabbles in artwork and is passionate about issues pertaining to mental health and minority politics.


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