Indian healthcare sector faces many challenges from shortages of beds to declining trend in nursing professionals. However, there are certain start-ups, which have resorted to address those challenges, thus finding a business opportunity. This brief presentation analyses the current ecosystem of technology-oriented healthcare start-ups in India from the perspective of services they're offering and further opportunities in this space.

1. TECHNOLOGY HEALTHCARE START-UPS: PROFILING AND ANALYSIS
FOCUS MARKET: INDIA
AUTHORS: GURPREET SINGH, MANISH KHURANA

2. Table of Contents
Healthcare start-ups: Introduction and Ecosystem Slide 4
Category Analysis Slide 7
Investment Analysis Slide 9
Opportunities Slide 15
Research Methodology Slide 17
2

3. Table of Contents
Healthcare start-ups: Introduction and Ecosystem Slide 4
Category Analysis Slide 7
Investment Analysis Slide 9
Opportunities Slide 15
Research Methodology Slide 17
3

4. 4
Healthcare Start-ups – Introduction
Reference
1: http://wdi.worldbank.org/table/2.15
CHALLENGES IN INDIAN HEALTHCARE
•Healthcare delivery system is evolving in India
with a number of start-ups serving different
elements in the value chain
•The doctors to patient ratio1 of 0.7 per 1,000
people in India is one of the most abysmal in
the world – this is all the more reason for
innovation to happen in the healthcare value
chain
•The ratio goes further down to 1:60,000 in the
rural areas
•US has about 20,000 oncologists, whereas
India with more than 1.25 billion population
has just around 1,500 oncologists
•The number of hospital beds per 1,000 people
in India is just 0.7. This puts tremendous
pressure on the existing public healthcare
infrastructure1. The global average of beds per
1,000 people is 2.9
•The number of nurses and midwives per 1,000
people in India is 1.7. This ratio is again quite
low given that this support staff have to cater to
a large population1
ADDRESSING THESE CHALLENGES
•Healthcare delivery system is evolving in India
with a number of start-ups serving different
elements in the value chain
•Most of these start-ups are service-oriented
with following dominant services:
•Enabling patients to connect with doctors
•Getting price transparency in diagnostics and
surgeries
•Increasing access to doctors (especially for
patients living in rural areas)
•Other services include electronic medical
record management
•So far, no start-up has been valued as a unicorn.
Most of the start-ups are still quite young (less
than 5 years of existence) and their business
model and offerings are evolving
Challenge
Improve healthcare
delivery especially in
the rural sector
Opportunity
Start-ups with their
wide range of
offerings can help
bridge the gap in the
access to quality
healthcare between
urban and rural
India

5. Healthcare Start-ups - Ecosystem
Pre-delivery /
Diagnostics
Healthcare Service
Delivery
Hospital In-home
Post-consultation
care
Care awareness
Emergency Support
5
Price Aggregator

6. Table of Contents
Healthcare start-ups: Introduction and Ecosystem Slide 4
Category Analysis Slide 7
Investment Analysis Slide 9
Opportunities Slide 15
Research Methodology Slide 17

7. Category Analysis
• Research suggests that most start-ups are focused
on Telemedicine and Appointment Booking
• It is healthcare delivery in rural sector that presents
the maximum opportunity as patients have little to
no access to doctors
• Among the firms with promising potential to grow,
Neurosynaptic Communications has product as well
as solution offerings to serve people in rural areas
• In-home Medical Care is another category where
there is a lot of interest and there are few firms
with only this single offering
• Bengaluru hosts the most number of healthcare
start-up firms followed by Gurugram and Mumbai
EMR – Electronic Medical Records
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8. Table of Contents
Healthcare start-ups: Introduction and Ecosystem Slide 4
Category Analysis Slide 7
Investment Analysis Slide 9
Opportunities Slide 15
Research Methodology Slide 17

9. Summary - Investment in Healthcare Start-ups
12
13
4
< 1 mn
1 to 10 mn
> 10 mn
Number of Start-ups by Investment Slab
221.9
32.3
4.3
Total Funds Raised in Each Slab
> 10 mn
1 to 10 mn
< 1 mn
• Four companies have received more than $10 million funding. Together these four companies, have raised $222 million.
• There are 13 companies in the '1 to 10 million' category (mid-sized), with a collective investment of $32 million
• 12 companies comprise of the ‘< 1 million’ set (small-sized), with an aggregate investment of $4.3 million
• Across all categories, there are a total of 21 companies active in telemedicine
• Other popular categories include Appointment Booking, Diagnostics and In-Home Medical Care
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10. Analysis of Firms with funds raised > $10 million
• Total funds raised - $222 million or 86% of the total funds raised by healthcare
start-ups. These are the BIG 4 of India's healthcare start-ups
• Practo rules the investments roost with $124 million and offers a host of services
• Portea Medical offers In-home Medical Care and Diagnostics, while Nightingales is
purely focused on In-home Medical Care
• Appointment Booking, In-home Medical Care, Diagnostics and Telemedicine may
have already set the direction for technology-oriented healthcare start-ups in
India
• These categories rightly attempt to address the challenges in the healthcare
sector in India by making healthcare more widely accessible to people
• For instance, India's patients to physicians ratio at 0.7:1000 is lower than WHO's
prescribed ratio of 1:1000.
• With Telemedicine, patients can reach out to doctors at least for non-critical
ailments and for second opinions. Thus, reducing the challenge of lack of
adequate physicians to some extent
• Other interesting category is In-home Medical Care. India's has 0.9 hospital beds
per 1,000 people vs global average of 2.9 for 1000. The situation is even worse in
rural India. In-home Medical Care can help address this issue as these firms
expand in tier-II and tier-III cities
124.0
46.5
40.0
11.4
Funds Raised ($ mn) in > 10 mn Slab
Practo
Portea Medical
Nightingales
Lybrate
10

11. Analysis of firms with funds raised in $1 to $10 million slab
6.0
4.4 4.0
3.2 3.0 2.5 2.0 2.0
1.2 1.0 1.0 1.0 1.0
Funds Raised ($ mn) in 1 to 10 mn Slab • This is an interesting set of companies that are actively seeking to raise more
funds to grow
• If we look at the investors’ profiles, for example, Welcome Cure is backed by
one of India’s largest media house, while Care24 is backed by Aegis
• Even the relatively smaller ones in this set have interesting investors
• Department of Science and Technology being one of the investors in
MediAngels
• Healthcaremagic was funded by Accel Partners and got acquired by US-based
Ebix – a provider of software and eCommerce solutions for insurance firms
• DoctorInsta is backed by RoundGlass Partners – an active investor in digital
health and wellness space globally
• Tele-consulting, Diagnostics and In-home Medical Care are the categories
where most of these firms operate
• There could be potential synergies between these firms and the BIG 4
(operational efficiency, increasing regional presences, increasing number of
registered doctors)
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12. Analysis of firms with funds raised < $1 million
0.9 0.8
0.7
0.5 0.5
0.3
0.2 0.2 0.1 0.1 0.1 0.1
Funds Raised ($ mn) in < 1 mn Slab • These set of companies are relatively early in the lifecycle and it will take
some time to reach a notable scale – they are not more than three years old
• Eureka Forbes Good Health (EFGH) backed by Eureka Forbes, one of the top
health-focused consumer durables firms in India, offers one of the widest
spectrum of services including Telemedicine, Appointment Booking,
Diagnostics and EMR
• Other firm offering one of the broadest range of services is PurpleHealth; it
offers Appointment Booking, Tele-consulting, In-home Medical Care and
Price aggregator
• Healthcare financing and Price Aggregator are unique key service offerings
in this group compared to the other two groups of start-ups
• Notable firms include Medikoe offers Price Aggregator and Marketplace
services and LetsMD offers Price Aggregator and Healthcare Financing
12

13. Analysis of firms with no funding data available
• This is the set of companies for which no funding data could be obtained
• One of the things that has been common in all set of companies is the
services they offer; even these companies are mostly active in
Telemedicine, Appointment Booking, Diagnostics and In-home Medical Care
• Healthcare at Home is one of the most innovative start-ups offering ICU at
home services
• This certainly goes well with the challenges of lack of beds and a declining
trend of nursing professionals
• Apart from this, this set of firms also offer other services such as MIS, EMR
and Price Aggregator
13

14. Table of Contents
Healthcare start-ups: Introduction and Ecosystem Slide 4
Category Analysis Slide 7
Investment Analysis Slide 9
Opportunities Slide 15
Research Methodology Slide 17

15. Opportunities
Access of Quality Healthcare in Rural
Areas
•One of the biggest opportunity lies in
finding ways to increase access to good
quality healthcare in rural areas where
otherwise the doctor to patient ratio is
abysmal
•Neurosynaptic Communications is one firm
which is doing notable work in taking
healthcare to rural areas in a holistic
manner with its range of solutions. There is
space for more firms to operate and thrive
in this space
In-home Healthcare Delivery
•The in-home healthcare delivery market
is expected to grow at a CAGR of 9% and
estimated at $349 billion
•This section of the growth in healthcare
market can be attributed to means of
double household income, changes in
social structure of families, and an
increased need for geriatric care
•HealthcareathomeIndia is providing
service of ICU at home service. It is firms
like these that can provide an alternative
solution to the low number hospital beds
in India
Other Big Opportunities
•Single specialty hospitals across tier-II and
tier-III cities – The number of hospital beds
per 1000 people in India is still quite low
and there is a need for more hospitals in
smaller tier-II and tier-III cities
15

16. Table of Contents
Healthcare start-ups: Introduction and Ecosystem Slide 4
Category Analysis Slide 7
Investment Analysis Slide 9
Opportunities Slide 15
Research Methodology Slide 17

17. Research Methodology
Identified and profiled technology-oriented healthcare startups that began
operations in last eight to ten years
Filtered the companies that offered services to patients; excluded those that
offered enterprise-only solutions
Capture their service offerings and investments data from secondary sources
including various news websites and technology blogs
To understand the variation in funds raised by these Start-ups, we’ve
categorised them into three investment slabs: ‘< $1million’, ‘$1 to $10 million’
and ‘> $10 million’
Total Companies Identified: 47
Total Companies for which funding data was
available: 32
Following categories have not been included for this
research:
* Pharmacy
* Firms with software offering for MIS in healthcare
* Social networking of doctors
* Healthcare concierge
* Fitness Start-ups
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18. THANK YOU!
Gurpreet Singh
+91-987-171-9590
gurpreet@niteo-partners.com
Manish Khurana
+91-903-600-8036
manish.khurana@outlook.com
FOR A MORE DETAILED RESEARCH PLEASE CONTACT