THE ROAD TO SMB IT NIRVANA

Express Computer

Project management is something of a Black Art. Change Management is a topic that deserves far more attention that it usually gets. The IT manager in the average SMB lacks the kind of extensive resources that a CIO/CTO in a large company can tap. So what is the SMB IT manager to do? There are some basic principles that, when applied diligently, can spell the difference between the success and failure of IT at an SMB.

- Communicate, communicate, and communicate: Do not leave your users hanging dry on the line. You have to communicate any major change before it you make it. Maintain a database of cell phone numbers of all HODs and SMS details of any proposed change to them before you make any substantial change to an existing system, particularly if the system in question is an essential one (think messaging, file & print, ERP etc.).

- Pick an appropriate solution: An enterprise-class solution may or may not work for a medium business. It definitely will be no good for a small business. There are SMB-specific solutions out there. Give them preference over enterprise solutions that have been jury-rigged to fit your needs. Exchange and Notes are wonderful solutions for large companies with thousands of users or even for IT-savvy organizations with a smaller user base. However, for a small company or even a medium business that does not have an IT team with sufficient skill sets they can mean a messaging system that is slow, unwieldy, underpowered and doesn’t scale when user’s needs grow. This is no reflection on the enterprise software. It is, however, exactly what happens when an SMB is unable to invest sufficiently in hardware and bandwidth to provide a decent messaging experience to end-users. Overall, an SMB is better off opting for a hosted e-mail solution from Google or Rediff rather than going in for a do-it-yourself approach.

- Listen to your users: When things go wrong it is all too easy to shoot the messenger. Instead, listen to your users and work with them to find solutions when things go wrong even if you feel that the problems are silly. From the user’s perspective, they are probably game changing.

- Big Bang/Steady State: The choice of how you go about upgrading and introducing new systems lies between the ‘rip off the plaster in one quick jerk as it’ll hurt less’ also known as the Big Bang and the ‘let’s do things incrementally’ or Steady State model. Each has its plusses and minuses. Take a call based on the situation. If you must put in a new SFA application as sales are languishing thanks to lack of timely information or lack of sharing of information between sales staff, then you need a Big Bang. If you have users complaining about slow response time and overflowing mailboxes on your e-mail system an incremental approach where you pinpoint the heavy users and determine if their needs are real in conjunction with business heads and then roll out upgrades for those users first might work better in such a case.

There is no magic wand to wave and chase the IT blues away but the above principles can help foster a healthy working relationship between the IT team and the rest of the organization.

 

SOFTWARE PRODUCT EARNINGS TO RISE 10-FOLD

Bangalore
Business Standard | The Economic Times | The Hindu Business Line | The Financial Express | The Times of India | 

The Indian software product sector is expected to register a 10-fold increase in revenues over the next seven years. Revenues may range between $9.5 billion and $12 billion by FY15, from the current $1.4 billion, according to a new Nasscom-Zinnov study.

However, these Indian companies are yet to reach out vigorously to the developed markets such as the US and Japan and remain confined to the domestic market. Of the existing 371 software product in India, over two-thirds were launched in the past three years.

Over 100 companies started their operations in 2007. The top 10 companies still dominate the software product development market, accounting for 84 percent of the segment revenues from India.

"We have taken a conscious decision to focus on India and some emerging markets where the risk is lower. We are looking at markets where we find it easier to enter, experiment faster, and where the market tolerance is higher," explains Bharat Goenka, MD, Tally Solutions. Even after 21 years of its existence, Tally is primarily focussed on India, apart from some emerging markets such as West Asia and Africa.

Vishnu Tambi, co-founder of Nagpur-based Excellon Software, concurs, "We introduced our first product – AutoSol – in 2006, and so far our customers are largely Indian. We believe that India is a very good market to test a product, and then go out. We are now preparing ourselves to enter into some emerging markets such as Malaysia, Thailand, the Philippines and Cambodia."

On its part, the Nasscom-Zinnov analysis reveals that the size of the domestic software product market in FY08 was $2.3 billion, of which, the Indian software product companies cornered about $460 million and the global software product companies garnering $1.84 billion. In return, the Indian software product companies sold about $960 million worth of products outside India – mostly in emerging markets.

Pari Natarajan, CEO, Zinnov, asserts, "We very strongly feel that by 2015, Indian software product business revenues would be more evenly balanced between domestic and export-based sales, and the share of revenues from the domestic market would increase from 32 percent in FY08 to an average of 41 percent by FY15 to reach $4-5 billion."

He adds that the key parameters – such as proximity of Indian software product businesses to the local market requirements, excellent understanding on localisation requirements, and ease of adopting customised and targeted sales approach – would fuel this growth.

The study also states that over the past three years, the annual revenue aggregate of the Indian software product businesses has grown at a CAGR of 44 percent. Leading Indian software product firms have strengthened their product portfolio through steady investments in organic growth as well as through overseas acquisitions.

However, industry leaders believe that the Indian software product industry is already late in trying for a success in a much larger market such as the US, which was the strong forte for the Indian IT services company. To take the products to markets such as these, requires a higher marketing investment and greater understanding of the market requirements.

The fact that most of the Indian product companies, while devising their plans, think specifically about the domestic market, makes their products unattractive to established markets abroad.

"We are already late in tapping opportunities in the US market. There is a history of services' companies going to the US, but not the product companies.

This is the reason why most Indian product companies should look at non-traditional markets such as India and China which are scaling up first, and where the demand is very high in areas such as security, retail, online gaming and mobile space," opines Sudhir Sethi, chairman & MD, IDG Ventures.

 

INDIA ALL SET TO RULE SOFTWARE TESTING MARKET

Durba Ghosh, New Delhi
The Economic Times

India is all set to become a leader in the software testing market with an increasing number of software development companies outsourcing their software testing work here. Industry analyst firm Gartner has pegged the worldwide software testing market at $13 billion and the global market for outsourced testing services to be around $6.1 billion, of which India is expected to corner a 70% share.

Software testing implies checking any IT system prior to implementation for multiple aspects like functionality, reliability, usability, security, compliance and performance. Market players like Hexaware and AppLabs believe that the need for outsourcing software testing has grown due to the high level of complexity and multiple intersection points in modern software.

“The winning combination of cost, communication, exposure to various domains, testing principles and test tools gives a clear edge to India in software testing,” said Hexaware Technologies global delivery head and chief software architect Ramanan RV. While software services are growing at an average of about 10-12% globally, testing is growing at over 50% every year. The market opportunity for Indian offshore testing companies is seen at around $8 billion by year-end, from $2-3 billion a year ago.

“Indian businesses have matured in terms of making IT central to all business processes. Hence, there is a very high level of business dependence on error-free software code,” said AppLabs president and CEO Makarand Teje.

A global case in point is eBay, which experienced a 22-hour outage of its website in 1999 due to software flaws. It cost eBay $5 million in revenue and an 11% drop in share price. The outage affected 1.2 million customers who were either trying to sell or buy something on the website.

Along with the growth witnessed in offshoring of software testing to India, the average deal size of such projects is also on the rise. A few years ago, the average deal size for an outsourced testing project was about $50,000-60,000, requiring a few testers. That has now grown to about $2-4 million per project.

According to Gartner, India will require around 18,000 testing professionals every year over the next three years to fulfill the demand seen in the software testing market.

 

TRANSFER OF COMPUTER SOFTWARE HELD TAXABLE

H P Aggarwal, New Delhi, August 4, 2008
Business Standard

When a foreign company transfers computer software to an Indian company from outside India, is the foreign company liable to pay income tax in India? This issue arose in a recent case of Airport Authority of India (AAI), which entered into two contracts with a US company – one for hardware and other for software. Whereas supply of hardware was held as non-taxable, but the supply of software was treated as “royalty” and “fee for technical services”.

Commercially there are two types of softwares, namely, “unbranded software which is specialised and exclusively custom made to cater to the needs of individual clients”, and “branded software” or “off the shelf software” which is standardised and marketed as such. The software supplied to AAI consisted of customised software.

AAI contended that when the US Company shipped the software and documentation, the property passed to AAI outside India. It also contended that the entire activities under the contract except some support activities were performed outside India. The essence of the contract is outright sale of some copyrighted software, but the software could be used only for the specified intended purpose.

The issue before the AAR was whether payment received by US Company under the transaction is liable to tax in India in the hands of the US Company? The AAI pleaded that the supply of software should be treated as sale of goods and the resulting income should be treated as business income.

Reliance was placed on a SC decision in the case of Tata Consultancy Services vs Union of India [2004-271 ITR 0401 {SC)] in which the supply of software was treated as sale of goods. It was also contended that there is a distinction between grant of licence to use a copyright and sale of a copyrighted article.

The Indian I-T Act does not contain any clear provision with regard to transfer of computer software. Therefore, a taxpayer is entitled to take help from internationally accepted commentaries like the OECD Commentary, which provides for treatment in case of transfer of full ownership rights as well as for partial alienation of rights. It is clear that even in case of partial alienation of rights, in certain circumstances, the consideration will be a business income and not royalty.

The AAR dismissed the assessee’s reference to OECD commentary, which clarifies the distinction between the right to use copyright and transfer of a copyrighted article. According to OECD only a transfer that enables a transferee to commercially exploit software copyright will give rise to royalty income.

But where the transferee gets exclusive rights for use, though short of full ownership, it will nevertheless be a case of sale of software. In the Microsoft case also, the Tribunal rejected the assessee’s contention to rely on the OECD commentary. In this case, the payment in respect of supply of software with an exclusive right to use was treated as royalty and was hence held taxable in India. The Tribunal rejected the plea to rely on Tata Consultancy case.

Even if the rationale of the ratio laid down is not questioned, the judgments will have a tremulous effect on India’s outsourcing business, which constantly requires new software besides modification and updgrade of the old one. The government should take a practical view and clarify the Indian law to synchronise the same with OECD commentary.

 

POOR WILL BE LEFT OUT AS HEALTH CARE COSTS RISE

Seema Singh, Bangalore, August 4, 2008
Mint

Although India’s spending on health-care delivery and drugs will rise almost five times to $126 billion (Rs5.4 trillion) in 2015 from $27 billion in 2007, over 800 million of its poor will still struggle with medical costs, says a report by Institute for Business Value, or IBV, of International Business Machines Corp, or IBM. Citizens will bear most of the cost, just like today where out-of-pocket spending accounts for 78% of the overall spending, the report says.

“Escalating medical spending inflation, which increased more than 200% between 1995 and 2005, will increasingly force citizens to choose between public and private services, or to forego care altogether, except for life-threatening situations,” says Healthcare in India: Caring for more than a Billion, a proprietary study by IBV.

“This is the first comprehensive attempt to look at the drivers and inhibitors of change which also lays down some key models in health-care delivery and management,” says K.S. Raghunandan, director of solutions and business development at IBM India Pvt. Ltd.

Just like the Reserve Bank of India computerized banks in the 1990s when foreign banks started coming in, some apex Indian agency now needs to lead the way and lay down technology standards in health-care, says Mohammed H. Naseem, vice-president of health-care at IBM India. “Inter-operable standards in electronic health records, clinical management and other areas can reduce incremental cost.”

The report brings out this shortcoming. Private hospitals, it says, are increasingly investing in IT systems but most progress is in areas such as billing, accounting and administrative systems, rather than clinical information systems.

“It’s true. There’s no holistic solution in IT infrastructure because Indian companies provide piecemeal answers and we have to go to overseas companies that do not understand our requirements well,” says Devi Prasad Shetty, cardiac surgeon and promoter of Bangalore-based Narayana Hrudalaya Pvt. Ltd, which owns a chain of hospitals.

The report says India needs to stress on preventive health-care. “We know prevention is better than cure, but the extent to which it can be beneficial was a revelation,” says Raghunandan. The report says 329,670 cancer cases, 51.2 million cases of heart disease and 41.4 million diabetes cases can be prevented by 2015, if Indians adopt a healthy lifestyle.

 

BLESSING IN DISGUISE: ATTRITION RATES MAY SLOW DOWN TOO

Pradipta Mukherjee, Kolkata, August 3, 2008
Business Standard

It’s a blessing in disguise, of sorts. Indian companies, which had to face a huge attrition problem over the last few years, can finally breathe easy. HR analysts said the economic slowdown is expected to reduce the attrition rates across industries, at least for the next two quarters.

The attrition rates had touched almost 35 per cent in some industries such as financial services and retail, primarily due to companies ramping up their manpower. But the party seems to be over for the time being.

The country's second largest bank, ICICI Bank, for example, froze promotions, reduced bonuses and cut annual increments in April this year — a sure indicator of companies trying to bring in cost efficiencies to prepare for the slowdown ahead. The bank says its attrition rate has not gone up.

Sampath Shetty, vice-president, TeamLease Services, a staffing firm, says the overall employment outlook has seen a decline over the last four quarters, with cities such as Mumbai and Kolkata reaching a growth threshold for job opportunities. Chennai would experience a hiring slowdown, with most of the manufacturing firms at the last stages of large-scale hiring for Greenfield projects.

Others agree. Milind Sarwate, chief of HR and strategies at Marico, says managing attrition had become very challenging for the FMCG industry, even after good salary hikes and career opportunities.

"But as the economy cools down, the attrition rates in the FMCG sector will come down from the current 20 per cent to around 12 per cent very soon. The companies will hire less, leaving limited options for employees to switch jobs."

Y P Yadav, managing director of Genius Consultants, a recruitment and corporate training firm, estimates the attrition rates in the retail and real estate sector to come down to 25 per cent beginning next quarter — a fairly high number, but is better than the earlier rate of 30-35 per cent. This is because retail chains will hire less and depend more on temporary staff and variable payments.

Spencer's Retail, for instance, will do away with about 40 of its not-so-profitable stores and hire less people. The existing employees will be relocated to the new stores locations. Spencer's used to hire 500-600 people per month till last year. But over the next two quarters, the company would recruit about 200-300 people per month, according to a spokesperson of the company.

“The July-September quarter will determine the course of industry over the next two years. A lot will depend on the performance of the economy. New recruitment will depend on how businesses shape up during the coming quarter,” said Amitabh Mundhra, director, Simplex Infrastructures.

According to data provided by Yadav, the information technology sector, including BPO services, software and hardware companies, currently witnesses average attrition between 35 and 40 per cent, which will again slow down as corporates curb hiring.

For instance, Patni Computers reduced its workforce by 400. Companies like IBM and TCS have slashed jobs in their software and BPO operations. IT company Hexaware has also announced that it will not hire for the next two quarters.

Simultaneously, telecom and banking services currently have an attrition rate of 25 – 30 per cent, while media, entertainment and manufacturing witness an attrition of 15 – 20 per cent currently, Yadav informed.

According to Devang Sampat, VP – marketing and programming of Cinemax multiplex chain, “The overall slowdown would cause less expansion which will directly affect recruitment plans. For instance, till last year we were expanding by 100 screens per year. But now due to the overall slowdown we are looking at 20-25 screens per year. Each Cinemax property would employ close to 100 people, and that will obviously come down drastically as we expand at one-fourth the rate compared to what we used to.”

Aviation, which has also been a big employment-generator, is yet another example. Go Air, for example, axed 400 jobs in the past six months and has frozen recruitment plans. Deccan, too, has frozen recruitment and is reviewing its business plans due to the sudden increase in jet fuel prices.

 

HR: SUM TOTAL OF ALL ROLES

Ajay Oberoi
Express Computer

Packaging is essentially the face that interacts and builds perceptions at first sight. It provides the touch and feel. Key requirement is to build assurance of competence and comfort. This comprises of communication, employee support, grievance handling, and creating a happening place.

Now if these are the expectations and the deliverables, then can HR be inferior to any other function in the organization? Rather, HR plays the role that is sum total of the roles played by the CEO, CFO, CIO, CTO, COO, CPO. Let us see this equation and its real meaning i.e. HR= CEO+ CFO+CIO+CTO+COO+CPO.

- CEO: Chief Ethics Officer¡Xcreate a culture of fairness and transparency; flexibility with precision.
- CFO: Chief Fun Officer¡Xmake it the happening place; employee should love to come to office.
- CIO: Chief Integration Officer¡Xintegrate people goal to organization goals and develop team spirit.
- CTO: Chief Talent Officer¡Xsource, develop and manage talent for current and future needs.
- COO: Chief Opportunity Officer¡Xcreate opportunity for all employees.
- CPO: Chief Processes Officer¡Xdevelop processes for higher productivity and people comfort.

Only a comprehensive model can address the complex issues HR faces. HR needs to focus on people to build a competitive organization. It needs to integrate people and processes for business performance for being truly strategic partners in business. In order to be seen as a value-adding and driving function, HR needs to perform various activities like reporting; administration, conceptualizing and operationalizing as a whole and not in isolation. And, for being growth-oriented, HR needs to be guiding and revitalizing through orienting and operationalizing work practices, timely and holistically (at all levels and parts of the business).

There are no shortcuts to organizational success, every department has to work its way up. And the management is too complicated to be reduced into a few steps or things to do. One needs to work one¡¦s way by going back to the basics i.e. being honest, frugal and prepared.

Future of HR

To my mind HR would be called upon to defy the bell curve of standard distribution and would be expected to develop people so that the curve is compressed. Essentially the gap between top and bottom performers will have to be reduced to improve overall productivity. For this, HR would have to build a psychological contract between the employee and the employer and develop durable, sustainable, competitive advantage through people processes.

It would also have to organize people into self-managed teams and decentralize decision-making. HR would be instrumental in building innovative compensation management practices including contingent portion. It would have to propagate and practice sharing of information; share knowledge across organizational boundaries and set the direction for change¡Xby identifying problems critical to the business success, take the proactive role in bringing about change and build commitment to strategic directions.

Ajay Oberoi is Executive Vice-president¡XHR & Admin, Aptech

 

BOUNTIES ON STRANGE SHORES

Sashi Chimala
Outlook Business (Edition: August 9, 2008)

There is a saying in the venture capital circles: a needle is stronger than a hammer. The point is that a small business has a better chance of market penetration by being sharply focused. In fact, focusing on a niche that is neglected by the bigger companies is sometimes the best strategy to make a huge impact, and possibly build the next Microsoft or Google.

When IBM approached a young Bill Gates in 1980 to build the DOS operating system, Big Blue was trying to outsource what it thought was a less important and non-critical task. As history proved otherwise, the PC became the single greatest invention of this century. And IBM’s lack of understanding of the potential of the ‘niche’ personal computer business opened the windows to Microsoft’s eventual domination of the industry.

While Microsoft was considered the undisputed leader in the software business until just a few years ago, a little known company called Google entered the small but growing area called the Internet search business. At that time, this was viewed as a not-so-attractive area, and the revenue potential was bleak, if not non-existent. At a June 2008 Microsoft event, Bill Gates admitted to Microsoft being the "real underdog" compared to Google.

What Google achieved in a very short span is no accident. The annals of business history is full of examples of small and nimble companies outpacing their bigger rivals by focusing on a small, under-served niche that the bigger companies often ignored. Identifying such gaps in any business area is perhaps the best chance for budding entrepreneurs to break into the business scene and make a huge impact. So, how does one go about identifying the niche and building a successful business around such a gap?

The orientation
Focus on ‘why’ and not just ‘what’. Understanding people’s deeper motivations is where the biggest opportunities for new ideas can be found. This approach opens up your eyes to ‘not-yet-fulfilled needs’. Starbucks Coffee is a great example. While the large players like McDonalds concentrated on ‘being everything to everyone’, Starbucks focused on just one speciality: coffee and related beverages. Today, even after 37 years since its inception, there is no significant competitor to Starbucks.

Not just niche, but a niche with potential. There are two types of areas that entrepreneurs can focus on: areas that continue to remain a niche and serve a small, specialised set of customers and areas that have the potential to become more mainstream as more customers adopt the trends in the future. The latter kind, obviously, has the best potential.

When you analyse successful companies that grew from a small speciality, you will notice that the entrepreneurs behind them identified a niche that was not currently served by existing competitors, but also had a huge potential to be tomorrow’s mainstream businesses. Then they designed their products and their companies to suit the needs of this customer segment. The international business landscape is full of success stories of many entrepreneurial Davids beating the mega business Goliaths. One of the best examples is Southwest Airlines. When Southwest entered the business, the airlines industry was dominated by big companies boasting a diversified mix of jumbo jets to commuter planes that served a wide network covering hundreds of terminals. Herb Kelleher, CEO of Southwest Airlines, focused on a unique market niche: They were the world’s only short-haul, high-frequency, low-fare, point-to-point carrier. They even simplified the entire process by purchasing just one type of aircraft. In the long run, the results spoke loud and clear. It is one of the few airlines that has shown a profit nearly every quarter since inception. Not surprisingly, Southwest thrived well even when economies were in recession. Today, after almost 36 years, when most major airlines are considering bankruptcy, Southwest continues to be strong.

 

HEALTHCARE FOR THE OTHER INDIA -II

K. R. Balasubramanyam
Business Today (Edition: August 10, 2008)

Network to firm up

The District Hospital in Chamarajanagar, 185 km from Bangalore, stands out as the best example of how a private hospital can test the limits of a government programme. Narayana Hrudayalaya (NH) has taken over the cardiac care unit at the district hospital. It’s the NH team that runs the show here.

When the government and ISRO together launched the project in April 2002, they zeroed in on Chamarajanagar and the Vivekananda Memorial Hospital run by an NGO, at Saragur in Mysore district.

While the Chamarajanagar unit has so far provided telemedicine consultation to about 900 patients, the hospital at Saragur has progressed enough to offer speciality care in a few disciplines such as woman and child health, orthopaedics, pathology, etc.

First in telemedicine

After undergoing surgery at the Regional Cancer Centre (RCC), Thiruvananthapuram, patients need not visit the hospital for follow-up check-ups unless it’s necessary. They can visit any of RCC’s five Early Cancer Detection Centres across the state.

The prescription is dispensed via telemedicine. “Last year, about 2,500 patients had telemedicine follow-ups,” says RCC Director Dr Balakrishnan Rajan. The southern coastal state was the first to bring all its 14 district hospitals under ISRO’s telemedicine project. When it kick-started the programme five years ago, the place it selected promised maximum impact: Sabarimala, the holy town, which draws lakhs of pilgrims during winter months.

To go mobile

The third state to report full coverage, Rajasthan’s network of 32 district hospitals is the largest among the four states. They are connected to six medical colleges and the Sawai Man Singh (SMS) Hospital through VSAT.

Each district hospital is connected to one medical college and the SMS Hospital for providing super-speciality medical advice. Says Dr G. N. Saxena, Professor (Medicine), SMS Hospital and Chief Officer for Telemedicine in Rajasthan: “The project targets districts that are in need of medical advice in branches like cardiology, pathology, neurology, etc. So far, more than 2,300 patients have been treated this way.”

A hand that heals

Located a few kilometres from Chittoor, a small town in Andhra Pradesh best known for its sarees and jaggery, Apollo’s facility at Aragonda was the first in the country to provide telemedicine. Aragonda is the native place of Apollo Founder and Chairman Dr Prathap Reddy. Apollo provides its services free to villagers from Aragonda and surrounding villages. That’s great for Yugendar.

While trying to untangle his kite from electric wires, nine-year-old Yugendar inadvertently caught hold of a live wire and electrocuted himself, losing two fingers and suffering burn injuries on his arms and legs, where the power entered and exited his body. Rather than rush him to a nearby city for super-speciality care, his parents instead went to the local Apollo Hospital and after an initial check-up, the boy was remotely referred to Apollo Chennai for further diagnosis.

Stymied by the Naxals

Not many states can match Chhattisgarh’s record when it comes to telemedicine infrastructure. It was the second state to network all its 16 district hospitals under ISRO’s telemedicine project. Each of them can hook to a super-speciality hospital like the Government Medical College, Raipur, or Apollo Hospital, Bilaspur, or the All India Institute of Medical Sciences, Delhi. Even Escorts Hospital in Raipur has done its bit—it has stood in for the lack of cardiac care facility at the Raipur medical college.

When the Chhattisgarh government launched the project three years ago, it was introduced only in a few districts where communication facilities were reliable. Subsequently, it was extended to other places.

 

HEALTHCARE FOR THE OTHER INDIA -I

K. R. Balasubramanyam
Business Today (Edition: August 10, 2008)

Few people would have heard of Kavaratti; fewer still, the Indira Gandhi district hospital there. The place is part of Lakshadweep Islands, 220 nautical miles off the coast of Kerala. Till a few years ago, it was a wrong place to fall ill with a disease that required superior medical care. But now, patients effortlessly, albeit virtually, step into Amrita Institute of Medical Sciences (AIMS) in faraway Kochi and meet up with specialist doctors.

There was a time when such patients and their attendants had to be either airlifted or shipped to Kochi at the government’s expense. But telemedicine—delivery of health services via telecommunication network—has changed their lives. This is a story not just of Kavaratti, but also of many remote places in India. Yet, Kerala, Chhattisgarh, Rajasthan and Karnataka stand out because all their district hospitals are under the telemedicine network. Barring Bihar and Uttar Pradesh, all other states, including eight in the Northeast, are reporting progress in implementing the telemedicine project, spearheaded by ISRO. “Our capability to provide connectivity to far-flung and remote places through satellites has been effectively utilised,” says G. Madhavan Nair, Chairman, ISRO.

Studies have shown that 90 per cent of ailments don’t require surgery. “If there is no need for surgery, then a doctor need not touch the patient at all. In that case, there is no need for both to be present at the same place,” says L. S. Satyamurthy, Programme Director, Telemedicine, ISRO. The project targets this 90 per cent who live in urban/rural areas with no access to speciality healthcare. A survey by Narayana Hrudayalaya (NH), Bangalore, reveals that the technology helps rural patients save 81 per cent of the money that they would have otherwise spent on travel and treatment. Amrita Institute’s random calculations show that each patient in Lakshadweep Islands saves Rs 16,200.

That is only logical as the technology enables transmission of patient’s medical records including images, besides providing live two-way audio and video link. With the help of these, a specialist doctor can advise a doctor or a paramedic at the patient’s end on the course of treatment to follow. He can even guide the doctor during surgery.

ISRO is driving the project by providing software, hardware, communication equipment and satellite bandwidth, all free of cost. The speciality hospitals chip in with critical medical advice. As many as 263 district/taluk hospitals across the country are linked to 43 super-speciality hospitals via ISRO’s satellite-based network, and the benefit has reached three lakh people, according to ISRO’s Nair.

As this is a rural healthcare project, ISRO has extracted a commitment from tertiary hospitals in return for free bandwidth. When they get patients for surgery from telemedicine, they can collect only concessional charges. NH and Amrita Institute, for instance, assess the patient’s economic condition before deciding on the fee.

NH and Apollo Hospitals pioneered ISRO’s telemedicine programme in India in 2002: while the former took over the cardiac care unit at the government hospital in Chamarajanagar in Karnataka, Apollo introduced telemedicine at its own hospital in Aragonda in Andhra Pradesh. It was the success of these two centres that led some states to devise full-fledged telemedicine programmes and network all district hospitals from 2003 onwards.

“After six years of work, the project has now reached a level of wide acceptability,’’ notes Satyamurthy. “ISRO’s objective is to develop the technology first and address the issues of last-mile connectivity in rural healthcare and create an ecosystem for bringing e-health,’’ he adds.

The idea evidently is to refine and popularise the technology so that even nursing homes in small towns can hook up with hospitals in cities and use telemedicine independent of the government support. Some hospitals like Apollo and NH are already doing it with broadband/ISDN connectivity. In a first of its kind instance, Mantri Developers has tied up with Apollo to provide the facility at its Mantri Espana, Bangalore. The Apollo Telemedicine Network Foundation has conducted about 36,000 tele-consultations so far. “In a country as large as ours and with doctors as few as we have, there is no other tool that can be as beneficial as telemedicine,” says Dr Prathap C. Reddy, Chairman, Apollo Hospitals Group. But as Dr Ajit N. Babu, Director of the Centre for Digital Health at Amrita Institute, points out, telemedicine is not an event but a process. ISRO officials note that the telemedicine project won’t be complete until all hospitals in rural areas are connected.

Business Today takes a look at whether telemedicine has really impacted the lives of poor people in states—Karnataka, Rajasthan, Kerala, Chattisgarh, and Andhra Pradesh—where almost all district hospitals are employing telemedicine.