“80% of Indian doctors live in urban areas catering to only one-third of population”

Dr Sabahat S. Azim shares the vision behind his company, its initiatives and offerings; focus on rural healthcare; growing role of digital technologies and much more

Dr Sabahat S. Azim, Founder & Chairman, Glocal Healthcare Systems is a medical doctor and an ex IAS officer. Having served the government in various positions, he quit the IAS and became an entrepreneur in his endeavour to fix the healthcare system in India. He successfully set up a pan India rural ICT Venture in the year 2007 before establishing Glocal Healthcare in the year 2010. Under his stewardship, Glocal has set up and operates 11 integrated super-specialty hospitals in Tier 3 cities of India and more than 600 digital dispensaries in rural areas.
In an exclusive interview, Dr Sabahat S. Azim shares the vision behind his company, its initiatives and offerings; focus on rural healthcare; growing role of digital technologies and much more.

What is the thought process behind Glocal Healthcare? Why did you choose to create a social venture rather than a fully business one?
Glocal Healthcare Systems seeks to bring state of the art healthcare to the underserved sustainably. Our aim is to make healthcare affordable, accessible and accountable for all. The idea was always to solve a social problem, but we wanted to do it in a sustainable manner and at scale which was only possible through a business model. So, we set up Glocal as a social venture with a social intent and accountability and regimen of a business, which could leverage capital markets to create impact at scale.
Given the challenges, how do you plan to realize your vision on ‘Affordable, Accessible and Accountable’ healthcare for rural and underserved populations? Any examples you may like to share?
 Healthcare can only be taken to the masses using an assembly line approach – by standardization and productization using cutting edge technology. Just like in the olden days only the rich could afford their portraits painted by gifted artists. But after the advent of the printing press and the camera, the masses could have their portraits. We have done exactly that by coding the entire medical knowledge, humanly impossible for a doctor to remember, into a clinical decision support system, with Machine Learning capability.
With integrated devices and the technology platform, our digital health solution is like healthcare in a box which can help doctors efficiently provide quality healthcare for the majority of cases including areas where they cannot physically reach. The standardization based on evidence based protocol reduces medical errors making healthcare more accountable. We are building state of the art healthcare facilities in areas, where they do not exist at one of the lowest cost and time, which deliver healthcare at one of the lowest costs in the industry. Our Digital Dispensaries take primary care to underserved areas, while our acute care hospitals provide high end secondary and tertiary care in tier 3 cities and the rural catchment around it.
“COVID has expedited the acceptance of digital health. Number of households using e-pharmacies has tripled.”
Your views on the growing importance of digital technologies in healthcare? How is the company leveraging them in terms of product offerings?
 Digital health technology is a game-changer for the healthcare industry. Digital tools will improve health equity by helping expand access, bridge geographic barriers, and reducing costs. It can improve access and drive down costs dramatically, making it viable to deliver healthcare in remote areas. As a matter of fact, the COVID has expedited the acceptance of digital health. Number of households using e-pharmacies has tripled. During the pandemic, telehealth providers saw upto five fold increase in teleconsultations. Even more encouraging was the fact that 80% were first time digital health users and 44% were from smaller cities and rural areas. The transformation has already begun.
While digital health may be a matter of convenience for the middle class urban population, it is the only hope for affordable quality healthcare for rural India. Today 80% of the doctors live in urban areas catering to only one-third of the population in India. Glocal has developed digital health solutions to deliver comprehensive primary healthcare, including doctor consultation, diagnostic tests and medicines, from a single point called digital dispensaries and close to the underserved population, where doctors and quality healthcare are otherwise not available.  This includes LitmusMx, a healthcare terminal integrating IoT and Point of Care devices; and LitmusDX – a Semantic Algorithm based Clinical Decision Support System. Also the EMRs. Hellolyf – a Telemedicine suite that connects doctors to patients; and Litmus Rx – an optional automatic medicine dispensing unit.
We have extended digital healthcare to support in-patient care through HelloLyf PX – a pre-fabricated digital healthcare center, which includes emergency care and beds for minor hospitalization. Again HelloLyf HX provides  high end acute care digital hospitals with digital OPDs and e-ICUs, where patient monitors, injection syringe pumps and ventilators are all digitally connected for remote monitoring leveraging experts from across the globe.
Glocal built the first permanent digital acute care hospital for the Nagaland government in just 100 days during COVID pandemic. What made it possible? Kindly share a few key highlights or takeaways from the project.
When the Government of Nagaland approached Glocal at the height of the pandemic to help create critical care infrastructure (ICUs and HDUs) in a limited time and budget, it was an opportunity for us to push the boundaries. It was a daunting task – set up a long lasting hospital from scratch within 3-4 months, in a location like Dimapur, with its own challenges. The place was far removed from the heartland from where all the material were to be sourced, the torrential rains during July, August, September, lack of skilled manpower, aversion of outside contractors due to the socio-political situation, and restrictions due to the raging pandemic all added to our woes. Our team worked 15-16 hours a day in such grueling conditions. That’s how we created the first truly digital hospital – where digital OPDs were possible, all critical care beds (patient monitors, injection syringe pumps, ventilators), devices and diagnostic equipment were digitally connected so that they could be monitored remotely by fewer staff and potentially be managed and treated with minimal physical contact.
The 200 bed hospital with all the required equipment and infrastructure was ready in 100 days for a record low cost. The building is certified for the highest level of seismic activity. It was made possible by our unwavering belief that we can find an optimal solution to any pressing problem with collective effort, the indomitable spirit and relentless hard work of our team members.
“Healthcare can only be taken to the masses using an assembly line approach – by standardization and productization using cutting edge technology.”
How do you measure the social impact of your offerings and how often? Would you like to share a few latest details?
We measure our social impact in terms of outreach as well as outcomes. Outreach in terms of the number of people who have access to affordable healthcare services and number of people we actually serve. This data is recorded every day, but we review it monthly. We take feedback from a sample of patients regularly. As a proxy of outcomes, we look at patient satisfaction and survival rates in our ICUs.
At our current average, we will serve 2.4 million patients annually. As per an independent study, 94% of our patients are below the poverty line, there is 96% satisfaction among hospital patients, and almost 100% among telehealth patients. The mortality rates in our ICUs (~10%) are comparable to the US, far below the national average.
Where do you see Glocal Healthcare in the next five years?
In the next five years, we would like to see ourselves as the largest player in the world in digital delivery of healthcare services to some of the most excluded and poorest people. We want to emerge as the most trusted name in delivery of essential, high end and acute healthcare outside of metros in India.

*This interview was first published in the September 2023 edition of BioVoice News eMagazine.