“Sukino is India’s first comprehensive continuum care provider”

In an exclusive interview with BioVoice, Rajinish Menon, Founder and Chief Executive Officer, Sukino Healthcare, shared company's foundational story, his views on the concept of Continuum Care in India, revenue model, growth drivers, and future outlook

Rajinish Menon, Founder and Chief Executive Officer, Sukino Healthcare worked with Microsoft for a little less than a decade and eventually was heading the startup team at Microsoft India and CEO in Residence for Reliance GenNext Accelerator. His experience across IT, Banking, Energy, Offshoring helped him to understand customer success and how the approach of a newer model of care, can be fine-tuned in the realm of healthcare.
Incepted in 2015, Sukino Healthcare has pioneered the concept of Continuum Care in India to revolutionize post-hospital discharge care for patients not in a position to go back home directly as well as senior citizens. Started with a small investment of fewer than INR10 Lakhs, the company has raised $1.5 million cumulatively from marquee HNIs who have invested in their personal capacity and few others through their family offices like Kris Gopalakrishnan (Co-founder, Infosys) who has invested through his family office, Pratithi Investment Trust. The last funding was in July 2020.
Founder and Chief Executive Officer of Sukino Healthcare, Rajinish Menon who is a Chartered Accountant by profession, was earlier heading the startup partner evangelism for Microsoft. Menon, also an angel investor, is on the board of many new generation startup companies. In an exclusive interview, Rajinish Menon shared the company’s foundational story, his views on the concept of Continuum Care in India, revenue model, growth drivers, future outlook, and much more. Read the excerpts:

BV LogoPlease take us through the foundational story of Sukino Healthcare including your journey so far and any unique experiences as well as challenges? 
I have seen my loved one grapple with illness and suffer due to an inconsistent healthcare system. My mother went through frequent periods of hospitalization. Sometimes it was for surgery (till date she has had 9 surgeries) whilst in others, it was to manage her pre-existing CVD and Neuro conditions. Each time it was a  seesaw moment. At times there was hope and help around but at certain other times, we just did not know what to do. Here in India, we have piecemeal working systems, and it is left to the patient families to sew it together and one can imagine doing this while coping up with the condition of a loved one.  My mom’s condition was going down fast and required acute intervention at times.  This is when I thought of the CRM processes that enterprises have and how such systems enable one to call and get a very customized warm welcome and solution. A case in point being the American Express card division. They seem to know it all and that is exactly what I wanted in healthcare too. Someone who understood my mom’s case and provide the continuity of advice and help in execution. This was the pain point I had discussed with my founding friends. We sensed there was an intrinsic need to bridge the gap between post-hospital discharge and optimal recovery for patients especially those in need of transitory care. We wanted to offer the finest quality continuum of care services using a combination of clinical expertise, skilled manpower, and advanced technology to alleviate the physical and emotional pain in patients. Thus, Sukino was born.
Let me break down the challenges for them to be understood better. Our first challenge was that of the acceptability of our model. It took some time for us to convince the consultants of the continuum of care model. Most consultants and patients were then comfortable with the model of home care with a human resource provided for care. Whilst we met their need,we also went above the normal expectation and provided a concierge of services to win their trust. This way we built trust and our immersion into healthcare started smoothly. Second, when we set up our continuum care centers, hiring efficient clinical talent was difficult as most of the good consultants and nurses preferred to work for top branded specialist hospitals. We had to meet them repeatedly to convince them about our new concept. Thankfully, most of them conceded due to our comprehensive and thoughtful service modules and investor profile. As we scale, we experience minor challenges like how we fit our continuum of care in a brown field infrastructure within a residential area without disturbing its tranquility and complying with city guidelines.
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Why did Sukino Healthcare come up with the concept of Continuum Care in India? What are your short-term and long-term objectives?
There has always been a need for rehabilitative care. Every patient who gets a discharge needs rehabilitation which is even more essential in case of a cardiac stroke, heart attack, bypass, hip/ knee replacement, etc. and the number of patients is rising every year. For instance, In India annually around 3 lakh heart operations are conducted, a rehabilitative care for these patients is a necessity. While they stay in the hospital for a short time, continuous care must be provided post the discharge of the patient for a longer duration. Incurring an expense of over Rs 20,000/- per day (approx. charges per day) in the hospital becomes extremely difficult for these patients. This urged us to explore further, and we worked ceaselessly towards formulating a comprehensive healthcare module.
Seeing the huge adoption of our services and care module, we wish to expand our operations both from the services and geographical perspective. As part of our continuum care offerings, we do intend to provide more services in the segment of oncology, day ambulatory services, and ICU care at home for our patrons. We would like to continue building a domineering presence in Bangalore, Kochi, and the adjoining cities of south India especially the ones that have a pronounced elderly population, people with advanced knowledge of healthcare, and an awareness of the concept of continuum care. And double down our investments.  We have already drawn a road map to take our services to select cities of South India. Chennai, Hyderabad, Vijayawada are on our radar.
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What are the primary offerings of your company and focused segments? Who are the target clients and how are you reaching out to them?   
Sukino is India’s first comprehensive continuum care provider. We provide a range of services like Continuum care facilities and extended home care where the same treatment protocol of the primary physician is carried out. Our service offerings are available for patients who suffer from chronic ailments. They include Neurology, Oncology, Nephrology, Cardiology, Pulmonary, Ortho, and the most recent – post-Covid-19 respiratory rehab.
We work as partners with hospitals and physicians. Our operational model at Sukino, ensures the continuity of the treatment charted out by the primary physician by keeping the physician in the loop. This is the primary reason why most consultants prefer referring their patients to us. The onboarding process begins with a detailed assessment of the patient to facilitate a smooth transition and seamless service. Post the initial assessment, the next course of action is discussed with the primary physician by our team of doctors and therapists to ensure that the treatment is executed as per plan. Each patient is provided with a 24/7 healthcare assistant based on their preference who makes them feel at home. A multidisciplinary round-the-clock team of doctors, ICU-trained nurses, therapists, caregivers, clinical dieticians, and psychologists work ceaselessly to make the patient and their families feel comfortable and well-informed.
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What kind of revenue model does your company follow?  What is the revenue earned by the company during FY 2019-20 & expected revenue in FY 2021-22? 
Sukino was started with a small investment of fewer than INR10 Lakhs. Post our investment, we have raised $1.5 million cumulatively from marquee HNIs who have invested in their capacity and few others through their family offices like Kris Gopalakrishnan who has invested through his family office, Pratithi Investment Trust. The company has always seen growth and this has been ranging between 60-75% YoY since 2016 and expect this growth to continue as we they a huge demand for our module of services.
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Which are the key growth drivers that will drive Sukino’s growth? Any unique trends in the industry?
We are in the core healthcare services sector and we must understand the new age developments and innovation in various fields of chronic ailments. Of course, this is needed from a perspective of keeping our patrons updated on the latest available treatment procedures and protocols. As you know, we follow the treatment plans of the primary consultant, and unless there is an emergency, we do not do anything contrary to what the primary consultant would have advised. Hence keeping abreast of the advancements and helping patients and their families understand is all that we do. Our knowledge advancement is primarily through the daily interactions we have with almost all the specialist consultants of our patients and these specialists are based both within India and abroad. Interacting with such a diaspora gives us a good information flow.
Sukino has reached this maturity because of the constant support it has received from the medical consultants and the acceptance of its model by various hospitals. We will continue our traditional model of care and support to all the medical practitioners and hospitals and help them assist their patrons through home care and center care support.
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How do you view the present state of healthcare in India, in both positive and negative contexts? How can you improve? 
 I strongly feel that the entire philosophy around health care needs to be changed. Till now our healthcare system has been following a disease-based approach but what we earnestly need is a patient-centric approach. This will broaden the spectrum of care and achieve the primary goal of health care, which is to reduce physical and emotional pain, help patients to continue living with dignity, and improve the quality of their lives. There should be seamless coordination between hospitals, physicians, nurses, paramedics, institutions, and commercial organizations to provide timely and optimal care to patients.
More efforts in educating and training physicians, nurses, and caregivers are required in this field. The subject of holistic health care should be introduced in the curricula of the undergraduate program of all doctors and nurses. Partnerships with health care facilities should be established and should encapsulate rehabilitation, counseling, therapeutic, and nutritional support in a home type set-up or within the comfort of the patients’ homes.
Apart from medicine and nursing I also hope to see some relaxation in government policy, especially for drug availability.
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What are the key learnings for your company during the COVID-19 pandemic and in which ways are you going to implement them in the future?
Ans: For us, round-the-clock care has always been a priority, and the COVID-19 pandemic has only further increased the need to bring respiratory rehabilitation to the forefront. This pandemic has taught us a great deal by putting us through a very challenging and ambiguous time. While we still try and understand the after-effects of COVID-19, it is important to create an atmosphere that prioritizes patient management, especially since the severity of the disease’s long-term respiratory complications remains to be seen. While the effects of it were dramatic and widespread, Covid-19 has taught families to try and maintain a work-life balance as well. I have been blessed with a family who fought the pandemic tooth and nail. We were very appreciative of the measures adopted by the Indian Government for us. Initially, we grappled with the uncertainty, but soon enough the new normal started to sync in and we became more patient and resilient in our behavior.
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What were the key initiatives of the company in the last 5 years, especially during COVID-19?
COVID-19 is a disease that requires highly specialized care, and patients need a level of medical attention and rehabilitation that is difficult to achieve at home. Some of them need continuous monitoring and non-invasive clinical intervention supervised by a medical expert. It is reported that post the initial illness, a majority of people have persistent lung abnormalities. While most are managed in general wards, a sizeable proportion requires intensive care support even after being discharged. To ensure the same, Sukino launched the ‘Respiratory Distress Initiative’ which is care for patients suffering from respiratory problems post-Covid-19, again a first in India. Once the patient is admitted, a detailed assessment is carried out by Sukino Healthcare’s medical consultants, therapy team consisting of Physio, Occupational, Respiratory therapists, and clinical psychologists. They map out the therapy sessions and fine-tune a goal-oriented treatment plan depending on the condition of the patient. Throughout the treatment, the progress of the patient is assessed every week with the Borg Dyspnea Scale, six minutes’ walk test, 12 minutes’ walk test, TUG scale, and the Cough Sputum Score. Sukino also uses Devices like Acapella and Flutter which play a major role in lung secretion clearance. The Acapella and Flutter device are techniques to help mobilize mucus from the airways. We even make the patients practice resistance training with the help of power breaths – While breathing is second nature most people do not breathe effectively. Here at Sukino, we teach breathing to help enhance the health of the lung post-Covid-19.
With our unique and multidimensional approach, patients show remarkable progress within a short period. The pandemic has not affected us in any way because our vision, mission, and all focus are geared at taking care of patients who need extended care. Times like these are when patient families need us more than ever when the need is to be a trusted partner, a dependable partner, and an economically viable partner.