Dakshas Foundation

The funding and support would be used to 

1. Support a core team and model virtual clinic for continuous improvement in Orthopedics and innovate for other medical specialties.

2. Help nonprofits all over the globe adopt and deploy Dakshas' existing intelligent orthopedic telemedicine platform that can help treat 90% of patients in community and primary care, over a phone call.

3. Spin-off and publicize self-screening and self-care orthopedic tools for individuals, both on line and offline.

4. Find guidance from peers, mentors and system to cut down our learning cycle.

5. Learn to mitigate challenges and risk to scale

Dakshas is an idea of trans-sectoral education and experiences in Orthopedics, Arthroscopy, Medical Research and New Venture Creation. 

The founder, Dr.Bharat Sharma, an orthopedic surgeon, worked for 12 years in healthcare settings in some of the largest and globally respected organizations - orthopedics at JIPMER (2005) and Southern Railway HQ Hospital, Chennai (2007), serving marginalized patients. A year in new venture creation at Indian Institute of Management, Bangalore (2008-09) led him to cost-account in time and our shared liability in ecologically eroded economies of 21st century.

Ideas for Dakshas evolved as he did his knee surgery research fellowship at Istituto Ortopedico Rizzoli, Bologna, Italy (2010-12) and then Keyhole Joint Surgery at Singapore General Hospital, Singapore (2012-13). These perspectives culminated in Dakshas model of Universal Healthcare over two years at Vivekananda Health Centre, Ramakrishna Math, Hyderabad (2014-2016).

Dakshas is an expression of a circular economy in eroded ecology of 21st century. It ensures the practitioner can share the patient's liability, ensures care at a price the patient can afford. We believe such patients, unburdened from healthcare expenses, would in turn unburden their environment and provide uncontaminated products and services to the practitioners.

Approximately 60 million Indians become poor because of healthcare bills every year. Such suffering is unacceptable in civilized society. Apart from the commercial focus on health infrastructure, technology and private medical colleges, the social sector is evolving a variety of interventions to tackle various aspects of the problem. Yet, there are few models that re-engineer processes, tackle the problem at a sectoral level or harness the potential of standard treatment guidelines.  

In contrast, Dakshas' orthopedic symptom-analysis engine, Meditorus, delivers pro-bono remote care even over non-data phone networks. Community health workers enter structured patient interviews on phone, generating patient case files and prescriptions. These are sent to remote physicians, for review. Prescriptions are released after physician approval, over an sms and email. Patients with red-flags are escalated to specialists in the same session. Video conference at home, or a community contact centers, allows, specialists to consult patients with red-flags. Only those patients who need physical examination, investigations or procedures need to visit health facilities.

The ability to manage 98% of patient complaints remotely unburdens the whole health system, allowing it to deliver equitable and sustainable care to the 2% who need specialist reviews and the 0.5% that need hospitalization.

Dakshas intelligent orthopedic decision support platform embeds standard treatment guidelines to help community and primary healthcare providers screen marginalized patient and generate a specialist level prescription. Complex cases are connected remotely for specialist opinion within the same or an asynchronous session. Dakshas is therefore a perfect fit for the current public health system, where nurses and primary care physicians are available to manage simple cases, while specialists are remote. Dakshas has successfully deployed this for orthopedics and hopes to extend to all specialties.

The second component would be to codify how Dakshas matches marginalized patients to healthcare free capacity. A cloud where individual stakeholders and providers can plug and play. Here all their free capacity is aggregated and matched to the nearest marginalized patient who needs that service. The service is then delivered at near-variable cost.

The third component is to able to plug resource gaps on demand, whether this is human expertise, equipment, instruments or consumables. This would allow all healthcare stakeholders to provide their core expertise to the cloud and offload all their non-core requirements to other stakeholders. 

These three components can ensure equitable healthcare delivery to marginalized populations across the globe.

Dakshas journeys with the patient as they traverse from illness to health. We stay the course through whatever level of healthcare the patient needs. We engage patient through community embedded organizations. We also implement comprehensive community level interventions, from preventive to end-of-life care. 

Over the last 29 months, Dakshas project scaled six times, treating over 42,013 unique complaints with 120,104 treatment sessions and 220 surgeries. Cost of healthcare was $3.39/patient, saving $350,000 in out of pocket expenses and over 1600 specialist working days. Model was deployed across 5 scenarios.

We launched an online orthopedic decision assist system that generates prescriptions for community and primary care, so specialists are needed only for 5-10% of patients. It is available to any nonprofit to serve their community. This ensures that community NGOs can delivery primary orthopedic care over a phone call. Patients referred to clinics or hospitals are matched to free capacity and operation theatre/surgeon utilization is optimized. All this ensures healthcare is delivered not denied.