The Indian startup landscape is the third largest in the world
Start-up ecosystem of India is the third largest in the world after US and UK. At the current rate, there will be more than 12, 000 start-ups in India by 2020 and it will create employment for 250,000 professionals. India has made great strides in Healthcare sector since 2010.  The government has made several landmark steps like NRHM, the Clinical Establishment Act along with new initiatives like Make in India, Startup India – Standup India. The private sector has grown across the value chain. A large number of Indian eHealth startups are seen mushrooming in the market. Hospital groups have emerged as stand-alone corporate entities, as have diagnostic providers. There are tremendous working opportunities in the industry. The industry is no longer only about hospitals, doctors, medicines, and patients; it has transformed to incorporate much promising working environment.
Digital health, eHealth startups in India find massive traction
The encouraging aspect is that it is already happening with Indian eHealth startups disrupting the way health care was delivered. More than 300 start-ups founded in the healthcare in the year 2015-16 itself.  These start-ups aim to close the gap between patients and healthcare providers using digital services and social networking mediums. They have changed the way health care is provided by hospitals, doctors and other medical centres. Additionally, they have successfully managed in providing affordable healthcare services to a large population of the country. 
There are distinct challenges for Healthcare Industry in India as well. The nation has access to only one doctor for every 1, 1674 patients whereas WHO has the ratio of 1:1000. There is a shortage of medical professionals too as most of the experienced talents are attracted to foreign companies. 
Technology convergence in health care is therefore expected to play a fundamental role in improving accessibility and meeting the challenges of infrastructure and workforce shortage. Smartphone-led mobile technology and digitization of healthcare practices together are trying to bridge the demand-supply gap of healthcare professionals. Digital health start-ups can enhance how healthcare gets delivered as well as the improving economic situation in India. They have already transformed the way patients get access to doctor, medicines and home health care. Using disruptive technology and advancements healthcare start-ups can offer healthcare accessible for all. 
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Procuring funds for digital health, eHealth startups in India is a challenge
Getting investment during early stage is a major obstacle for Indian start-ups. Early-stage funding and accurate evaluation are other significant concerns for entrepreneurs. Healthcare start-ups need to look beyond old ways and make use of “Internet of Things” to connect physicians from urban to the primary medical centres in rural areas via cloud computing. 
All the concerned stakeholders need to play an active role towards developing a support system for start-ups. It is very much evident that massive investment is required in the upgrading of healthcare infrastructure, to improve accessibility and quality of care. The government needs to understand the issues faced by private sector currently and take measures to improve the funding situation in the respective states. The industry must consider this as a business opportunity to establish their presence and expand their operations.
A collective effort from all stakeholders from healthcare sector is required to tackle challenges faced by the medical community. Additionally, foreign investors and enterprises can play an essential role in the growth of the sector.  PE and VC firms could form dedicated teams to identify healthcare startups that possess excellent growth potential and become their angels in the real sense, by hand-holding from an early stage until maturity.
Health care start-ups may also explore new sources of funding, such as venture debt and crowdfunding to secure financial support for their ideas. India could learn from the practices in Chile, the U.S., the U.K., Japan, etc. which have recognized the role and importance of the availability of quality health care in the overall growth of a nation. These countries have boosted the growth of health care startups by formulating specific policies and programs and launching initiatives that resulted in various innovations in health care services. Startups may emerge as one of the best bets towards better health care for the nation.
Areas of focus for future growth of digital health, eHealth start-ups in India
1. Setting up PPC Policy and Framework:
Leveraging the PPP policies and guidelines of the central government, all the Indian states must prepare and publish their own PPP Policy specifically for the healthcare sector. It will surely bring more transparency in the process and give the industry a greater confidence while engaging in discussions with the respective state governments.
2. Government expenditure to maximize health care gains:
The focus of government’s funding should be more in health promotions and disease prevention and primary health care for all while reducing the Government’s direct intervention in the secondary and tertiary health care levels.
3. Private sector incentive to boost supplement spending:
Private hospitals need the support for setting up 30-50 bed healthcare facilities with basic health infrastructure in the rural and semi-urban areas through additional tax benefits, with a mandatory clause to provide quality and affordable care for the target population. There should be a clear policy for incentives, tax rebates, land acquisition, and SEZ status approval for attracting big private players.
4. Innovation in health Insurance for greater coverage:
Only 10% of Indian population gets covered by insurance and hence innovative measures needed to change this situation. Health insurance products should be designed in a way they are acceptable to the semi-urban population. Social media and technology interventions should be used to create high awareness and reach out to prospective health insurance buyer.
5. Taxes for government health care funds:
The government can consider introducing a health-related component within the Income Tax structure that will act as a secondary source for Government health care funds.
6. Building capacity for medical education:
Availability of qualified and skilled personnel in rural and non-metro cities is far behind the current demand in both the government set-up as well as the private facilities. State governments must take the initiative to come up with a PPP framework to either increase the capacity of existing institutes or set up new training institutes by partnering with professional institutions.
7. Regulating the prices of essential drugs:
There is need to procure and supply medicines to various Government distribution centres as generic medicines instead of being branded, which could reduce the drug 10-20 times than usual. It will greatly help the end user from a rural area.
Growth in the next decade will be closely linked to the nature and extent of reform along with the participation of private players. India’s health challenges are unique and complex, but also offer remarkable opportunity. Thus, the next five to ten years hold exciting possibilities, while like being a challenging journey.
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