mdhilmDhil is a digital health company which creates and provides content related to health to Indians. Core topics for the company are reproductive health, family planning, women’s health, diabetes, diet, among others. In the first part of our conversation with Nandu Madhava, founder of Mdhil, he spoke about his business, and how Indians are consuming health content on SMS and Video, among other things. In the second part, he speaks more about his business and the state of digital health sector in India.

Monetisation on Mobile

Medianama: How do you monetise on the mobile?
Madhava: Mobile is going to be a carrier based solution. Right now carriers or VAS based solutions are ones who have managed to monetise mobile in a big way. We have several VAS partners that we work with depending on the carrier.

VAS Regulations

Medianama: How has the change in VAS regulations really affected to your business?
Madhava: Around 70-80 companies are trying to address this issue. People who have been monetising off VAS recognise that even if you are generating revenue from VAS, there are questions around its long term stability. Companies like Onmobile, One97 that have generated great money from VAS are all re-positioning themselves as mobile internet companies. In the perfect world, with efficient access to the APIs then mobile web companies, carriers and developers can make a lot of money off it. This is coming. The steps that Vodafone has taken to share more revenue with developers is a good sign. We want to diversify our risk beyond VAS. That’s why we love the growth of our video, web platform and brand engagement.

Medianama: Are TRAI regulations the reason to shift focus from SMS content to more of web and mobile web content?
Madhava: Not necessarily, the TRAI regulations scores many questions around regulations, false billing and promotion. We shifted because we are focused on addressing how to do people access health information and how do we deliver that in a compelling way. We see more can be done on mobile web, desktop web, mobile web than on SMS.

Subscription Model

Medianama: Do you the subscription model suits Indian audience for the health space?
Madhava: There is a lot of utility in getting other people to pay you instead of the end consumer. If you give something free to the right audience and capture information about them, there are lot of brands who will pay you for that information. I won’t sell it but I’m interested in running such projects. At least for the next 12-18 months, our services will remain free. We would like to be lifetime free but I see that we will have services that will be in freepium model with value added services.  Beyond travel, jobs and matrimony, people are finding it hard to sell something in the ecommerce space. The user behaviour on the internet is  yet to be defined. Until pain points like payment gateways are solved, it is difficult to get money from the end users. There are very few who have managed scaling like that.

Regional Language Content

Medianama: How does consumption of other language content take place on the mobile?
Madhava: In Mary Meeker’s report of the top 25 most valuable companies in the world, 6 of them are Chinese. These companies are worth billions. The smallest company is worth about $3 or 4 billion. We don’t have a single company in India that comes close to that. When you look at the Chinese web, it is not in English. It is in Chinese. A large company with social utility to Indians has to be in the languages that they understand. The web has to be made more relevant for the rest of India. Local languages has to be the way that we do that.

Medianama: How do you plan to enable users to ask questions in their own language on your website?
Madhava: Good question and we haven’t figured that out yet. We are working on it is the best thing I can say.

Medianama: Why is that you have only a few videos in different languages on your website?
Madhava: We have made the big push for regional languages only in the last six months. But that is going to become a important to us. Getting into other languages beyond Hindi is a relatively newer strategy for us but it is one that we are excited about.

Medianama: How are you trying to leverage your website for your content? Are you even trying to create a destination for health content at all?
Madhava: We are looking for good engineers to help us with building what we want. We want to think of mDhil as a platform beyond just providing content. In the next 3-6months there are going to be significant changes with the platform that we are building. We are trying to build it as a destination where people can get educated about a topic specifically in their language.

Content Partnerships of mDhil

Medianama: How much does Youtube contribute to your traffic and revenue?
Madhava: We don’t discuss revenue numbers. Youtube is a key component for what we do. Youtube has become the ultimate source for video discovery. When you fall out of Youtube, there are probably a handful of global sites that can possibly claim to rival Youtube.

Medianama: What are the other content parnterships that you have?
Madhava: Our content is distributed across MSN India, Sify, Yahoo India and we have expanded with Yahoo Maktoob, their Arabic site to the Middle East. We also have some smaller partners like Deccan Chronicle.

Medianama: How do you cater to the Arab market?
Madhava: One of our most popular topics in the middle eastern market is women’s health. Women there sometimes unfortunately have limited rights or limited access. At the same time, Saudi Arabia is completely 4G. A typical user in Saudi Arabia is more likely to have a phone and access to web. We have something that is relevant compared to what they used to get from Europe or U.S. Middle East is a great area for our expansion.

Medianama: Any particular reason why you collaborate with RJs to do your show like videos?
Madhava: Information needs to be delivered with a sense of empathy. You are often scared of researching something health related. All of our content is factual and reviewed by physicians. There also has to be entertainment, interest and fun in it without being condescending. In Melinda Gates’ TED talk on 3 lessons that non-profits can learn from Cocoa Cola, she highlights that Cocoa is not saying drink sugar water because you are thirsty but drink Cocoa because its fun. She says health messaging has to take a similar tone because people don’t internalise negative emotions, as they do with positive emotions. That’s why we work with personalities. We will be developing more this year.

Medinama: Do you have partnerships with any radio channels?
Madhava: Not officially. No.

Advertising & Competition

Medianama: Have you considered advertising on your website?
Madhava: I’m much more interested in working with a larger brand or sponsor than working with some Ad Sense to generate revenue because we see that the quality of user database and the quality of the solutions we can offer to a brand is more valuable than simply giving ad space.

Medianama: Who do you see as competition in this space?
Madhava: Our competitors are large companies who are doing this in the U.S and rest of the world. In India, we have seen several people start and stop due to focus on short term monetisation. We don’t really have other strong competitors within India. If I wake up tomorrow and find out that five other competitors are doing this better than me then I will be happy because someone actually cares.

Digital Health Care Sector in India: 

Medianama: Why do you think the digital health sector has not taken off in India?
Madhava: Investors don’t really understand the issues in India. Most people want to copy what works in the U.S. In India, the health sector is broke. One way that investors can make money is by investing in hospital chains and investing in pharmaceuticals. One reason why digital health has not grown is because a lot of money has gone into traditional private equity sectors. Brick and mortar businesses are not digital but you see VCs actively investing in them. So there has been a shortage of capital for digital. Regulations are also not very clear. There were sweeping policy changes in the Obama administration for huge amount of money to flow into digital health. I hope that happens in India.

Medianama: What are the key challenges and what needs to change with respect to digital health taking off?
Madhava: Similar to many other sectors, greater access to broadband, 3G and 4G, more efficient payment gateways are needed. COD is a way of acquiring customers and not a business model. You can’t make any money with COD. It would be great if you find better ways for people to transact online. If the Indian government creates a more  hospitable environment for foreign investors all forms of healthcare businesses will flourish and do better.

Medianama: What is the state of regulation of mhealth in India?
Madhava: When we started providing services over mobile, other VAS companies also came up thinking they can do it. They will hire a fresher to scrap content off the internet and say they have health tips. Some of it was factually inaccurate. Some of the carrier partners that we worked with were fine with that incorrect information. Pushing quackery is a bad thing. All though there are regulations against quackery in India, enforcement is a whole other issue. There isn’t really a ton of regulation about mhealth. Even if there, enforcement is a whole other thing.

Medianama: What is your take on government projects on mhealth? Have you considered applying?
Madhava: Our door is always open to work with government. We have met people from various forms of the government, both U.S and Indian government on various mhealth projects. Our biggest challenge has been the speed at which they move which is sometimes very slow. We are more than happy to work with the government. But if you are startup, it comes down to how fast can you get products launched, services launched.

Future Plans

Medianama: What are the other business models that you are considering?
Madhava: As we have increased revenue every year, we have seen that there are several ways in which we can monetise. For me at this point of time, the focus is lesser on monetisation and more about growing the right audience and solution. I’m much more interested in mdhil becoming a platform to get the right information. As we build in more features, we will be able to capture more user data and delivery more targeted information to them.

Medianama: Would you be sticking to providing health information? Or would you also be looking at booking doctor appointments, video based personalised consultation or similar things?
Madhava: When I was in New York, 7-8 month ago, I met one of the founders of ZocDoc,  Oliver Kharraz. They don’t think that their business would even work in India because of different dynamics. In the U.S., you have approximately 1 million health professionals for a nation of say 300 million people. In India, you have 1.2 million health professionals for 1.5 billion people. Doctors don’t really struggle here to book appointments. If it was an opportunity I would have gotten into it. When you talk to those people whose businesses are getting copy pasted to India, even they don’t think that it will work here. We are still focused on answering that question of how do people access health information and build a great product around. You won’t see us get into other services. Those have simply not scaled in India.

Medianama: What are the challenges with the above mentioned models of businesses?
Madhava: These services haven’t really scaled except in certain cases where you are an Apollo or Narayana Hrudayalaya and have a hub and spoke model set up with low cost tele-cameras to bring patients in. Again, it is a way of acquiring patients but not a business in itself. They might say we are in rural areas. The medical industry is slow to adopt technology which partly explains why the Obama administration gave the medical industry huge tax incentives to upgrade their technology. In an interview, Oliver Kharraz says that it took them four years in Manhattan to convince physicians to use their service. That’s New Yok in 2007, a fully penetrated internet market. Services like that are going to take a long time to work in India.