Rajiv Aarogyasri Health Insurance Scheme - eGovReach

Expansion of the Scheme

DiseaseCRITERIA OF SELECTION• Emergency and Life saving in nature• Requiring Specialist Doctors & Special Equipment• Not ordinarily available in Govt. Hospitals (Area/CHC )• Verifiable Diagnostic and Post treatment Protocols• Not covered by other Government schemes• 938 procedures in 31 systemsMEDICAL (159 PROCEDURES)• Critical care• General Medicine• Infectious Diseases• Pediatric Intensive Care• Neonatal Intensive care• Pediatric General• Cardiology• Nephrology• Neurology• Pulmonology• Dermatalogy• Rheumatology• Endocrinology• GastroenterologySURGICAL (779 PROCEDURES)• General Surgery• ENT• Ophthalmology• Orthopedics• Surgical Gastroenterology• Cardio Thoracic surgery• Pediatric Surgery• Genito-Urinary surgery• Neuro-surgery• Surgical Oncology• Medical oncology• Radiation Oncology• Plastic Surgery• Polytrauma• Prostheses• Cochlear Implantation

Health Card, Sum Insured• BPL family covered means the group of individuals as indicated in „Health Card‟ or „White ration card‟ (BPLcard).• Sum insured per family - Rs.1,50,000/-• Benefit on floater basis, can be availed by individual or family• Additional Rs. 50,000/- in case of need from Buffer amount

Patient Facilitation & Beneficiary Choice• Aarogyamithra• Help Desks in PHCs/Government Hospitals• Assistance Counters in Network Hospitals• 24 hour call center Toll free line for this SchemeDIRECTLY TONETWORK HOSPITAL(25%)MAKE A PHONECALL (5%)BENEFICIARIESCMCOREFERRALS (5%)ATTEND HEALTHCAMP NEARBY (45%)GO TO PHCAAROGYAMITHRA(20%)

Highlights of the SchemeInitiated as a pilot project.Now grown into a major programme.Started with 163 procedures in 6 systems;938 procedures now covered in 31 human systemsAll Trauma cases covered.Coverage of BPL family increased from 1.80 crore to 2.04 crores.Follow-up treatment for one year provided for 125 procedures.Cochlear implantation for children up to 12 yrs age included

Patient Work Flow

Manpower DetailsEMPANELMENT DEPARTMENT :To empanel the hospitals as per the guidelines ofthe Scheme.MIS :To collect collate and report data on real timebasis Collect hourly information from theAarogyamithras, regional coordinators, districtcoordinators etc.24 HOUR CALL CENTER :To provide support through toll free help line -24x7x365INFORMATION TECHNOLOGY :To ensure web enabled services like e-preauthorization, claim settlements and realtimetransactions are maintained 24-hourbasisHEALTH CAMPS :To plan, intimate, implement & monitor the campsas per the guidelines of the Scheme.FOSS :To coordinate the daily activities of field staffand monitor onlinePRE AUTHORIZATION :To provide round the clock preauthorization's withspecialist doctors for each category of disease andto process the preauthorization within 12 workinghours.FIELD OPERATIONS :To coordinate with the Network Hospitals at thefield operationsFOLLOW-UP-MEDICINE:To coordinate the follow-up consultation anddistribution of drugs as per the instructions of theTrustCLAIMS SETTLEMENT :To process the claims as per guidelines of thescheme through online system

Manpower DetailsHR :To manage human resources for the scheme andmaintain online database of staff.TRAINING :To build the capacity of stakeholders and staff forsmooth running of scheme.ADMIN :To co-ordinate administrative aspectsVIGILENCE :To keep vigil on all services and stake holders.LEGAL :To assist & co-ordinate all Legal aspects. Tocoordinate with the Network Hospitals at the fieldoperationsGRIEVANCE - FEEDBACK :To redress the grievances within turn around time (TAT)FEEDBACK- To send feedback formats, collect and analysefeedback of the patients as per the directions of the Trust.TOTAL MANPOWERDOCTORSPHC MITHRASNETWORK HOSPITAL MITHRASCALL CENTER EXECUTIVESFIELD OPERATIONSDISTRICT MEDICAL OFFICERSVIGILENCELEGALHEALTH CAMPSINFORMATION TECHNOLOGYGRIEVANCE DEPARTMENTHUMAN RESOURCEOTHER DEPARTMENTSTOTALNOS18319221606291347252712309137253124908

Network Hospital – Responsibilities (329 hospitals Empanelled)• Organize Health Camps once in a week• Separate Reception and Registration• Free food for In-patients• Dedicated Medical Coordinator (RAMCO-Doctor), Camp Coordinator( A MCCO)• Free Transport to In-patient from Mandal Head Quarters• Provide Computer, Printer, Scanner, Digital Camera, Webcam and 2MBPS connectivity• Follow-up consultation and distribution of follow-up medicines provided bythe Trust• Cashless services• Free consultation, diagnostics and treatment, irrespective of surgery

Hospital Empanelment StatusSTATUSNO.Application Applied 887Active Hospitals as on 29.07.2011Application Incomplete 32Application Expired 156Hospital TypeNo.ofHospitalsNo.ofBedsReady to be Inspected 01Inspected 698Empanelled 506Rejected 252Delisted, De-Empanelled, Suspended 166Active Hospitals 340Corporate 243 38258Government 97 27099TOTAL 340 65357

Health CampsPamphlet DistributionPublic Address SystemMike announcement in AutosDandora / beat of tom-tomPlaying of Audio-Visual media(Cassettes, Audio CDs & DVDs)

Health CampsTHESE GROUPS HELP TO MOBILISE MORE PATIENTS AT CAMPS BY WORD OF MOUTH PUBLICITYMEDIUMPatient ScreeningMedicine Distribution

Health Camps• For bringing the awareness amongst the rural masses about the diseases they are sufferingfrom and providing free medical advice and medicines to the rural people.• 47.45 Lakhs people have been screened at their door step by specialist doctors of networkhospitals at 28,008 Health Camps• 2,97,547 Patients referred from Health Camps to network hospitals• 340 network hospitals are conducting around 984 camps in a month across the state ofAndhra Pradesh. Emphasis is been given in Tribal and Backward areas.IEC ACTIVITIES FACILITIES @ CAMPS INCENTIVES TO DOCTORS MEDICINE DISTRIBUTION

ITDA Region Wise Health Camp DetailsS NO ITDA REGION DISTRICTNO. OFMANDALSCOVEREDNO. OFCAMPSUNDER ITDAMANDALSNO. OF PATIENTSSCREENED INITDANO. OFPATIENTSREFERRED INITDA1 BHADRA CHALAM KHAMMAM 32 883 126168 86762 ETURU NAGARAM WARANGAL 11 258 49602 22743KOTAWEST GODAVARIRAMACHANDRAPURAM4 127 18438 7314 PADERU VISHAKAPATNAM 18 520 82112 49835 PARVATHI PURAM VIZIANAGARAM 14 432 69307 36696 RAMPACHODAVARAM EAST GODAVARI10 327 51940 24327 SEETAM PETA SRIKAKULAM 13 496 73960 4620GUNTUR 6 137 26765 1259KURNOOL 13 323 41479 21328 SRISAILAMMAHABOOBNAGAR10 254 37112 1661NALGONDA 3 59 8430 354PRAKASAM 7 143 25327 1381RANGA REDDY 7 243 35390 14519 UTNOOR ADILABAD 37 925 129592 6139Grand Total 185 5127 775622 41762

Call Center 1800-425-7788 Cond..Consolidated Inbound & Outbound Calls From 01.04.2007 To 29.07.2011CategoriesCountInbound 542971Outbound 4143183Project Office 665Total Calls 4686819INBOUND CALLSCategoriesCountGeneral Information 530727Doctor Advice 9457Complaints 3978Total Calls 542971OUTBOUND CALLSCategoriesCountPHC 2374890Health Camp 338399Network Hospital 768388Follow up 661506Total 4143183

Types of Training ProgramsTraining department imparts training to all Network Hospitals through the programs listed below:• Empanelment Training Program• Network Hospital Training Program• Induction Program• Re-Orientation Program• Soft & Communication Skills Training ProgramTRAINING PROGRMS EXECUTED FROM JAN 2009 TO JULY 2011S. No Type of Training Program No. of Programs No. of Participants1 Empanelment Program (EP) 12 6092 NWH Re-Orientation Program (ROP)17 15933 NWH Training Program at NWH‟s (NWH) 92 11764 Induction Program (IP) 149 35875 PHC Training Program (PHC) 35 20176 NWH On-Job Field Training Programs 6 1037 NWH Aarogyamithras Reorientation Program 3 1038 Departments Training Program (DT) 6 2129 Soft Skill Training Program 8 117Total participants 328 9517

Aarogyasri ICT - Comprehensive SolutionsComplex Application > Simple to Use > Quick & Quality servicewww.aarogyasri.orgBPL recordsRegistrationsReports-MISFeedbackIssue TrackerTDSDigital SignatureHospital EmpanelmentPre AuthorizationClaimsCall CenterAccountsGrievanceSMS GatewayHealth CampsFollow upsOnline PaymentsE MailAdminService Intelligence toolOnline DonationBio MetricBiometrice-Mail

Solution Highlights• Completely paperless• Monitor the program from anywhere• Round the clock availability of portalOVER 5000 EMPLOYEESFORSUPPORT AND OPERATIONS• All transactions available for Public Scrutiny• Complete Accountability & Transparency• Cashless transactionsBETTER MONITORING &CONTROL MECHANSIMTHROUGH “ICT” SOLUTION• Online and Real time• Inventory of all medical records• Card verifications against Civil Supplies BPL data• Internal communication between all Users - emailCORRUPTION FREEENVIRONMENT• Online View/Update of bed capacity available in Hospitals• Online claims, payments and Control systems

Scheme Without ICTFraud and Corruption at allstages:• Hospital Empanelment• Medical Camps• Registrations• Pre- Authorization• Claims and Billing etc• Difficulty in handling Huge money transactions nontransparent• Cannot achieve SLAs for pre-authorizations• Communication becomes non-effective• Less Accountability• Monitoring and controlling becomes a nightmareGain for PrivateAgenciesVictims – BPL FamiliesService delivery is atstakeGovernment objective is atrisk

ICT Solution – Technology PerspectiveECONOMIC SCALABLE SECURITY• Right Sizing of Infrastructure• Open Source technologies• Tomcat – Web Server• Jboss – Application Server• Oracle 10g – Data Base Server• Synaptris – Reporting Tool• Started with 500 Users and nowhandling around 5000 User Base• Designed to handle huge data• Load Balancing at Web,Application layers with multiplenodes• Standard development processes- COE• Encryption and Decryptions• LINUX based servers• Digital Certificate/Signatures• Secured Deployment ofInfrastructure – PeriodicVulnerability tests – ( BS7799 )• Role Based Access andAuthenticationEnd-to-End ICT Solution including Hosting of the servers by TCSRELIABLE ROBUST PERFORMANCE• Standard backup mechanism• Proven storage mechanism• Load Balancing and Stand-by• Link Redundancy• Standard J2EE• Proven Framework – “n” tier• Huge data capture (3TB) – NAS• IBM P-series H/w etc•Optimal settings of all servers•A virtual warehouse solution•High Internet bandwidth –24Mbps and High end•Clustered environment

Infrastructure - EarlierInternet2 mbpsFirewallSwitchWeb Server 1TOMCATJBOSSNode 1Database Server ORACLEStandby DB ServerOracle Datagaurd ConfiguredFILE SERVER

Aarogyasri ICT - ArchitectureTRUSTIntranet-105mpbsNIMSKOTIInternet-40mpbsRadware 1Monitoring ToolWeb&AppFirewallMonitoring ToolISSAS-WEBMailDIGITAL SIGNATURESwitchCISCO 1Web Server 1 Web Server 2CISCO 2 - StandbyREPORTING WEBSAS-META DATASAS-Analytics PRO &ForecastingSynaptris/ModJKJBOSSNode 1/Node 2JBOSSNode 3/Node 4REPORTING APPSREPORTING DBSAS-EBIDatabase -2RACDatabase -1Standby DBFILE SERVERSANNAS - 1NAS - 2STAGING ENVIRONMENTUAT ENVIRONMENTTRAINING ENVIRONMENT

MVC ArchitectureWater fallSpiral ModelIncremental Model

MVC ArchitectureACTION VIEW HOMEPAGEINCOMING REQUESTController Front ServletACTION CONTROLLERDATA MODEL

A Unique Application & Scenario 2008 – 09 Vs 2009 - 10• Centralized database (> 150 roles, > 200 workflows)• Highly dynamic & real time (Scheme demands)• Round the clock availability ( Around 500 users even @ midnight)• Complex functionality (Schemes & Phases, > 20 modules & Increasing)• Integration with other tools (Email /Sify, SBH, Call center, Bio Metrics etc)• Very sensitive (SLA based pre-auth/claims etc, High exposure)• Huge user base ( > 5000), high bandwidth (40 mbps + 150mbps-MPLS) and huge data volumes• Highly confidential (Precious data and huge money transfers, Digital Sign.)• Heavy MIS usage (Operational Analysis)July 17 th 2008 Current % GrowthNumber of users 5000 400% - 4 timesConcurrent users 2000 900% - 9 timesSize of data – transacted /day ~10GB ~200GB 1900% - 19 timesSize of the data addition/day ~2GB ~20GB 900% - 9 timesPage Hits/day ~9,00,000 ~1,60,84,836 1100% - 11 timesBandwidth 16 mbps ~ 40 +105 800% - 8 timesTCS Considers - One of the “sensitive and technically challenging” project

ICT Solution – Usage of Web PortalDetailsNumber of page hits/ViewsSize of the data appendedSize of transactional dataDaily Average~1.98 Cr / 38 lacs~15 GB~200 GBTotal Users ~4000Number of concurrent users logged ~2000Internet Link Bandwidth40 Mbps /105mplsDetailsNumber of various Roles 169Number of Workflows ~ 250Number cases worked uponNumber of patientregistrationsNumber of pre-authorization~8000 per/day~ 4000 per/day~1400 per/day

Diagram for In Bound Call CentreUser calls the AarogyasriToll free number1800-425-77-88BSNL Exchange(Lakdikapool, HYD)PBX SERVERBSNL Terminal RoomModems-6APPLICATION SEVERModems-6SIFY/VPNAarogyasriWeb server(Locatedat TCS )DATA BASE SEVERVoice RecordingSTORAGE SEVERPOP UPPOP UPPOP UP. . . .POP UP

Diagram for Out Bound Call CentreAgent 1. . . .Agent 2 Agent 3 Agent 50AUDIO CODEPBX SEVERAPPLICATION SEVERPRI CARDTOTAL 6 MODEMSDATA SEVERTOTAL 6 MODEMS IN BSNLTerminal RoomApplication web serverlocated at TCSVoice RecordingSTORAGE SEVERBSNL, Tata, RelianceAirtel, Vodafone,Aircel , Idea, etcUsers

CCTV & Access Control System1) CCTV (Closed-Circuit Television )‣ Camera‟s‣ DVR‟s2) ACCESS CONTROL SYSTEM‣ Solus Access Control System‣ Solus Attendance Management System‣ Solus Visitor Management System‣ Solus Lift Access Control System withStair CasesClosed-Circuit Television (CCTV) is the use of videocameras to transmit a signal to a specific place, on a limitedset of monitors.Why Need of the CCTV: It is used to Capture the eachand every moment of the employee in our Organization.you have CCTV can be enough to prevent any crimesoccurring in the first place, helping keep your staff safe butalso preventing you from losing business due to a largeaccident that may result in your having to close up.3) SERVER‣Application server‣Testing Server‣ DataBase Server

CCTV SystemCamera’sDVRRouterMonitorInternetRemoteClient

Access Control SystemAccess Control System ( ACS) :This Application designed and Modified specific to project where user details are updated inapplication database and sent to all the Mifare readers enabling access rights for calling lifts onsuccessful authentication. When you entered the Employee Information into the SACS Applicationwe Required the bellow things.• 4k Mifare Access Card• Access Card Writer• Finger Enroll Kit4k MifareAccess CardAccess Card ReaderFinger Enroll Kit

Other Technology Partners• ORACLE – Oracle Database• REDHAT – Linux Servers• SBH – Online Payment• SYNAPTRIS - Reports• IBM - Servers• SIFY - Mail Solution & MPLS VPN• VSNL - Internet Link• BHARTHI - Internet Link• BSNL - Internet Link• HCL – CC Cameras• SOLUS – Access Management• FORTINET – Firewall• XEROX – Printing Services• HP – Servers• MICROSOFT – OS• SYMANTEC – Antivirus• EZSMS – SMS Services• CORAL & CONVOX – Call Centre• PRECISION SOFT - Bio Metrics• TCS CA – Digital Signatures• RADWARE – Link Proof Load Balancer• RADWARE – Link Proof Load Balancer• CISCO – Routers & switches• EASYMEETING – Video Conference• SAS – Service Intelligence Tool.

Hospital – Surgeries/Therapies (29.07.2011)Gender - Surgeries/TherapiesGender Surgeries/ Therapies Surgeries/ Therapies (%)Children 120979 11.84Women 346939 33.95Men 553968 54.21Age - Surgeries/TherapiesTotal 1021886 100.00Age Group Surgeries/ Therapies Surgeries/ Therapies (%)Below 45 653842 63.98Above 45 368044 36.02Total 1021886 100.00Hospital Type Surgeries/Therapies %Preauthorized Amount (RsCrs)%Corporate Hospitals 807552 79.03 2328.08 80.61Govt .Institutions (NIMS, SVIMS & M.N.J) 73978 7.24 196.29 6.80Govt. APVVP Hospitals 9990 0.98 26.35 0.91Govt. DME Hospitals 130366 12.76 337.50 11.69Total 1115834 100.00 3128.04 100.00

Consolidated Month Wise Surgeries/Therapies As on 29.07.1153981696010381137947110912002692361137643902434774057589101901856521087229392466526407236592629928687278632585526791277062548525482275282607726262254112744429724308383145731062350993383531753313933180933396329103371837572367710500010000150002000025000300003500040000Apr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07Jan-08Feb-08Mar-08Apr-08May-08Jun-08Jul-08Aug-08Sep-08Oct-08Nov-08Dec-08Jan-09Feb-09Mar-09Apr-09May-09Jun-09Jul-09Aug-09Sep-09Oct-09Nov-09Dec-09Jan-10Feb-10Mar-10Apr-10May-10Jun-10Jul-10Aug-10Sep-10Oct-10Nov-10Dec-10Jan-11Feb-11Mar-11Apr-112007-08 2008-09 2009-10 2010-11NO OF SURGERIES/THERAPIESMONTH-YEAR

Phase-IPhase-I - 1st RenewalPhase-I - 2nd RenewalPhase-I – 3rd RenewalPhase-I – 4th RenewalPhase-IIPhase-II- 1st RenewalPhase-II- 2nd RenewalPhase-II-3rd RenewalPhase-IIIPhase-III-1st RenewalPhase-III-2nd RenewalPhase III - 3rd RenewalPhase-IVPhase-IV-1st RenewalPhase-IV-2nd RenewalPhase-VPhase-V-1st RenewalPhase-V-2nd RenewalPremium Factorized to the Number of Procedures2.502.001.501.000.500.00

Cochlear – Hospital Wise Progress ReportS.NOHospital WisePatientsScreenedPreauthorisationsApprovedSurgeries / TherapiesPerformedClaims Paid @ 5.20 LacsCasesCOUNT COUNT AMOUNT COUNT AMOUNT COUNT AMOUNT1Apollo Hospitals Enterprises Ltd(Jubilee Hills)1939 257 133640000 254 132080000 193 96500002 ENT Nursing Home 757 120 62400000 118 61360000 101 50500003 Govt Ent Hospital - Koti 498 102 53040000 74 38480000 54 27000004Maa Hospitals Pvt. Ltd. (Unit OfVasavi ENT Institute)1139 150 78000000 143 74360000 135 67500005Quality Care India Ltd (CareHospitals Banjara hills)274 43 22360000 41 21320000 26 1300000Grand Total 4607 672 349440000 630 327600000 509 25450000

Maintenance of HeamodialysisS. No Hospital Name NH location No of Units/ ShiftsNo ofPatientsNo ofSurgeries/Therapies1 Gandhi Hospitals Hyderabad18 Units - 3 Shifts (Tues,Wed, Fri & Sat) and 2 Shifts(Mon & Thurs)342 24662 Government General Hospital, Guntur Guntur 13 Units - 4 Shifts 399 22113 Osmania General Hospital Hyderabad 15 Units – 3 Shifts 431 21774 King George Hospital Visakhapatnam 11 Units - 3 Shifts 290 15775Government GeneralHospital,Kakinada Kakinada 9 Units - 3 Shifts216 12919 Units - 3 Shifts(Mon, Tues, Thur & Fri) 196 12676 Govt General Hospital Kurnool Kurnool2 Shifts (Wed & Sat)7 Mahatma Gandhi Memorial Hospital Warangal 8 Units – 3 Shifts 126 10728 S.V.R.R.Hospital Tirupathi 6 Units – 3 Shifts 128 10639 Govt. General Hospital- Vijayawada Vijayawada 8 Units - 2 Shifts 191 77910Rims Govt. General Hospital,Srikakulam Srikakulam 10 Units – General Shifts175 718Grand Total 2494 14621

Heamodialysis Units at Hospitals

Heamodialysis Units at Hospitals

Heamodialysis Units at Hospitals

Follow Up AnalysisHOSPITALTYPENO OFELIGIBLEPATIENTSNO OFPATEINTSAVAILEDPERCENTAGEON AVAILEDVs UN AVAILEDPERCENTAGEON TOTALAVAILEDNO OFPAIDCASESPAIDAMOUNTAPVVPHOSPITALSDMEHOSPITALSGOVERNMENTINSTITUTIONS27050 5160 19% 6% 714 934051219 60 27% 0% 2 175213224 4440 34% 5% 5733 9732112CORPORATE 156168 75734 48% 89% 69450 109054915TOTAL 196661 85394 43% 100% 75899 119722830

Other States Replicating The Scheme21 States studied the scheme - Arunachal Pradesh, Assam , Andaman and Nicobar, Bihar,Delhi, Chhattisgarh, Goa, Gujarat, Haryana, Jharkhand, Kerala, Karnataka, Lakshadweep,Maharashtra, Madhya Pradesh, Odisha, Punjab, Pondicherry, Rajasthan, Tamilnadu , UttarPradesh•Tamil Nadu• Karnataka• New Delhi• Maharashtra•CGHS/ESI•Rajasthan•Arunachal PradeshKalaignar Insurance Scheme for Life saving diseases from23 rd June 2009. The coverage is for Rs 1 Lakh for a family for four yearsVajpayee Aarogyasri launched on 1 st February 2010Formed Aapka Swasthya Bhima Trust in December 2010Government launching under the name“Rajiv Gandhi Jeevanadhai Yajona”Decided to replicate the same platform.Decided to launch similar scheme.Studied the scheme for implementing in their state

Awards & Recognitionse-India Awards 2010Jury Award –„„Health Insurance Initiative of the Year‟‟Citizen Choice Award – “Health Insurance of the Year”'E-Governance Initiative in G2G category for 'E-Office„ –Citizen Choice Awarde-India Awards 2009CSI Nilihent Award' 09Manthan South Asia Award' 09"Government Policy Initiative of the Year'through Public OpinionJury Award for 'Civil Society / Development Agency of theYear'Award of Excellence - Project of the Year2008 - 2009 Project Category G2GService Delivery Leveraging ITForum for Health-Geneva' 09Skoch Challenger Award 2008For Service Delivery

Recognition

Social AuditLetter Feedback from patients

Results

Critical Success Factors of the Scheme• Top Level Leadership - Political & Administrative• 85% Population are covered under the scheme.• All BPL families of Andhra Pradesh are eligibleunder the scheme.• Coverage of 938 Procedures under 31 categories• Patients are screened at door steps by all theempanelled hospitals by specialist doctors byconducting Health Camps• Patient can choose the hospital of his own• Quality treatment• End-to-end Cashless Treatment• Follow up treatment for 1 year for identifiedprocedures• FIFO (First in First Out) in Claim Process• Transparent workflow• Online Claim Process• Evidence & Outcome Based• Free Food & Transportation for patients• 5 Level scrutiny in all process• Field Verifications for all emergency Cases• 24*7 Telephonic Approvals for emergency cases• 24*7 Preauthorization• 12 Hrs – TAT for Preauthorization• Tight, real-time controls• Online pre-authorizations• Complete medical records online• Patient Satisfaction Letter• Social Audit - Individual letters sent to patients• Proactive – Initiatives like scar photos collection• Reshuffling of Aarogyamithra for every 2 Months inscientific methodology• Strong Vigilance Team• Strong Field Operations Team• Efficient Work Management by e-Office• 100% Network Uptime• Simple, patient-centric process -Aarogyasri HealthCard• Extensive use of Technology, especially IT– Comprehensive Portal– End-to-end workflow application– Completely paperless, efficient, transparent– Electronic payments to network hospitals– TDS deductions, adjustment to IT dept online– Highly evolved IT system• Partnership• Customized to Health Insurance needs

Social Audit – RachabandaRachabanda‣Started on 24 th Jan 2011 till 12 th Feb 2011‣Covering all 23 Districts of the state of AndhraPradesh‣Public attended 64.47 Lakhs‣Public Representatives participated 1.22 Lakhs‣Total Beneficiaries participated 30,433‣Total of 24,383 events were conducted‣Total number of Staff attended : 54,605‣ 6.11 Lakh Temporary Andhrapradesh Cardswere distributed‣ 3.80 Lakh Pamphlets were distributed during theprogram to create the awareness on Aarogyasri

Social Audit - PrajapathamPrajapatham‣An initiative by Govt. of Andhra Pradesh takingadministration to the door step of the people.‣Conducted in 21 Districts‣Started on May 19 th 2010 till June 14 th 2010‣Public attended 40.94 lakhs‣Public Representatives participated 1.29 lakhs‣Total Beneficiaries participated 34.584

Proposed Methodologies• Data recovery facility• Mobile Applications for efficient fieldlevel operations using GPRS andCloud computing.Friday, August 05, 2011 56

THANK YOU

District Progress (As on 29.07.11)DistrictHealthCampsPatientsScreenedPatientsReferred In Patients OutPatientsNo of Surgeries/TherapiesPreauthorizedAmount(In Crs)East Godavari 1243 236683 13206 84742 189358 75786 214.14Guntur 895 187210 11768 83663 265255 72206 214.80Krishna 884 138594 10901 80222 181271 71899 206.52West Godavari 1268 238432 12532 67315 206120 60963 176.85Ranga Reddy 1245 187216 7878 64975 119051 56586 159.00Hyderabad 920 213512 5101 65330 98470 55912 154.09Warangal 1087 234754 11632 62263 167025 54917 145.28Karimnagar 926 175691 9099 56362 151728 50376 130.85Nellore 900 141244 10657 59242 150729 50239 136.16Vishakhapatnam 1060 180603 12492 53617 105814 47340 127.49Nalgonda 1312 178181 8169 54032 107332 47209 130.05Prakasam 942 170495 11330 51397 137959 44828 132.54

District Progress (As on29.07.11) Contd…DistrictHealthCampsPatientsScreenedPatientsReferredInPatientsOutPatientsNo ofSurgeries/TherapiesPreauthorizedAmount(In Crs)Mahabubnagar 1409 214997 11276 49270 65639 41957 120.15Srikakulam 1326 209767 13530 39120 59415 35987 96.50Chittoor 1377 266494 17577 40901 146722 35140 102.47Kurnool 1200 162637 9169 40008 52686 34270 99.03Anantapur 1472 227669 16433 35209 65437 30854 96.55Vizianagaram 983 153180 8688 33217 56741 29606 77.84Medak 1145 200887 9023 33832 56256 29017 84.05YSR 1012 180085 11336 33850 70130 29104 89.51Khammam 1239 177403 11460 31726 90906 27948 80.50Nizamabad 1291 228502 10326 25590 55947 22227 64.20Adilabad 1286 177097 8031 19904 36895 17515 49.65Total 26422 4481333 251614 1165787 2636886 1021886 3128.04

Category Wise Surgeries/Therapies (As on 29.07.11)CategorySurgeries/ TherapiesPreauthorized Amount(In Crs)ONCOLOGY 211255 291.47CARDIAC & CARDIOTHORACIC SURGERY 124822 820.48POLY TRAUMA 116744 278.85GENERAL SURGERY 96990 250.84GENITO URINARY SURGERIES 93162 217.93NEUROSURGERY 71178 264.31NEPHROLOGY 65031 76.57GYNAECOLOGY & OBSTETRICS SURGERY 38621 104.19CARDIOLOGY 30811 84.14PEDIATRICS 30036 70.21ENT SURGERY 27990 41.75NEUROLOGY 27841 60.84ORTHOPEDIC SURGERY & PROCEDURES 20352 48.30

Category Wise Surgeries/Therapies (As on 29.07.11)CategorySurgeries/ TherapiesPreauthorized Amount(In Crs)PEDIATRIC SURGERIES 16199 63.62PLASTIC SURGERY 12282 56.19OPTHALMOLOGY SURGERY 12102 16.77SURGICAL GASTRO ENTEROLOGY 6389 29.88GASTROENTEROLOGY 5586 24.30CRITICAL CARE 4742 27.30PULMONOLOGY 4845 14.50GENERAL MEDICINE 2454 7.11RHEUMATOLOGY 906 1.51COCHLEAR IMPLANT SURGERY 664 34.43ENDOCRINOLOGY 418 1.75DERMATOLOGY 377 0.92PROSTHESES 64 0.01INFECTIOUS DISEASES 25 0.05Grand Total 1021886 3128.04