Healthcare Pulse
Digital health, decoded · by Mayank Madhur
Healthcare Pulse
Digital health, decoded · by Mayank Madhur
Ten flagship programmes. One question: of everything India announced, how much is actually adopted and working? Re-weight the evidence, edit the scores, read the analysis, open the proof. Every verdict recalculates live.
India announces digital-health milestones constantly. This tool asks the harder question for ten flagship programmes: of what was announced, how much is actually adopted and working? Each is scored 0–5 on three axes against sourced evidence, and a single reality score shows how much of the promise is real. Nothing here is fixed — you set the assumptions and the whole board responds.
Four headline reads on the whole stack. Portfolio reality is the average of all ten programmes — how much of everything announced is actually real. The next two split that average by type: rails that deliver a service to a person vs rails that move data between institutions. Widest gap flags the single programme furthest from its own promise.
Reality blends two things: is it being used (adoption) and is it working (outcome). Decide how much each counts. An investor weights outcome; a ministry tracking rollout weights adoption. The whole board moves with the dial.
A BCG-style read of the stack, adapted. Horizontal axis is adoption (is it used?), vertical is outcome (is it working?), bubble size is the population at stake. The four corners tell you what to do: top-right (high both) = scale and protect it; bottom-right (used but not working) = fix the outcome; top-left (works but unused) = drive adoption; bottom-left (low both) = stop announcing, rebuild. Bubbles redraw as you edit scores.
The Quintuple Aim is the field's scorecard for what good care must achieve: better outcomes, better experience, lower cost, a well workforce, and equity. Here is how many of the ten rails meaningfully serve each, and how those rails actually score.
Each programme scored 0–5 on ambition, adoption and outcome. Green is what's real; the hatched zone is the gap to what was promised. Below each: why the gap exists, and what would close it. This is analysis, not a press release.
Every rail's reality score, sorted. The dashed line is the portfolio average. The distance between the line and each bar is the distance between the announcement and the patient.
How the scores are built, the two consulting lenses applied, and every figure's origin.
(wₐ·Adoption + wₒ·Outcome) ÷ Ambition, as a percentage. How much of the promise is real. 100% means it fully delivered on its stated ambition.
Ambition − (wₐ·Adoption + wₒ·Outcome), in points. The wider the gap, the further the press release sits from the patient.
Scale and political backing of the promise. All ten are maximal national flagships, so each starts at 5. Lower it if you judge the promise more modest.
Real usage or onboarding vs target. 0–1 announced only · 2–3 created but thin · 4–5 live and recurring at scale.
Hard evidence it moved cost, access, time or quality. 0 none yet · 2–3 partial · 4–5 demonstrated impact at scale.
Layer splits rails into direct service vs digital infrastructure. Quintuple Aim maps each to the five goals of good care. Both are analytical lenses, not official categories.
Outcomes, experience, cost, care-team wellbeing and equity. Extends the Triple and Quadruple Aim; wellbeing and equity are the newest, and the least served here.
BCG's 1970 portfolio tool, adapted: adoption replaces market share, outcome replaces growth, and bubble size is population at stake rather than revenue.