Elective learning ProJR and the first blended learning medicine department elective online learning portfolio archived

Archived from October 2013: https://likethechickenscratch.blogspot.com/2013/10/the-first-foot.html?m=1 as a mirror blog to preserve content as a backup.

ARCHIT JAIN, certified mountaineer under Indian Mountaineering Federation, presently dogged at sticking out an entrepreneurial venture propelled by short listing of the basic idea by the E-cell IIT-Bombay, A sportsperson at heart à claiming moniker at various fields (also bagged 2 bronze medals in table tennis at PULSE-2013) and thus the college sports’ coordinator. A gourmand and a sight-seer, inter alia; and writing here to share the experiences of my primal bailiwick-MEDICAL SCIENCE!

I am in my 2^nd proff in Chirayu Medical College and Hospital, Bhopal. Presently I am working under the guidance of Dr. Rakesh Biswas with the object of drafting a case report for the British medical journal. And this writing here presents my experience from the same…

As it is a tendency of humans to assume what’s going to happen before setting foot on an unwearied path; I, in my heart, carried less doubt about the workshop I was going to attend. As especially in the domain of medical sciences, at metaphorically a young age, we doctors are sure to expect sessions of brainstorming and an unrelenting test of knowledge. But guess I was totally wrong this time!

Though the entire course was a bit lethargic considering it required a 7 hours run in order to cover 40 odd kms, changing 4 public transports each day and working like this for 14 consecutive days ; I am thankful it proved to be worth the effort!

I reached People’s College of Medical Sciences on 19^th October at 9:00 am. Dr. Biswas was on his routine round when I first met him. It was in the casualty ward that I was introduced to him by Sumit, a friend of mine who took up the course with me. And then the training began.

Case discussions-

As I stated earlier, I was expecting loads and loads of lectures along with Power point presentations and a wall of tough questions to be put up by the doctor in-charge but it seemed I had a lot of air to keep!!

Dr. Biswas had this unique thing about his teaching prophecy whereby he discussed each and every little point about the patient with us. This was yet another experience in itself as being a 2^nd Proff student it is not very often that we are exposed to such open discussions

After taking up the indoor patients, the round in the OPD began.

During this sir told us about a website called UDHC.CO.IN, how it was made and how it benefits not only the middle class but also the poor people. UDHC is basically a user driven health care website through which a patient can be followed easily without revealing his/her identity just by giving him/her a botanical name. All you need to do is to enter the history in the INPUT tab with the consent signed by the patient and share it. It is also a very helpful tool in taking a piece of advice or sharing a case with fellow doctors around the world. I personally found it to be a unique and an innovative step which has helped the sufferers to consult reputed doctors around the world now for free. But for us it undeniably became a platform to discuss our findings with experienced doctors.

In the OPD we came across a patient who was a 31 years old man with a complaint of vomiting, nausea and a non-radiating pain in the right upper abdomen from past 30 days. During those 30 days he had an apparent loss of weight with marked anorexia. There was a decrease in his bowel movement and an increase in flatulence.
The patient had no difficulty in swallowing and the vomit contained recognizable food particles eaten several hours back. Neither black stools nor rectal bleeding was observed. He told us that he used to be

a non-vegetarian and used to consume 250 gm of meat thrice a week previously but has had been a pure vegetarian for the last 6 years. He also consumed tobacco (gutka) 8-10 packs daily and alcohol (180ml) once or twice a week.

He had neither a past history nor a family history of such a problem.

Endoscopy showed: deformed, shortened bulb with inability to push scope into 2nd part of duodenum.
Blood report:-Mild anemia.

R.B.C showed: mild anisopoikilocytosis with microcytes.
W.B.C showed: normal total count & normal.

From his complaints of the last 30 days and considering the endoscopy report findings I proposed that the possibility of duodenal ulcer was pretty less. According to me it was a case of obstruction due to polyps of GI tract. Biswas sir and I discussed for a while and he was then extended a treatment for ulcers. But due to a difference of opinion we have asked him to visit us over the next fortnight to track the success of the treatment.

One-on-one interaction with the patients has been one of the major benefits of this program. Sir gave us complete freedom to examine the patient up till our will and to spend as much time as required to extract all the information in order to solve the patient’s problem. It was as if we were the pilot of the Boeing loaded with the passengers, with total authority and in charge!

Sir also gave us the permission to utilize the research lab in which we could perform basic yet very important hematological and biochemical tests. Through this we realized how even a small lab with minimal resources can be used to make powerful diagnoses.

The routine we followed, for creative learning, under the BMJ program was as follows:-

Taking PATIENT’s HISTORY

UPLOADING IT IN UDHC

INTENSE DISCUSSION (ON WEB CBBLE at that time in tabula rasa)

This pattern of learning was new but I had to quickly adapt myself to it. The best thing about this approach was the ease with which we could discuss each case with sir as well as it gave us enough practice. I spent more time thinking about various cases-first in the ward/OPD, then in my hostel while preparing the case report and later discussing the problem and raising queries. This made the course and the studies easy and immensely interesting as now I could correlate my anatomy and physiology quite well on the basis of the various practical cases I dealt with.

And the subsequent elective ProJR data can be accessed here: https://medicinedepartment.blogspot.com/2021/03/medicine-department-training-programs.html?m=1

UDLCO CRH ProJR plan: The role of Insurance and patient capital in optimizing healthcare ecosystems

Summary:

Insurance has emerged as a critical entry point for healthcare innovation and entrepreneurial strategies, particularly in resource-constrained environments. Pioneering approaches with certain micro health insurance schemes, demonstrate the potential of insurance in bridging gaps for rural populations, reaching over 3.4 million beneficiaries. However, the inherent "lottery-like" design of insurance—where many contribute for the benefit of a few—aligns with principles of patient capital, requiring long-term investment and tolerance for risk. This paper explores why investors and entrepreneurs favor insurance as a gateway to healthcare, analyzing its ability to control capital distribution, catalyze social impact, and integrate sustainable financial models utilising current non dystopian Orwellian models of healthcare data capture and delivery.

Keywords

Insurance, healthcare strategy, patient capital, micro health insurance, rural population, capital distribution, social impact

UDLCO Keyword glossary:

http://userdrivenhealthcare.blogspot.com/2023/11/glossary-of-user-driven-healthcare.html?m=1

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Introduction:

The healthcare sector often faces challenges in scalability, affordability, and accessibility, especially in rural or underserved areas. Insurance has increasingly been viewed as a pivotal entry point for addressing these challenges, as evidenced by certain purportedly successful schemes that reached millions of rural individuals with micro health insurance, offering a low-cost solution to healthcare financing while leveraging principles of patient capital. This paper examines why insurance is considered a strategic entry point by investors and entrepreneurs and explores the interplay between insurance models and long-term capital sustainability using current utopian (non dystopian) Orwellian interventions toward persistent clinical encounters through IT AI user driven data capture tools such as UDHC, CBBLE (cable) and PaJR.

For conversational learners who can easily deal with TLDR, there's a conversational learning and thematic analysis at the bottom, which could be a better starter into the project plan before digging into the methodology below.

Potential Methodology:

Thematic analysis employed to examine conversational insights from healthcare discussions and prospective longitudinal follow up involving various micro-insurance strategies and grass roots, individual patient health investors (the insurance buyer) perspectives as well as prospectively followed up individual patient health outcomes. Key themes such as insurance as a capital control mechanism, patient capital integration, and the "lottery-like" design of insurance can be leveraged to explore how "patient capital" (in this case literally the micro capital investments being built up by every individual patients) are utilised for different patients in a transparent and accountable manner to provide every individual patient investor a large bang for their small buck in terms of individual patient centered learning outcomes and individual patient illness outcomes eventually contributing to collective societal medical cognition outcomes. Transparency and accountability is ensured through current utopian (non dystopian) Orwellian data capture interventions developing persistent clinical encounters through IT AI user driven data capture tools such as UDHC, CBBLE (cable) and PaJR previously described here: https://www.researchgate.net/publication/344227236_Persistent_Clinical_Encounters_in_User_Driven_E-Health_Care, 

https://pmc.ncbi.nlm.nih.gov/articles/PMC4587042/,

https://pmc.ncbi.nlm.nih.gov/articles/PMC6163835/, 

https://pubmed.ncbi.nlm.nih.gov/40674544/, 

https://userdrivenhealthcare.blogspot.com/2025/07/user-driven-orwellian-eyes-at-pivot-of.html?m=1, 

https://medicinedepartment.blogspot.com/2025/08/multidisciplinary-integrative-photonics.html?m=1

Data from secondary sources, including various past micro health insurance health schemes and principles of patient capital, can be synthesized to contextualize findings.

CC licence: https://commons.m.wikimedia.org/wiki/File:PatientCapitalgraphic.jpg

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Expected Results:

1. *Insurance as a Capital Distribution Tool*: Entrepreneurs and investors prioritize insurance due to its ability to centralize and control the flow of funds across the healthcare ecosystem. This ensures efficient allocation of resources while mitigating risks.

2. *Patient Capital Integration*: The "lottery-like" nature of insurance aligns with patient capital principles, where long-term investments are made with tolerance for delayed returns, fostering sustainability in healthcare financing.

3. *Scalability and Accessibility*:

Insurance schemes may demonstrate how micro health insurance can reach large underserved populations, offering a scalable solution for healthcare delivery especially when utilised using current generation for different patients in a transparent and accountable manner to provide every individual patient investor a large bang for their small buck in terms of patient centered learning outcomes and collective societal illness and health outcomes . It would also demonstrate the effectiveness of current utopian (non dystopian) Orwellian data capture interventions developing persistent clinical encounters through IT AI user driven data capture tools such as UDHC, CBBLE (cable) and PaJR.

4. *Investor Enthusiasm*: Insurance provides a predictable entry point for investors, combining social impact with financial returns, albeit at a patient and moderate pace.

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Discussion

The strategic emphasis on insurance stems from its dual role as a financial tool and a mechanism for social impact. Various global models of successful micro insurance schemes highlight the potential of micro health insurance to address the healthcare needs of rural populations effectively. However, the design of insurance as a "lottery" system raises critical questions about equity and sustainability.

By pooling resources from a large population, insurance ensures that only a subset of beneficiaries requires care at any given time. This aligns with the principles of patient capital, where investors are encouraged to adopt a long-term perspective, tolerating delayed financial returns for broader societal benefits. However, the challenge lies in maintaining the longevity of insurance models, as most insurance companies are looking at short term gains that are not designed to outlive their investors.

Entrepreneurs and investors favor insurance as an entry point because it provides control over the capital distribution chain, ensuring efficient allocation while fostering scalability. Moreover, insurance schemes catalyze market creation and combat poverty, as seen in the success of certain. The integration of patient capital further strengthens these models, blending financial sustainability with social impact.

In conclusion, insurance emerges as a strategic tool for healthcare innovation, balancing financial rigor and social equity while leveraging the transformative power of patient capital, especially when the capital is brought in by each individual patient either through their time or micro premium money spent while an online platform contributes transparent and accountable data toward societal scientific advancement in healthcare. It also provides individual healthcare returns in the form of transparent and accountable healthcare outcomes for each individual.

https://userdrivenhealthcare.blogspot.com/2025/09/udlco-crh-projr-plan-role-of-insurance.html?m=1

Conversational learning and thematic analysis:

[07/09, 06:46]hu1: Sir, when I met Dr Celebrity he mentioned that if I had to build the celebrated hospital of today I would've started with insurance. The same was quoted by multiple investors and entrepreneurs in healthcare. Why are they bullish on insurance? Is it because you control the whole capital distribution chain? Or something else. They(investors and entrepreneurs) say that insurance is the best entry point.

[07/09, 07:15]hu2: Because that was his own business strategy. 

He pioneered a very inexpensive micro health insurance scheme reaching out to more than 3.4 million rural poor. 

Well clearly insurance can never have benefitted all the 3.4 million rural people because the very design of insurance is like a lottery. Many pay so that some can benefit assuming that not all 3.4 million will need the same level of care at the same time and if when they do the benefits of "patient capital" will creep in? And here the patient is the investor who simply needs to be patient about his her investment for a long term but then most insurance companies are not designed to outlive them! https://en.wikipedia.org/wiki/Patient_capital

[07/09, 07:16]hu1: Got it! But what about multiple investors and entrepreneurs mentioning that insurance is the best entry gateway?

[07/09, 09:34]hu2: Because they have their short term exit plan and aren't investing long term patient capital toward societal optimization

[07/09, 09:35]hu1: Got it. So, how will we ensure our funding?

[07/09, 09:36]hu1: I mean, if investors will think like this and we won't align to their investment ideology, then who will fund us? I think, we'll have to find the right investor.

 

Because everyone doesn't think about short term exits

What's your take, sir?

[07/09, 09:42]hu2: The right investor finally is at the bottom of the pyramid who will pay a micro amount regularly as patient capital. Currently PaJR patients pay us throughout their time and their time can be monetized if their entire PaJR workflow is being archived transparently and accountably in an online platform?

Thematic Analysis of the Conversational Content:

Theme 1: Insurance as a Strategic Gateway in Healthcare

Dr. Celebrity and other healthcare entrepreneurs emphasize insurance as the ideal entry point for building sustainable healthcare systems. The rationale lies in insurance’s ability to centralize and control the capital distribution chain, ensuring efficient resource allocation. It operates like a "lottery" system, where contributions from many fund the needs of a few, making it an attractive financial model for scalability and social impact. Micro health insurance schemes exemplify this approach by reaching millions of rural individuals with affordable healthcare. However, the model inherently requires long-term sustainability and tolerance for delayed returns, aligning it closely with *patient capital* principles.

Theme 2: The Role of Patient Capital in Insurance

Insurance integrates patient capital, where investors are expected to forgo immediate profits for long-term returns. The conversation highlights the alignment between patient capital and insurance, noting that investors need patience and resilience to sustain such models. However, traditional insurance companies often fail to outlive their investors due to short-term financial goals, creating a gap in long-term societal optimization. Patient capital’s willingness to prioritize social impact over maximum financial returns makes it a suitable framework for health insurance models focused on equitable healthcare access.

Theme 3: The Divergence Between Investor Mindsets

A critical tension arises between investors’ short-term exit plans and healthcare’s need for long-term funding. While some investors seek quick profits, others align with patient capital ideology, prioritizing societal benefits. The conversation underscores the importance of identifying "the right investor"—one who values sustainability and accountability over immediate financial returns. This investor could be found at the "bottom of the pyramid," represented by individuals contributing micro amounts regularly, creating a decentralized yet resilient funding model.

Theme 4: Transparency and Accountability in Funding Models

To ensure funding sustainability, the conversation proposes archiving and monetizing patient workflows transparently via online platforms. This approach not only builds trust but also provides a mechanism to efficiently channel micro payments into scalable healthcare solutions. By leveraging technology, the funding process becomes more accountable, encouraging both patient contributions and investor confidence.

Theme 5: Balancing Social Impact and Financial Viability

The analysis highlights the dual challenge of maintaining social impact while ensuring financial sustainability. Insurance, when paired with patient capital, offers a unique middle ground between venture capital’s financial rigor and philanthropy’s altruism. Entrepreneurs and healthcare leaders must navigate this balance, ensuring that their models align with both societal needs and long-term investor goals.

Conclusion

The conversation reveals insurance’s potential as a gateway for transforming healthcare systems, provided it is supported by patient capital and transparent funding mechanisms. Identifying the right investors—those who value long-term impact over short-term exits—is crucial for success. Additionally, leveraging technology to archive workflows and ensure accountability can foster trust and sustainability, ultimately reshaping healthcare financing for broader societal benefits.