Travel, scheme and money help that keeps dialysis patients in their chair
TL;DR Chairkeep works inside dialysis units. It asks every new patient a short set of questions about transport, income, documents and food, then a coordinator fixes what it finds, using state schemes, transport arrangements and employer letters. Dialysis operators pay per active patient, because empty chairs cost them money.
Dialysis in India is a three-times-a-week commitment that many patients cannot physically reach. In a state-wide database, about 49% of patients stopped dialysis and 13% died within a year. In one publicly funded Andhra Pradesh scheme, only about 53% were still on haemodialysis after six months[1]. Almost 60% of patients travelled more than 50 km to a unit and nearly a quarter lived more than 100 km away[1].
So why do they stop? The reasons are rarely clinical. Sessions cost roughly ₹1,000–4,000 each in private centres, and transport is a cost on top[2]. A patient who loses a day's wages twice a week, or whose scheme paperwork lapses, drops to two sessions, then one, then none.
What it does, in regulatory terms - a non-clinical patient support service. It makes no treatment decisions and is not a medical device. Clinical care stays with the unit's nephrologist.
Every patient starting at a partner unit answers a short screen covering transport, household income, documents, food and who can accompany them. The questions follow the structure of established social-needs screens used abroad, adapted to Indian schemes[3]. Each answer that fails becomes a task for a Chairkeep coordinator. That could mean enrolling the patient in the state scheme or the national dialysis programme, arranging a shared auto or ambulance route with other patients from the same block, getting the ration card renewed or writing to an employer about shift timing.
The seed pitched integrating social data into patient records. I've reframed it, because data alone changes nothing in India and no reimbursement pays for collecting it. Attendance does pay. The software exists to assign and track the fix, and to show the unit how many sessions it saved.
Dialysis operators pay, not patients. A unit under the public-private model is paid per session, so a patient who stops is lost revenue and a lost slot. Private chains have the same incentive at ₹1,800–3,500 a session[2]. The buyer is the operations head of a chain or the administrator of a hospital unit, while the nephrologist is the person who must agree it helps.
The public programme has built the capacity: 1,925 centres across 751 districts and 13,824 machines, with 33.16 lakh patients served, on figures the health ministry portal heads as at 31 August 2026[4]. The portal's own footer carries an earlier update date, so verify before quoting it. With chairs now widely available, the operator's problem has shifted from building units to keeping them full.
There is no published figure for dialysis patient-support services in India. The narrow signal is attendance itself - about 53% continuing at six months in one public scheme[1], against roughly 10 to 12 sessions a month per patient at ₹1,000–4,000 each[2]. A unit that holds 30 extra patients for six more months is the whole business case.
The largest dialysis chains run reminders and a virtual assistant for schedules and reports[2], which is scheduling rather than social support. Hospital medical social workers do some of this work, one patient at a time, where a post exists. In the US, one referral-coordination software firm sells to health systems and reports that 96% of closed-loop referrals are completed, on its own figures[5]. Nobody in India appears to sell the screen, the fix and the attendance report as one service to dialysis operators.
| Difficulty | Moderate (41/100) |
| Starting capital | ₹70 L–1.4 Cr |
| Time to launch | 5–8 months |
The software is simple. The difficulty is that your product is a person - a coordinator who knows the district's scheme desks and can arrange shared transport. Proving the attendance effect takes months, and operators will want a comparison against their own units before paying.
No medical-device or clinical licence applies here, as long as you keep to logistics, documents and money.
Building this outside India? The categories above usually have a local equivalent, so check with your own regulator.
Don't let AI decide who is eligible for a scheme or who gets help first without a coordinator checking. Scheme rules change by state, and a wrong rejection costs a patient real money.
Want to work out the AI layer for Chairkeep? Talk to Yash →
Here's what can go south -
I like this for a founder with public-health operations experience and the patience for hospital procurement. If you're a software-only team then I'd pass, because the value sits in the coordinator's local knowledge. Prove one thing first - in one unit, that screened patients attend more sessions over six months than a comparable group.
Plan for roughly ₹70 L–1.4 Cr, mostly coordinators, transport arrangements and the months needed to prove an attendance gain.
No medical licence applies. You need company registration, GST once over the threshold and DPDP compliance, and you must verify each state's scheme rules.
Yes, missed sessions driven by travel and money are a problem in many countries. Map your local support schemes and health data rules first.
The free Chairkeep validation kit has the line-by-line capital breakdown, the effort scoring, the data-protection and contracting checklist, a 14-day validation sprint with pass/fail targets, a 90-day launch plan, 10 interview questions for operators and patients, and 5 assumptions to test. Download the kit →
Thinking about building Chairkeep or something close to it? The make-or-break work is proving an attendance gain an operator will pay for. If you need a hand, you know where to find me. Talk to Yash →
For illustration only. Names are fictional and ideas hypothetical; sourced facts are real but may be out of date. Nothing here is legal, financial or professional advice, and Yash Khatri is not personally liable for any use of it. Read the full disclaimer.