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Registered with Registrar of Newspapers under RNI No. MAHENG/2012/46040, Postal Registration No. MH/MR/N/242/MBI/12-14, Published on 27th Total number of pages 48 of every previous month. Posted at Patrika Channel Sorting Office, Mumbai-400001, Posting date: 30th & 31st of every previous month

Aligning business and healthcare in India

June 2013 • Vol 1 • Issue 9 • Rs50

Published by ITP Publishing India

>>>EXCLUSIVE Smart Healthcare india summit

patient relations trainING to impress

Technology

the latest DEVELOPMENTS IN pacemakers

case study

Sound

How A home-grown EMR HAS helped LVPEI

projects

NH HSR layout, bengaluru & saket city hospital, delhi

MoveS

Dr MI Sahadullah, CMD, KIMS Healthcare Group, on HIS BUSINESS sTRATEGY

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Contents News 10 This month’s important news updates projects 18 Narayana Hrudayalaya’s upcoming project at HSR Layout, Bengaluru 20 Remodelling of Delhi’s GM Modi Hospital into Saket City Hospital

Straight talk 22 Dr MI Sahadullah, chairman, KIMS Healthcare Group, on the group’s expansion plans in India and the GCC

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Technology 27 New-generation pacemakers 30 LVPEI’s home-grown EMR

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patient relations 34 Dr Alexander Thomas on the link between staff behaviour and a hospital's reputation

special 37 In-depth report on what topics dominated the discussions and deliberations at the first Smart Healthcare India Summit held last month in Bengaluru

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Editor's note

JUNE 2013 • VOL 1 • ISSUE 9 ITP PUBLISHING INDIA PVT LTD Notan Plaza, 3rd floor, 898 Turner Road Bandra (West), Mumbai – 400050 T +91 22 6154 6000

Deputy managing director: S Saikumar

Summit up

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hat is common between the likes of Fortis Healthcare, Manipal Health Enterprises, HCG, Global Hospitals, Medica Synergie and BSR Healthcare that have multicity presence and players like Hinduja Hospital, SevenHills Hospital, CloudNine, Bangalore Baptist Hospital, Prime Hospitals, Mallya Hospital and BLK Super Speciality Hospital that operate from a single location? While each of the brands has a distinct focus, they are all in sync when it comes to their unflinching determination to improve the three 'A's (availability, affordability and accessibility) of quality healthcare. ‘Smart Healthcare India Summit’, organised by Healthcare Radius in Bengaluru, engaged luminaries from some of the bestknown groups in the country on a single platform to deliberate on the key challenges and growth trends shaping the Indian healthcare industry. Industry bigwigs also chalked out a slew of pragmatic solutions addressing the three 'A's. Delve into the thoughts of the leaders in the conference report. When it comes to leaders or leadership position, except for Fortis Healthcare, it’s mostly groups based in south India that are making their presence felt outside the country. Find out how Dr MI Sahadullah, CMD, KIMS Healthcare Group, is spreading the group’s footprints in India and the GCC region in our cover story. While the industry celebrates its rapid progress and increasing clout overseas, it is also mourning the passing away of Dr Sanjeev Malik, one of its finest strategists. Based out of Dubai since joining DM Healthcare, he was a caption par excellence. His death has been a great loss to many in the industry, including me.

Publishing director: Bibhor Srivastava Group editor: Shafquat Ali T +91 22 6154 6038 shafquat.ali@itp.com

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Printed and Published by Sai Kumar Shanmugam, Flat no 903, Building 47, NRI Colony, Phase – 2, Part -1, Sector 54, 56, 58, Nerul, Navi Mumbai 400706, on behalf of ITP Publishing India Private Limited, printed at Jasmine Art printers Pvt.Ltd., A-737/3, TTC Industrial Area, Mahape, MIDC, Navi Mumbai. India and published at ITP Publishing India, Notan Plaza, 3rd floor, 898 ,Turner Road , Bandra (West), Mumbai – 400050 Editor: Rita Dutta

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Healthcare Radius June 2013

Published by and © 2013 ITP Publishing India Pvt Ltd Title verification no. RNI No: MAHENG/2012/46040


a dv i s o r y b oa r d Our editorial board holds up a mirror to the healthcare industry, helping us underscore the key trends and developments of the industry

Dr Alok Roy Dr Narottam Puri (Hony) Brigadier Chairman, Medica Chairman, NABH and Dr Arvind Lal advisor, Fortis Healthcare Chairman and managing Synergie director, Dr Lal PathLabs

Dr Praneet Kumar CEO, BLK Super Speciality Hospital and chairman, NABH appeals and grievance committee

Dr Girdhar J Gyani Director general, Association of Healthcare Providers

Dr Ravindra Karanjekar CEO, Global Hospital and chairman, NABH accreditation committee

Dr G Bakthavathsalam Dr MK Khanduja

Chairman, KG Hospital & Post Graduate Medical Institute

Chairman, BSR Healthcare

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Dr Gustad B Daver Director, professional service, PD Hinduja Hospital

Brigadier Joe Curian CEO, SevenHills Hospital

Dr Duru Shah Eminent gynaecologist

Dr NC Borah Chairman, GNRC

Sandeep Sinha Director, South Asia and Middle East, Healthcare & Life Sciences, Frost & Sullivan

Dr Sanjeev Singh Medical superintendent, Amrita Institute of Medical Science and chairman, research committee, NABH

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KIMS receives Golden Peacock Excellence Award

KIMS Healthcare Group has received the Golden Peacock Business Excellence Award for the year 2013. The award was presented in a two-day event at Dubai Global Convention on Business Excellence at Burj Al Arab, Dubai. The award recognises organisations from public, private, government, manufacturing and service sectors that stand out for their best practices and CSR. Dr MI Sahadulla, chairman of KIMS Group, received the award from His Excellency Honorable Sayyad Abdal Cader Sayed – Hossen, Minister of Industry, Commerce and Consumer Protection, Government of Mauritius in the presence of Lt Gen J S Ahluwalia, president, Institute of Directors, Sudhir Vasudeva, chairman and MD, ONGC and many other dignitaries.

Being Human with Fortis Foundation In an effort to rekindle hope for children suffering from congenital heart defects, The Fortis Foundation (the philanthropic arm of Fortis Healthcare Limited) has come together with Being Human, the foundation promoted by actor Salman Khan, to create a heart-warming initiative, ‘The Little Hearts Programme’. The joint initiative will leverage Fortis’ extensive network of hospitals across the country. Over 50 children have already Actor Salman Khan been treated within six few weeks at the Fortis Hospital in Mulund, Mumbai, and at Fortis Memorial Research Institute, Gurgaon. Speaking about the tie-up, Shivinder Mohan Singh, on behalf of the Fortis Foundation, said, “There could be no better occasion to start ‘The Little Hearts Programme’ than at the launch of our flagship hospital, The Fortis Memorial Research Institute.” Said actor Salman Khan, “From time to time, Being Human is approached by cases of children with heart conditions. The solution is very specialised and not financially affordable for a number of people. We needed to partner with a reputed institution that could offer a sustained solution, preferably at a panIndia level. In Fortis, we have found such a partner. Within 10 minutes of my first meeting with Shivinder Singh, we shook hands and 50 cases have already been attended to in less than six weeks.”

A voice clinic in Eastern India Apollo Gleneagles Hospitals, Kolkata has launched a unique voice clinic that offers a 360 degree solution for treating all kinds of voice disorders. The voice clinic is a wholesome amalgamation of services such as diagnosis, consultation, surgery and rehabilitation, powered by experience and expertise of well-renowned voice and laser surgeons. The department also has a full-fledged speech and rehabilitation section comprising seasoned voice and speech therapists and also offers voice analysis therapy. The clinic is equipped with state-of-the-art equipment such as fibre optic laryngoscope, video stroboscope and voice analysis software (PRAAT). Said Dr Rupali Basu, CEO, Apollo Gleneagles Hospitals, “Voice disorder is a condition that can affect people across all age groups from different walks of life. The treatment for this has to be a combination of therapy and surgery. The Apollo Gleneagles Voice Clinic is aimed at curing such disorders by offering a bouquet of superior services under a single roof.”

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Nova to install Renaissance Surgical Robot Nova Orthopaedic & Spine Hospital, a newlyopened state of the art hospital in New Delhi, dedicated to orthopaedic and spinal surgeries, will soon install Renaissance surgical robot system. This is the second Renaissance system installed in India. According to the vendor, Renaissance, Mazor Robotics’ next generation surgical guidance system for spine procedures, is transforming spine surgery from freehand operations to highly-accurate, stateof-the-art procedures, with less radiation – even for minimally invasive surgery, scoliosis, and other complex spinal deformity cases.

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Manipal Hospitals invests in Reproductive Services Manipal Health Enterprises (MHE) has invested growth capital in Ankur Healthcare, a speciality centre focused on delivering comprehensive services in the areas of reproductive medicine -IVF, andrology and men’s health. This venture, to be called Manipal – Ankur Andrology and Reproductive Services (MAARS), will be led by the founders of Ankur Healthcare: uro andrologist Dr Vasan SS and reproductive medicine expert Dr Bina Vasan. Dr Vasan now will lead the new entity as the CEO and Medical Director, while Dr Bina will head the reproductive medicine division. The new entity would see the centres expand from four to 12 over the next 18-24 months, with new centers located in existing hospitals of MHE, standalone centres in cities like Chennai, Pune, Hyderabad, Indore, Chan-

digarh etc. as well as setting up such facilities within other hospitals. This investment also marks the beginning of Manipal Hospital’s foray into allied healthcare delivery formats in partnership with established players in specified clinical areas. Said Rajen Padukone, MD and CEO, MHE, “Our focus on allied healthcare delivery formats will ensure that key traits like quality, technology, ethical practice and affordable care will continue as top priority. Our new initiative, MARS would be one of a kind venture that would create a chain of specialty hospitals focusing on andrology reproductive medicine and men’s health in the country. This synergy will initiate new benchmarks and new medical trends in our country.”

Test reveals high toxic lead content SRL Diagnostics’s Atomic Absorption Spectroscopy test has found high toxic lead content in samples. According to findings by SRL Diagnostics, of the 600 odd samples received every month for Atomic Absorption Spectroscopy, which detects metal content in body fluids, about 350 contain lead. This is followed by copper (125), zinc (50) and other metals such as arsenic, mercury, aluminium and chromium. Said Dr BR Das, president – research and innovation, SRL Diagnostics, “The number of samples with metal content have gone up over the years. We started in 2010 with about 250 samples

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monthly and today we screen around 600.” Even a small amount of exposure to lead can cause long term health hazards, especially in children. The presence of lead in human bodies can result in anaemia, hypertension, impaired fertility, etc. Also, lead does not allow other toxic metals such as copper and zinc to be flushed out of the body. Lead can remain in the body for more than 45 years. Lead is the highest toxic metal to be found in human bodies. Extreme pollution, construction activity and indiscriminate use of Ayurvedic medicines are the primary reasons for the presence of the toxic metal in human bodies.

Hinduja Hospital bags best ICT award PDHinduja National Hospital, Mumbai has bagged the ‘Best Information & Communication Technology (ICT) enabled hospital in Maharashtra’ award at the e-Maharashtra awards. The award in healthcare segment was introduced for the first time to recognise and award organisations for their initiatives taken in Maharashtra through innovative use of ICTs. Joy Chakraborty, Director, Administration and Mahesh Shinde, Director, IT, received the award from Rajesh Aggarwal, Secretary IT, Government of Maharashtra. Said Chakraborty, “We have realised that efficient and effective healthcare delivery needs to be supported by IT.” Some of the initiatives taken by the hospital include, PACS along with digitisation of imaging records and reporting system. This was with the intention of bringing down the turnaround time of reporting and better image archival facility in imaging department of the hospital. The hospital’s PACS is amongst the first few in India to have PACS with a voice recognition system.

Carestream Ships over 6,000 wireless DR Detectors Carestream Health has shipped over 6,000 DRX detectors since launching the CARESTREAM DRX-1, a revolutionary wireless X-ray detector used in surgical suites, ER/ICU and radiology departments—as well as clinics, imaging centres, nursing homes and field military hospitals. The DRX-1 detector delivers high-quality, affordable digital X-ray images in about four seconds. “Our wireless DRX detectors and DRX systems deliver exceptional image quality while simultaneously improving productivity and controlling costs,” said Diana L Nole, president, Digital Medical Solutions, Carestream Health. “These attributes enable healthcare providers of all sizes to enhance patient care while adapting to lower reimbursements,” added Nole.

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approximate size of the unorganised men’s fertility services market in the country

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at a gl ance Sky Hospital branch inaugurated Sky Hospital and Research Centre, Imphal, has recently inaugurated a new centre at Porompat near JNIMS. While the hospital would primarily be treating heart ailments and cardio vascular problems, it would also provide services related to

obstetrics and gynaecology, paediatrics, general surgery, orthopaedics, medicine, nephrology, ENT, dialysis etc. Sky Hospital and Research Centre is now a government recognised centre for treatment of heart diseases and necessary surgical operations.

LVPEI launches ‘Next-25’ L V Prasad Eye Institute (LVPEI) has launched ‘Next 25’ initiative as a progression of the institute’s measure of expertise, best practices and cutting-edge capabilities, accumulated over 25 years of service in the elimination of avoidable blindness. The institute would have the following: Academy for Eye Care Education,

Centre for Ocular Regeneration, Child Sight Institute, Institute for Eye Care for the Elderly, Institute for Eye Cancer and Centre of Excellence in Eye Banking. As part of LVPEI, these institutes will encompass care from primary to advanced tertiary care, education, research, public health, planning and policy.

A cancer hospital in Vizag A cancer hospital would soon be set up at Vizag in Andhra Pradesh. The hospital, located at Aganampudi, would be a 100-bed hospital for poor people. The centre would be equipped with state-of-the-art

equipment required for detection and treatment of cancer. The government has sanctioned Rs400 crore for setting up the centre, which will be completed in the next two years.

Advanced Cardiac Care Centre in Mumbai Mumbai’s Godrej Memorial Hospital, a unit of Godrej Memorial Trust, recently inaugurated an Advanced Cardiac Care Centre for the benefit of residents of Mumbai and its suburbs. The centre, located at the hospital, is well-equipped to conduct angiography, angioplasty, bypass and valvular surgery. It is also capable of performing neurological procedures in a minimally invasive manner. The centre is equipped with a new cath lab, a dedicated operation theatre and an ICU.

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The industry loses a leader Dr Sanjiv Malik, senior vice president and CEO, Aster Hospital & Medical Centres- GCC, met with tragic death at the age of 50. He suffered a heart attack at his residence, and passed away before medical help could reach. The last rites on him were performed in New Delhi. Dr Malik is survived by his wife Aradhana and daughter Arunima. Only a month ago, he had lost his mother. Prior to DM Healthcare, he worked in a law firm specialising in Intellectual Property Rights and brand protection strategies and as executive director for MMR Eye Institute. He came into the national limelight when he was the Regional Director of Max Healthcare. He demonstrated business acumen in leading and managing operations, effectively discharging his functions and achieving higher rate of organic growth for the organisations he managed. He was respected as a business leader with great ideas and strategies that always yielded results. He had extensive experience in conceptualising and implementing SOPs, process improvement, resource allocation, costing and utilisation in hospital operations as well as in managing HR activities like manpower planning, recruitment, performance management, and training and development. His knowledge about industry and his oratory skills made him a much-sought after speaker at healthcare conferences around the world. Dr Malik had received his MBA in healthcare management from the Faculty of Management Studies (FMS), Delhi University, and MS - Ophthalmology from Western Regional Institute of Ophthalmology, Ahmedabad.

Etihad Airways & Apollo Hospitals join hands Apollo Hospitals has signed an agreement with Etihad Airways to provide special travel benefits for medical value travellers flying to visit Apollo Hospitals in Chennai, Hyderabad, Delhi, Bengaluru and Ahmedabad. Under this arrangement, patients and their attendants travelling to Apollo Hospitals destinations in India from Etihad travel destinations will get a five per cent discount on their ticket prices for a round trip. Etihad connects to Abu Dhabi, Dubai, Bahrain, Doha, Kuwait, Dammam, Jeddah, Riyadh and Lagos.

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AMFAH INDIA, 2 Park Paradise, Opp. Windermere Bldg., Oshiwara, Andheri (W), Mumbai–53. All India: 09967 232424 | Ph: 022 – 40107074, 26319527

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Fortis Hospital organises stress management workshop On the occasion of World Hypertension Day, 17th May, Fortis Hospital, Mulund conducted a learning session for BEST drivers and conductors. The first round of the workshop organised at Wadala Bus Depot had participation from more than 100 drivers and conductors. Said Dr Manjeet Singh, Consultant Occupational Health Physician at Fortis Hospital, Mulund, “BEST employees underwent extensive physiotherapy sessions to battle stress and were also imparted training in CPR.” According to a recent report, around 40 per cent of BEST bus drivers and conductors tested for chronic disease suffer from hypertension and most of them were not even aware of the disease. A study conducted by students from a city college, tested 500 BEST employees of which 200 employees were found to be suffering from hypertension. Every fifth person in the city of Mumbai is afflicted with high blood pressure. “Since heart attacks, a byproduct of high blood pressure, are on the rise, it is vital that that everyone knows at least the basic CPR which was the main crux of this workshop,” said Dr Singh.

Hospitals in Karnataka to pay less for power Thanks to the persistent lobbying by The Association of Healthcare providers of India (AHPI), the electricity tariff for hospitals in Karnataka is no longer at par with cinema halls and city malls. AHPI submitted and pursued the representation for tariff reduction to The Karnataka Electricity Regulatory Commission (KERC), which had proposed high rates for the current year as well. Hospitals, which would now get the benefit of about 15 per cent, have now been kept in a separate category. Charitable hospital tariffs have also been announced. Here again, hospitals get significant benefits. The requirement to qualify as a charitable hospital is a 12-A certificate issued by the IT department. Said Dr Girdhar Gyanii, secretary general, AHPI, “Hospitals are affected in a big way by the high electricity tariffs as their expenditure is up to 60 per cent on direct patient services. In fact, two to four per cent of all hospital expenditure is towards electricity use. Nearly all hospital functions require adequate and uninterrupted supply of power. It is only then that the hospitals will be able to provide high quality services and a sterile environment all year long.” The tariff is a huge relief for hospitals.

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Dr Viswanathan to be felicitated

Govt to launch more nursing colleges Giving a boost to nursing care in India, Union Health Minister Ghulam Nabi Azad has stated that six nursing colleges would start functioning by the end of this year at the six AIIMS-like institutes. He also stated that an Indian Institute of Nursing is proposed to be set up at Chennai, besides a centre of excellence in nursing in Delhi. He informed that 20,000 more nursing seats will be created this year.

The American Diabetes Association has selected Dr Vijay Viswanathan, chief diabetologist and head, MV Hospital for Diabetes for the first Vivian Fonseca Award. The award, which would be given at the 73rd Scientific Sessions to be held during June 21-25 in Chicago, Illinois, has been established by the Association to recognise diabetes research focused on the South Asian, Asian American, Native Hawaiian, and Pacific Islander populations and/or research by a scientist from these parts of the world. Dr Viswanathan is being awarded for his work on diabetes and TB. “The connection between diabetes and TB is gaining much importance, the world over. We found that TB patients with diabetes fare badly, compared with those without diabetes,” said he.

BPL Medical Technologies gets Rs1,100 million BPL Medical Technologie has secured an equity commitment of INR 1,100 million (approximately US$20 million) from Goldman Sachs, a leading global investment bank. BPL Medical Technologies is a group company of BPL Limited and is into manufacturing of medical devices. The investment will be used to further expand the company's medical device business and is subject to customary approvals.

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First look

The HSR project The new Narayana Hrudayalaya facility at HSR Layout of Bengaluru plans to bring world class multi speciality care to the area By Team HR

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he Narayana Hrudayalaya (NH) group is commissioning yet another project in Bengaluru. Besides a tertiary care boutique hospital in the Whitefield area, NH will soon be inaugurating a 100-bed multi-specialty hospital on 18th Main road, sector three at HSR Layout area. The hospital is will start its OPD and IPD in June. In the first phase, the IPD will have 50 beds. This brown-field project is a joint venture between renowned film producer Basant Kumar Patil and NH. While Patil has provided the land and the building, NH will take care of equipment, staff and management of the project. Spread over 68,000 square feet, the facility has been designed by NH’s projects’ team, while the interior is done by a city-based firm. Keeping the patient populace in mind, the hospital has a few general wards, while most of the other rooms are air-conditioned semiprivate rooms, private and deluxe suites. The hospital will offer all basic specialties and super specialties, except cardiac surgery and trauma. It will also have critical care services, which include medical ICU, cardiac ICU, neonatal ICU, and dialysis units. Furthermore, it will have two general OTs and one dedicated OT for obstetrics and gynaecology services. Diagnostic facilities it will house include 64 slice CT scan, ultrasound, X-ray, echocardiogram, TMT, laboratory services, cardiac cath lab and endoscopy. The hospital will be manned by a medical team of around 40 consultants and junior doctors. Said Dr A Nagasubramaniam, facility direc-

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The hospital will have two general OTs and one dedicated OT for obstetrics and gynaecology services.

The work for the hospital is in full swing.

tor, NH Hospitals, HSR Layout, “We plan to provide multi speciality services under one roof, keeping quality in mind.” He added that the hospital is built to cater to the acute and varied medical requirements of residents of HSR Layout and surrounding areas. “Patients suffering from acute health problems, both

The hospital will have cutting edge technology like the 64 slice CT scan.

Semi-private room in the hospital.

cardiac and non-cardiac, need not navigate the city’s traffic and travel a long distance to reach to a hospital. Our hospital’s critical care services, manned round the clock by experienced specialists and backed by stateof-the-art technology, will be a boon to such patients,” he added.

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Projects

Spicing it up Thanks to Spice Global, the recently commissioned Saket City Hospital in Delhi hasn’t just received a face-lift but also a total efficiency overhaul BY team hr

The Saket City Hospital was previously known as GM Modi Hopital

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he transformation that GM Modi Hospital in Saket, New Delhi, has undergone is unbelievable. The multi speciality tertiary care hospital, now known as the Saket City Hospital, is refreshingly different from its old avatar. The first phase of the revamped project with 230 beds has recently started functioning. For the project, the space from the earlier 100-bed hospital has been smartly utilised, without adding extra floors or altering the basic structure. Singapore-based Spice Global, with business interests in telecom, finance and entertainment and promoters of the hospital, has pumped in Rs150 crore for the first phase. By 2016, the group plans to invest close to Rs1,400 crore in total, all of which is promoter funding, when the full project with 1,000 beds would be ready. The centrally air conditioned hospital, spread across 12.5 acres of land, offers super-specialities like cardiac sciences, neurosciences, gastroenterology and gastrointestinal surgery, orthopaedics and joint replacement, gynaecology and obstetrics. Other facilities include 24x7 emergency, day care, OPD and in-patient care, critical care, operation theatres, radiological and pathological laboratories, blood bank and dialysis along with a range of centres of excellence covering multi specialities such as clinical

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nutrition, dentistry, dermatology, endocrinology, ENT, internal medicine, ophthalmology, psychiatry, psychology, physiotherapy and preventive health checks. Explaining the reason for the revamp, CEO Mahesh Inder VS said, “Spice Global’s venture in the healthcare space is a strategic move and is a testimony of our continuous efforts to take on new challenges. With the Indian healthcare industry charting a robust growth curve, there is an enormous scope for the conglomerate to serve the increasing patient population to access qualitative diagnosis and treatment.” He added that the hospital was rechristened to give it a more contemporary name. Targeting patients from Saket and its neighbouring area, the project aims to break even within 18 months. At Saket City Hospital, technology is the backbone of the healthcare services, ensuring greater cost efficiency, scalability, reliability, connectivity and enhanced quality of service. Its technology partner IBM has successfully implemented a browser-based user interface for the Hospital Information Systems (HIS) and a seamless Enterprise Resource Planning (ERP) solution. Also, clinical support at Saket City Hospital is underlined by installation of equipment like Clinical Decision Support System (CDSS) module, facility for virtual ICU and cath lab.

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Projects

The CT scanner provides outstanding image quality at 256-slice per second and 75 per cent low radiation.

The patient rooms are designed for comfort and privacy.

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n collaboration with partner Philips Healthcare for diagnostics, treatment and preventive care, it has established an advanced diagnostic centre. Its radiology unit is equipped with ultramodern technology, like the MRI Ingenia, which promises elevated clinical performance and accelerated patient management. The CT scanner provides outstanding image quality at 256-slice per second and 75 per cent low radiation. For the challenging minimally invasive procedures, it has Veradius, a mobile C-arm system with flat detector (FD). This breakthrough technology gives clarity, space and convenience to carry out critical surgical interventions. Other equipment at the hospital include digital X-ray, ultrasound, colour Doppler and mammography. Employing about 500 committed professionals, most of its services of the hospital are in-house. It will only outsource some non-core services like housekeeping, food and beverages facilities. Considering that this is a new hospital, how does the management plan to market it? “During the first phase of the project, we aim to create positive conversations both within and outside the vicinity of our hospital. While our outreach campaigns will create awareness about product lines, services and clinical talent at the hospital, satisfied patients will share testimonials with peers. Our presence on both traditional and new media is of immense importance to us. Both will play pivotal roles in sharing our achievements with the target audience at large,” says Inder. The USP of the hospital, according to Inder, is the 'world class healthcare'. “Our endeavour is to develop patient-centric protocols and algorithm-based standardised clinical practice to deliver clinical outcomes, which will make us one of the best centres of the world. The hospital boasts of patient-friendly staff and doctors in professional environs. We ensure there are no overstays and that patient-specific treatment is imparted in a transparent manner. Patient-centric attitude and hard core service value are epitome of the hospital,” says he. With world class infrastructure and excellence in patient care, Saket City Hospital is positioning itself as an important player in the market. In the coming months, besides offering best of healthcare, it plans to create centres of excellence and develop sub-specialities in each clinical speciality. It also plans to focus on clinical trials, research, academic programmes and newer modalities like stem cell therapy and gene therapy.

The hospital has installed MRI Ingenia, which promises elevated clinical performance and accelerated patient management.

The hospital has helpful reception staff.

The state-of-the-art ICU is designed such that the nursing station has easy access to patients at all times.

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Within the next three years, we aim to double our bed strength to 2,000 beds�

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Poised for growth K

Straight talk

While polyclinics and pharmacy chains are more profitable in the GCC, brown-field projects are the best way to grow in India, feels Dr MI Sahadullah, CMD, KIMS Healthcare Group Interviewed by Rita Dutta IMS Healthcare Group, which started with a 250-bed multi speciality hospital at Thiruvananthapuram, today has a chain of hospitals, polyclinics and wellness centres in India and the GCC countries. It has recently acquired two brown-field hospitals, and is looking for more. Please tell us about the two new hospitals that KIMS took on in Kerala. This month, we acquired majority stakes in two brown-field projects in Kerala, one in Kollam and the other in Kottayam district. The hospital in Kollam, a 100-bed project, was commissioned a year ago. Now, the hospital will be known as KIMS Kollam Hospital. While the hospital is partly functional now, the revamped project with 150 beds will be ready by August this year. The KIMS Kottayam is a project by an NRI businessman, based in the US. It is under construction and will be a 150-bed project, out of which 80 beds will be commissioned soon and the remaining 70, by September. Though both are multi speciality hospitals, the focus will be on orthopaedics, trauma and women and child care. What is the investment and revenue model? Appropriate investments will be made for revamping and installing equipment like 0.5 T MRI and 16 slice CT. The investments will also be made to take the facilities up to the standards that KIMS has been following in its other hospitals. For the Kollam project, we are expecting the cash breakeven within a year as it is a functional project with a ready patient base. For Kottayam, we estimate that it will take about 18 months from the date of commissioning as it is not yet functional. How did you zero in on these two projects? Frankly speaking, we have received a large

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Straight talk

number of offers from around the country to acquire hospitals or manage them, most of them being from Kerala and other south Indian states, a few from the west and north of India as well. However, we are selective about which hospitals we manage. Our Investment Advisory Board helps us select projects after careful analysis of aspects such as market feasibility, demographics, spending capacity and crucial project details. In the past, we have turned down several projects as their design lacked provision for scaling up or altering the infrastructure as per our requirements. Other reasons for turning down projects were high valuation, hospital built without any STP plant and human resource issues. We selected the Kollam and Kottayam project as they conformed to all our standard requirements and quality norms. The Kollam project had been functional for a year and the aesthetics and human resources were favourable for a takeover. What happens to the existing workforce at the two projects? We plan to retain the employees in the Kollam project, after reviewing their qualification, experience and remuneration. If they are not up to the mark for a certain role, they would be shifted to another department or role that suits their profile. Where found deficient, they would be trained. Their salary would be brought up to the KIMS standards. However, there is no such retention required in the Kottayam project as manpower has not been hired for it by the promoter.

What are your expansion plans in the hospital vertical in India? Our total bed strength stands at 1,000 with hospitals in Thiruvananthapuram, Kochi, Kottayam and Kollam. Soon, we will be adding institute of cardiology and institute of orthopaedics in two separate buildings within the hospital premises at KIMS, Thiruvananthapuram. Within the next three years, we aim to double our bed strength to 2,000 beds. And for this, we are looking at both Greenfield and brownfield projects, but we are clearly more keen on brown-field as it is a more profitable model. For Greenfield, we are looking at Thiruvananthapuram and Kochi as it would be easier to construct such a project from an established base. We are interested in brown-field projects

40%

Revenue generation 60%

India

GCC

either through a JV or fully acquired, in other parts of South India. Our model is to acquire hospitals with a bed strength of 150-200 to provide quality care. We are earnestly looking at some acquisition potentials in Hyderabad, Chennai, Bengaluru and Coimbatore. Which brown-field projects interest you? We do not prefer projects that have been functioning for many years as it’s difficult to bring about changes in them or alter the impression about the hospital in the minds of people. We prefer going for projects not more than a year old or under construction, and having a structure that will allow scaling up. Why the interest in wellness centres? With the concept of healthcare changing from treating illness to maintaining wellness, we wanted to create a chain of wellness centres. Each wellness centre, built with an investment of Rs 4 to 5 crore, has a dental clinic, cosmetic clinic, consultation clinic and a pharmacy with healthcare products. As of now, we have two wellness centres in Thiruvananthapuramv and Kochi. In the next three years, we plan to establish a network of around 20 wellness centres in Tamil Nadu and Kerala. How is the group’s international arm expanding? Our international business, managed by KIMS international investment company - KIMS Holding Company, runs a chain of hospitals and polyclinics in the GCC region. As of now,

The Bahrain region with one polyclinic (left) and one hospital (right) contributes to the maximum revenue from the GCC countries.

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Straight talk

we operate two hospitals with around 100 beds each and a slew of six polyclinics in the GCC countries. The polyclinics are like day care centres, offering consultation, laboratory, radiology, emergency room and observation beds. Our polyclinics contribute to 40 per cent of our business and hospitals to around 60 per cent. Overall, our international business currently contributes to 40 per cent of our revenue, out of which Bahrain contributes to around half the revenue. We are setting up two more hospitals in Saudi Arabia and Qatar, each is around 80-bed. We are also setting up two or three more polyclinics in Saudi Arabia, Qatar and Kuwait. Considering the size of our international presence, how does your international business report such high revenues? That is because the paying capacity of patients in the GCC countries is higher. For instance, a basic consultation with a doctor in India costs around Rs200 to Rs300, while it costs around

We are earnestly looking at some acquisition potentials in Hyderabad, Chennai, Bengaluru and Coimbatore

Why he became an entrepreneur? As a specialist in internal medicine and Administrator at Saudi Aramco Hospital at Dhahran in Saudi Arabia, he wanted to leave at a point when he felt under challenged. “Even though other opportunities were available, I decided to return to my home state of Kerala. Since my family ties were strong, I knew that I would get better opportunity to serve the society here,” says Dr Sahadullah. The primary reason he decided to set up a hospital and not just practice medicine on his return was because he believes that as a practitioner one only plays a limited role, while a hospital touches the lives of many more people. In the back of his mind, there was also this nagging thought that his father could have been offered better medical care before he died in a public hospital in Kerala. “After that incident, I wondered: didn’t people in this state deserve better? I believed that we could do much better,” says he. Firm on contributing towards the development of quality healthcare in Kerala, he started planning a 100-bed hospital in Kerala. However as more family members and friends joined him in his endeavour, the KIMS Hospital was started as a 250-bed multi-super speciality hospital in Thiruvananthapuram. Today, the group has six hospitals, two wellness centres, six polyclinics in India and the GCC countries.

The group’s 600-bed hospital at Thiruvananthapuram is its first in India and is the flagship hospital of the group.

The wellness centre has a health store attached to it.

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Straight talk

KIMS footprints in GCC Bahrain: 1 hospital, 2 polyclinics Muscat: 1 existing hospital Saudi Arabia: 1 hospital, two polyclinics and one upcoming hospital and polyclinic Qatar: 1 existing polyclinic, 1 upcoming hospital and 1 polyclinic Kuwait: 1 upcoming polyclinic UAE: 1 polyclinic

A KIMS polyclinic in Riyadh, Saudi Arabia

How KIMS EARNS ONE RUPEE 6% Restaurant

24% Clinical department

7% Room rent

33% Pharmacy

3% Other income 33% Registration/Consultation

20% Laboratory

HOW KIMS SPENDS ONE RUPEE 14% Employee cost 8% Depreciation 6% Administration cost 49% Operational expenditure

4% Finance cost 19% Professional fees

Wellness centres in India • Investment required: Rs4 crore • In-built area: 5,000 square feet • EBIDTA margin: 20% Hospitals in both India and GCC Secondary care (100 to 200 beds)

26

How do you decide whether to start polyclinic or a hospital in a particular geography? When we are looking at low and middle income group as the patient base in the GCC countries, we prefer polyclinics. When we are targeting the affluent class, then we go for hospitals.

You have more polyclinics than hospitals in GCC... That's for multiple reasons. It is easier to start a polyclinic as the process of procuring permission for starting a hospital there is far more stringent. The investment for polyclinics is less, it’s only around Rs20 crore as compared to Rs80 to Rs100 crore for a 100-bed hospital. Also, we have a ready clientele of Malayalees in GCC countries familiar with the KIMS brand, so the centre kick off is faster. The net breakeven time for polyclinics is around one year, while that of a hospital is two years. Polyclinic is a good business model and we are exploring it for Kerala as well to provide primary healthcare. Why do you prefer having 100-bed hospitals? Because the population in each GCC country is too small to have a profitable tertiary or quaternary care centre. What’s next in GCC? A chain of pharmacy and ophthalmic centres. We are planning for 20 pharmacies and ophthalmic centres in the next three years. We are pumping in Rs40 crore for the ophthalmic centres, and Rs100 crore for pharmacies. But many players have burnt their fingers in pharmacy retail? In India, pharmacy retail is a difficult business, mainly due to poor margins. Here, only pharmacies attached to hospitals do well. In GCC countries, on the other hand, pharmacy business is driven by demand and also there is no referral system. The pharmacy business gives a lucrative EBIDTA of 25 per cent in GCC countries. The ophthalmic centre business gives an even better EBIDTA of 30 per cent. How much will you invest in global expansion and what is the source? The total investment earmarked for expansion is around Rs 500 crore. The investment is a mix of debt and equity. We have already taken PE funding from US-based Orbimed and Ascent Capital, Bengaluru.

Money matters Polyclinics in GCC • Investment required: Rs 20 crore • In-built area: 10,000 square feet • EBIDTA margin: 15 to 18%

Rs2,000 in the GCC region. A surgical procedure would cost two and half times more in GCC.

• Investment required: Rs 70 to 100 crore • In-built area: 1,00,000 to 1,50,000 square feet • EBIDTA margin: 20% Tertiary care (250 beds) • Investment required: Rs 100 to 150 crore • In-built area: 2,00,000 to 2,50,000 square feet • EBIDTA margin: 20%

In comparison with DM Healthcare, which is also exploring Kerala and GCC, why KIMS is seen as a cautious player? Yes, it’s true that DM Healthcare is more aggressive in their growth plans and expansion. But let’s not forget that they started before us, and they took time to consolidate their business, before they went for expansion. Coming to us, now that we are a decade-old company, we have started expanding at a rapid pace. We want to expand at a rate that we can handle well. If we expand too fast, we may be faced with challenges like lack of trained manpower and it might also put a strain on our finances. Our growth is based on ethical and best practices and clinical focus on evidenced-based medicine. We are also socially sensitive to promote CSR activities and inclusive growth that will make the progress more sustainable. We are definitely here to stay and thus in no haste.

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Technology Today’s pacemakers are multiprogrammable in contrast to the earlier versions, which simply stimulated the heart.

Picking up pace Today’s pacemakers are packed with features that help hospitals achieve better patient outcomes and reduce length of hospitalisation, enabling hospitals to service more patients By Rita Dutta

C

ardiac pacing has evolved immensely since the first pacemaker operation was conducted in 1958. Back then, the pacemaker box had to be placed outside the body as it was large and bulky, preventing implantation. They had to be plugged into electrical outlets and could fail in a case of power outages. Since then, the pacemaker has evolved in size, weight, battery life and functionality. Today’s standard pacemaker weighs just 25 to 30 gm and is around 10 to 12 cc in volume. According to Sanjeev Nair, business manager, India Medtronic Pvt. Ltd, the advancements have benefitted patients immensely by improved outcomes, quality of life and

longevity, lesser side effects and shorter hospital stays. The technology has also helped in lowering cost of managing the disease. Today’s pacemakers are multi-programmable in contrast to the earlier versions, which simply stimulated the heart or offered highenergy shocks when the patient's heart rate exceeded a cut-off point. Says Dr Santosh Kumar Dora, consultant, cardiology and electrophysiology, Asian Heart Institute, Mumbai, “Today, we have mostly demand pacemaker, which can stimulate the heart only when needed. If it senses intrinsic beat, then it will get inhibited.” It can verify how much current is needed to stimulate the heart muscle and accordingly give the right amount of current. Says Dr SK Gupta, senior consultant, car-

diology, Indraprastha Apollo Hospitals, New Delhi, “The new generation pacemakers can monitor blood temperature, breathing rate and other factors, and adjust the heart rate according to the changes in activities.” For patients whose heart cannot adjust its rate to meet the body’s demands, today we get ‘rate responsive’ pacemakers. As the normal heart rhythm slows down or speeds up many times during the day, depending on the level of activity and other factors, a rate responsive pacemaker uses special sensor that recognises these changes in the body. It also records and stores abnormal heart beats. A major breakthrough in pacemaker technology was ushered in by MRI compatible pacemaker. According to Dr Gupta, prior

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Technology

The growing market The major vendors in pacing are Medtronic from USA, St Jude’s Medical from USA, Boston Scientific from USA and Biotronik from Germany. Sreepacetronix, an India based company also offers basic functionalities of a pacemaker. Now, Bengaluru-based cardiac implant maker MediVed Innovations in a technology tie-up with Uruguay’s CCC is coming up with India’s first indigenously developed artificial cardiac pacemaker, which is expected to be three time lower than the imported variety. According to Sanjeev Nair, business manager, India Medtronic, the cardiac pacemaker market

Leads of new-age pacemakers are thinner and last longer.

in India is expected to grow at a brisk rate as people are becoming more aware and cardiac pacemakers are also becoming more user friendly with added features. The drivers for growth include changing demographics, ie as more people turn 60, the demand for cardiac pacemakers will increase with increased life expectancy. Growing awareness about the utility of pacemakers among general masses also increases the demand for pacemaker. “Insurance companies have started to cover patients for the cost of operation in case of cardiac pacemaker implant, which has given a boost to the demand and more such initiatives are likely to give the industry an impetus,” says Nair.

Today, we have mostly demand pacemaker, which can stimulate the heart only when needed. If it senses intrinsic beat, then it will get inhibited” — Dr Santosh Kumar Dora Consultant, cardiology and electrophysiology, Asian Heart Institute, Mumbai

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to this, patients with a pacemaker could not undergo MRI investigation as the alloys were sensitive to magnetic forces and ran the risk of causing damage to the heart, leading to death. Switching off the pacemaker even for a few minutes was out of question as it could be fatal for the patient. Research points out that owing to these limitations, every five minute a patient is denied an MRI because of an implantable cardiac device. With around 75 per cent of patients with implantable cardiac devices being asked to undergo MRI scans over the lifetime of their device, MRI compatible pacemakers have specially turned out to be a boon for old patients, who usually require an MRI for several conditions, the most common being for abdomen and brain imaging. “Now, post-implant life gets even better for these patients with the advent of much improved second generation MRI-compatible pacemakers,” says Dr Gupta.

T

he current generation of pacemakers help improve heart’s pumping capability, especially in certain category of patients, who have very low pumping function associated with heart’s electrical conduction abnormality. Modern pacemakers include microprocessors that collect data about how well the heart and pacemaker are working. These microprocessors can also monitor the patient’s physical activity and adjust the heartbeat as needed. Furthermore, pacemakers can now regulate and synchronise contractions between the multiple chambers of the heart. A new pacemaker with advanced remote

patient management capabilities is being used to treat patients with bradycardia (when heart beats very slowly). This pacemaker has the capacity to transmit implantable cardiac data to physicians and other healthcare providers. “The new remote patient management system allows physicians to conduct remote followups of these patients to monitor specific device information and heart health status,” says Dr Gupta. Not just the pacemaker technology, the improvement in the leads in a pacemaker has made the procedure safe. “The leads have become thinner and last longer as compared to earlier times when the lead size was large and was tending to have insulation problems or having lead fracture,” says Dr Dora. Similarly, the spontaneous pacemaker failures are extremely rare now. That’s not all. While earlier, there were single chamber pacemakers available in the market, today we have multi-chambers pacemakers. Also, while earlier the risk of interference from machinery would affect the functioning of pacemakers, the advances in device circuitry and insulation have cut down the risks. Due to development of integrated circuits and miniaturization of components, modern pacemakers are getting progressively smaller even as they are more getting more capable of carrying out complex functions. The battery technology too has kept pace with the development in circuitry, resulting in devices that are safe and that function almost up to 10 to 12 years, before the batters need to be replaced.

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Technology

The new generation pacemakers can monitor blood temperature, breathing rate and other factors, and adjust the heart rate according to the changes in activities” — Dr SK Gupta Senior consultant, cardiology Indraprastha Apollo Hospitals, New Delhi

The process of inserting pacemakers

A

nother trend on the pacemaker front is the re-use of pacemakers taken out from dead patients. According to Dr Bhim Shankar, senior consultant cardiologist and electrophysiologist, Frontier Lifeline Hospital, Chennai, “Studies have suggested that there is no harm with re-used pacemakers.” Frontier Lifeline has implanted five re-used pacemakers for poor patients and other hospitals in India too are following suit. Faced with a wide variety of choice, how does one choose the pacemakers? Dr Dora says, “The pacemakers have definite indications. The patient has to meet the indications to qualify for implantation. There are international guidelines for pacemaker implantations, which pacemaker to be used in which kind of patients.” According to Dr Bhima, “Depending on the financial affordability, higher end model, like MRI compatibility, is chosen than the base model. Occasionally special features, particularly useful to the clinical condition, are taken into account.”

W

hile the advancements have benefitted patients immensely, a major impediment to the use of the advanced technology is the prohibitive cost, mainly the MRI compatible pacemaker, and for pacemaker which is useful to boost the pumping. Also, the leads in the cardiac resynchronization pacemaker are difficult to implant and can only be done by trained persons. According to Shankar, “IED infection is on the rise as implants are on the rise. Lead extraction and replacement are a challenge, though they are

Price tag • Standard single chamber pacemaker: Rs70,000 to Rs80,000 • Standard double chamber pacemaker: Rs1,50,000 to Rs1,80,000 • MRI compatible pacemaker: Rs50,000 to Rs70,000 more than other versions • Cardiac resynchronization pacemaker: About Rs4,00,000

not related to pacemaker themselves.”Another impediment is the rate of infection, whether due to the carelessness of the doctors or the catheter. Also, pacemakers must be kept away from cell phone as the pacemaker can misinterpret the cell phone signal as a heartbeat and withhold pacing, producing symptoms such as sudden fatigue. Lack of regular follow up by patients in rural areas makes things difficult. “If there is a problem in the pacemaker or lead in the rural areas, it may go unnoticed,” says Dr Dora. In the coming years, experts predict that pacemakers will become smaller, more intelligent and will last long and require fewer replacements. “The advances in technology will enable the pacemakers to mimic natural heartbeat, which in turn will provide the patients with longer, better quality of life with more freedom and least restrictions,” says Nair. The market is looking forward to the launch of lead-less pacemakers. Still in research phase, this will be only as big as a capsule. It is expected to work without electrical leads and can be directly implanted to the heart muscle through a catheter, doing away with surgery. As no surgery is required, the infection risk will be limited to the catheter equipment. Research is also underway to extend the battery life further and have rechargeable batteries.

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Technology

Smart initiative

LVPEI’s home-grown EMR has earned national and international recognition because of the many ways it has helped improve the hospital’s efficiency and healthcare delivery By rita dutta

T

echnology isn’t just changing the way hospitals are treating patients, but also the way they are managing healthcare. Today, it’s common for hospitals to store clinical data regarding patients electronically. Electronic medical records (EMR) applications enables storing and retrieving clinical data at the click of a button, eschewing the age-old practice of physically maintaining patient clinical data on paper. However, among all the buzz of hospitals going paperless, one can hardly find a group where clinical data of patients is accessible across its various tiers of referral centres. LV Prasad Eye Institute or LVPEI, which has a network of 110 centres, 93 of them being primary eye care centres in remote rural villages, has embarked on the uphill task of

30

networking its entire ‘Eye Health Pyramid’ on a digitised platform. LVPEI’s ‘Eye Health Pyramid’ encompasses service delivery at four different levels, ranging from tertiary care to city centres, secondary centres and village vision centres. In the village vision complex, 10 vision centres connect to a secondary centre, which then refers patients requiring further evaluation and management to the tertiary centres linked to them. The innovative IT application, which integrates ophthalmic EMR with Hospital Management System (HMS), focuses on ophthalmology and eye care service delivery. Named eyeSmart, the application has won the NABARD Award for Rural Innovation and also received international recognition through IT @ Networking Awards 2012. Says Anthony Vipin Das, consultant ophthal-

mologist and team principal, EyeSmart EMR, LVPEI, “Knowledge about the disease and the previous history is vital for the treating ophthalmologist to arrive at clinical decisions. The need for having an EMR in rural settings is all the more crucial as accurate documentation is lacking here. Patients move between different healthcare givers and the records are either poorly maintained or lost.” Das has developed the system in-house along with his team. Being cognizant of factors like difficulty in data retrieval across geographical barriers, lack of storage space and long hours spent in gathering research data that continue to plague medical record keeping, EyeSmart’s endeavour has been to establish a transparent, seamless and effective EMR system in the rural areas that will empower both the patients and the physicians treating them. “Adequate documen-

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Technology

Objectives of eyeSmart

Patients can now move anywhere in the vision centre complex of LVPEI without having to carry their medical records.

• Provide cutting-edge IT solutions to assist healthcare professionals to deliver state-of-the art eye care to the public. • Enable patients to walk into any centre, anytime and still be able to access their healthcare records. • Build an innovative working eye care IT model to network the entire LVPEI Pyramid spanning from the urban to the rural centers. • To ensure accurate documentation of all clinical records for easy retrieval by the clinician. • To use clinical data for cutting edge research at the convenience of a click to analyse the information. • To provide the patient a complete summary of his examination at every single visit across all platforms and levels of eye care. • To make the clinical processes and work flow systems more efficient and significantly decrease the working time involved. • To decrease the component of errors involved due to legibility issues in the hospital. • To provide the patient and the clinician a more enriching experience in delivery of comprehensive eye care services.

tation is essential for quality and continuity of healthcare services, and also to receive correct treatment, payment benefits from health insurance providers, and ensure proper continuity in case the patient is seeking care from multiple providers,” says Das, explaining the need for developing the application. Starting with a small urban centre at Madhapur in Hyderabad, today eyeSmart has successfully integrated 22 centres in the states of Andhra Pradesh and Karnataka, out of which, 16 centres are in the villages that connect to their respective secondary centres in Paloncha, Cherukupalli, Thudukurthy and Bellary. The group has used an EMR concept of totally integrating all functions of a hospital from a common point, namely the patient. All functions, including clinical and administrative, are interlinked in a single EMR and HMS system and through a single patient record. Patients

can now move anywhere in the vision centre complex without having to carry any medical records as all the medical information is readily accessible to clinicians, thanks to EyeSmart. The application allows online booking of appointments and personalised SMS alerts, even at the rural centres. The system sends automated SMS to patients after registration, before checkout and to remind them of appointments and/or surgery. “Sending SMS greatly improves the connection and experience with the patient and the healthcare provider. Not only is there better compliance with follow-ups, but patients are also happy that we take extra effort in reminding them about the medical commitments,” says Das.

The project has made use of different flash tools, document viewers and others to intelligently assist doctors in managing patient data at the convenience of a click anywhere, anytime. Doctors can access case sheets on mobile phones, and have appointment details 24 hours, all year round. The application is enabled for using on various platforms like iPads, iPhones and tablets. While the patients need not carry their physical reports with them, to operate in a transparent manner and also to make patients aware about their medical condition and prognosis, the hospital hands over a printed copy of the medical report to the patients at the end of every examination. The benefits of the innovative application are witnessed in more ways than one. It has led to improvement of customer service like accurate, comprehensive medical reports at a single click, digitised prescriptions for medicines and glasses, lesser waiting time for patients, better compliance with follow-ups and streamlining of patient flow in centres. Since the patients can visit the village vision centres for follow-ups they achieve significant savings in time and money. “The project has also led to increased employee productivity as it enables lesser time spent on written records, faster processing of informa-

The personalised SMS alerts of the application has led to better compliance with follow-ups.

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Technology

The group envisages creating systems that will support its physicians to have access to relevant clinical data on demand.

The goal of eyeSmart is to enable electronic documentation for faster retrieval sans geographical barriers, and to transform the entire network into a paperless one.� — Anthony Vipin Das Team principal, EyeSmart EMR, LVPEI

32

How it all started August 2010, but was soon adapted in three other branches in three cities of state of Andhra Pradesh. Success of the EMR system in the small centres spurred the group to upgrade the EMR system and its functions for its tertiary care centre at Vijaywada in Andhra Pradesh. The EMR was specially created The project has kicked off at a small urban centre at Madhapur in Hyderabad

with sub-specialities in ophthalmology. Soon after, the group proceeded

Interestingly, the eyeSmart project did not

to adapt EMR in its first secondary centre at

kick off as a mega project, but as an in-house

Paloncha and this was followed by successful

exercise for building an EMR application for a

networking of all other village vision centres

small urban centre at Madhapur, Hyderabad. The

to its secondary centres. Today, 22 centres are

EMR project for the first centre flagged off in

networked with eyeSmart.

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Technology

tion of patient statistics, dynamic patient status displayed to administrators, faster entry of patient medical records and faster printing of prescriptions and refraction records,” says Das. It has helped the group save expenses on paper, maintenance of records and storage space. The processes are now streamlined. The benefit witnessed by the physicians are equally immense as they can now view the patient data anywhere, anytime without the geographical boundaries that earlier restricted it. The total cost of development of the application and hardware and connectivity costs till date is about Rs85 lakh. The recurring costs include an amount for maintenance, team salary, up-gradation of the hardware and payment for the connectivity. So, how were employees trained to use it? The group established a dedicated EMR Support and Installation Team (ESIT) that is based in the cities of Hyderabad, Bhubaneswar, Vizag and Vijaywada. It has 12 full times employees responsible for training, managing and troubleshooting issues that arise at the EMR centres. The central office located at Hyderabad coordinates all the major planning and development of the application. Asked about its user-friendliness of the application, Das says, “It is intuitive and easy to use.” He informs that people take anywhere between a few hours to a week to adapt to the system post training.

Currently on eyeSmart City Centre Hyderabad, Vizag, Vijayawada Tertiary Centre (KVC Campus) – Vijayawada Secondary Centres Paloncha, Cherukupalli, Thoodukurthy, Bellary and KAR Extension - Hyderabad Vision Centre (Village) Manuguru, Thallada, Dammapeta, Ellandu, Charla, Aswapuram, Tekulapalli, Chandrugonda, Kallur, Amruthaluru, Bhattiprolu, Nagarkurnool and Bijnapalli

There were some challenges in implementation too, the first being connectivity and power issues, which are common in rural hinterlands. These have been addressed and alternative backup plans put into place. The group currently uses the BSNL Rural Plan and also have placed backup data cards from other private vendors in the event of a problem in the primary line. Training and monitoring the centres in real time too was a challenge. However, this was made possible with the formation of an EMR Support and Installation Team (ESIT). The ESIT caters to live and remote support to the staff and users and gathers essential feedback

on the application. It is also responsible for enforcing protocols of quality data documentation. “ESIT members are currently based across four cities with 12 full-time employees catering to the twenty two centres running on EMR. New centre installations, support and maintenance is also handled by the ESIT. We have a fully equipped office and simulated training centre based in Hyderabad, India,” informs Das. The 33-month-old system has seen over nearly three lakh consultations and around two lakh new patients have been entered on the electronic system. Now, the group is in the process of expanding the system to all the 110 locations, 99 of them located in the rural villages and towns of the LVPEI Eye Health Pyramid. “The application is also turning out to be an effective educational tool for students and fellows training at the institute. Standard procedures, classifications, evidence based medicine protocols integrated into the system help to deliver more effective care and also aid in teaching,” says Das. Once, LVPEI successfully completes integrating the remaining centres in the network by 2015, it plans to showcase EyeSmart as a model for all other healthcare departments of the group to implement, confident that the workflow is similar in the delivery of healthcare.

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33 30-05-2013 20:06:14


Patient relations

First impressions matter How your staff behaves with new patients seriously affects your reputation By Dr Alexander Thomas

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Patient relations

I

’m impressed! You’ve done your hospital proud today,” said Suresh Dayal to nurse Satya and nurse Saisha, as he was being discharged from the hospital. Dayal was a wellknown entrepreneur in Bengaluru. Delighted with the care he had received during his long admission, he had just offered the nurses a gratuity as a token of appreciation. To his astonishment, however, they had declined it because they believed they were merely doing their duty as professional care providers. When Dayal insisted, they accepted the gift – but as a donation to the hospital, which would send him an official receipt for the amount. The nurses’ dedication to patients and their loyalty towards the hospital moved Dayal deeply. It left a lasting impression on him. Not only did he make a donation, right there, that was many times the original amount, but continues to be one of the hospital’s regular donors and staunch supporters to this day. The professional attitudes of the nurses, their integrity and loyalty made such a positive impression on Dayal that the entire hospital benefited from his goodwill. Clichéd though it may be, our first impressions are often our lasting impressions. The behaviour of the first employee or associate of a hospital that a patient or his relatives meet can play a decisive role in making (or breaking) the hospital’s image. The impressions we create are conveyed to patients through what they see, hear and touch.

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well-organised, aesthetically appealing hospital space complemented by courteous staff helps put the patient at ease. This is not limited to the hospital’s physical ambience, but includes the organisation culture and its professionalism; the interpersonal interactions, behaviour and nonverbal communication of the staff; and how the staff present themselves. Even slight movements of your body can convey messages to the observer. These messages form the foundation of the verbal communications that follow. Kristina G Ricketts, of the Kentucky Extension Leadership Development programme, explains how you can use your eyes, smile, arms and posture to make your nonverbal communication positive and be approachable. For instance, maintain good eye contact. Look at the person when they are talking to you, but look away once in

Ways to win patients over Courtesy. If staff members are relaxed and smiling, patients sense and absorb this positive energy. As they say,” Smile and the world smiles with you.” Being generous with warm, pleasant and welcoming smiles is an instant winner when it arises from genuine regard for the patient and is backed by good manners and courtesy. Respectfully addressing patients by their name also creates a human connection that may help put them at ease. Presentation. As representatives of an institution, the way we present ourselves in our dress and grooming makes a significant difference. As faces of our hospital, we must always ensure that we are dressed appropriately. A patient who comes to the hospital for the first time knows nothing about us and has only what they see to go by and, as the saying goes, ”A picture is worth a thousand words.” Besides, when we look good, we feel good and this makes us confident and effective in our work. Attention. In a specialised area such as healthcare, details that appear insignificant to a patient determine diagnosis, treatment and care. Paying attention to detail should thus be an essential aspect of our work. As healthcare professionals, we listen well, rather than selectively, hearing the patient out, resisting preoccupation with our own personal issues and focusing on the patient by making eye contact, asking precise questions and giving them our complete attention, rather than answering phone calls in between. Commitment to service. Health is an area that touches the core of one’s existence. The patient’s sense of vulnerability should therefore draw out our compassion. Hospital staff is thus expected to have high service orientation and stretch themselves to adopt a ‘can do’ mindset even when formal work requirements have been met. Attending to the last patient standing patiently at the end of a long queue may not be pleasant when we are hungry and late for lunch. Neither is seeing a patient who is a few minutes late. But both are acts of good practice that will be remembered. Competence. Maintaining professional competence can mean life for a patient, just as much as a lack of it can result in disability or death. Possessing up-to-date knowledge in our respective fields is thus crucial. This convinces patients that they are getting the best medical attention possible; it also builds a hospital’s brand. The ingredients of competence include not only technical knowledge and skill but also constant preparedness, self-organisation, time management and work management. Timeliness. As service-oriented people, staff members of a hospital need to do their utmost to keep waiting times for patients to a minimum. This means that staff should be punctual at their respective stations and that, while ensuring that no time between attending to patients is wasted, the time needed to provide quality care to a patient does not suffer either.

Paying attention to detail is an important aspect of patient interaction

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Patient relations

satisfactorily, going the extra mile gains their goodwill many-fold.

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Non-verbal communication is as important as verbal communication.

a while so they don’t feel you’re staring. Have a smile on your face because it shows confidence. When your arms are crossed, it means your body is closed off. So take your hands out of your pockets, to establish trust. Keep your posture erect – back straight, shoulders pulled back, chest out, and the weight of your body resting evenly on both legs. This posture shows confidence. Don’t lean in too much during conversations: it may convey that you’re over-eager to listen. Instead, sit back in a relaxed manner.

V

erbal communication comprises two essential elements: speaking and listening. In a hospital setting, it is of vital importance that a patient understands what the staff is trying to convey. Speaking clearly, respectfully and correctly and listening carefully shows patients that you are professional and empathetic towards them. Asking confirmation questions and summarising what they are conveying helps. How we use our voice – the tone, loudness, pitch, rhythm and timbre – can have remarkable impact on a patient’s perception. So does the speed at which we speak – the pauses and the stress on different words and our accent, vocabulary and pronunciation. Sometimes, the noises we make while speaking, such as clearing the throat, sighing, sniffing or giggling also become significant in the sum total of the auditory messages received by a patient. Research conducted by Harvard University, Yale University and the Massachusetts Institute of Technology shows that the objects we touch and feel directly impact our perceptions of others. For example, the hardness of

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a chair one is sitting on produces perceptions of strictness, rigidity and stability. Companies like Apple use this knowledge, designing products with smooth, rounded edges because that makes people believe that they are easier

The behaviour of the first employee or associate of a hospital that a patient or his relatives meet play a decisive role in making (or breaking) the hospital’s image to use and have superior performance. Every point of physical contact – seats, bedding, furnishings and counters — patients in a hospital are exposed to, matters. If what a patient has seen, heard and touched leaves them feeling positive about a hospital, they automatically become advocates for the hospital. But 19th-century American statesman and diplomat Charles Francis Adams went a step further. He said, “No one ever attains very eminent success simply by doing what is required of him; it is the amount and excellence of what is over and above the required that determines the greatness of ultimate distinction." Although patients are content to have healthcare professionals address their health issues

rs Krishnamurthy was in the waiting room of the dental clinic with an unbearable toothache. Seeing this, the receptionist, Ranjini, ensured that the lady was seated comfortably, brought her some water to drink and then asked the dentist if Mrs Krishnamurthy could be seen sooner. Now, none of this brought direct relief to the patient. But Mrs Krishnamurthy, who was watching, greatly appreciated Ranjini’s thoughtfulness and was reassured that the hospital, as an organisation, was genuinely concerned about her wellbeing. By going the extra mile, Ranjini created a positive first impression of the clinic in Mrs Krishnamurthy’s mind. As hospital staff, we can, through our sensitivity, provide patients with memorable experiences, anticipating a patient’s need and doing or saying something to make the patient feel special. Genuine concern coupled with compassionate care does wonders. As American poet Maya Angelou once said, “People will forget what you did and what you said, but people will never forget how you made them feel." That was what Ranjini had achieved. Excellent customer service is about creating a good impression by exceeding a patient’s expectations. It makes them feel valued as people. As individuals, the impressions we create on others are not restricted to face-to-face encounters, but are conveyed via a variety of communication formats, from telephonic conversations to emails. Each encounter a patient has through a hospital touch point is important. As patients move through the hospital organisation, their impressions get reinforced one way or another. Therefore, the professionals linked to a hospital need to put their best foot forward at all times. Whether we like it or not, we are ambassadors.

Dr Alexander Thomas is director and CEO of Bangalore Baptist Hospital. Excerpted with permission from the chapter ‘First Impressions Matter’; from the book, Communicate. Care. Cure ... A Bangalore Baptist Hospital Initiative for the Nation.

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Smart Healthcare India Summit pOWERED BY

Rajen Padukone, managing director & CEO, Manipal Health Enterprises.

Addressing the three 'A's The Smart Healthcare India Summit focused on overcoming the key challenges facing the industry— availability, accessibility and affordability By Team HR

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e have nine beds per 10,000 people, as against the world average of 27. We have six doctors per 10,000 people whereas the global standard is 14. We have 13 nurses per 10,000 people as against the global standard of 28. A look at these statistics reveals the grim reality the industry is grappling with. According to Rajen Padukone, managing director & CEO, Manipal Health Enterprises, “To address the shortage, we need to double the number of doctors, triple the number of nurses and quadruple the number of paramedics.”

Padukone was speaking on the topic of ‘Government & Healthcare - An Approach’ during the ‘Smart Healthcare India Summit’, a two-day conference held on May 23 and 24 at the Sheraton Hotel in Bengaluru. The summit, organised by Healthcare Radius, attracted key industry leaders across the country to deliberate on trends shaping the industry and to seek pragmatic solutions to cost-effective and accessible healthcare delivery. The summit was powered by Knauf, which was the platinum sponsor. It also had Godrej Interio as associate partner, Philips and Daikin as gold partners, Gyproc, Everest, Allengers, Airox Technologies as silver partners, Tyco

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(L) Chhitiz Kumar, Dr Ravindra Karanjekar, Brigadier Joe Curian and Dr MK Khanduja. as the networking partner, CPS as the documentation partner and Medium Healthcare as the knowledge partner. Speaking about the skewed distribution of healthcare services, Padukone, who kick-started the event, said that healthcare facilities are mainly concentrated in the cities, leaving central, eastern and north eastern part of the country with inadequate facilities. While 60 per cent beds are in the private sector, they are largely in 20 cities and 46 per cent of the population has to travel at least 100 kilometres to reach a hospital. According to Krishna Kumar, SVP and head of business, Philips Healthcare, India and subcontinent, “For all the talks of India becoming an economic superpower, we run the risk of becoming sick first as a country before becoming rich, with our large burden of chronic diseases and low per capita expenditure on healthcare. Be it pharmaceuticals or procedures, charges in India are lowest in the world. In terms of accessibility to imaging, oncology and cardiology services, India is way behind the other nations in the BRIC contingent.” We are barely able to provide enough care even for the most pressing healthcare needs: cardiology and oncology. There are just 314 comprehensive cancer centres and 1,000 cardiology centres. While two third of healthcare is in the hands of the private players, Kumar feels that one has to look at private healthcare even in the future if one has to make healthcare accessible. “However, the Government can also play a key role in enabling quality healthcare to the masses by increasing the number of healthcare facilities, increasing the safety net for healthcare insurance cover and work towards building a relationship based on trust with the private sector. The

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Government should change its perception that private sector is all about profiteering, while the latter has to be more mature by looking at the larger picture,” said Kumar. According to Padukone, the way forward lies in looking at the Government as a provider and payer and also by encouraging Private Public Partnerships (PPP), which would bring about a paradigm change, linking education to healthcare.

P

adukone set the pitch right for the panel discussion on PPP, moderated by Rita Dutta, consulting editor, Healthcare Radius. The big question posed was given that there are more examples of failures than successes of PPP in healthcare, what drives large number of private players to go for PPP? Dr Ravindra Karanjekar, CEO, Global Hospitals, Mumbai, said, the need for PPP is driven by the vast number of beds requirements, the wish of faster scaling up by the private sector and the need to address huge need of quality healthcare at an affordable price. Often, the management is outsourced to the private sector, after the infrastructure and investment is made by the Government. Said Brig. Joe Curian, CEO, SevenHills Hospitals, which is a PPP with BMC, “Any partnership starts deciding what you want to achieve. In most cases, the private player is keen on taking responsibility of running the project while the Government provides the land either free or at a concessional rate as this helps bring down the cost of care.” Representing a successful PPP project was BSR Healthcare, which successfully manages the imaging department of a public hospital in MP. Said Dr MK Khanduja, chairman, BSR Healthcare, “We have been interested in PPP in the

diagnostic sector, given our vast expertise in the field. In the said hospital in Madhya Pradesh, the CT scan at the hospital was under utilised.” Prior to handing over to BSR, the hospital managed only 600 CT scans in over four years, either due to lack of availability of resources or bandwidth to manage the department. After BSR took over, it performed 500 scans in just over three months. However, many partnerships face roadblocks. Take, for instance, the ongoing tussle between SevenHills Hospitals and its PPP partner BMC. Commenting on the ongoing court case with the partner, Brig. Curian attributed the conflict to the changing stance of the Government every now and then. “For the Government, the goalpost keeps changing. Be it in the original MoU or the lease agreement, the word ‘free’ was never been used, but still the Government insists that the hospital provides free treatment and free medicine. As per the agreement, only 20 per cent of the in- patient and out-patient care was to be provided to the yellow ration card holders. Later, the Government said that all BMC employees have to be provided free treatment. And all this in addition to the hospital paying Rs10 crore to the Government as lease per annum,” said Brig. Curian. The last straw was when the hospital was also asked to provide free medicine. “According to an interim ruling by the court, the hospital has been asked to charge for medicine,” he said. Talking about the proposed PPP of Wockhardt Hospital with Government of Maharashtra for managing GT Hospital, which never took off, Dr Karanjekar attributed it not to low margin of the project, but to lack of trust by the Government and its changing terms every now and then. Dr Praneet Kumar, CEO, Dr BLK Super Speciliaty Hospital, seconded that by stating that

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private players are not in PPP only for profit. In fact, that is a misconception. “Private players are into PPP because the business model ensures availability, accessibility and affordability to quality healthcare.” He also lamented about how his attempts with the Government of Goa for managing district hospitals failed, even after the MoU was signed. “To introduce super speciality services in its district hospitals, the Government of Goa was interested in partnering with private players. We signed the MoU for the project, but before the issuance of the agreement, elections came in, the government changed and the new Government wanted to manage them on its own,” said Dr Kumar.

tion plays in healthcare delivery, Ratan Jalan, founder, Medium Healthcare Consulting, narrated anecdotes of how patients can misinterpret doctor’s communication. “When a doctor says that a patient’s tumour is getting better, patient wonders whether the tumour is increasing or decreasing in size.” He narrated another incident when a doctor informed a lady patient the test result for cancer was positive. The patient looked up and said, “Thank God”. The doctor, cleared his voice again, and said, “I just told you, it’s positive.” The patient replied, “I am relived as you said it’s positive.” That’s why healthcare professionals need to be careful about how they converse with patient.

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o, what makes for a successful PPP or what factors one needs to look into to avoid conflicts at a later stage? According to Dr Praneet, one should go for PPP only after much deliberation, reading the fine print carefully and only after checking the financial viability. He added that a PPP can only work if it becomes PPPP, a public-driven PPP. According to Chhitiz Kumar, director, Government Business and PPP, Philips Healthcare, the company has set up a team of chartered accountants, financial and legal consultants that look into the project in minute detail before entering into a PPP. It participates in PPP in three ways, as a technology provider to a clinical partner, as an equity partner along with the clinical partner or through a separate company, where, besides Philips there is a clinical partner and a construction partner that builds the project. According to Kumar, the troubles with changing stance of the government or the changing authorities can be dealt with when both partners enter into a model concessional agreement. This was drafted by the central government for PPPs in road and transport sector and has been copied by various state Governments for other sectors as well. “Having a model concessional agreement rules out the possibility of changing goalposts,” said Kumar. While thinking better availability through PPP, providers cannot ignore the patient experience. Highlighting the crucial role clear communica-

ommunication with the patient begins much before s/he steps into the hospital: it commences when a patient starts enquiring about the facility and takes appointments. A panel discussion, moderated by Brig. Curian, addressed the various facets of patient experience. “How does one deal with cases where patients are happy with doctors, but relatives complain about various other aspects,” asked Brig. Curian. Commodore Indru Wadhwani, president & CEO, Mallya Hospital, Bengaluru, who was a panellist in the discussion, informed that his hospital often gets such complaints by relatives, followed by requests of discounts not only from general wards, but also from deluxe and semi deluxe wards. “Based on the economic class of the patient, we give discounts of 10 to 15 per cent on bed charges and investigations and but not on other things, like doctor consultations and medicine,” he explained. But how does one deal with dissatisfied patients? “A dissatisfied patient does 10 times more harm than all the good work done by the marketing of the hospital,” said Brig. Curian. Padukone of MHE said, “Hospitals have to be less reactive and more proactive in building good patient relations.”

Dr Ravindra Karanjekar of Global Hospitals.

Ratan Jalan of Medium Healthcare.

Aspi Khambata of Allengers Medical Systems.

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major complaint which hospitals often receive is that of the final bill being more than the estimate. Suggesting dual strategies to deal with such issues, Padukone said, “It’s important

Bhaskar P of Tyco Fire & Security India Ltd.

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Smart Healthcare India Summit

(L) Rajen Padukone, Commodore Indru Wadhwani and Dr Alexander Thomas. to be transparent and upfront about the cost right from the beginning. Having packages is a good way to deal with such concerns. Also, it’s important for the hospital to be firm and not give in to intimidation by relatives if pestered upon for discounts.” Highlighting another aspect of a better patient experience, Dr Mudit Saxena, COO, HealthCare Global Enterprises, Bengaluru, said that sometimes simple strategies help. HCG, for instance, provides food for patients or arranges video entertainment when appointments are advanced or delayed. He also mentioned about the importance of feedback forms and calls made to patients post discharge as an effective way of assessing patient experience. According to Dr Alexander Thomas, CEO, Bangalore Baptist Hospital, Bengaluru, “Satisfied patients lead to greater employee motivation.” He also spoke about various strategies used by the hospital to improve on patient communication, which has led to greater patient satisfaction. One way to ensure good patient experience is to have motivated employees and hospitals need to reward these employees. Padukone informed about the award instituted by MHE for its employees, be it nurse, paramedic or a security staff across its all locations, to recognise staff members, who have gone out of their way to help others. But can the management of hospital and patient experience be maintained, when an organisation is undergoing rapid expansion? This facet was best explained by the example of HCG, an aggressive player with 27 units. According to Dr Saxena of HCG, the hub and spoke model

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has helped the organisation grow at a rapid pace. To set up a new centre, HCG conducts environmental scan of the area, assesses cancer incidence, checks out the availability of medical expertise and local corporate companies and insurance schemes, possibility of collaboration with a local practitioner. It provides radiology, and physics services through the hub, cross utilisation of resources, capacity utilisation of central physics, design complex treatment plans and centralised pathology. While many factors need to be considered while expanding a facility, attention needs to also be given to fire safety. In a panel discussion on ‘Business innovation and cost efficacy through fire safety and security and loss prevention’ moderated by Amar Subhash, general manager, commercial & retail, Tyco Fire & Security India Pvt. Ltd, Subhash spoke about the lack of awareness, training and maintenance issues in fire safety. He cited the fire that gutted Kolkata’s AMRI Hospitals and killed several people as an example of a badly handled fire management control. He said that 50 per cent of fire alarms in the country don’t work.

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o, what is the reason behind the laxity? Said panellist Dr M Veera Prasad, executive director, Prime Hospitals Group, Hyderabad, “It is statutory for hospitals to have fire safety measures, but often fire mishaps happen due to operational failure.” He said that fire safety officials of the hospital may not become fire fighters when needed due to lack of training, the ground level water to be utilised for such

M Jason of HCG. mishap may have been utilised for something else and even the space around the hospital which is to be used for fire brigade, may remain blocked. Referring to the AMRI fire, Dr Partha Pal, medical superintendent, The Mission Hospital, Durgapur, said it was a combination of mechanical failure (fire sensors not working) and human failure (as evacuation did not happen on time and no training was imparted about such a mishap). So, do hospitals really care about fire safety or is it just for clearance from fire safety officer that matters?” asked Subhash. Jalan was also part of the panel discussion, said, “Today, fire safety measure is as important as healthcare insurance cover. So, hospitals have to care.” What about hospital’s willingness to spend to strengthen its fire safety measures? According to fellow panellist Harish Manian, facility director, Fortis Hospitals, Bengaluru,” “After the AMRI incident, the importance of fire safety measure became more focused than ever before. More monetary sanction came in to strengthen the fire safety measures to avoid any such mishap.” Agreed Sumit Agarwal, CFO, CloudNine Care, Bengaluru, “We are talking about sick individuals, who cannot save themselves under such circumstances. So, when it comes to fire safety, there should not be any restriction on the investment to ensure fire safety. No, such basic requirements also won’t make a dent at the EBIDTA.” To avoid fire mishaps, Subhash pointed out that it’s not only important to install fire safety equipment, but to also ensure their maintenance and conduct mock fire drills and training. One of the key factors that leads to improved

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hospital functioning is its use of IT. According to Dr Raja Sekhar Gujju, medical director, Global Health City, Chennai, who spoke on ‘Implementation of Electronic Medical Records and Cloud Storage’ at the Summit, the benefits of EMR include improved clinical outcomes through pathways; medication management; decision support systems, identifying the right information at the right time, accessibility to consolidated data and reduction of errors in discharge summaries. The selection of the EMR should include documenting EMR requirements, conducting hardware requirement analysis, cost of the product; implementation cost; support cost, validating the vendor’s clients list, checking the featured modules that are required and implementation team and timelines. Speaking on cloud computing, he informed that SaaS allows users to run existing online applications, PaaS allows users to create their own cloud applications using supplier-specific tools and languages and IaaS allows users to run any application of their choice on cloud hardware of their choice.

T

he second day of the conference focused on several other factors that are equally important facets of the industry. Whether it is determining strategic growth or operational excellence, ensuring quality, chalking out HR retention and brand building strategies, and debating on drywalls, such decisions impact the organisation’s standing in the industry. Speaking on ‘Best practices to achieve operational excellence in healthcare through HRD’, Kumar Krishnaswamy, head, Shared Service and Clinical Engagement, Fortis Healthcare, said, “Healthcare is part of service industry whose success depends on the employees. While employees are same everywhere, the difference is created by the HR and that difference will determine the operational excellence of the organisation. To create that difference, HR should be seen and accepted as part of business.” He said that business environment is tough, where every penny counts. Today, talent is scarce and everyone wants the same talent. Every employee has the same question ‘What is in it for me?’ Everyone has a path in front. Everyone has

his/ her own mind. Everyone has many options. Today, lifestyle is as important as work style. He said that HR has to be aligned to the business, to encourage culture building, do costs monitoring, have HR operational efficiency, do planned recruitment, succession planning, performance management and learning and development.. From HR strategies to over all strategies that can bring about excellence in healthcare operations management, the summit had Dr Saumitra Bharadwaj, medical superintendent, Medica Superspecialty Hospital, Kolkata, stating that operational excellence is a philosophy of leadership, teamwork and problem solving, resulting in continuous improvement throughout the organisation. “It delivers patient delight, better safety to patients and employees and better bottom line. The idea of excellence should be imbibed by the founding team at the conception stage. It can relate to architecture, IT, man power and processes,” said he. The common in mistakes healthcare operations are hospital architecture not being married to IT architecture or architecture not being work-friendly. But every strategy fails, if quality is not on the agenda. Speaking on ‘transformation in healthcare delivery - adding value by enhancing quality’, Joy Chakraborty, director – Administration, Hinduja Hospital, Mumbai, said, “Risks and outcomes in healthcare are uncertain in nature. It has comparatively high degree of variation, specific to healthcare consumers, inter-related to different systems in the body, environment: care provider, multiple skill involvements and real time decision making.” He said enterprise risk management (ERM) involves performing risk assessment, establishing ERM framework with the objectives of risk management being aligned with organisation’s strategy. It defines the roles and responsibilities, establishing the ownership of risk, developing reporting protocols, educating and training staff and reporting to executive leadership. Value is health outcomes achieved per rupee spent. “If value improves, patient, payers, suppliers and providers all are benefited. Value is not a code word for cost reduction. Value in healthcare remains highly unmeasured. It depends on out-

Joy Chakraborty of Hinduja Hospital.

Parag Shastry of Godrej Interio.

Gaurav Chopra and Sujayanti Dasgupta of HKS India.

Amar Subhash of Tyco with Dr Raja Sekhar Gujju of Global Hospitals.

Healthcare Radius June 2013

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Smart Healthcare India Summit

Sumit Agarwal , Dr Veera Prasad, Ratan Jalan, Harish Manian and Dr Partha Pal. come/ results not inputs. Cost reduction without regard to the outcomes achieved is dangerous and self-defeating, and leads to false savings and potentially limited care,” said he. To ensure quality and operational excellence, we need skilled manpower, but increasingly retaining them is a challenge. In fact, it’s easier acquiring talent than retaining it. A panel discussion on practices in employee engagement and talent retention, which was moderated by Dr Ravindra Karanjekar, CEO, Global Hospital, Mumbai, sought some solutions to this problem. Chakraborty from Hinduja Hospital, who was a panellist, said, “Having good resource is the key differentiator today and an organisation can achieve its goal and much more than its competitor because of its manpower.” But can HR be positioned as a business driver? Dr Bharadwaj from Medica Superspecialty Hospital, Kolkata, said the HR should not be relegated to the sidelines drafting policies, doing appraisals and doling out promotions. “HR should rather have good exposure to operations, and be a part of it. It should actively chalk out the career path of employees, keeping their career goals and strengths in mind,” said he. According to M Jason, senior manager, HR, HCG, the role of HR has not emerged the way it should have in healthcare. “Unless the HR is given its due priority, organisations cannot attain their full potential,” said he. The role of HR is equally significant in training and developing a team. According to Dr Karanjekar, however retaining people in number two position is more difficult than re-

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taining someone in number one position. Jason disagreed saying, “If new joinees’ concerns are not addressed, then chances of them leaving is higher than an employee who is there for a few years,” said he. Besides providing skilled talent a good package, it’s important to provide them conducive atmosphere and space to work in, and also train them constantly. “Even small and inexpensive measures like showing them films are valued by employees, and goes a long way in strengthening our relationship with them,” said Dr Bharadwaj. Is multi-tasking encouraged by hospitals? Dr Praneet, said, “If an organisation does not do multi-tasking of employees, there is a problem in hand.” However, Jason differed saying that the concept can lead to confusion. “One will finally be judged by their KRAs and KPIs and not by the additional role one has played,” said he. According to Chakraborty, it’s difficult for employees to multi task for an organisation like Hinduja as there are people specialised in their jobs. It is also important to have a champion for a process to avoid confusion. The summit also had a panel discussion on drywalls to ensure faster opening by reducing the construction time, with superior performance and enhanced aesthetic appeal. The session was moderated by Ashutosh Puranik, Business Develpment Manager, Saint Gobain Gyproc India Pvt Ltd, Mumbai. The panellists were Dr Makineedi Veera Prasad, executive director, Prime Hospitals Group, Hyderabad, Gaurav Chopra, managing director, HKS India, Rakesh

Dr Saumitra Bharadwaj of Medica Superspecialty Hospital.

Kumar Krishnaswamy of Fortis Healthcare Verma, general manager, Boards Division, Everest Industries Ltd., Mumbai. Sujayanti Dasgupta, associate and senior healthcare planner, HKS India also spoke on weaving together the poetic into the pragmatic during brand creation. The summit helped bring industry leaders on a common platform, provoking many thought path-breaking strategies. It also proved to be a networking platform for professionals.

Healthcare Radius June 2013

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31-05-2013 09:43:31


Smart Healthcare India Summit

Partnerspeak The vendor partners at Smart Healthcare India Summit spoke on a wide range of topics

Krishna Kumar, SVP, Philips Healthcare.

Speakers were felicitated at the event.

Sanjay Jaiswal and Airox Technologies.

Chhitiz Kumar of Philips Electronics Ltd.

Dr Mudit Saxena with Swapnil Nagarkar Godrej Interio.

M Chandrasekharan of Daikin India.

Rakesh Verma of Everest Dry Wall Systems.

Ashutosh Puranik of Saint-Gobain Gyproc India.

Fire & Security Said Bhaskhar P, director – business development, Tyco Fire & Security, India, “Fire accidents have repeatedly grabbed headlines across India. “ He said that the primary concern in the healthcare sector is heat-dissipating equipments, combustible gases / fuel, chemicals, electrical wiring, high voltage connections used in different areas. Drywalls Said Rakesh Verma, general manager, boards division, Everest Industries Ltd., Mumbai, “Drywalls can be built faster, are lighter and eco-friendly. They ensure convenience and design flexibility. They are high on hygiene and safety quotient with fire and moisture resistance.”Said Ashutosh Puranik of Saint -Gobain Gyproc India, Mumbai, "Drywalls are lighter than bricks or blocks that are used in traditional masonry construction. Since they are made from gypsum plasterboards, they offer a higher acoustic performance. They also facilitate a disturbance-free environment in hospitals, thus ensuring faster patient recovery." Green technologies Speaking on ‘Green technologies for healthcare facilities’ M Chandrasekaran, deputy GM, Daikin Airconditioning India spoke on diffeerent types of chillers such as heat recovery chillers that help save energy and costs and also do not harm the environment. He explained that a templiflier is a water to water heat recovery device that provides hot water at a specified temperature using waste heat from a low temperature loop. Hospital beds Speaking on ‘Safe Healthcare’, Parag Shastry, chief ergonomist at Godrej Interio - Ergonomics Cell, spoke about EN 0601-2-52, a new norm aimed especially for the side rails as a basic safety feature of a bed. Side rails primarily protect the patient against falls. The design of gaps in or between side rails must not endanger patient’s health. He suggested looking at ergonomicallydesigned beds, keeping in mind the need for comfort, safety and hygiene for patients and care-givers. One needs to select hospital beds with utmost care and do due-diligence so as to prevent risk of entrapment, falling HAI and pressure ulcers; in-turn increasing the throughput of the hospitals, reducing the ALOS and creating a win-win for the patient and the hospital. This eventually leads enhanced reputation of the hospital or medical care facility.

Healthcare Radius June 2013

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Consumer ConsumerConnect ConnectInitiative Initiative

pOWERED BY

Knauf Powers Smart Healthcare India Summit The leader in drywall building materials was a key supporter of the biggest congregation of the who's who in healthcare

K

f Middle Bin Ahmed, Managing Director, Knau ss addre ing open his g durin East,

nauf, a leading manufacturer of drywall building materials, was the platinum sponsor for Smart Healthcare India Summit, held in Bengaluru on 23rd and 24th May at Sheraton Hotel. The two-day powerpacked summit was attended by industry leaders and over 150 delegates. During his opening speech, Amer Bin Ahmed, Managing Director, Knauf Middle East, said, “From where I come from, healthcare meets the spiritual, emotional and clinical needs of patients. Today, healthcare is more than clinical care. It has become synonymous with hospitality and well-being.” Knauf is interested about consolidating its business in the Indian sub continent. “All over India, the bed-to-people ratio is 1: 422, while the WHO recommends a minimum of 3 beds

per 1,000 people. India’s per capita disposable income (at current prices) has grown 2.6 times in the past 10 years and 1.6 times in the past four years. All these reflect a huge potential for growth,” said he. The summit provided Knauf the right platform to showcase its products and highlight its market leadership. Ahmed mentioned about the rapid growth of the company, which was founded in 1932 by Dr Alfons and Dr Karl Knauf to introduce gypsum based building materials, so that people could build faster, better and cheaper. Today, the company has over 150 plants spread across 37 countries in Europe, the Middle East, Asia, USA and Latin America with a workforce of about 18000 and annual revenue of approximately six billion euros.

Knauf Middle East Bin Ahmed MD Bin Ahmed hands over a momento to Rajen Padukone, CEO, MHE

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30-05-2013 20:36:11

25


Building the Future Knauf is one of the world’s leading production and construction material company with over 220 facilities and 22,000 employees present in over 60 countries. Knauf is a family-owned business, headquartered in Iphofen-Bavaria, Germany. The 80-year-old company specializing in gypsum products has an astonishing range of over 30,000 products, and that tally is growing all the time. The company’s Dubai headquarter services the entire region, and represents its first foray into the Middle East. In addition, it has a manufacturing facility in Ras Al Khaimah, and with a production capacity of 30 million square meters of gypsum board a year. This production is exported throughout the GCC, East Africa and India, which constitute Knauf’s main growth markets at present.

Ras Al Khaimah, UAE

The Crown Prince of Ras Al Khaimah, His Highness Sheikh Mohammad Bin Saud Al Qasimi with Knauf’s Managing Director and Shareholders, RAK, UAE

KNAUF LLC PO Box 112871 Dubai, UAE Tel: +971 4 337 7170 Fax: +971 4 334 9659

KNAUF RAK PO Box 50006 Ras Al Khaimah, UAE Tel: +971 7 221 5300 Fax: +971 7 221 5301

KNAUF Qatar PO Box 27111 Doha, State of Qatar Tel: +974 4452 8191 Fax: +974 4452 8181

KNAUF KSA Branch PO Box 3051 Jeddah 21471 KSA Tel: +966 2 606 7364 Fax: +966 2 606 7251

Website : www.knauf.ae | E-Mail : info@knauf.ae 44-46_HCR_Jun13_KANAUF_Consumer Connect initiative.indd 45 26 25-27-_HCR_Jan13_KANAUF_Consumer Connect initiative.indd

30-05-2013 22-12-201220:36:14 14:41:09


Consumer Consumer Connect Connect Initiative Initiative

Knauf lends its support to first ever event on smart healthcare management by Healthcare Radius Knauf's vast range of products

Being one of the world's leading productions and construction material company with over 220 facilities, Knauf has a wide variety of products. Knauf recognises that each part of a new hospital holds unique challenges, such as mixtures of acoustic, fire ratings and impact performances. It has solutions for special requirements such as X-Ray protection (new technologies), interior and exterior design, and Access Panels options for operation theatres.

“From where I come from, healthcare meets the spiritual, emotional and clinical needs of patients. Today, healthcare is more than clinical care. It has become synonymous with hospitality and wellbeing.” — Amer Bin Ahmed, Managing Director,

Knauf Middle East

The company provides an extensive range of 30,000 products and support solutions and certified to various international quality standards (ISO, ASTM, DIN and EN BS). Knauf Drywall Systems can be used for walls, X-Ray shielding, wet rooms, ceilings & acoustics and room aesthetics. Knauf provides robust wall constructions that withstand virtually all types of traffic. In practice, this means: long life maintenance-free walls, extended renovation cycles and improved operating costs. Knauf drywall construction boards can be used efficiently and have flexible applications in damp and wet rooms and open more freedom of design by selecting the right type of board. Knauf provides on-site training to improve efficiency and quality, reduce wastage of materials, learn proper application methods, less installation time, practice in the use of high-end drywall tools, ensure successful delivery of projects and create job opportunities.

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Healthcare Radius June 2013

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30-05-2013 20:36:24


Consumer Consumer Connect Connect Initiative Initiative

Knauf lends its support to first ever event on smart healthcare management by Healthcare Radius Knauf's vast range of products

Being one of the world's leading productions and construction material company with over 220 facilities, Knauf has a wide variety of products. Knauf recognises that each part of a new hospital holds unique challenges, such as mixtures of acoustic, fire ratings and impact performances. It has solutions for special requirements such as X-Ray protection (new technologies), interior and exterior design, and Access Panels options for operation theatres.

“From where I come from, healthcare meets the spiritual, emotional and clinical needs of patients. Today, healthcare is more than clinical care. It has become synonymous with hospitality and wellbeing.” — Amer Bin Ahmed, Managing Director,

Knauf Middle East

The company provides an extensive range of 30,000 products and support solutions and certified to various international quality standards (ISO, ASTM, DIN and EN BS). Knauf Drywall Systems can be used for walls, X-Ray shielding, wet rooms, ceilings & acoustics and room aesthetics. Knauf provides robust wall constructions that withstand virtually all types of traffic. In practice, this means: long life maintenance-free walls, extended renovation cycles and improved operating costs. Knauf drywall construction boards can be used efficiently and have flexible applications in damp and wet rooms and open more freedom of design by selecting the right type of board. Knauf provides on-site training to improve efficiency and quality, reduce wastage of materials, learn proper application methods, less installation time, practice in the use of high-end drywall tools, ensure successful delivery of projects and create job opportunities.

46

Healthcare Radius June 2013

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46 Healthcare Radius June 2013

01-06-2013 14:50:45


How to boost your hospital’s revenue. And profits.

Date Friday, July 26, 2013 Venue Hotel Oberoi, M G Road, Bengaluru Programme Fee Rs 9500 per participant (excl tax) Registration write to drvijay.raaghavan@med-ium.com Or call him at + 91 90080 20304

Healthcare Marketing MasterClass has been designed for Promoters, CEOs and CMOs to help them fine- tune various elements in their marketing strategy to drive profitable growth. It will focus on ready-to-implement takeaways through real-life hospital examples. It will cover various modules like Product, Branding & Pricing Strategy, Advertising, Digital & Social Media, Sales Force Effectiveness and Public Relations. Ratan Jalan is widely acknowledged as a thought leader in healthcare marketing. An alumnus of IIT and Harvard Business School, he headed strategic marketing initiatives for the Apollo Hospitals group. He also worked with Lowe Lintas, a globally renowned advertising agency for almost a decade. Winner of S P Jain Marketing Impact of the Year Award, he is a frequent columnist and has authored a cover story in Marketing Health Services, a prestigious publication by American Marketing Association. He is a guest speaker and faculty at industry forums and leading institutes like ISB, IIMs, Johns Hopkins and TISS.

Healthcare Radius Magazine, June 2013  

Aligning Business & Healthcare in India

Healthcare Radius Magazine, June 2013  

Aligning Business & Healthcare in India

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