The COVID-19 outbreak has severely impacted the revenue generation of hospitals across the country, which is likely to continue till early part of FY 2021. The out-patient division (OPD) segment is operating at 20–30 percent of the earlier base case expectations, majorly caused by the lockdown, along with the reduction in general public going to hospitals as a precautionary measure. Similarly, the in-patient division has been impacted by the government’s notification to postpone non-essential and elective surgeries. The segment is operating at around 25–50 percent of the base case assumptions and this trend is believed to continue till early next year.
We at Columbia Asia Hospitals have witnessed similar sets of issues. Generally, our revenue and cost budgets are analyzed, reviewed, and finalized by the month of February to make plans and execute for the next financial year. Following the routine, the revenue, cost, and capital investment plan were prepared for FY 20-21 to be effective from April 1, 2020. But by the end of March 2020, the entire scenario started changing. The inflow of patients, surgical-medical mix, out-patients, elective procedures started declining. Everything impacted net revenue even if the fixed costs were reduced to optimum levels.
Going forward we will resume the new normal for operations and new project expansion. For operations, we have essential replacement CapEx, which will be fulfilled to sustain operations. We also have a new project coming up in Pune, which has been delayed for almost a year.
We would be looking at a completely fresh thought process of investment, which will be more patient centric with lesser human intervention. There will be more investment on patient centric digital platforms with accurate results. Flexible design and construction of greenfield facilities will be done to enable faster re-purposing of beds. These designs would maximize infection control, for example, more single rooms, flexible HVAC systems and closed ICU beds. We would also be providing flexibility of converting step-down beds, which could be easily converted into ICU Beds.
While elective care is restricted across many countries, patients requiring high risk/complex care, such as those with cancer may not be able to wait for treatment. Columbia Asia hospitals are designed in such a way that areas dedicated for treatment of patients suffering from infections such as COVID-19 can be blocked without affecting other areas treating patients needing elective care and procedures. Such infrastructure facilities may become a permanent feature in the near future.
Numerous examples exist worldwide of virtual care, sometimes supplemented with AI which is now the first point of interaction for nonacute care.
A single, digital-first front door for health services is being established. The patient journey starts with an app or online and is then redirected to the optimal care setting regardless of physical or virtual modality;
Growing categories of remote/online services will naturally require more input of clinical information. Some basic services can be fed through home-based devices, but more is expected to be collected through specialized facilities available in convenient locations, such as pharmacies, imaging centers, and pathology labs; and
Patients may choose to avoid hospital stays whenever feasible, accelerating the transition to ambulatory care settings for increasingly complex care and procedures. We will also see more and more day care procedures being conducted followed by remote monitoring of patients.
To sustain operations and new project expansion, Columbia Asia Hospitals will be looking to investment into areas like ambulatory care, diagnostics radiology and imaging, cardiology–invasive and non-invasive, laboratory, emergency medicine, critical care, operating rooms equipment, wards, gastro enterology, urology, neurosciences and neurosurgery, general surgery, and ENT.