Dr Kunal Jawahar Thakkar
BAPS Pramukhswami Hospital

Simple, Sustainable, And Smart – The Future Of Healthcare

On the healthcare market in India

The healthcare market in India is a fast growing market. It has become one of the largest sectors in terms of revenue and employment. Diversity is the beauty and challenge in healthcare in India compared to the global market. If we look into the statistics, we have a long way to go to provide basic but quality healthcare at people’s doorsteps. At the same time, the cost-effectiveness and innovative practices make Indian markets competitive.

The penetration of health insurance in India is very slowly reducing the out-of-pocket expenditure but the reliance on insurance is of a very small fraction compared to the global scenario. Though the Indian healthcare market is expanding at a quick pace, the focus should be on technological up-gradation and quality of services. As there would be more interventions from the government sector to regularize pricing at various levels, the focus will shift from cost to better technology and better service. The consumer will have a choice to accept or reject a healthcare offering.

One of the concerning issues in providing quality healthcare where India lags behind vis-à-vis the global market is communication. At all levels in healthcare delivery there is lot of scope in improving communication with patients, families, and all stakeholders. Training in communication is not just for the customer care executives or front-line staff but it is equally required for technically sound specialists and super-specialists of medical and nursing profession. This can be achieved by bringing change at the medical and para-medical education level where a doctor or nurse or technician in the making is already trained and sensitized about the importance of communication in healthcare. On one hand India has a strategic advantage of being an innovative cost-effective healthcare market, but there are a lot of areas where conscious intervention is required.

On budgetary allocation in healthcare

Budgeting in the healthcare industry has a very thin line to walk on. Numerous internal and external factors affect its budget. What plays a vital role in budgeting is the mission and basis on which any organization is formed. Be it profit making or otherwise, a major chunk of budgetary allocation goes toward doctor and personnel fees. Other considerations while deciding on budgetary allocations include operating margins, expansion plans, and technological up-gradation. Depending on at which stage an organization is, the budget allocation for procurement of new technology, high-end equipment, replacement of existing equipment requires anywhere between 15 and 30 percent of total budget. This also includes infrastructure modifications for new equipment, installation, training, and maintenance contract costs.

On vision for health and family welfare and challenges faced while implementing health services

My vision is that the idea of healthcare rather than being scary should put anyone at ease or make them comfortable. Being healthy should not be stressful for a person or family or community. We need to convert the whole experience of healthcare delivery to be simple and satisfying. A more humane approach and a little more empathy will do wonders. In short, we need to make healthcare simple.

Implementation of health services is always challenging. One of the major roadblocks being availability of trained manpower. Healthcare as a service sector requires numerous people interactions and that too with focus on technical and communication skills. On an average a person has to interact with 8–10 different categories of healthcare professionals while getting his service. To get such a healthcare professional with a mix of technical and soft skills will always remain a challenge, which has raised because of lack of training at academic levels, rigid pay structures, difficult working hours, or brain drain.

Another critical challenge is to match with technological up-gradations. A huge cost is incurred in this and it is a continuous process as it is a need for today. So, trained human resource and costs behind rapid technological advancements are two major challenges.

On monitoring the quality of private healthcare

It can be rightly stated that the quality of healthcare and its monitoring is a matter of concern, be it private healthcare or a public healthcare system. What makes monitoring of private healthcare challenging is the vast nature of the task. But let us ask ourselves: has the quality not improved in last two decades? It has significantly improved and we can give the credit to anyone we like, be it consumer awareness, pressure of bigger healthcare players, government interventions, establishment of standards to look up to, or just a process to sustain in the competitive market. We have the National Accreditation Board for Hospitals & Healthcare Providers (NABH) standards and those have evolved too since its inception. We have standards for hospitals, small healthcare organizations, dialysis centers, blood banks, imaging centers, dental facilities, allopathic clinics, AYUSH hospitals, eye care organizations, clinical trials, and panchkarma clinics. We have set standards for most modes of healthcare delivery.

What is now important is how we as stake holders follow it. First it is not mandatory to follow standards and achieve accreditation and second it is a very difficult task to regularly monitor that the standards are followed. Ownership of all stake holders to achieve and maintain quality is required today. Whether it is monitored or not, everyone needs to ask: are we doing enough to provide quality healthcare? Intent is also important while implementing quality. We need to ask ourselves that “are we doing it just for the sake of a certification or accreditation? Or do we really intend to improve the quality of healthcare delivery?” We need authentic data and correct reporting so we can set benchmarks for the Indian healthcare system and then compare it with global standards. The move of the Insurance Regulatory and Development Authority of India (IRDAI) that requires hospitals to have minimum accreditation standards by NABH or National Quality Assurance Standards (NQAS) by the National Health Systems Resource Centre (NHSRC) has forced many to take quality seriously. But it is going to take correct intent, lot of time, efforts, and continuous monitoring to make quality a habit.

Another aspect of monitoring quality is monitoring by the consumers. Those who avail healthcare services need to be aware about the basics of quality standards. Quality being a subjective term, may be interpreted differently by everyone. But the patients as consumers and their families need to be sensitized about quality too. Today, while purchasing any product, one ensures that it is manufactured through a well-monitored process and has passed various quality checks. Similarly, while purchasing services one should be able to check, monitor, and verify the quality of service and this can only be done by sensitizing the population.

We can say that quality cannot be a department. It is a philosophy that has to be accepted and weaved into the structure of any organization.

On importance of public private partnership in making healthcare a success

There is no doubt that PPP models are important for making healthcare a success. But what is more important is that the model should run. Detailing of execution of such models requires a lot of understanding, regional flexibility, and accountability. At the end, numbers show how well any program is implemented, and how far it has achieved what it was supposed to achieve. Effective implementation is the key.

On smart healthcare

Healthcare is not just limited to hospitals. The barriers of infrastructure, accessibility, are a thing of the past. Now the era is of smart healthcare. Like smartphones and smart houses, the time is of smart healthcare where every stakeholder has to upgrade. Digital transformation, access to knowledge about healthcare, and rise in awareness for health will all lead us to solutions of many problems and will generate new concerns like self-diagnosis, self-medication, and many more. The use of robotics, automation, machine learning, and artificial intelligence, has started to have a huge impact on healthcare along with other industries. Wearable health trackers and mobile health apps have already reached homes. Artificial intelligence (AI) is used for data mining and providing consistent and smart information out of the medical records.

Automation leads to reduction in repetitive tasks and improves precision and has changed the market of diagnostics in a big way. Genetic research, production of drugs, and virtual healthcare delivery are all affected positively by AI and automation. What we are witnessing is a paradigm shift in healthcare delivery at all levels. With everything at disposal, it will be the responsibility of the healthcare community that a judicious and positive use of available resources is made.

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