Human

Experience
Looking Beyond
Patient Experience
“Wherever the art
of medicine is loved,
there is also a love
for humanity.”

- Hippocrates
Healthcare’s
next leap: humane
experiences
As consumer-driven healthcare
grows in popularity, healthcare
providers must now focus on a
positive patient experience.
The COVID-19 pandemic has further
accelerated the need for patient
centricity, compelling many hospitals
and health-tech companies to
deploy technologies to address
these trends. Teleconsulting,
telemedicine and Uber-like
ambulance services are amongst
the many solutions that are now
well-established in many regions.

While technologies and process

enhancements have improved
convenience, o ering a holistic and
humane experiences for patients is
undoubtedly the next big
opportunity. Compassion, patient
dignity, appropriate communication,
personalisation, healing, community
involvement are a few aspects that
are indirectly related to clinical care
but produce a huge impact on the
individual’s well-being. It also
demands that healthcare providers
re-examine their purpose and core
values and place equal focus on
employee experience and wellness,
create a culture of compassion, and
collaborate actively with a broader
technology and clinical eco-system.
This book o ers unique perspectives
from key actors across the
healthcare provider ecosystem
• The treatment of patients with
compelling you to reassess the
chronic diseases should be focused
e cacy of accepted patient
on helping them lead normal lives.
experience metrics such as
satisfaction and engagement. • Healthcare should be focused on
While compiling these astonishing mental and emotional well-being
insights from medical professionals, along with clinical outcomes.
editors, technologists and patients-
turned-medical entrepreneurs, • Technology can play a significant

it became clear that while these role in enabling healthcare

essays focus on Indian healthcare, providers to enhance experiences

the themes have global relevance: for consumers and sta and enrich
their lives.
• Patient experience is as integral to
quality healthcare as clinical • A policy framework that provides

outcomes. Every healthcare worker appropriate weightage to patient

must believe wholeheartedly in the experience is required.

values of compassion and

The voices and experiences
empathy, which should guide their
described in these pages make it
interactions and engagement with
evident that the need for humane
patients and fellow human beings.
healthcare and human-centered

• Respect and dignity to every experiences is more relevant than

healthcare consumer and sta ever before. Focusing on these new

member should be the cornerstone opportunities will impact lives and

of every healthcare provider’s create new avenues for growing

mission. medical services.

• A purpose-led organisation can

mobilise its sta around its core SRIDHAR VEDALA
values and beliefs, which in turn Editor
fosters a people-oriented culture. Director, Futurewerk
 c o nte nts

8
Human Interaction is Core to
Delivering Outstanding Patient Experiences
Dr GOPICHAND MANNAM
Chief Cardiothoracic Surgeon &
Managing Director, Star Hospitals

16
Compassion, Dignity and
Respect - Core to Human Experiences
Dr PRAMOD GADDAM
CEO, Fernandez Foundation
38
Leveraging Technology
for Experiential Care
RAJIV SIKKA
22
Dialysis Patients: Experiencing
Group CIO, Medanta - The Medicity
the Joy of Leading a Normal Life
KAMAL D SHAH
Co-Founder, NephroPlus
46
Home is Where the Elderly Belong
TARUN SHARMA
Founder, Yodda

30
Technology can Play a Unifying Role
to O er Holistic Human Experiences
TIRUPATHI KARTHIK
54
Putting the Care in Healthcare
CEO, Napier Healthcare
Dr BOBBY JOHN
Editor, Journal of Development
Policy and Practice
 Human Interaction is
Core to Delivering
Outstanding Patient
Experiences

08
Dr Gopichand Mannam
Chief Cardiothoracic Surgeon &
Managing Director, Star Hospitals

Dr Gopichand Mannam
graduated from Guntur
Medical College, in Andhra
Pradesh. He obtained an FRCS
Edinburgh in General Surgery
from the Royal College of started STAR Hospitals,

Surgeons of Edinburgh and a 320-bed multispecialty

FRCS Glasgow General hospital. Dr Mannam has

Surgery from the Royal College performed more than

of Surgeons Glasgow. He 30,000 heart procedures in

further underwent extensive his career spanning

training in adult and 27 years. He started

paediatric cardiac and HRUDAYA - Cure a Little

thoracic surgery at the Royal Heart Foundation in 2005.

College of Surgeons, London. He was awarded Padma

Shri, the fourth-highest
In 1994, he returned to India, civilian award in India, for
and after significant stints at performing over 2000 free
Apollo Hospital, Medwin surgeries for children.
Hospital and CARE Hospital,

09
 Patients and their relatives are
naturally prone to high levels of
anxiety and emotional distress
during hospital visits. In India,
the cost associated with
medical care further adds to
the burden already felt.
Healthcare providers must
therefore go beyond excellent
clinical care and increasingly
also address the overall
emotional state of the patient.
This is the first step in creating
special experiences for
patients and their families.
In a hospital, this can only be
achieved by involving
everyone, from the CEO to
front-line sta . Providing a
positive patient experience
Patient experience is an starts with ourselves - the
integral part of quality medical doctor, the nurse, the caregiver
care. Most people are now - and is a deeply personal
accustomed to digital process. At a fundamental
experiences o ered by hotels level, medical professionals
and shops across the world, must transcend their highly
and expect similar experiences logic-oriented training and
from hospitals and healthcare develop a deeper connection
providers. While hospitals can to their own and their patients’
certainly draw on innovations feelings. The most important
from these industries to qualities that every healthcare
enhance convenience, simplify professional must possess are
processes and enable empathy and compassion,
seamless communication, and the ability to
patient experience is a much communicate responsively
broader topic. and honestly.

10
Empathy and compassion Providing a positive
determine the capacity to patient experience starts
sense the emotional state of with ourselves - the
the patient. It’s all about doctor, the nurse, the
putting yourself in the patient’s caregiver - and is a deeply
position. This enables doctors personal process.
and nurses to engage patients
appropriately at a human level
and leads to more e ective
communication. Even more
importantly, empathy and
compassion can significantly Finally trust between doctors
transform patient sentiment and patients can only be
towards the hospital visit and maintained through honesty.
their disease making it a more It is therefore a critical quality
pleasant journey. Stress and that all healthcare
anxiety also often lead to a professionals have to display
breakdown in communication proactively. This also means
and responsiveness. People that clinical sta should not
assimilate and process hesitate to own their mistakes
information di erently. or lack of knowledge. This
The ability to establish a emotions-oriented approach,
connect with patients and combined with clinical
their families and appropriately expertise, leads to much better
communicate with them go a clinical outcomes and provides
long way in making them feel a more holistic customer
comfortable and administering experience. At Star Hospitals,
quality care. This allows the from the start, our focus has
doctors and nurses to create been to invest time and e ort
an environment of trust and in creating a culture in which
explain clinical procedures everyone at the hospital
and diagnoses more understands the importance
e ectively. of human side of healthcare.

11
 Technology, if
Building a patient
used e ectively,
can undoubtedly centric organization
lead to greater
At Star Hospitals, empathy and
convenience and
patient experience is embedded at
enable better the core. It is a continuous process
communication. with the aim to include customer
feedback, leadership transformation,
process redesign, culture change,
and adoption of new technologies.
Training our sta on customer
centricity, motivating them,
rewarding them for aligning to our
vision and values is fundamental to
building our brand for the long-term.
The tenets of our approach are:

12
 Focus on sta journey: People are
Common purpose: Quality the most important part in the
healthcare is a collective e ort and evolution of Star Hospitals’ journey.
everyone within the hospital must be We therefore also need to
aligned around the organizational increasingly focus on the employee
purpose of delivering a great journey. Looking at mapping the
experience. This requires an employee journey not only helps in
organization wide e ort and must identifying barriers to the delivery of
start at the very top. The leaders quality care but should also shape
who are seen as role models must an organizational culture.
believe in and contribute to the It further provides insights into our
vision of delivering patient centric leadership style, organizational
healthcare. Awareness about decision making, and training
patient experience must then drive required at all levels.
self-transformation and looking at
Process redesign: Standard protocols
care from a patient’s perspective.
have always been a key tool to
Adhering to this common purpose is
ensure quality care but the delivery
therefore a vital step.
of outstanding patient experience
Focus on patient journey: A great requires a careful review of our way
number of clinical and non-clinical of working within the entire
sta members are involved in organization. Lapses in protocols
delivering a good experience at must obviously be flagged and
the many touch-points patients go addressed in an easy and
through. A mapping of the patient transparent manner.
journey together with all hospital
Technology, if used e ectively, can
sta is critical to understanding
play an important role in simplifying
issues. This exercise not only helps in
and automating these processes
identifying key pain points but is also
and provide access to data.
an opportunity to create innovative
This will undoubtedly lead to greater
ways to enhance our ways of
convenience and enable better
working.
communication.

13
 Barriers to delivering
experiences

There is a general tendency by most

hospitals and healthcare providers in
India to emphasize clinical expertise
and define experience around
clinical outcomes. This is due to the
ways of working and established
culture at most hospitals.

Incorporating a broader, more

empathy-oriented patient care
approach in regular sta behavior is
easier said than done. Doctors and
healthcare sta must become more
When a doctor
aware of the importance of patient
believes in god-
experience and unlearn many of
like status and
their existing ways of working.
gets carried The easy access to digital channels
away by allows patients to share their hospital
adulation there visit interactions with hospital sta
is a greater but also with a wider community.
tendency to This feedback can be both positive
overlook patient and negative but more importantly
experience. provides key insights into customer
expectations.

While every hospital and care

provider may have unique issues,
common challenges are usually
the god-like aura around doctors,
underestimating patient feedback,
the lack of awareness amongst
sta and insu cient leverage of
technology.

14
The doctor with a god-like aura:
positive assessment. It is therefore
In India, historically, doctors have
critical for all sta at the hospital to
almost had a god-like aura about
realize how their actions may impact
them. This is understandable as most
patient and the hospital’s reputation
people are deeply grateful when
overall.
they finally recover from a serious
illness. This however can be a trap; Lack of awareness and education
when a doctor believes in this and Patient experience is sum of
gets carried away by adulation experiences at every touch-point
there is a greater tendency to within a hospital. Even a few people
overlook patient experience and displaying the wrong attitude
even be too confident in clinical towards patients will have a serious
diagnostics. This eventually leads to impact. Even though there are many
patient dissatisfaction. Nevertheless, factors that contribute to this
the corollary scenario is also quite problem, sta social background
frequent when patients do not make and education levels is a critical one.
expected recovery in their health, This has a direct influence on values
the blame often falls on the doctor and beliefs which in turn contribute
alone. to quality standards. Unfortunately,
little attention is paid to include
Underestimating the power of
topics such as empathy and
patient feedback: With the
relationship building in medical,
widespread availability of
nursing or hospital administration
information on the internet, patients
courses. My hope is that this attitude
are increasingly well-informed and
will change progressively.
have a strong voice with regards to
their hospital experiences. Leveraging technology: Meaningful
They read reviews about hospital, implementation of technology can
clinics, and individual doctors. reduce the length of time-
They perform comparisons and consuming activities for nurses and
take second opinions before making doctors. This in turn would free up
decisions on their health. They are their time to focus on patients and
also quick to post feedback and enhance convenience for patients.
reviews on social media channels It is important for IT teams at
which can create a significant hospitals to also demonstrate
impact. We need to be aware of the empathy and compassion in order to
fact that a patient may have had a look at usability and benefits from
great experience during their the patient and sta perspective.
hospital stay but encountered a Unfortunately, the few technology
problem during billing or parking. resources within hospitals often lack
The negative feeling will often a deeper understanding of patient
completely reverse their initial care and experience.

15
 Compassion,
Dignity and Respect -
Core to Human
Experiences

16
Dr Pramod Gaddam
CEO, Fernandez Foundation

Dr Pramod has been a

member of the Fernandez
medical team since 1994 and
took over as the Head of the
Department of Neonatology
in 2001. In 2009, he became a charge as the CEO of
full-time working director of Fernandez Foundation in
Fernandez Hospital. 2019, he has played a
As the Head of Neonatology, seminal role in establishing
he introduced several Fernandez Child
innovations and best practices Development Centre, which
that set Fernandez apart. cares for children with
These innovations include special needs. Dr Pramod
introducing a Kangaroo completed his MBBS from
Mother Care ward at the Government Medical
Fernandez in 2004 and College, Bellary, and his MD
establishing a Human Milk in Paediatrics from Kasturba
Bank in 2007. After taking Medical College, Manipal.

17
 Purpose is the heart of the
experience

Digitality may completely

Midwifery care not just
dominate all aspects of our
reduces maternal and
lives, including healthcare.
infant mortality rates but
Yet, the importance of human
also significantly lowers
touch in a doctor-patient
caesarean section rates.
interaction cannot be
diminished or taken away.
This experience continues to
be fundamental to Fernandez’s
way of o ering maternal and
childcare.
In a successful pilot in
We are strong advocates of Telangana, nurses working in
natural birthing and midwifery public hospitals trained in
in line with our purpose. midwifery by Fernandez
Alarmed by the high maternal Foundation are helping to
and neonatal mortality rates in increase normal births and
the country, Fernandez began reduce caesarean sections.
the first in-house professional They also ensure that women
midwifery educators training have a birth companion and
way back in 2011. Midwifery enjoy respectful maternity
care not just reduces maternal care. This initiative attracted
and infant mortality rates but the attention of the central
also significantly lowers government. As a result,
caesarean section rates. we are one of India’s
Today, we o er midwifery care 14 National Midwifery Training
to help promote and support Institutes that o er midwifery
women with natural birthing in training to both state and
a high-volume “client” load. central government.

18
 Enabling the right
experiences by
Values - the driving force doing things di erently
We strive to ensure every woman we To provide high quality, evidence-
are privileged to serve experiences based and respectful care for
dignity, respect, and compassion. mothers and babies, we evaluate
and adopt approaches aligned
Dignity is about empowerment.
with our core values.
We ensure that our midwives and
obstetricians spend time with every Specialisation with dedicated
woman one-on-one to understand departments: Our core focus rests
their birth preferences. We put with the care of the mother and
women at the centre of their birthing her newborn. We have a team of
Conventionally, they are kept in an
journey by supporting them with midwives, obstetricians,
incubator that entails not only higher
choosing a birth companion and anaesthetists, and paediatricians
costs but also keeps babies
birth positions of comfort. Respectful round the clock to ensure safe
separated from their mothers for
maternity care is at the heart of all birthing and newborn care.
days. We believe in Kangaroo
the services we o er. Privacy during To help mothers and babies better,
Mother Care (KMC) technique,
birth is every woman’s right. Today, we have specialised departments
where babies are wrapped to their
our three hospitals have individual such as low-risk obstetrics, high-risk
mothers’ chest
birthing rooms for every woman obstetrics, multiple pregnancies, and
with a special broad strap.
regardless of her socioeconomic foetal medicine, which experts lead.
This skin-to-skin contact keeps
status, thus ensuring equitable care
them as warm as they would be in We firmly believe that newborn
across the board.
an incubator. Additionally, it makes care should be within maternity units
We don’t address women birthing babies physiologically more stable, and that the mother and her baby
with us as “patients”. They are enables them to bond better with should never be separated.
mothers-to-be or women who are their mother, have fewer serious Our Tertiary Neonatal Intensive
pregnant. We believe that calling infections, go home sooner, and Care units eliminate the need to
them patients would treat breast-feed better and longer. shift the baby out for medical care.
pregnancy as a disease. Studies have shown that KMC
babies catch up with their normal The other area we are passionate
Integrity is about doing things that growth rate faster than babies kept about is children with special needs.
are right for mothers and babies. in incubators. More importantly, the The awareness and incidence of
For example, babies with low birth mother is fully involved in the care of Neuro Development Disorders (NDD)
weight need special care, which is her baby. The psychological and is increasing. Not many centres o er
initially provided as intensive care in emotional impact on the mother the entire spectrum of expertise -
a critical care unit. Once they helps her cope better and reduces that is, Evaluation to Therapies under
stabilise, they need to be kept warm. her anxieties. one roof and that too at an

19
 a ordable cost. To fulfil this need,
we set up Fernandez Child
Development Centre with Divi’s
Foundation for Gifted Children
(DFGC).

Fixed salaries for our physicians:

At Fernandez, Unlike the general trend, we decided
there are no to have our teams on fixed salaries.
incentives based There are no incentives based on
on how many how many procedures one performs.
procedures one This makes working in teams and
performs. following evidence-based practices
easy. There is a clear understanding
of protocols at every level, thus
enabling uniformity and
standardisation of care.

Investing in our people: We have

over 2,400 employees, with 78%
being women. We encourage /
sponsor our employees (at all levels)
to pursue higher skills or education.

20
 Foundation), a leading Obstetrician,
has converted a successfully
running private limited company
We ensure every woman
(hospital) valued at a few hundred
who walks into our
crores into a not-for-profit
hospitals has consistent foundation promoting midwifery.
experience of respectful
Our clinical research focuses on
care, beginning from
finding cost-lowering treatment
admission to discharge. options for mothers and newborns.
Cost-lowering does not mean
lowering standards of safety and
quality.

Processes and transparency: Our mission is to make pregnancy

Organisation culture
We ensure every woman who and childbirth safe for every

Our organisational culture ensures walks into our hospitals has pregnant woman as an organisation.

there is no ambiguity in our consistent experience of respectful We achieve this by o ering the

employees about our core purpose, care, beginning from admission to collaborative midwifery model of

which helps us connect better with discharge. There is transparency care where the midwife is the

our customers. New doctors, through a customer’s journey via primary carer. Obstetricians and

irrespective of their expertise, are honest and detailed communication. allied specialists are called in

mentored by senior consultants on Deviations from a protocol need to wherever needed. Thus healthy

the job before they are on their own. be justified and discussed in an open women and women with complex
atmosphere for future learning. medical or surgical needs are cared
Some approaches that are unique for by a close-knit protocol-driven
to Fernandez are: People and ownership-driven culture: team of professionals.
We have an ownership driven
Clinician-led: We are a clinician-led culture. We operate a reasonably Fernandez Hospital, which began in
organisation. Clinicians are integral flat organisation structure, with no 1948 with two beds, has grown into
to all non-clinical departments like bureaucracy and ensuring an three IP facilities, with over 100 beds
quality, administration, purchase, open-door policy. We encourage each, two OP facilities, and
and operations. This ensures that teams to step up and take contributes to over 10,000 births
clinical care and safety are not ownership. We pride ourselves on every year. Our journey has been
compromised. For example, if it is a creating a welcoming space for long and rewarding. Generations of
pharmacological product, it goes everybody. We focus on both the mothers and babies continue to
through a committee that evaluates personal and professional growth come to us, purely based on trust
its e cacy based on research of every team member. built painstakingly by word of mouth.
evidence. While we encourage Our unwavering focus will always
organic growth in leadership, Practice what we preach: remain respectful, equitable and
we do have lateral entries to bring The leader, Dr Evita Fernandez compassionate care. The revenue
in fresh ideas. (Chairperson, Fernandez will inevitably follow.

21
 Dialysis Patients:
Experiencing the
Joy of Leading a
Normal Life

22
Kamal D Shah
Co-Founder, NephroPlus

Kamal did his Chemical

Engineering from Osmania
University and developed
software for Apple products
for about 10 years before
co-founding NephroPlus.
He strongly believes that being
diagnosed with kidney disease
is not the end of life but the
beginning of a new life —
albeit a slightly di erent life.
Yes, you do have to make
compromises but that does
not have to prevent you from
living the life you want to live.
Kamal is on dialysis, swims
every day, works full time,
and travels regularly.

23
 The concepts of human-
centred design and customer
experience have been around
for a long time and have taken
a prominent role recently in
the context of digital
transformation. While it’s true
that technology is an enabler
for superior experiences,
it cannot be a substitute for
that vital human element.
Such authentic experiences
are only possible when a
culture of empathy is
embedded in the fabric of an
organization and its leaders
live and breathe customer
experience. It must be core to
the culture of the organization
and its people.

24
 My life was normal again, almost.
From the beginning, I was
determined to lead a normal life, go
back to work, watch movies with my
friends and family, enjoy a meal
outside, travel, maybe even exercise.
A personal Peritoneal dialysis gave me that
freedom, it was wonderful.
journey towards
better care During a trip in December 2004,
I was at a beach in South India when
The story of NephroPlus and what it the infamous Tsunami happened.
stands for is closely linked to my Due to this, my peritoneal dialysis
personal journey. As a young catheter came into contact with
graduate, many years ago, I aspired unclean water, resulting in an
to pursue a Master’s degree in the infection that made the use of this
US. Within a few hours of being method impossible. I had to give up
administered the necessary vaccines Peritoneal dialysis and was back to
for travel, I went into kidney failure square one. If I say that I was
and developed a condition later devastated, that would be an
diagnosed as atypical HUS, a rare understatement, but something
kidney disorder. I had to get on inside me triggered once again and
dialysis immediately. I was shocked my determination to live a normal life
and devastated. grew even stronger. Together with
my nephrologist and after some
After a year and a half of dialysis,
research, I started doing Daily
I received a kidney from my mother,
Nocturnal Home Haemodialysis,
which after initial promising results,
which can be performed overnight
unfortunately failed, leaving me no
in the comfort of your home.
other option but to get back on
Even though it requires five to six
dialysis. During an Internet search,
8-hour sessions per week, it was still
I stumbled upon Peritoneal dialysis, a
preferable than spending endless
less invasive method. This was a life
hours at the hospital.
changing experience because it
allowed me to be more in control of I wanted to avoid the hospital at all
my health, did not require hospital costs. My life became normal again.
visits, did away with needles and I was active, started swimming and
required fewer diet restrictions. worked full time.

25
 The dialysis patient
at the center of care
Being
I started sharing my experiences
customer
through a blog to help other patients
centric means lead normal lives. Through this
adapting exchange, it became clear that
services to the there was a dire need for quality
lives of those dialysis in India and that nobody
who consume was truly looking at the patient’s
these. perspective. Vikram Vuppala, who
had been a strategy consultant and
was also passionate about building a
business that changes people’s lives
reached out to me. NephroPlus was
conceived. What started as a small
4 bed centre in Hyderabad has now
grown into the largest dialysis
provider in Asia with 275 centres in
3 countries serving 18,000 dialysis
patients.

26
 Patient experience is
more than just painting
Why did it work? From the the walls Technology as an enabler
beginning we strongly felt that
Technology is the backbone of
“patient experience” is at the heart Ensuring excellent patient
NephroPlus and has enabled us to
of success. We began by addressing experience every day and
scale our operations to 160 cities
our patients as guests and were at scale required a relentless focus
and 275 dialysis centres.
committed to making them feel as on clinical and operational
Every dialysis centre uses the
such in our centres. The setting is excellence, technology and people.
same portal for billing, materials
cheerful and bright, patients could
Clinical and operational management, clinical data
watch TV, use Wi-Fi connection and
excellence is truly the key driver management and captures every
other services. This is in stark contrast
for high quality dialysis. We aspect of patient related
to any normal hospital setting.
brainstormed extensively with information. It is impossible to ensure
We regularly hold events that nephrologists, technicians and other standardised quality without one
combine education, entertainment team members to come up with system and as much digitisation as
and networking. They include best-in-class protocols that are possible across the network.
insights from vascular surgeons, followed rigorously in all our centres.
Early on, we realised that we needed
dieticians, nephrologists on how to An elaborate audit mechanism
an ERP system given the growth in
live a normal life while being on performed by our quality team
the number of centres. We have
dialysis. A still bolder initiative is the ensures that these protocols are
continuously invested in this system
biennial multi-sport event, called the followed and improved at all our
and are now in the middle of a
Dialysis Olympiad, organized in a centres on a continuing basis.
major upgrade including a mobile
stadium. The confidence boost to This is the NephroPlus way.
app which was recently released
patients is amazing.
Focusing on the right details beyond allowing patients to book their
Being customer centric means regular disease control guidelines sessions, view their complete
adapting services to the lives of makes a big di erence. For example, investigation history, contact their
those who consume these. ensuring high water quality requires nephrologist and get access to
Patients often worry about not being a stringent treatment process. invaluable content around dialysis
able to perform their dialysis when Regular checks are carried out on care. Technology also allows us to
traveling with their family and the water containers and all the increasingly capture clinical dialysis
friends. With the network of centres dialysis machines. Optimising patient data digitally. The analytics
across Asia giving the same feel and outcomes call for additional work on performed on the data have an
commitment to quality, we expect the part of technicians that must not enormous impact on how both
the customer experience to be only be written down but also doctors and patients can manage
consistent everywhere. followed up and incentivised. their well-being.

27
 People and culture:
We realised early on that building
teams with the right mindset, skills,
experience and values in line with
patient care would be the greatest
challenge. To this end, we
committed to building leadership
capacity, training and fostering a
strong culture across the whole
company.

Leadership and capacity:

We do not believe in control-based
management and therefore strive to
build leadership and share
responsibilities at all levels.
Even at the top level, the roles are
split. Vikram, with his background in
strategy consulting, looks after the
financials, fund raising etc.
while I look primarily at clinical
and patient-care aspects.

Training academy: Technicians go

We do not through a 2-year program in our own
believe in academy. They are trained on
control-based theoretical aspects of dialysis and
management. our specific protocols. When they
graduate, they are placed in one of
our dialysis centres and go through
continuous training programs
throughout their professional career.
As quality is such an important
aspect of the service, technicians
must go through an internal
certification process and take
specific exams twice a year.

28
From a career-path perspective,
a technician has excellent growth
opportunities. They can increasingly
take more responsibilities within the
centres and progress towards
greater involvement at regional
cluster level. With the growth of the
company, many team members can
become quality managers at a
wider zonal or even at a country
level.

Culture: As our salaries are typically

slightly lower than the market, our
unique culture and values are what
keeps our people committed to us.
A connection to our collective
purpose of making lives of our guests Expansion,
better is important to us. The
organisational hierarchy is flat and Vision and Courage
even at the size we are reaching, we
In India the growth scope for
still have an open-door policy.
quality care at reasonable prices is
In terms of culture, everyone unlimited but in order to do this
obviously looks up to the lead successfully, taking the patient’s
managers. Those at the helm of view into account is really important.
quality and operations must take Quality care also requires building a
the lead in imbibing our work culture, robust platform that delivers quality
acting as role model for all those on outcomes on a consistent basis and
the front lines. When we hire our keeps people gainfully engaged.
managers, we spend a lot of time to Even though this calls for a lot of
ensure that their values are aligned personal investment and time,
with our own and that they truly improving lives and serving the
believe in changing lives rather than community provides a sense of
just doing a job. fulfilment which is at the core of
our organizational culture.

29
 Technology can
Play a Unifying Role
to O er Holistic
Human Experiences

30
Tirupathi Karthik
CEO, Napier Healthcare

Tirupathi Karthik is Chief

Executive O cer of Napier
Healthcare Solutions Pte Ltd.
A leader in Healthcare
technology, Karthik has
extensive business leadership
experience across Asia, the solutions (Hospital
Middle East and USA, Information System) for
particularly in the enterprise healthcare providers. Since
software space. He is a its inception 26 years ago,
passionate advocate for the Napier has been enabling
innovative use of technology seamless experience for
that turns technology hospitals and its patients at
investments into competitive every touch-point. Napier’s
di erentiators for their customers are spread
stakeholders. Napier across Australia, South East
Healthcare provides end-to- Asia, India, major Gulf
end technology platform countries and Africa.

31
 Digital technologies, as we
know it today, are leaving a
lasting impression on people’s
lives. Yet, this is just the
beginning. AI and technologies we must understand
such as cloud have the that technology is only
potential to redefine our lives. an enabler.
Nonetheless, for these
technologies to thrive and
reach their full potential, they
must enable extraordinary
human experience, more so This was best appreciated
in the healthcare sector. illustratively during the global
However, we must understand covid pandemic surge when
that technology is only an teleconsulting services o ered
enabler; it is this human relief and support to people
centric approach that will around the world who were
drive healthcare providers to a ected by lockdowns. It was
e ectively leverage in the interest of everyone, be it
technology to enhance the the overstretched frontline sta
lives of patients, their families, in hospitals or the visiting
employees, vendors or in short public as hospital visits
the society as a whole. enhanced the risk of exposure.

32
Healthcare is
homebound
The trend of consumerism in
healthcare has been growing for
several years. People in general
believe that since they are paying
for services, they must be treated as
customers, just like in any other
services sector. In countries where
healthcare services are provided
mostly for free, for example NHS
(National Health Service) in the UK,
income tax payees demand superior
experience citing the taxes they pay.
People are increasingly demanding
delivery for services where they are,
rather than where hospitals are, The demand for services is also
especially when it comes to long- closely linked to demographics.
term care and elderly care. In acute Asia-Pac, the Middle East and Africa,
care situations, hospitalisation is still have a relatively younger population
the choice. During the pandemic, when compared with the European
the demand for home care became countries or Japan. Naturally, in
urgent as elderly visits to a these countries with younger
healthcare facility was highly risky. populations, the focus of hospitals
Many providers who understood the and technology vendors has been
urgency and the need, stepped up on acute care. As they encounter
and embraced digitalisation to o er ailments related to the elderly,
what people wanted. Teleconsulting healthcare providers are focusing on
and telemedicine are some both acute care and long-term-care.
examples, but many forward looking Napier Healthcare was initially
organisations expanded beyond focused on acute care for the first
teleconsulting and telemedicine to 15 years, but subsequently we have
o er a number of new home care integrated more to o er an end-to-
services. Many hospitals are end platform that o ers solutions for
transforming to o er holistic hospitals, nursing homes, home care,
healthcare services. day care or allied services.

33
 Mindset Change
The service industry is intrinsically
human centric. But technology
adoption can take this to a di erent
level altogether, impacting its core
values in multiple ways. This would
call for change in the mindset at
di erent levels. Technology expertise
is not a limiting factor here.

Holistic approach:
From an organisational perspective,
o ering outstanding human
experience requires a holistic
approach that must include patients,
their families, employees, partners,
suppliers and others. Technology
must enable everyone who,
together, can deliver their brand
promise.
The barrier
to adoption Various factors come into play as to
how the service providers view the
of these
technology on o er. If the Singapore
technologies
Health system is the reference point,
is not so
being publicly funded, their
much about requirements tend to be di erent
expertise but from providers in South Asia such as
organisational India where 80% of healthcare
culture. providers are private. The private
providers look for solutions in billing,
claims, recovery of dues, inventory
management etc.

Human-centric providers look at

enabling their employees with tools
and solutions not only to automate
mundane activities but also to
enhance their well-being and
performance. Most providers would

34
want to e ectively use their limited
resources and sta . In a homecare
scenario, if a provider has to cover
four patients during the day, they
have to answer questions like what
consumables to carry in the role. Healthcare providers are

ambulance, which patient should recruiting technology leaders from

they visit first, how should patients be other industries who bring best

grouped, what resources are practices and also transform the

required, what will be the utilisation culture, especially by bringing in a

of these resources and so on. This is culture of proactive measures to

where they are considering AI for address a problem.

optimised route planning amongst

Physicians' preference:
other things.
There is also an element of mindset

There are multiple applications of AI change for physicians. Some

such as predicting the length of stay physicians are so busy that there is

in the hospital based on patient little time for them to adopt new

condition, predicting occupancy of ways of working without disrupting

beds and planning consumables, their practice. In such cases the

resources, support services and other adoption of technologies such as

capacity utilisation-related aspects. electronic medical records (EMR),

online monitoring, teleconsulting etc.,
Another example is in the area of tend to be limited. A mindset change
Radiology and adopting AI to is required to look at overall
prioritise patients who need experience from a patient’s
immediate care. The solution is perspective who may have to travel
simple as it involves feeding a certain to hospital, wait at the hospital and
number of images into the machine end up increasing their exposure to
for it to learn and perform an infections.
analysis. This solution can help
Radiologists highlight cases which Clinical mindset:

merit their immediate attention and While this is again linked to

thus prioritise those patients. organisational values and culture,

in many developed countries like
Again, the barrier to adoption of Singapore certain aspects like EMR is
these technologies is not so much a given. On the other hand in many
about expertise but organisational South Asian countries, they are yet to
culture. Many of our customers work adopt EMR comprehensively.
with us as partners to collaboratively A mindset that focuses on clinical
innovate and deliver solutions. excellence can leverage data and
In particular, we are seeing the analytics to interpret
emerging role of IT to play a critical disease/recovery patterns.

35
 Adopting technologies
to deliver outstanding
human experience
When looking at technology
adoption there are many factors
to be considered.

Consumer perspective:
Technology must enable enhanced
experience for patients, consumers
and their families at every touch-
Technology point on their journey.
adoption is a A hospital information system (HIS)
continuous enables hospitals to automate their
process. core processes making it seamless
for both consumers and sta to
manage various processes.
Technology adoption is a continuous
process that involves innovative
solutions and the ability to respond
to consumer needs. A model that
promotes engagement with
consumers and technology partners
is essential to continuously identify
and o er superior solutions.

36
 Cloud: Availability without
interruption, mobile access etc. are
now mandatory. Most organisations
are migrating to cloud based
solutions. We at Napier completely
re-designed our applications with
a cloud architecture, to build a new
platform that is aligned with current
and future expectations of our
Employee perspective: Technology is customers. What used to be
as important for employees as it is for months for implementation and
consumers. Technology solutions can installation - provisioning of
automate and optimise most platform for customers takes
mundane activities, provide insights only a few days now.
from large data sets to make critical
Flexibility and lock-in: Most
decisions, whether financial or
customers would like to o er
operations related. Technology
di erentiated services and
solutions can also enable sta to
experiences to their consumers.
connect with each other, o er well-
The core systems must be flexible
being solutions, help them plan etc.
and o er ways to easily integrate
Doctor perspective: new solutions. Also no one likes
Data analytics and AI can play a lock-in with a certain vendor or
critical role in recognising trends technology. We have built our
related to care and make important platform on open source
decisions about patient care and technologies.
treatment.
Security: Security is an important
Technology perspective: consideration in healthcare.
Speed: It was most apparent during Privacy is a big issue and need Healthcare providers, doctors, nurses,
the pandemic, that the speed of to be managed, especially in an frontline sta are supporting us
response was extremely important. environment where systems are across the world. New technologies
Organisations with legacy systems being accessed from home. will enable them to reach millions of
with limited capability for scaling up Implementing security and privacy others who need care, contain the
found it di cult to respond. Whereas solutions at own data center may spread of diseases, enhance care for
others with open and cloud based prove very expensive as compared the elderly and most importantly
systems were able to not only to best in class o er by cloud o er solutions to the latest
respond faster, but also o er newer providers such as Google, challenges without letting go of
services in shortest possible time. Amazon or Microsoft. that human touch.

37
 Leveraging
Technology for
Experiential Care

38
 Rajiv Sikka
Group CIO,
Medanta - The Medicity

Rajiv Sikka is the Group CIO of standardized initiatives across also an executive council
Medanta hospitals. In a career hospitals. Prior to joining member of CIOs of India, a
spanning over three decades, Medanta, Rajiv had worked in 25-year-old forum of IT
he has the perfect blend of Polaris as Senior Vice President professionals comprising
having worked across sectors for 13 years. As Enterprise multiple CIO bodies. He is
and multiple functions - Group Head, he was also on advisory boards of
initially as a technology responsible for P&L and has academic institutions and IT
solution provider and now worked extensively in multiple companies.
leading IT transformation. regions across the globe. Rajiv
In current role as CIO, Rajiv is has been featured many times
responsible for group IT across healthcare informatics
functions covering digital forums and publications, and
transformation initiatives and he is a regular panelist/
IT Operations. He formulated a speaker on digital initiatives in
five-year IT roadmap and healthcare. He is a member of
successfully rolled out multiple CII-led National AI Forum. He is

39
 There are hundreds of
touch-points in a typical
patient journey; these are both
conventional and digital.
The scale of large hospitals
makes it more di cult to
Data and digital technology provide personalized
have the potential to create a experiences at every
vastly superior patient touch-point solely through
experience and build trust conventional channels.
between patients and At Medanta, digital channels
healthcare providers. This trust bridge this gap by enabling a
in turn enables positive online consumer experience even
reviews and word of mouth before the patient registers for
publicity. Furthermore, satisfied a consultation. Patients can
patients are more engaged explore the hospital through a
with their physicians, virtual tour on the website,
proactively seek information learn more about the doctors
on their health and care plans and access a wealth of
leading to better decisions on information about their
managing their health. condition. They can also carry
out most transactional tasks;
This generally leads to these include booking online
improved health outcomes appointments, paying bills,
and experiences. It is, accessing diagnostic reports
therefore, not surprising that and using the telemedicine
harnessing and providing facility. At Medanta, digital
medical information to technologies are heavily
patients play a prominent role leveraged and supported by a
in improving clinical outcomes. 24x7 operation control centre.

40
 implemented relatively quickly for
patients isolating at home. With a
COVID led to a prolonged pandemic, doctors and
patients realized that these
phenomenal push for technologies were easy to use and
digitalization often more convenient than a trip to
the hospital. This led to its
Digital health technologies have widespread acceptance.
existed for a long time, but their
Remote devices:
adoption by health care providers
Electrocardiography (ECG) is a life-
has been limited for various reasons
saving diagnostic test for cardiac
such as unproven ROI, lack of access
patients. The pandemic made ECG
to technical resources and inter-
tests at the hospital di cult to
operability. For example, although
perform and generally meant a
the Electronic Medical Record (EMR)
greater Covid-19 exposure risk.
automates workflows between The pandemic has
Hospitals introduced an alternate
di erent healthcare entities such as
solution in the form of a medical- compelled the health
hospitals, diagnostic units and
grade hand-held ECG device. care industry to look
pharmacies, its adoption has been
The device monitors the patient’s beyond their regular
limited, making the processes
heart parameters within the comfort
ine cient and error prone. strategies
of a home and is completed in less
The pandemic has compelled the than a minute. Test results are
health care industry to look beyond available to the cardiologists in the
their regular strategies and has been hospital almost instantaneously.
driving the adoption of technology This has helped considerably in
to o er many creative solutions. reducing Covid-19 infection rates
linked to hospital visits.
Care away from the hospital:
Persistent infection rates forced These initiatives were enabled by
patients and doctors to adopt digital technologies. Furthermore,
remote consultations. Over the smart phones, Internet penetration
course of a few months, this became and their adoption by patients and
the “new normal”. Remote care givers are making digital health
monitoring solutions were also a core component of care giving.

41
 Overcoming
challenges to
digital adoption
Although digital adoption has
increased in the past five years,
it has largely been concentrated
within specific functional areas.
In India, most care providers face
challenges related to cost, privacy,
security, lack of integration standards
and connectivity.

Cost:
There is currently no dearth of
sophisticated technology solutions
The huge
that can fully support physicians in
volumes of
their goal to improve clinical
data is still not
outcomes. However, the cost of
being used these solutions is often prohibitive
very actively considering health care pricing
for treatment. points in India. This makes the
adoption of these solutions very
demanding.

Privacy:
The potential consequences of
digitization on data privacy can be
substantial and must be considered
carefully before any technological
implementation. Specifically, in a
digital environment, ownership of

42
 Security:
As in other industries, cyber security
threats are real and represent a risk
to patient clinical information
privacy.

data must be clearly established. A comprehensive data governance

Important decisions that must be is the backbone of security and
made include: directs the implementation of proven
technologies accessing and sharing
• Data ownership - should the
data securely across entities. At a
data be owned by the
minimum, the following guidelines
patient, hospital, state,
should be in place:
central government, or will it
be even a sort of collective • Data must be encrypted at rest
ownership? • Its access must be authenticated
• Data transfer between and done with consent
providers - How will data be • Audit trails should exist for all
transferred between service access
Poor connectivity:
providers and what • Data availability and resiliency
According to a recent government
governance framework must be implemented through
report, while India has over 350
would apply? technological choices such
internet service providers,
• Commercial misuse as distributed storage
prevention broadband penetration remains low.
Lack of standards for health This makes the provision of mobile-
With advancements in medical information exchange: based healthcare a challenging
sciences and technology, huge Data standardization and mission to accomplish. Under the
volumes of data are increasingly interoperability are the foundation umbrella of the National Digital
streamed from wearable devices for connecting the healthcare Communications Policy, the
using IoT into Big Data platforms. ecosystem. These are daunting tasks government is planning to provide
This data is still not being used very because they require collaboration extensive public Wi-Fi coverage
actively for treatment, but and agreement across industry within the next two years. Regulatory
diagnostics and screening processes players. Nevertheless, significant bodies such as TRAI are creating
are increasingly making use of it. progress has been achieved through models to increase the reach of
There is an increasing need for a the establishment of several mature connectivity by sharing cross-sector
regulatory policy framework for standards such as SNOMED, ICD, infrastructure with utility companies
collecting such data. This can be DRL and DICOM. Furthermore, and other organisations. The speed
done based on the work already data exchange standards such as of expansion of the fibre network
done within global best practices HL7, FHIR and C-CDA are also and the Internet will have an
such as the General Data Protection well-recognized by the exponentially positive impact on
Regulation (GDPR) in the EU. healthcare industry. “Health for All” (HEAL) objectives.

43
 The healthcare
technology market -
challenges and
opportunities
The market for health-tech solution
providers is still in its early stages in
India. With global healthcare
solutions being cost prohibitive, a
scene of local technology providers
and start-ups have emerged in India.
They o er Electronic Medical
Records (EMR) and Hospital
Information Systems (HIS) solutions of
di ering maturity levels. This has led
Technology
to a gradual adoption of technology
investments by hospitals and care providers that
will eventually have increasingly realised the
improve the benefits of digitalisation in terms of
quality of care. quality assurance and automation
at a minimum.

However, the market in India is

extremely fragmented with no clear
leader. Hospitals generally feel that
their needs are special and demand
a high degree of customisation.
This has led to the prevalence of
custom developed implementations
instead of ready-to-deploy products.

44
 Adoption of
digitalization
pays in the long run
Technology adoption is often not
financially rewarding and creates
additional burdens for small private
clinics and hospitals because of
additional allocation of human and
other resources. But larger hospitals significant funds to encourage a
and healthcare service providers wider adoption of EMR to improve
In most cases, these customised usually understand that technology health information exchange across
deployments end in failure because investments will eventually improve healthcare providers.
hospitals in India generally do not the quality of care, patient outcomes
have the experience and maturity to and reduces medication errors. India has a set of unique challenges
articulate requirements properly. It pays in the long run. to tackle. The country is large,
To be fair, hospitals are more focused heterogeneous, densely populated
Regulatory bodies must also and its healthcare infrastructure is
on running healthcare services and
understand that digital still in the initial stages. In order to be
technology implementations seem
transformation is critical for laying e ective, the digitalisation of
more like a distraction.
the foundations to achieving the healthcare must therefore be
The biggest challenges in rolling out HEAL objectives, especially within customized to these unique
HIS / EMR solutions in hospitals are primary healthcare. The government requirements. We should therefore
speed and cost, which can be much should incentivize early digital look to best practices from similar
better addressed through standard adoption for hospitals and other rollouts in other countries.
products. Additionally, the best healthcare providers. It is important that government
product players usually also provide This approach can be readily bodies and healthcare providers
best practices and regulatory noticed around the world in order to work in close alignment with industry
compliance as part of the product bring hospitals on a common experts to develop practical models
roadmap. These are important platform and increase the speed of that cover the whole healthcare
benefits that make the market quite digitization. For example, the South spectrum, from preventive to
promising. Korean government had allocated tertiary care.

45
 Home is
Where the
Elderly Belong

46
 Tarun Sharma
Founder, Yodda

Tarun Sharma is widely subsidiary of BMC Software successful IPO. Prior to

recognized as a technologist, Inc. for the last ten years. joining Virtusa, Tarun
thought leader, social worker, Tarun also served as the co-founded EC Cubed,
intrapreneur and an Chief Customer O cer for which was recognized in its
entrepreneur within the Asia Pacific and Japan, early days as the top 100
technology industry in India. responsible for ensuring companies to watch for in
He is the founder of Yodda, a customers successfully realize the B2B e-commerce space.
premium parent care value from the BMC products The company was funded
company, and the co-founder and solutions they use. by large venture capitalists
of Mgneto, an HR consulting In addition, Tarun led BMC’s like Battery Ventures, Boston
and recruiting company. engineering center in Ukraine. Millenia and Infosys and
He sits on the board of a few Cambridge Technology
Tarun joined BMC from Virtusa
companies, including Partners.
(“VRTU”), a global software
GlobalLogic India.
services company, where he
Most recently, Tarun Sharma was SVP of the technology
was the Chief Executive business and part of the team
O cer of BMC Software India that took the company
Pvt. Ltd., a wholly owned through its startup years to a

47
 Ambulances are not only late,
but often ill-equipped for
critical care on slow roads.
At the hospital, the absence of
a central medical record
administration system means
patients are compelled to
repeat diagnostic tests multiple
times, and furnish paperwork
related to their own medical
histories to doctors and care
providers. As a result, patients
say they often feel a sense of
mistrust towards their
healthcare providers.
They commonly perceive that
hospitals are solely driven by
profit, and are suspicious of

Navigating a typical hospital in doctor-recommended

India can be unsettling. diagnostic tests and high

consultation fees for the
Swamped with a high volume brief time spent meeting
of patients, overwhelmed the patient.
hospitals generally tend to
compromise on patient Patients say they feel a similar

experience. This problem is sense of mistrust towards

even more noticeable at insurance companies which

government hospitals where make the entire claims process

patient volumes are cumbersome and frustrating.

considerably greater than at For example, even in

private hospitals. supposedly cashless

transactions, patients are
For patients who need critical regularly made to wait hours
care, the troubles start even for insurance approvals. These
before they reach the hospital. unwieldy processes, long wait

48
The hospital experience is
overwhelming for most
consumers.

times, unreasonable payment

requirements, limited
availability of doctors,
perceived lack of empathy
from the hospital sta , and
many other factors make the
hospital experience
overwhelming for most
consumers.

Now imagine what it feels like

for the elderly.

With a population of 138

million, India’s elderly
population forms a sizable
proportion of healthcare
consumers who receive care in
an unfriendly healthcare
environment. Moreover,
with the dismantling of the
traditional Indian joint-family
system and a lack of a
well-developed elderly care
provider ecosystem, these
consumers and their families
want alternatives outside a
hospital setting.

49
 Elder care alternatives
While hospitals are crucial for the
delivery of critical care and
emergency services,
complementary care alternatives
are rapidly growing, especially in
home care where elders experience
less anxiety being cared for in their
own environment. Startups are
leading the charge to improve the
quality of elder care by bridging
existing gaps in the way elder
healthcare is currently delivered.
The
These startups innovatively integrate
startups are
technology with physical solutions,
innovatively digitally connecting patients with
integrating appropriate health providers, and
technology o ering home care, ease of
with physical information sharing, and simplified
solutions. processes to obtain care.
By collaborating with an ecosystem
of healthcare providers and
technology companies, these
startups have galvanized traditional
providers to transform their patient
care. For example, Sancheti Hospital,
in the city of Pune, has created
Healyos, which o ers most routine
hospital outpatient services to
people in the comfort of their homes.

50
Enriching the This experience made me reflect on
the challenges faced by millions of
lives of the elders across India living on their
elderly with Yodda own, as well as by their family
members who live away from them
Yodda was created with a singular and lack the flexibility to be
purpose of addressing the needs of physically present to care for their
the elderly and enriching their lives. loved ones. This is how Yodda - a
The motivation was borne out of my platform for family members to
own personal journey linked to my ensure the well-being and diligent
parents’ health and illnesses. care of their parents– was born.
Several years ago, when my father Our services, solutions and tools
su ered a stroke, I went through monitor health and ensure high
the excruciating experience of quality holistic care. We focus on:
interminably waiting for an
ambulance that never arrived, and Homecare:
then driving my father around in a We believe that hospitals and old
car to several hospitals before care age homes are not the right places
was available. The precious time we for elder care unless required.
lost took with it my father’s mobility Elders who receive care in the
and speech. He passed away a few familiarity of their own environment
months later. Some years later, my experience significantly lower
mother was diagnosed with breast emotional stress. Home care is also
cancer, and had to undergo logistically and financially e cient.
chemotherapy, radiation therapy, Through our partner network of
frequent diagnostic tests, and high-quality home care providers,
prolonged hospital stays. All these members can access qualified
combined made the experience doctors, nurses, care sta ,
extremely hard on us both.. medication, and health equipment.
With their permissions, their parents’
However, one thing that I am medical data is digitized and stored
eternally grateful for is the fact that on Yodda’s platform, readily
I was able to spend those last accessible to relevant healthcare
moments with them. I was lucky providers.
enough to support my parents and
ensure that care was properly Healthcare services:
provided to them. I cannot imagine When hospital visits are required,
how my parents would have Yodda provides comprehensive
managed without me physically support services, with
being there. knowledgeable attendants who will

51
 accompany elders to hospital
appointments and diagnostic tests,
provide emotional and logistical
support, make patients aware of
their circumstances and perform
on-site chores such as registration,
admission, bill payment, prescription
purchases, etc. We also specialize in
handling critical emergencies as
they arise to ensure the safety of the
parents under our care.

Comfortable living services:

In addition to health and emergency
care, we provide convenience
services to ease the daily lives of
parents and their children.
These support services include
running simple yet tedious errands in
a timely fashion, appliance and
home repairs, banking and insurance
liaising services, and more.
The issues
related Connected family:
to old-age Yodda ensures that elders
and their families constantly
loneliness and
communicate through various digital
depression
channels and provides transparency
must be
into their daily lives. In emergency
addressed. situations, Yodda provides
continuous updates to family
members and seeks intervention
and guidance where required.

Emotional support:
We address the issues related to
old-age loneliness and depression,
through community building and
engagement activities led by
special Yodda Envoys.

52
Yodda has
four unique qualities
Responsible and empathetic sta :
A lack of empathy and personal
responsibility are often cited as key
issues by patients interacting with
healthcare providers. Yodda hires
sta who understand what it means
to have a calling: former members of
the Indian armed forces, who are
trained in emergency management,
and have a feeling of urgency,
empathy and an unwavering sense We are also looking at the
of duty towards the parents we seek application of certain technologies
to serve. In addition, Yodda trains its that will enhance the overall well-
sta on how to execute various being of the elderly and connect
facets of elderly care. them with broader communities.

Well-defined processes: Relationship support:

Yodda uses ISO certified service Finally, Yodda provides a dedicated
delivery fulfillment systems and team of primary care and field care
processes, so that we deliver representatives who facilitate proper
consistently high-quality services coordination and delivery of
with e cient resources. services.

Improved care: We believe that to provide reliable

Yodda is continuously developing and consistent home care, both the
ways to enhance experiences for physical and technological aspects
the elderly and their families by of care must work in tandem.
incorporating technologies such as We built our foundation on empathy,
wearables, AI/ML, real time image transparency, and consistency to
processing, smart devices like Alexa, foster trust and enhance elder
wellness applications sensors, etc. well-being.

53
 Putting the
Care in
Healthcare

54
 Dr Bobby John
Editor, Journal of Development
Policy and Practice

Bobby John focuses on In 2004, he founded Global Bobby also worked as the
ensuring health outcomes - Health Advocates in Advocacy and Public A airs
equally at ease with processes Winterthur, Switzerland as a lead for the India o ce of
of formulation and non-governmental the Bill & Melinda Gates
implementation of organization focused on Foundation between 2010-11
development policy and engaging all sections of and as the HIV AIDS
financing, strategic society towards the Coordinator for World Vision
communications, or in the formulation and India between 2001-02.
weeds of biomedical research, implementation of e ective
development and translation. public policies to fight disease
and ill health. Today, Global
Bobby trained at the Armed
Health Advocates is
Forces Medical College, Pune,
independently registered in
but stepped out of a career
the EU with o ces in Paris and
with the Indian Army to work
Brussels, as well as in Chennai,
among the rural poor in village
India.
Kedgaon of Maharashtra,
India. He subsequently worked
as the Administrator for the
NM Wadia Hospital in Pune,
Maharashtra.

55
 In Indian clinical settings,
consumer protection covers
the delivery of specific clinical
services and expected clinical
outcomes, but not ‘patient In the early 90s, however,
experience’. For instance, if a hospitals in India took a few
patient admitted into hospital small steps towards better
for cataract surgery on the left patient experience. This was
eye is mistakenly operated on during the HIV epidemic, when
the right eye instead, the hospital administrators began
hospital is liable to pay to discuss patients’ rights,
damages for not delivering the focusing on topics such as
expected clinical outcome. whether or not an infected
However, if the surgery is individual should know their
performed correctly, diagnosis, if an individual’s
according to guidelines, but consent was necessary prior to
the patient has had to endure performing certain procedures,
a time-consuming admissions or if the individual should have
process and rude bedside the right to private counselling,
nursing care, the hospital is not etc. As a result, certain
liable for damages because regulatory guidelines related to
the basic outcome was met. patient experience were
India’s hospital operators do introduced; however, this
not see patients as consumers, positive beginning did not lead
and as a result, a positive to broader adoption across the
consumer experience is mostly healthcare sector. Today, most
accidental, and not by providers still lack focus on
institutional design. patient experience.

56
 them meals when they are in
hospital. The same disregard is also
common to other citizen services,
Challenges to such as police, emergency services,
railways, clinical services and Our collective social
achieving holistic
diagnostic services. behaviour which is not
healthcare grounded in respect for
Economic:
Based on a recent survey, the fellow humans.
According to the preamble to the
Constitution of the World Health average monthly salary in India is

Organization, "Health is a state of 32,800. However, if you examine

complete physical, mental and social median salaries, you get a di erent

well-being, and not merely the picture. The median salary in India is
16,000 month which means half the Performance measurement:
absence of disease and infirmity."
Indian population is earning less than Most hospitals in India are
Holistic healthcare must focus on
16,000 per month. This inequality overburdened by high volumes of
providing for all these aspects, but
has two significant implications. patients due to the lack of primary
there are serious discrepancies
First, that half the population cannot healthcare infrastructure across the
between what is and what should
access basic care, let alone good country, and patients self-referring to
be. Any attempt to change the
patient experience, which is only secondary and tertiary care
current state of healthcare in India
available to the privileged few who specialists. As a result, hospitals have
must take into account the complex
have the financial capacity. Second, a consultation model that allows
and interlinked underlying issues that
with such low incomes, many doctors very little time with patients.
need to be understood.
individuals in the healthcare system According to a study, it takes a
Social: are employed under exploitative doctor about an hour to note down
The absence or disregard for work conditions with little training a patient’s medical history
patient-centric care at hospitals is and guidance to deliver patient thoroughly. In contrast, another study
rooted in our collective social experience. A comparison of nurses’ has found that doctors in India
behaviour which is not grounded in salaries o ers a glimpse of this typically interrupt patients an
respect for fellow humans but driven disparity: the salary of a sta nurse average of 12 seconds after they
by an individual’s financial and social at All India Institute of Medical begin describing their symptoms.
standing. For example, patients who Sciences (AIIMS), Delhi’s premiere The dangerous implication is that
can pay will receive luxury stay medical institute, is approximately doctors, pressured to see as many
experiences at hospitals, while 50,000 per month, while many patients as they can, prescribe
patients who do not have the means nurses at private hospitals earn just treatments without taking detailed
often have to rely on family to bring 7,000-8,000 a month. patient history into consideration.

57
 The success of surgeons in the
hospital system is also measured by
metrics such as the number of
procedures or surgeries they have
performed, rather than how happy
their patients are with them.
This creates a cult of personality
with patients lining up to meet these
doctors regardless of how they are
treated. In the absence of patient
satisfaction survey metrics, the
procedure metric has become a
gold standard for hospitals
everywhere, and even the new
generation of medical professionals
end up pursuing the same success
formula.

Education:
In Europe and North America, the
The
medical education curriculum puts
consultation emphasis on developing soft skills
model allows such as empathy and compassion,
doctors very as they are known to significantly
little time with contribute to enhancing the
patients. therapeutic experience of patients
who can share their anxieties and
feel heard. In India, however,
developing these soft skills is not part
of the education curriculum.
The focus of Indian medical schools
is solely to teach clinical aspects,
resulting in a lack of awareness that
seriously limits a medical
professional’s ability to deliver
holistic, patient-centric care.

58
Creating a new,
empathetic holistic
care system
Given the complexity of India’s
healthcare system, a gradual
Reimagine medical education:
approach to transforming
Today, the criteria for someone to
healthcare could steer practitioners
enter medical school in India is
and institutions towards becoming
purely academic, and restricted to
more empathetic and
those who have studied biology as
compassionate, delivering positive
part of their higher secondary
patient-focused experiences along
education. Educators could consider
with clinical outcomes. This requires
taking new admissions criteria into
a concerted e ort to build the
account, including the applicant’s
following areas:
character and intellectual traits, such
Build an inclusive framework: as their views on being humane and
The quality assurance framework considerate, and their emotional
that exists for clinical outcomes can intelligence. In addition, applicants
be extended to incorporate patient could have multidisciplinary
experience, provide transparency in educational backgrounds, including
the healthcare delivery process, and engineering and humanities. For
recommend guidance and remedies example, a medical graduate with
for any lapses. Such a framework an undergraduate degree in
could also address the unhealthy computer science would think of a
dynamic that currently exists human-centric approach to
between providers who treat designing AI solutions for healthcare.
patients based on their ability to pay, Lateral entries from other
and patients who are suspicious of educational disciplines enrich the
the treatments prescribed by medical system by bringing fresh
providers, especially when they approaches to solve traditional
include expensive diagnostic tests. problems.

59
 It is important that students in the
medical education system
understand human relations and
feelings, and have the maturity and
empathy to deal with them.
A first-year student who has joined
Although right after senior secondary school
healthcare is might lack this maturity,
considered a understanding and experience, even
collective if they are academically proficient.
e ort, 80% of By making undergraduate studies a

its workforce is mandatory prerequisite to medical

studies, students will gain the
disproportiona
maturity that gives them a better
tely underpaid.
understanding of people,
relationships, and of their own
propensity for a care-oriented
profession.

Apart from medical education itself,

institutions should also o er certain
foundational credits in the
curriculum that are required for
completion of the degree.
Courses on topics such as human

60
centred design, individual dignity,
compassion, empathy, bedside
behaviour, etc. should be o ered for
all disciplines of study. In addition, all
course content should be revised to
focus on patient experience by
emphasizing human empathy.

O er equitable compensation:
The paradox is that although
healthcare is considered a collective
e ort, 80% of its workforce is
disproportionately underpaid.
A new payment mechanism would
ensure equitable salaries and aggregate data across time and

benefits that would go a long way space with a single platform that

in not only stemming attrition and captures their historical medical

extortionist behaviours, but giving information, rather than patients

dignity to underpaid workers who and doctors having to spend their

spend more hours on the hospital valuable time capturing this

floor caring for patients. information again and again every

time they change hospitals or
Build a technology platform: doctors. This can also help doctors
Although there is huge potential for make informed decisions within the
the application of technology to limited time available to meet the
improve the patient experience, patient. A corollary to the lack of
adoption is limited and time is the issue of triage, i.e.
heterogenous, with highly localized examining the patient’s history,
systems that do not allow identifying the potential issue,
information sharing between inputting the symptoms and
providers. A universal technology diagnoss, and accordingly directing
platform can be enabled to address the patient to the right department,
many critical challenges that are where care can be given in
putting hospitals under such pressure accordance with the system
today. For example, a national data provided.
universal patient data platform can

61
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