Currently 1.3 Billion.

Projected at 1.5 Billion by 2022

Source: World Population Prospects, 2015 Revision, UN Population Division

 Ranked 143 in the world among 188 countries.

Source: The Telegraph

Comparison with Nepal, Bangladesh and Vietnam
 Fast growing population
Lack of or inadequate Infrastructure
Paucity of Manpower (Doctors, Nurses,
Paramedics)
Changing disease profile and Re-emerging
diseases
Extremely Low Public Expenditure on Health
and its Inefficiencies
Out of Pocket expenditures
Inaccessibility of Healthcare Services
 Rural population 72 % of
total population.

Access to hospital beds

34% of total beds.

32 % of rural people travel

over 5 Kms for OPD care.
 Communicable diseases have
reduced.

While Non-communicable
diseases have drastically
increased.

Emergence of newer diseases.

Reemergence of TB and
increasing Drug resistance are
major concerns.
 NCDs contributed to an estimated 53% of all deaths
in 2014

Major Cause: Lifestyle and Behavioral changes

Altered working conditions,
Increased pace of life and stress levels
Modifications in dietary patterns
Decreased physical activity,

Simple interventions to lower NCD risk factors

can reduce pre-mature deaths by half to two-
third
 Doctors Nurse
Staff: patient ratio 1:1681 1:1100

WHO stipulation 1:1000 1:500

Shortage 0.4 million 2.4 million
 Ever Increasing Demand.
Improving economic conditions-
Affordability.
Non-communicable diseases : Chronic Care.
Increasing healthcare infrastructure
Investment.
Focus on Tier-II and Tier-III cities.
 Healthcare accounts for 4.3% of GDP

Healthcare delivery i.e. Hospitals, nursing homes,

diagnostics centres, and pharmaceuticals,
constitutes about 75% of this market.
 3 million beds needed to achieve the target of
3 beds per 1,000 people by 2025.
1.54 million doctors and 2.4 million nurses
required
Investment of USD 86 billion required to
achieve these targets.
Source : Deloitte Global Healthcare outlook
 Traditional Modern
APPROACH One Size Fits All Personalized
INFORMATION FLOW Fragmented, One way Structured, Two-way
FOCUS Provider Centric Patient centric
LOCATION Hospital-based Decentralized,
Community-based

TREATMENT Specialized Collaborative

DECISION MAKING Based on Individual Shared Information
Expert Based on Protocols
and Analytics

OBJECTIVE Treating Sickness Preventing Sickness

(Wellness)
 Personnel shortages
Health reforms
Technology changes and adoption
Financial challenges
Patient safety & quality
Care for the uninsured
Physician-hospital relations
Patient satisfaction
 Capacity Management

Inventory and Materials Management

Demand Management

Supplier Relationship Management

Customer Relationship Management

Information and Technology management

 Acquisition and allocation of resources:
Work force
Equipment &
Facilities.

Inability to manage capacity leads to

Revenue loss
Delays
Operational Inefficiency and
Patient dissatisfaction.
 Facility location and aggregate
capacity size
Facility Size of inpatient care units
Inpatient admissions scheduling
Surgery scheduling

Hospital staffing
Assign workers to shifts, units and
Workforce
tasks
Managing disruption(Rescheduling)
 Managing Level of equipment, supplies and
devices

Objective:
Avoid shortage (or stock-out) of Medicines &
Equipment
Reduce Overstocking
Sorting Medicines
Arranging Stock
Generating Bills, Stock & Sales Reports
Avoid wastage due to Expiry
 Telemedicine

EMR/EHR

mHealth

RFID

Data Analytics and AI

 Use of IT and Tele-communications
technology to provide clinical healthcare.

Advantages:
Improved access
Reduced costs
Reduced waiting times
Increased Productivity of
employees

Applications of Telemedicine.
 Application of wireless and mobile technologies such
as mobile phones, sensors, monitors to provide
health services.

mHealth Applications Global

Treatment Service Access
Remote
Chronic disease treatment
management Dissemination of
Diagnostic Remote Clinical health
POC Diagnostics trials information
Portable imaging Disaster Disease
support/care surveillance
Biomarker sensing
Measurement Clinical decision Medication
tracking and
Sensor sampling in making safety
real time Prevention and
Integration with wellness
health data interventions
Radio-frequency identification (RFID) uses electromagnetic fields to
automatically locate and track tags attached to objects.

Locating and
Inventory
Tracking
Management
Equipments

Patient tracking Infection

(Location and control
Discharges) (Monitoring )
RFID Applications
 Improved Staff
and Resource
planning

Disease Identify high

patterns and risk patients to
outbreak provide early
predictions interventions.

DATA
ANALYTICS

Clinical
Predicting Decision
Readmissions Support
Systems.

Individualized
care based on
patient profile.
 Indian Healthcare

2. Improved quality and low cost attracting

1. India ranks 143 in healthcare Index
medical tourists to India

3. India faces severe shortage of skilled nurses and doctors

Changing Technological Landscape
 Ranked 143 in the world

Source: TheTelegraph
Comparison with Bangladesh, Nepal and Vietnam
 http://www.populationconnection.org/how-and-when-india-
will-overtake-china-in-total-population/
https://www.telegraphindia.com/1160922/jsp/nation/story_109
573.jsp
http://www.hindustantimes.com/india-news/targets-fixed-15-
years-ago-fact-check-on-repackaging-of-national-health-
policy-2017/story-1FbjE6PnKSMed1C6mp56II.html
http://www.sesric.org/imgs/news/image/729-pres-5.pdf
http://medcitynews.com/2013/12/rfid-big-data-intersect-
texas-hospital-pointing-future-healthcare/?rf=1
https://hbr.org/2015/12/how-rfid-technology-improves-
hospital-care
http://tapasvan.me/what-is-telemedicine-by-american-
telemedicine-associationata/
 Non-communicable diseases. NCDs represent an important high-volume
and high-value opportunity. These accounted for nearly 53 per cent of
mortality in 2009-10. Average bill size for NCD hospitalisation was
nearly 50 per cent higher than the remaining in 2004-05. For the
hospital, the lifetime value of the patient will go up at no incremental
capex.
Non Metro urban market. This geographic segment will provide a large
opportunity even for secondary and tertiary multispecialty hospitals. The
business model for these hospitals will need to be adapted to lower
costs, and staffed with a different doctor pool.
The urban poor. This is the segment in which the private sector has the
lowest penetration. Less than 50 per cent of hospitalizations take place
in the private sector. This cluster will represent 10 per cent of Indias
population by 2022, and could represent an interesting source of growth
in metros.
Government sponsored social health insurance programs. This
opportunity, combined with the one above, will open doors to a hitherto
underserved population. These schemes had provided hospitalisation
cover to 183 million people by 2009-10. Early examples indicate that it
is possible to develop low cost facilities to focus on such program.
 First, invest in business model innovation.
Corporate chains will require different modules within
their network - with different levels of capex,
equipment usage, doctor models, non-healthcare
services and utilities, and modes of payment.
Second, maintaining profitability and ROIC18 in the
existing facilities through greater operation efficiency
and optimisation of capital [Exhibit 12].
Third, collaborate with other stakeholders in private-
private partnerships to plug leaks in patient funnel.
This requires solutions that increase awareness,
improve access to diagnostics, improves follow-up
on referrals and strengthens trust amongst patients.
 empowering people through enhanced health literacy and engaging patients in
clinical decision-making, self-management, care planning, provider choice, within
reasonable limits, self-monitoring and self-treatment; particular attention to
empowering and engaging vulnerable and marginalized populations can help to
address inequalities in access to care and care outcomes;
building capacity to restructure public health services so that they can respond
effectively to public health emergencies and deliver better occupational and
environmental health, and safe and healthy food and nutrition;
ensuring a comprehensive continuum of services with strengthened primary
health care as the provider hub and first contact point for people, coordinating
services from health promotion, health protection, disease prevention, diagnosis,
treatment and long-term rehabilitation to palliative care;
moving away from traditional modalities of service delivery, for example by
empowering people to self-manage their chronic conditions, modernizing
evidence-based guidelines and standards, developing care pathways flexible
enough to meet individual needs, promoting the appropriate use of medicines and
other health technologies, and redesigning the role of hospitals;
Promoting coordination among professionals and services, including pharmacists,
social and long-term care and informal carers, to ensure continuity of care and to
remove barriers to access to needed care;
managing processes for quality and better outcomes through effective
intersectoral action and regular monitoring of performance, including systematic
feedback to providers.
Tele-mentoring
 Lack of personal
touch
Reduced care
continuity

Applications of Telemedicine.
 Inventory Management
Capacity/Demand Management
Human Resource management
Supply management
IT management
Customer Relationship Management.
 Improved Staff and Resource planning
Identify high risk patients to provide early
interventions.
Clinical Decision Support Systems.
Individualized care based on patient profile.
Predicting Readmissions
Improve clinical trial design
Disease patterns and outbreak predictions
 Capacity Management
Acquisition and allocation of resources:
Work force
Equipment &
Facilities.

Inability to manage capacity leads to

Revenue loss
Delays
Operational Inefficiency.
Interaction at Tata Main Hospital,
45
Jamshedpur
Inventory & Materials Management
Managing Level of equipment, supplies and
devices

Objective:
Avoid shortage (or stock-out) of Medicines &
Equipment
Reduce Overstocking
Sorting Medicines
Arranging Stock
Generating Bills, Stock & Sales Reports
Avoid wastage due to Expiry
Interaction at Tata Main Hospital,
46
Jamshedpur