How Digital Innovation and Transformation played a crucial role in Manipal Hospitals' Pandemic Response
By Arunima Rajan
In an exclusive interview with Arunima Rajan, Karthik Rajagopal, Chief Operating Officer, Manipal Health Enterprises Pvt. Limited, talks about how Manipal embraced digital technology to overcome the pandemic's hurdles.
The pandemic has severely tested all organisations' resolve and resilience, and hospitals have been no exceptions. Hospitals had an added dimension given the need to be in the frontline of dealing with the virus. At Manipal Hospitals, the pandemic also brought out options to innovate and learn, collaborate across boundaries, and fast track technology adaption– including digital routes, many of which would outlive COVID-19 and influence healthcare facilities function in the future.
Considering the travel curbs, social distancing norms and other behaviour changes influenced by the pandemic, Manipal Hospitals introduced a patient app with a video consultation feature in-built, besides several other options that provided digital routes of engaging with our hospitals. About 15% of their out-patients have already moved to this app, and they expect this to grow to 20% over the next year. The ease of use and transparency that such services provide have contributed to high rates of patient adoption.
Karthik Rajagopal, Chief Operating Officer, Manipal Hospitals
Karthik Rajagopal, COO, Manipal Health Enterprises Pvt. Limited elaborates on this and more.
What are the lessons (few important things) that your hospital has learned from practising medicine in 2020, and how are you making sure that you are prepared next time?
The healthcare industry has seen a dynamic shift in practices during the pandemic, as the segment needed more flexibility and accessibility to meet the need of the hour. The pandemic led to the widespread adoption of digital technologies in the healthcare segment. From teleconsulting platforms to e-ICU provisions, advanced ambulance services with live streaming remote monitoring systems, to full-fledged mobile-friendly apps for patient care, Manipal Hospitals has openly embraced digital technology and intends to explore new avenues/more possibilities to enhance the digital health ecosystem. This is one of the critical approaches that can assist in tackling potential pandemic in the future.
Telemedicine got a clinical spotlight due to COVID. Has the system adapted to telemedicine?
Telemedicine platforms have been recent adoption by the patients and the healthcare segment during the pandemic. Convenience is the key factor that has caused the rapid adoption of telemedicine. While the concept is relatively new in India, there is an increase in the adoption of teleconsulting platforms by about 50-95%. The Government introduced even a unique programme the National Digital Health Mission (NDHM) programme to produce all the healthcare-related documents online. Observing these latest developments in India, Manipal Hospitals emphasises evolving in the telemedicine space and has taken extensive steps to adapt to this trend. There has been a rise in demand of up to 50% patrons for telemedicine at Manipal Hospitals, and all the healthcare centres have the resources to handle the demand. And some of the patient segments like senior citizens, expectant mothers etc., would get necessarily triaged to the tele-consulting space and would need to make physical visits to the hospitals only when absolutely necessary.
How has the pandemic impacted your financial bottom-line? How can one mitigate such risks in the future?
The first six months of 2020 saw a reduction in nearly 15% revenues than the preceding year. There was an even more significant impact on EBIDTA. However, as the pandemic waned from October onwards, we witnessed non-COVID patients returning for elective procedures. As domestic and international travels get normalised, we expect the sector to resume its earlier growth path. We may have lost a year in terms of growth trajectory; our FY 21 plans may get pushed to FY 22. However, the healthcare sector's primary features that attracted us and several others to invest remain unaltered. These features relate to the population's size, demographics, morbidity patterns, and the increase in access and affordability. We also do not see anything dramatically changing in the long term outlook for the sector.
What changes do you foresee in the healthcare delivery business model?
The pandemic brought out options to innovate and learn, collaborate across boundaries and fast track technology adoption – including digital routes, many of which would outlive COVID-19 and influence how healthcare facilities function in the future.
One such healthcare delivery model includes a mobile-friendly patient app, which enables the patient to get the tests done at their residence, upload the medical reports on the mobile app, receive the doctor's decision on the next steps for treatment virtually, and evade the need to travel for every consultation, they are favoured by the general public. Outstation patients across the country and international markets who are confined to their natives find this extremely convenient and resourceful.
Teleconsulting is another area that is set to play a significant role in the future in terms of accessing secondary and tertiary care in tier 2 and 3 towns and villages. Teleconsulting will also be highly favoured for their time conserving process and global access.
Enumerate three structural changes to improve healthcare delivery in India?
Primary healthcare: The ratio of allopathic doctors in India is comparatively less compared to other developing countries. There is a need to overcome it and improve primary healthcare delivery in India. While there is a primary healthcare centre established, the healthcare delivery to the smaller towns need to be formed. Telemedicine is undoubtedly an effective method. However, there is a need to explore more technology in primary healthcare delivery.
Maternal Care, Infant Mortality Improvement: In smaller towns, Antenatal Care (ANC) plays an essential role in a healthy pregnancy and safe childbirth. There is a need for ANC, Asha workers to receive training to improve the medical outcome. Programs to be conducted involving a super-specialist to train them and save multiple lives. Additionally, there is a need to provide relevant and trusted content to expecting mothers through virtual platforms, educate them about the symptoms and ensure a timely visit to the hospital.
Transforming from Illness to Wellness: Lifestyle diseases are increasing, in the form of diabetes, hypertension, and cancer, to name a few. This is spreading among both the higher and lower stature. While the healthcare budget announced 64,180 crores towards preventive healthcare, there might be a need to increase that budget as the burden of lifestyle diseases is exceptionally high. The focus needs to enhance towards preventing lifestyle diseases as the cost of treatment is 16 times higher than the cost of prevention. This also requires a change in the mindset of the population. The larger population will need to see significant benefit in making preventive health checks a necessary part of their health regimen.
Universal Health Coverage: The country is embarking on achieving universal health coverage. Every individual in India can be entitled to comprehensive health security. There is a need to prepare a strategy that can ensure that people across the country gets healthcare delivery.
What role should the Government pay going forward?
The Government has provided us with an exemplary healthcare budget that lays a strong foundation for the healthcare segment to progress in primary, secondary and tertiary care facilities. The key focus needs to be on execution, as per the roadmap that the Government has framed.
What are the measures you are adopting in your hospital to protect against COVID beyond masking and social distancing?
Manipal has set up separate wings for the treatment of COVID and non-COVID patients with separate entrances. With our in-house app's assistance, patients update the symptoms of their medical conditions and fix their appointments accordingly. Patients are provided with time slots to avoid overcrowding. Contactless registration is one of the practices initiated. Additionally, to reduce the queue at pharmacies, a few of our pharmacies have a provision of packing the medicines prescribed and directly handing them over to patients. A drive-in facility has also been organised for people to give their blood samples to clinical laboratories without physically entering the hospital premises. Besides this, our home care offerings have been significantly enhanced, and home isolation packages for mildly symptomatic patients have been introduced. These Home isolation packages will have a role to play even after the pandemic and could be used to care for patients who would otherwise have needed Hospital admission. We are trying to make the experience of a hospital visit as seamless as it may be for a patient and make it more and more patient-friendly.
What were some of the tech innovations that helped your organisation in the battle? Anything that you want to acquire or is on your wish list?
Our in-house mobile app Manipal Hospital helped our patients soldier through the pandemic by providing a wide range of healthcare services with its 10-20 unique features, including a billing system. For any medical procedure, be it consultation or surgery, the payment link can be sent to the concerned person, which allows them to pay it from whichever part of the world they are in. This definitely helps in elderly care as the children or the caretaker may not be accompanying the patient physically to the hospital. It seems hassle-free for the patient to quickly move out of the hospital to complete the consultation, admission, or procedure. More features like wearables that monitor the patient's health much after leaving the hospital are on the anvil. We expect the app to become the single largest source of patient interaction outside of physical hospital visits. About 15% of our out-patients have moved to this app, and we expect this to grow over 20% by this year. The ease of use and transparency of such services provided have contributed to high rates of patient adoption.