What is the difference between a healthcare brand and any other brand that you come in touch with? “When all other brands have specific touch points, it is not with you through out. However, when healthcare touches you, it touches you for life. I think healthcare brands have so far failed in keeping that promise of continuity of care,” answered Dr. A. Raghuvanshi, Vice Chairman, MD & Group CEO, Narayana Health (NH), Bengaluru-based multi-specialty hospital chain.
At a very basic level, there continues to be crying need for more and more hospitals that deliver the fundamental aspects of healthcare – good patient care and top-notch doctors. “When we were trying to rebrand ourselves, I looked at websites and mission statements of several healthcare providers across the world and all of them said care for patients,” recalls Dr. Raghuvanshi. While he agrees that it is important, he believes that it is also important to keep people out of these hospitals and the industry is just waking up to that.
He also highlights the importance of information technology in the healthcare industry. “Healthcare is one industry which does not use technology at all. If you remove the IT, none of the industries – be it stock exchanges or airlines – will function. But in healthcare, the only technology we use is in our equipment and none of the other functions in healthcare are using technology the way it is meant to be,” says Dr. Raghuvanshi. But, it is gradually changing and mobile technology is going to be the future.
Understanding the environment
There is a demand and supply mismatch in healthcare and that makes the industry very complacent. “We do not think we need to do things better, we don’t think we need to do things differently and we do not utilise technologies which are fairly simple,” says Dr. Raghuvanshi.
There is also a huge inequality across the states and most hospitals face issues with respect to human resources. The industry is short of almost 200,000 doctors in this country. In fact, it is quite surprising to note that at any given time there are 100,000 MBBS doctors who are a loss to the system. “This is because there are 43,000 seats in MBBS courses across the country but only 17,000 seats for PG courses. Every young graduate today wants to become a PG specialist doctor,” says Dr. Raghuvanshi. These students have to sit for common entrance exam which many of them do not pass due to the limited number of seats. Almost half of the candidates, who could have been offering primary care, are a loss to the system. “A lot of policy initiatives need to be taken here,” says he.
Accessibility and affordability, the key
Accessibility and affordability are two issues that the industry is burgeoned with. If it is not addressed, especially in a country like ours where a huge number of people are below the poverty line, the industry cannot progress. This is the environment in which brand NH was born and Dr. Devi Shetty, chairman and a cardiac surgeon, and his team built this brand based on this realisation. “And the only asset we had was the passion and the skill which we had acquired,” states Raghuvanshi.
When Dr. Devi Shetty returned from the U.S. in 1989, he started to practice in Kolkata. He used to see about 100 patients everyday and not one of them would come back for surgery. This is not because they didn’t want surgery but they could not afford surgery. Shetty realised that the healthcare problem in India was more of an economic problem than a clinical or technology or skill-related one.
Dr. Raghuvanshi too recalls his medical practicing days. A pediatric cardiac surgeon by profession, he says, “When a young mother comes with a small baby in her arms to see me, when you tell them that your baby needs surgery, the first question they ask you is not whether he is going to be alright or how much time is it going to take for him to get better. The first question is how much is it going to cost. And when you hear that question, every day, it gives you a sense of anxiety and can also be your inspiration to do something.”
Shetty and his team decided to do something about this situation. He believes that if a solution is not affordable, then it’s not a solution at all.
The hospital was not set up with an intention of creating a healthcare brand. “We didn’t start this enterprise because we wanted to go across the world. We started it simply because we wanted to create a space for ourselves to be able to do the quality of work in an environment which we thought was appropriate for our patients,” recalls he.
The first heart surgery was done over a 100 years back but even today only 8 per cent of the world’s population can afford heart operations. In the U.S., every year, there are approximately 400,000 cardiac procedures (not angioplasties) taking place while in India, with a much larger population, has only 120,000 cardiac procedures taking place annually. “So you can imagine the requirement,” says Dr. Raghuvanshi.
With such a background Dr. Shetty set up Narayana Hrudayalaya (now known as Narayana Health) in Bengaluru and Rabindranath Tagore Institute of Cardiac Sciences in Kolkata in 2000. “Once we started, we realised that it was important for us to be economically relevant and viable. We have CT scans and MRI machines, but we needed to utilise it optimally which cannot be done if we provide only cardiac care,” recalls Dr. Raghuvanshi. So NH became a multispecialty provider and today has 26 hospitals with close to 6,900 beds and 13,000 people working in the organisation. It is currently present in 16 cities and has 1,500 doctors.
“As we grew organically, we ended up having a very confused brand. Even today, I am sure most of you do not look at NH as a brand that is a chain present across the country with a number of hospitals,” says Dr. Raghuvanshi. NH had various forms of logos and identities and people always confused it as a heart hospital. The organisation also had some other issues. When it went international or to the Northern parts of India, people could not pronounce Hrudayala. So, Narayana Hrudayala was renamed to Narayana Health.
The management team also did a formal exercise with its people and articulated its vision and mission so that the message does not get lost to people who are a part of NH, which is a very rapidly growing organisation. “There is always a risk of losing your core values when you have a whole lot of people joining you from different backgrounds and different cultures,” shares Dr. Raghuvanshi.
Technology, leading the way
Today, NH is present in many parts of India though its focus is primarily on Eastern and Southern India. The hospital does have a presence in the North as well and is trying to develop a cluster around its Northern and Western centers. “We are building a children’s hospital in Mumbai and want to build a cluster of other units around that as well,” shares Dr. Raghuvanshi.
The organisation again articulated its core values to all its stakeholders recently. “They are core to any industry but becomes even more important to healthcare because of the effect it has on people’s lives and it is not only the person who receives care but also all the people who surround that person,” says he. While all these efforts have led to a lot of awards and recognitions, what is important is its consistency in performance.
Going forward, NH is trying to use technology as much as possible to improve the healthcare standards. One of the major efforts that it has done in recent times, for which it has finished a pilot and is running across its network, is a project called iCare. This is an iPad-based application where the entire critical care data of the patient gets directly populated on to the device. Going forward, NH as a group believes that technology is going to play an important role in its progress and is now working towards embracing it into its processes.
Healthcare touches you for life
Demand supply mismatch has made the industry complacent
Most hospitals face issues with respect to human resources
Accessibility and affordability are two issues that the industry faces
Even today only 8 per cent of the world’s population can afford heart operations
Dr. Devi Shetty Set up Narayana Hrudayalaya (now known as Narayana Health) in Bengaluru and Rabindranath Tagore Institute of Cardiac Sciences in Kolkata in 2000
Later, NH became a multispecialty provider to become economically viable.
Narayana Hrudayala was renamed to Narayana Health
NH’s primary focus is on Eastern and Southern India. It does have a presence in the North and is trying to develop a cluster around its Northern and Western centers.
It is building a children’s hospital in Mumbai and wants to build a cluster of other units around that as well
NH aims to use technology as much as possible to improve the healthcare standards. Launched an iPad-based application called iCare.