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Healthcare Delivery

Working towards a Lean Healthcare system

With the increasing emphasis on the application of concepts of lean management in hospitals across the world, gaining popularity as ‘Lean Healthcare’, Value Stream Mapping (VSM) is an elementary tool that allows one such implementation. The common principle behind lean management is ‘to do more using less’. The VSM model is particularly designed for hospitals and healthcare settings that have a direct influence on the admission of patients and their time of treatment. This article presents a case study of a tertiary care hospital of India where the ‘Lean transformation-VSM’ of the ‘Patient-admission’ process is administered for the reduction of time taken by the admission process. Efforts were made to reduce the admission of the patient for making the process smoother and faster when compared to the existing process in the hospital.

The first step involved in the experiment was to gather information of existing patient admission process followed in the hospital by: Direct observations, Interviews and Patient follow-ups. A comprehensive study of the patient admission operations was accomplished, which was later successfully utilized to recommend improvements to reduce delays. Analysis of the existing state was done using a ‘time-motion study’.

The non-value-added steps were identified in conducting the ‘Root-cause Analysis’ of every step involved in the patient admission cycle. A new process was designed by syndicating them, streamlining or reviewing the categorization of events to support greater competency or even discarding few steps. Efforts were made to implement the ‘Modified value stream process map’.

The result was astonishing! The entire experiment helped in bringing down the time of whole process of admitting the patients from an average of 25 minutes per patient to 15 minutes per patient. The hospital was able to achieve almost 40% of reduction in overall patient’s time for their admission process. This in turn offered the hospital with the earnings of higher patient satisfaction.

The understanding of recreation and the steps involved in conducting this recreational study built a strong groundwork for verifying and validating the simulation model-VSM.

John F. Kennedy said ‘We must use time as a tool, not as a crutch’. Efficient optimization with the help of Lean Management can enhance not only the operational efficiency but also the quality of care provided to the world. The experiment was just a drop into the wide oceans of Lean!

About the Authors


Dr. Feroz Ikbal
Assistant Professor,
Tata Institute of Social Sciences Mumbai campus
EmailID: feroz.ikbal@tiss.edu


Dr. Megha Jogi
Master of Hospital Administration (MHA),
Tata Institute of Social Sciences Mumbai campus
EmailID: meghajogi9@gmail.com
With the increasing emphasis on application of concept

Categories
Healthcare Delivery

Lack of collaboration and communication, reason for the mess in the healthcare system in India

It was revealed that India has only 938,861 registered allopathy doctors or just seven doctors per 1,000 people, per a report released by health minister J.P. Nadda. So not surprisingly most discussions in healthcare today are around ways and means to build more infrastructure and increase access to care. Indian healthcare was ranked 112th in the world in a survey by the WHO. So there is a sense of urgency to improve our care standards. Many startups have sprung up in the healthcare space promoting better health and preventive care. Investments are pouring into the country; new state of the art hospitals are being set up. Digital is the new mantra and we are soon going to live happier and healthier lives.

Categories
Healthcare Technology Public Health

Why Internet of Things (IoT) makes sense for Healthcare

Internet of things dominated my world this week as I participated in Liveworx16. Liveworx is the signature event of Thingworx a PTC company. PTC Chairman and CEO Jim Heppelmann  has taken a big gamble by integrating the traditional industrial design strengths of PTC with a up and coming technology area like Internet of Things (IoT)

The event saw a curious mix of CAD/CAM experts who were trying to understand how IoT was going to help them mingling with IoT experts who had already implemented a few projects and were looking to consolidate on their early mover advantage. But one Industry that is looking at IoT very seriously is healthcare. Yes you heard me its healthcare, and may even leapfrog other industries when it comes to IoT adoption.

downloadBut then why should healthcare look at IoT?

Well that is a good question that is being asked by many hospitals and rightfully so. Hospitals have a duty towards their patients, community, physicians and staff and the last thing they want to do is to embark on a new technology for the sake of technology. But before we look at why IoT, we should probably try to understand the origin of IoT.

Some might argue that IoT is not new, maybe the patenting of the passive RFID in 1973 was the origin of IoT. By the 1980’s many manufacturing units were already connected. Some others like consumer goods were using a form of IoT. For example Coke was using a similar technology with its vending machines in 1980’s which was invented at the Carnegie Mellon University. 1980 was also the year CERN launched World Wide Web (WWW) and the internet was born. By 1990’s Wal-Mart had mandated all organizations that are displaying their goods to have advanced RFID chips. This had led to the famous spat between P & G and Wal-Mart. I am not sure who blinked first but for a while P & G was off the shelves at Wal-Mart.

By 2000’s we started connecting devices to the internet. Power grids and Energy companies started systems which were talking to each other. Soon cell phones were connected and then by 2008, we saw the inflection point on the number of connected devices. Today we have wearable devices that can send your physiological data to your physician that can help him or her track your health parameters like BP and sugar levels.

IoT in India is not new either. I know for example a hospital in Delhi-NCR region  had ambulances with  antennas on its top, ECG machines, and monitors along with physicians in the ambulance. This way despite the traffic jams in India, the critical records of the patients would arrive at the ER and the physicians and surgeons would make the necessary preparation for stabilizing the patient and save valuable time that otherwise they would have wasted in these tests. At that time Rajesh Batra who was head of technology, was able to make this work and get the physicians and management on board by demonstrating the value of IoT in an ambulatory set up.

“IoT has the potential to improve care” says Rajesh Batra , “But we need to be careful about security as it very easy for a breach which would be dangerous for a hospital”

He continues the same zeal in Kokilaben Hospital in Mumbai where he currently is the CIO. He is also looking at integrating IoT with emerging areas like Omni Channel with iBeacons to give a truly connected experience at the hospital.

As I have written many times in the past, we in India have this unique opportunity to create a new healthcare model that can help 1.3 billion people manage their health. I think an important component of that is population health.

Now a hypothetical population health program could work on the principle of a hospital enrolling a set of patients who need chronic care, let’s say for example diabetes into a program. The program entails these patients to check their sugar levels regularly and through IoT their sugar levels get updated into a program dash board that the physician can see. If the sugar levels are within the parameter then there is no incident. But if the sugar levels rise or fall outside of the normal range. Then the system alerts the physician. The physician would check if this is one off case or is there is a regular pattern. Based on this he or she can intervene and schedule a checkup and enter the same in the record.

download-1-250x179Now this is a simple example, but helps us to understand how a potential IoT solution could work in population health. It would not only help in tackling chronic diseases in India, but could serve as the only option in tier 2 and tier 3 cities where access to hospitals is not available.

In subsequent pieces I would like to explore more areas in healthcare where IoT could have implications. I definitely see some Medical Devices companies taking the lead in this space. Also concerns around security need to be addressed, but would love to hear your views as well on this topic.

Categories
Healthcare Delivery

India Hospital Reviews: Helping People Make the Right Healthcare Decisions

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In an age of apps, listings and instant ratings, it’s quite ironic that while we wouldn’t think twice before reaching for a Zomato to decide on the best coffee, we almost always blindly walk into a hospital without showing much concern for its credentials or past records.

With several international players entering the healthcare market in India, customers have access to world class treatment but it often comes at sky high rates, even for basic consultation. Compare this with regular nursing homes and one is plagued with issues regarding hygiene and conduct. Given that most lifestyle decisions today are based on reviews and ratings- from food and travel to even groceries and plumbing- it seems only too natural and essential to have a transparent hospital rating system accessible by anyone looking for quality healthcare in India.

Categories
Healthcare Delivery

Havells all set to enter the Indian Healthcare market

 

Yes that’s not a typo, Havells India the manufacturers of electrical equipment are all set to enter the tertiary healthcare sector in India.

The Havells brand is owned by QRG enterprises and they already run a tertiary care center in Faridabad. So they have some experience in the running of a hospital.

In the next 2-3 years we would see 5-6 hospitals set up by QRG in the NCR region in northern part of India. The company plans to raise debt to fund this diversification and fund the balance with internal cash reserves.

QRG enterprises plans to set up the chain under the name ‘QRG’ and plans to invest more than Rs 1000 crores into this push. It will start with the Rs 250 crore 450 bed super specialty hospital in Faridabad called ‘QRG Health City’.

Now this is not the first time that a business has ventured into Healthcare.

Apollo Tyres entered the Healthcare business under the brand Artemis and has a healthcare set up in NCR. There have been other examples of such diversification.

There are many reasons why businesses like to enter healthcare

Firstly the healthcare business is recession proof.

Secondly the Indian healthcare sector is set to expand to Rs 280 crores in 2020 with a CAGR of 12%. There are very few sectors that will have double digit growth.

Thirdly the demand for healthcare is going to expand rapidly and the revenue cycles are faster as most of healthcare is paid for by patients from their pockets. So the revenue realization is much faster for this sector in India.

 

but is this a viable option for businesses to take? Enter Healthcare at your own peril is my take on the matter, but what do you think about it? Please do let us know…