Overview Healthcare Sector in India
The Indian Healthcare Sector is expected to reach US$100 billion by 2015 from the current US$ 65 billion, growing at around 20% a year, according to rating agency Fitch. Some of the major factors driving the growth in the sector include increasing population, growing lifestyle related health issues, cheaper cost of treatment, thrust in medical tourism, improved health insurance penetration, increasing disposable income, government initiatives and focus on Public Private Partnership (PPP) models
- Hospital and diagnostic centres FDI inflow was US$ 1.3 billion during April 2000 and March 2012, according to the latest Department of Industrial Policy & Promotion (DIPP) data
- Medical and surgical appliances FDI inflow stood at US$521.6 million during the same period, according to DIPP data
- The drugs & pharmaceuticals sector has attracted FDI worth US$9.2 billion between April 2000 and March 2012
- Medical tourism in India has also received a boost with arrival of patients from countries with advanced medical system. This underlines the fact that India has good infrastructure and talent. According to a new report by RNCOS, titled “Booming Medical Tourism in India” India’s share in Global Medical Tourism Industry will reach around 3% by end of 2013. The report states that medical tourism is expected to generate revenue around US$ 3 billion by 2013 growing at CAGR of around 26% during 2011-2013. The number of medical tourist is expected to grow at a CAGR over 19% during forecast period to reach 1.3 million by 2013
- The Indian health insurance market is also on upsurge providing lucrative growth avenue for both the existing players as well as the new entrants. According to RNCOS report, the health insurance market is one of the fastest growing & second largest non-life insurance segment in the country. Posting tremendous growth in last two fiscals, the health insurance premium is expected to grow at a CAGR of over 25% for period spanning 2009-2010 to 2013-2014.
According to a survey conducted by consulting firm, Grant Thornton, India is expected to witness largest number of mergers and acquisitions in the pharmaceutical & healthcare sector in 2012.
While above facts are staggering and encouraging thus setting up a hospital has become an interesting investment option by entrepreneurs in private sectors for growing apathy of government towards this sector as can been seen from last 10 years slow passed progress by government for healthcare compared to private players. With India shinning story healthcare sector has witnessed expansion in past 5 years and even witnessing now. But every new development has its sets of challenges
Broadly classified in Private & Public Hospitals various Types set up exist
- Government aided and run Hospital
- Private Hospitals (Trust & Charitable Hospitals)
- Corporate Hospitals
- Private Public Partnership
In addition to above most hospital either staff Full Time Consultants or Visiting Consultants Model or a combination of both.
Healthcare Delivery Forms:
- Primary Care
- Secondary Care
- Tertiary Care
- Quaternary Care
- Home & Community Care
Competition for a new Hospital
Nearby established Hospital -The hospitals (Private or Public Set ups) have been from many years and have established its independent identity or an extension arm of established chain. Have Drs established repute among the nearby GP fraternity and won patient’s trusts and confidence with competent staff and care for patient in set ups operating.
Nursing Homes -Smaller set ups as 5-50-100-200 bedded nursing homes in neighborhood offering convenience of treatment and associated established full time or visiting consultants.
Visiting Consultants -Good nexus of referral patient’s base from among Dr Fraternity and allied referral community centres for effective PR practiced from many years.
Polyclinics -Concept in practice for years, providing convenience and specialist availability at one place. Generally located in important areas carefully selected by owners with chemist in-shop facility optionally/selectively.
Satellite Clinics– Concept gaining fast acceptance for convenience of patients and internet prevalence with electronic medical records facility and connected to group hospital and major consultants visiting with consultation at site or telemedicine facility at such centres
Diagnostic & Imaging Centres -Mushrooming self managed and part of reputed chains gaining faster acceptance being in neighborhood with giving services as home sample collection & priority report facility.
Physiotherapy Centres -Individual centres at important locations or becoming important by way of publicity and quality services offered from time to time.
Trauma & Burn Centres -Specialized centres run by government and private operators doing a good service for needy patients requiring assistance
Telemedicine -With development of ICT (Information Communication Technology) as internet this branch is developing and connecting healthcare to far flung rural or less developed healthcare facility regions/areas.
A Hospital set up coming with all forms of healthcare delivery or chosen healthcare delivery (primary, secondary, tertiary healthcare) has to view all above competition in a positive way and work in synergy for providing an effective framework then only the community can benefit and cost of investment can be justified and recovered in few years, than wait for a decade and continue to be a loss making venture for years together.
For success a new hospital has to focus on areas as:
- Providing & maintaining infrastructure -with all facilities planned/operational matching infrastructure, best of equipments etc and maintenance of the facilities
- Short listing and selecting the best of consultants & set business aspiration targets– with a will to make the brand success
- Recruiting Trained staff or providing the best of training– to technical & and technical staff
- Setting Marketing Team & Marketing Objective– for ensuring hospital branding & support from all healthcare providers as GP’s, VC’s, ensuring patient welfare activities & working partnering with all healthcare facilities in area for optimum utilization of resources
- Medical Tourism promotion team – for giving “atithi devo bhava” ideology depiction to all international patients coming to the hospital choosing India a preferred destination for their treatment as getting international business as India being one of preferred destinations internationally.
- Brand Hospital with 360 degree approach-Print & Digital Media Usage, internet branding exploration as update website, blogs, PR. Effective use of all promotion mix.
- Academic enrichment of Drs Community -CME’s, Conference Participation, Panel Discussions
- Organizing Community outreach Programmes -as health camps-free & subsidized health checks, awareness talks and opinions sharing.
- Administration & Operations Effectiveness– as clarity on tariffs, competitive rates, effective patient services for IPD & OPD patients.
- Working in Affiliation -Polyclinic Clinic, Nursing Homes, Diagnostic Set-ups & Satellite Clinics concept.
- Telemedicine-For distant destinations or rural area
Let’s discuss each of above one by one
Providing & maintaining infrastructure– while most new set ups are coming with best of infrastructure as equipped with latest machines and maintaining their facilities initially. With passing time and lesser business than anticipated the maintenance of facilities may deteriorate as can be seen with many set ups and thus becomes a cause of concern. This shall be largely observed by hospital staff or by people visiting the hospitals that when hospital started its operations or expanded its services the faults in infrastructure or services were rare and hassle free operations of services was there, but with passing times each service linked to maintenance has deteriorated. In long run providing and not maintaining Hospital infrastructure or services has impacted hospital businesses. No patient wants anything lesser in service and quality where they afford and pay than government run hospitals which provide free or subsidized treatment. Private hospitals have to focus this aspect as investment for long term returns
Short listing and selecting the best of consultants – Selection of Consultants is an area which is crucial to hospital success. Mix of experienced and fresh talents can be a recipe for success along with a will for succeeding for self and hospital that every consultant must emulate. The consultant’s first and foremost behaviour towards his patients in terms of patiently listening the patient, educating him about his disease and the time approximation of care along with proper medication prescribed and explained to patient will make a difference in patient’s outcome of treatment and choice of hospital. Thus a consultant behaviour and attitude towards the patient apart from his clinical knowledge has a lot to do with success for any hospital he is affiliated. Consultants as well have to participate for all efforts hospital makes to promote them, most consultants attached to big hospital set ups feel their job is to see patients and marketing or marketing activity planning is not their area or left to marketing teams. Thus through hospital management business aspiration targets should be made clear to consultants with respect to new patients expected every day, so that they start thinking in that direction and support initiatives to develop the business. The consultants who have displayed positivity in their attitude and cared for their patients and shown their willingness to participate or taken initiatives for increasing their practice have really made a difference for them and increased their patients and hospital business.
Recruiting trained staff or providing the best of training & Motivation -Technical & non technical staff at all levels again can be a breed of experienced and freshers. Skilled jobs should be filled with right matching profiles and compromise should not be made on such fronts. Then hospital must have an endeavor to see that whichever areas they are operating recruited manpower is familiar with rules and regulations. Constant training, supervision and on job mentoring is required. Hospitals should mandatorily have a training manager to ensure the technical and non technical trainings are constantly done including soft skills as this is a service industry the best of treatment given to patients from entry in hospital to exit will make his experience worthwhile to come back again for his healthcare need. Timely appraisal and rewarding the performers will a motivation once a year. Instead best performers in the month certified by their HOD should be rewarded or acknowledged in front of all so that others to feel the need for the same. Timely promotions and increments should be based on merits as performance targeted and met. Inefficient staff once proved over a time should not be tolerated as it will impact hospital business.
Setting Marketing Team & Marketing Objective -All new hospital have to have aggressive marketing for initial few years before they get established. Marketing will always remain important as completion is brewing up with time hospital even old in system have started realizing this fact. Hospitals need to choose people very selectively largely from Pharma domain and already experienced healthcare professionals will make a difference. Hospitals need to train marketing team on various aspects of hospital in term of infrastructure, consultants and services offered. The marketing team should be always clear on competitive edge hospital has and competitive advantage if any in industry, a detail competitive intelligence data should be either available or worked out. This aspect along with constant training will give confidence for marketing to make in roads and see success fast. Branding a part of marketing again has to have clear insight from self experience and management direction what aspects of hospital need to be focused with time. Complete branding calendar with branding budgets has to be worked strategically and ensured with 360 degree approach and see the perspective “knowledge is information rightfully given to the customers internal and external at right time”.
The hospital has to target patient referrals through Doctors, Corporates, Direct to customer activities, International Patients, Staff Referrals, Government Subsidy Schemes, Health/Privilege Membership card Schemes, Insurance/TPA tie-ups. The teams have to be selected based on target patient referrals and trained accordingly. With setting of marketing team the marketing objectives should be set for a year and evaluated at intervals to access the effectiveness.
Medical Tourism promotion team – As India is becoming one of preferred destination for medical tourism and as it generates high value business for Indian Hospital Set-ups this area if properly focused with setting up of inpatient care hospitality and marketing can be an indomitable area for success of the hospital. Hospitals should focus on getting patients from countries as US, UK, Africa, UAE etc where people would prefer India for Health and Tourism being cost affordable. Hospital need to work budgets and plans of developing the area of Medical Tourism seriously. Health facilitators with time if appointed in those countries along with developing relations with health and tourism departments of those countries endorsing India as preferred destination and hospital among preferred listing hospitals can make a difference. Hospital website has to be continuously updated as required with providing timely details to international patients and giving them the best of hospitality and medical care with treatment outcomes will prove as a better testimonial for next patient through marketing or word of mouth publicity. Success of international Business can help get hospital established fast if properly focused.
Brand Hospital with 360 degree approach – All forms of promotion mix as advertisement (print & digital), Personal Selling (Dr’s/specialist/Hospital concept Selling to GP’s & consultants), Public Relations (press releases, company literature, videos, websites and annual reports), Sales Promotion (Participation in exhibitions, setting up competitions with attractive prizes, temporary price reductions, door-to-door calling, telemarketing, personal letters on other methods), Direct Marketing (direct communication with Dr’s and patients) have to be used.
Appropriate branding material has to be designed based on promotional mix. For a hospital basic branding as Hospital Brochure with Department details, Consultant details is a must. Specific handouts or brochure for departments or patient awareness material as required should be planned as a part of branding calendar target. Branding has to constantly visualize the requirement and prepare for creating awareness and interest in target population if hospital wants to establish its credentials strongly in fast paced changing environment
Academic enrichment of Drs Community -with CME’s, Conference Participation, and Panel Discussions will make Dr’s strengths and facilities offered by the hospital exposed to larger audience of medical fraternity for improved referrals. Marketing departments should ensure this as a regular feature with proper calendar focusing Dr’s and Departments to develop fast and generate increased revenues for hospital. This also serves as updating the advances in field of medicine to Dr Fraternity for improved patient outcomes. Hospitals which target route of Academic enrichment planned and executed properly will get the consultants and departments a better support for referrals and win appreciation for medical knowledge up-gradation within their own fraternity of Dr’s.
Organizing Community outreach Programmes – for establishing direct patient connect with hospital community outreach programs as health camps-free & subsidized health checks, awareness talks and opinions sharing will help hospital brand name & services awareness fast in corporate (Companies) and non corporate affiliations (Housing Societies, Communities). Hospital need to have a calendar of these events with proper alignment of paramedic staff including Dr’s team and support teams. Marketing team should focus regularly Organizing Community outreach Programmes as a part of marketing Calendar to ensure hospital has more direct walk-in customers.
Administration & Operations Effectiveness – as clarity on tariffs, competitive rates, and effective patient services for IPD & OPD patients will help gain momentum for hospital from start to long road ahead. Best of hospitals in vicinity to be monitored for competitive intelligence and benchmarking along with each and every hospital visiting patient experience should be a learning curve to prove the standards and trust of patients. Biggest hassles are faced in areas of operational inefficiencies which detaches the patient from hospital to competition. Patient feedback should be a part of audit process and necessary improvements in areas should be implemented in time bound manner. To bring patient in hospital can be one challenge but retaining patients would be other challenge which can be overcome by developing operational expertise. If any new hospital that’s wants to build trust with patients by offering compassionate healthcare experience, the operations of hospital has to be excellent than competing hospitals. Compromise in this area should not be accepted as could prove fatal for hospital development.
Working in Affiliation – association of hospital consultants with Polyclinic Clinic, Nursing Homes, and Diagnostic Set-ups & Satellite Clinics will help initially as well as in long run for any new set-up in a big way by getting patients from targeted areas fast than any big branding initiatives planned. Tie-up with existing Nursing Homes, Diagnostic Set-ups not having all facilities can be good referral spots for providing complete healthcare to all patients with associated bigger hospital set-ups. Polyclinics can be a solution for cost effective way of reaching to masses in targeted areas. Setting up a satellite clinic in chosen destinations away from hospital can help as referral centres for any new hospitals as a prolong strategy. The consultants attached to hospital should be willing to take this route to help them and hospital establish fast. Local GP, consultant & Chemist support shall be crucial along with patient awareness in Polyclinic & Satellite Clinic chosen areas. The Hospitals taking route of affiliation with Nursing Homes, Diagnostic Set-ups or Polyclinic or Satellite Clinic set-up and working in association healthcare fraternity will develop patient base & business faster based on concept of reaching out to masses with convenience.
Telemedicine -concept for distant destinations or rural areas is catching up and any new hospital should not be way from this ICT revolution. Working in alliance with other providers could be an initial solution and gradually establish the technology self can help hospital becoming a national & in international player fast in this booming industry.
Author of article: Dr. Ravindra Pratap,Gupta Head of Marketing & Strategic Planning,SevenHills Hospital & Healthcity
Brief About Author
Dr Ravindra Pratap is among the top management teams in SevenHills Hospital & Health City. With a profound experience of over 17 years in Sectors spanning Pharma, Retail Education & Healthcare in some of the leading organizations as Sanofi Aventis, Novartis, Micro Labs, Future Group, Indira Groups of Institutes is an independent thinker& analyst expert and helps implementing workable strategies for sectors across the experience domains
Issued in Public Interest
(As an author of this article I have not used any examples to avoid offending or endorsing any brand in Healthcare in India. This article is based on purely my personal experience observing healthcare as an expert with a wish to see that the hospitals read and view that are they really serious on developing the Hospital in a 360 degree approach that helps them to break even before agreed or generally accepted timelines in Healthcare Industry)