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4 Select Case Studies of Healthcare


Providers In India

In the previous section, an attempt has been made to highlight


India’s healthcare scenario, tourism scenario, policy framework for
promotion of healthcare and tourism, estimation of the present
status of healthcare tourism in India, potential for healthcare tourism,
initiatives taken by both government and private sector to project
India as an ideal healthcare destination. This section highlights the
facilities available with select players from the industry and
practices adopted by them, to project the individual entity as also
the country as a whole, as an ideal healthcare destination. Though
there are many leading players in the healthcare services sector,
the study has chosen to provide more thrust on analysing the
practices of medium-sized players with multiple specialties, across
the country. In addition, few case studies are also presented that
are using traditional therapies such as Ayurveda and Yoga. The
identified companies / healthcare service providers are
representative sample of a whole lot of firms engaged in
improvising the healthcare tourism environment in India.

4.1 ESCORTS HEART INSTITUTE AND RESEARCH


CENTRE
Escorts Heart Institute and Research Centre (EHIRC) was
established in 1988 with the mission objective of becoming a
leading professional healthcare company in super specialty tertiary
care, with a focus on cardiac care and a range of products,
services and quality, consistent with the highest customer
expectations.

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EHIRC has full-fledged facilities (including 9 operation theatres,


4 cath labs, 2 heart stations) with a capacity of more than 300
beds, of which about 164 are critical care beds. EHIRC provides
intensive care to patients, pre/post-surgery or angioplasty,
emergency admissions or other patients needing highly specialized
healthcare services including tele-cardiology (ECG transmission
through telephone).
A notable feature of EHIRC is provision of air-ambulance
services in India, in association with Deccan Aviation, called
‘Medivac’. Medivac aims at providing speedy and state of the art
air-lifting services for emergency patients who can not go through
the rigorous of traveling by road. Under Medivac, the patients will
have priority access to a fleet of aircraft and helicopters along
with the emergency equipments and doctors.
Other facilities in the hospital include advanced laboratories
performing complete range of investigative tests (in the fields of
nuclear medicine, radiology, bio-chemistry, haematology, transfusion
medicine and microbiology), preventive cardiology department with
a fully developed programme of monitored exercise, Yoga, and

Exhibit 21:
Medivac Emergency Response Procedure

Source: Escorts Heart Institute and Research Centre; http://www.ehirc.com/


individuals/brchr.pdf

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meditation for life-style management, centrally air-conditioned and


environmentally sealed hygienic system, and a vast computer
network of over 300 nodes linked through Ethernet, utilising the
latest IT tools. With such facilities, EHIRC provides top-end services
in areas of acute care, invasive and non-invasive cardiology and
state of the art surgical procedures, besides playing a leading role
in prevention, early detection and the reversal of heart disease.
The marketing strategies of EHIRC include provision of
healthcare facilities in tourism circuits in and around New Delhi.
EHIRC has established a network of hospitals in other nodes of
‘Golden Tourism Triangle’ in the Northern India. In addition, the
network includes other cities such as Patna, Jodhpur and Indore.
Provision of healthcare services across the borders through local
presence is another strategy adopted by EHIRC. Hospitals have
been set up by EHIRC in Nepal and Afghanistan.
EHIRC, in order to promote in-country healthcare tourism, has
established facilitation centers to reach out to patients located in
far-away areas such as Siliguri, Ludhiana, Jammu. Facilitation
centers have also been set up abroad, in Bangladesh and
Uzbekistan. In such facilitation centers, patients can consult
cardiologist, cardiac surgeons, through video-conferencing facilities.
In addition, the facilitation centers will provide appointment with
doctors, room reservations, travel and stay arrangements, as also
follow-up consultation.
EHRIC has been contributing to the development of healthcare
indicators of India, by its community outreach programme for
treatment of heart diseases. The community outreach programme
comprises of free health check up camps, public awareness
programme, continued medical education programme, mobile
school of echocardiography, training on basic life support system.
The aim of the programme is to redress the imbalance by providing
cardiac care to the individual’s doorstep in rural areas. Various
facilities like clinical examination, ECG, and Echocardiography are
provided free of cost along with advice by a team of highly qualified
doctors and staff.
In order to strengthen its commitment to prevention and early
diagnosis of heart diseases, EHIRC is also undertaking extensive

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awareness programmes. These awareness programmes aim to


provide the community with knowledge about the prevention and
control of the risk factors to heart diseases. Public education plays
a vital role in the whole programme as various aspects of heart
diseases are discussed with the help of audio-visual presentations.
The programme lays emphasis on sharing of information with
doctors in the local areas about the latest developments in the
field of cardiology and cardiac care. It also provides expertise to
local population on treatment and prevention of heart diseases.

4.2 FRONTIER LIFELINE


Frontier Lifeline Private Ltd. or Dr. K M Cherian Heart Foundation,
has a 120-bed International Centre for Cardiovascular Thoracic
and Vascular Diseases, with infrastructure that would cater to a
range of treatment for cardio-vascular disorders. The Centre has
four modern operation suites, designed and equipped to perform
the most complex cardiac procedures on neonates and the elderly.
The special feature of the hospital is having two separate intensive
care units for adults and children, including specialised doctors,
intensive care specialists, and equipments designed to serve the
very different needs of the two groups. Another interesting feature
is a separate wing, with additional facilities, set apart exclusively
for foreign patients for their convenience. International patients from
nearly 30 countries (both developed and developing countries)
come to Frontier Lifeline for treatment. Majority of the patients are
from Iraq, Fiji, Kenya, Sri Lanka, Guyana, Uganda.
Unmatched combination of dedicated human skills, advanced
technology and world-class infrastructure are some of the features
that sets Frontier Lifeline as one of the preferred hospitals by
international healthcare tourists. To elaborate further, Frontier Lifeline
focusses on technology upgradation and the equipments available
in the hospital are from internationally reputed manufacturers. Some
of the hi-tech medical equipments available in the hospital include
Flat panel cardiac catheterization lab with spin, Enhanced external
counter pulsation, Carto imaging technology, tissue engineered
valves and cardiac substitutes.
The team of surgeons in Frontier Lifeline constantly keeps
abreast with the latest know-how in international surgical techniques

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and technology. This equips them to perform the most intricate


surgeries for congenital and acquired heart diseases, thoracic,
vascular diseases and organ transplantation. The team is actively
engaged in training programmes and research in areas such as
angiogenesis, gene therapy and genetically engineered valves in
cardiovascular diseases to ensure accurate diagnosis and
improved patient care.
In addition, Frontier Lifeline is one of the few hospitals involved
in cutting edge research on angiogenesis, gene therapy and
genetically engineered valves – an area that is normally the territory
of highly specialized research centers. The hospital has dedicated
research laboratory with GMP facilities and international
certifications. Further, Frontier Lifeline offers rare capabilities for
the assessment of cardiac arrhythmias and electrophysiological
studies. Clinical application of stem cells for failing hearts in infants
and adults is another new area in which Frontier Lifeline has had
success. The structure of the hospital is strengthened and
interlinked with an Electronic Data Processing Department, a
Medical Records Department and a Blood Bank.
Giving an all-round care is the policy of Frontier Lifeline hospital,
not only to the patients but also to the attendants of the patients.
Frontier Lifeline has made available facilities for patient attendants
with reading library, coffee kiosks, visitor’s lounge, multi-cuisine
cafeteria, business center with internet facilities, 24-hour pharmacy,
spiritual and pastoral care, rehabilitation and holistic therapy.
Frontier Lifeline offers several support services that are
exclusive and unique. The Nutrition and Dietetics Department in
the hospital has region-specific chefs to cater to international
patients. Encompassing all the health avenues with great detail,
the hospital has incorporated sensitive areas with Pastoral /
Spiritual care and medical social workers to take care of the mental
and psychological needs of the patients. With a view to offering
holistic healthcare, Frontier Lifeline has tied-up with the
Sanjeevanam Ayurvedic Center. Comfortable guesthouses in the
vicinity of the hospital also provide attendants and patients a homely
atmosphere, and calm ambience to relax, during recuperation.
Like the other few specialty hospitals analysed in this study,
Frontier Lifeline also has created history in achieving several

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medical milestones. The Department of Cardiothoracic and


Vascular Surgery of Frontier Hospital houses India’s first state of
the art porcelain operating suites with separate adult and paediatric
intensive care units. The hospital was the first one to undertake
successful coronary artery graft, first internal mammary artery graft,
first correction of transposition of great vessels using senning
technique, first successful bilateral internal mammary artery graft,
first heart transplant after the legislation of brain death, first bilateral
lung transplant, first auto transplant, and first heart and lung
transplant in India.
Frontier Lifeline aims to enhance quality healthcare by
streamlining all formalities and procedures starting from admission
to discharge. Treatment charges are kept transparent and brought
under economically viable package schemes. Tie-ups have been
established in order to strengthen healthcare skills of the hospital.
The hospital has signed a MOU with Indian Institute of Technology
(Chennai), for developing academic expertise in medical
biotechnology. The students of the M.Tech. course would get
hands-on experience at the hospital. In addition, another MOU has
been signed with the Division of Cardiac Surgery of Asahi General
Hospital in Japan for exchange and training of nurses in the
Japanese hospital. Under this MOU, the Japanese cardiologists,
in return, will undergo short time training programmes in the
Frontier Lifeline facilities.
Frontier Lifeline also has the distinction of contributing to the
healthcare development of deprived society in India. Frontier has
started the St. Gregorious Cardiovascular Centre at Parumala,
Kerala, the first tertiary cardiac care unit in a village of India. This
emphasizes Frontier Lifeline’s social commitment and concern for
promoting rural healthcare. The hospital hosted the first-ever
International Conference on Rural Cardiac Care at Parumala to
address the obstacles faced and to highlight the need for good
rural cardiac care in India. Another network of cardiac hospital, St.
Joseph’s Hospital, under the umbrella of Frontier Lifeline has been
set up in Nellore, which is catering to the general public in and
around Vijayawada.

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4.3 KERALA INSTITUTE OF MEDICAL SCIENCES


Kerala Institute of Medical Sciences (KIMS), a 450-bed multi-
specialty hospital, was commissioned in 2002, with the mission
of having state of the art infrastructure for provision of healthcare,
learning and research. The facilities at the hospital, which has been
awarded the ISO 9001:2000 certificate, include a high-end cardiac
catherisation laboratory, hi-tech operation theatres, a 24-hour
emergency department, CT scan, facility for open heart surgery,
blood bank, neurology and neuro-surgery departments, facilities for
anthroscopy, joint replacements, cosmetic, microvascular and
reconstruction surgeries.
KIMs has over 35 specialised clinics for treatment related to
various specialties / procedures such as adolescence, arthritis,
anticoagulant, allergy, arthoscopy, asthma, breast, burns, botox,
child development, contact lens, cosmetic, chronic obstructive
pulmonary disease, diabetic, dysphagia, endocrine, fracture, growth,
haematology, high-risk pregnancy management, interstitial lung
disease, immunisation, infertility, low-back-ache, lung cancer
detection, menopause, paediatric respiratory, rheumatology,
smoking cessation, sports, thyroid, tuberculosis, vertigo and voice.
More than 1000 highly trained, skilled and motivated medical and
para-medical staff handles most modern diagnostic and operational
equipments in these facilities.
Quality and accreditation are prominent strategies adopted by
KIMS to ensure world-class treatment at third-world prices. KIMS
has acquired ISO 9001: 2000 certificate from BSI Group. The
facilities are accredited by National Accreditation Board for Hospitals
(NABL), India; and Australian Council for Health Standard
International. KIMS is in the process of completing the accreditation
of its laboratories by NABL.
Upgradation of technology and medical equipments is another
priority area for KIMS. It has the most modern and sophisticated
equipments such as 1.5 Tesla MRI machine, Karl Stonz Pulsar
Stroboscope, a Sleep Lab for biological sleep study analysis, dental
chairs fitted with intra-oral camera and critical care ventilators, most
of which are the first of its kind in Kerala state.

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KIMS, as pioneer in the state for promotion of healthcare


tourism, has empanelled with Government and semi-Government
Institutions in India, Republic of Maldives, Sultanate of Oman,
Bahrain, UAE and UK. KIMS, receives a growing number of
international patients from countries such as USA, Australia, New
Zealand and Europe, in addition to developing countries. The
management feels that the satisfied smile and goodwill of these
returning patients are its main international marketing tools. For
active promotion of medical tourism and dissemination of proper
information to medical travellers, KIMS has tied up with various
companies in different countries. These companies are either tour
operators or travel facilitators, such as Sahara Global, Focuz
Holidays, Tops Air rescue, Unilife Inc, Swadesh International. The
tie-ups facilitate representation of the hospital and its services by
these companies. Tops Air Rescue is one of the few companies
providing air ambulance service, nationally and internationally.
Further, KIMS has tied up with insurance companies in India and
abroad for promotion of medical tourism. To market the healthcare
brand of the hospital, KIMS has also floated a tour company, Great
India Tour Company, which offers a variety of travel services.
Healthcare tourism is being promoted by KIMS with multi-
pronged strategies such as quality in healthcare and clinical
standards, and adoption of patient-safety norms. Such measures
make the travellers feel comfort with translation and food choices,
provision of cost-effective, efficient and timely procedures, and
backed by proper follow-up treatment. In addition, KIMS offers tailor
made transparent packages for foreign visitors either for elective
procedures or for health maintenance schemes.
KIMS focusses on specialties such as cardiology and cardiac
bypass surgery, ortho-replacement surgeries and arthroscopy,
cosmetic surgery, dental procedures and artificial dentition, voice
correction and laryngology, botox injection, nephrology – dialysis
and organ transplant with live-related donors, endoscopy, neuro-
surgery, paediatric surgery, ophthalmology and preventive check-
ups.
In order to leverage Ayurveda, the holistic healthcare of India,
with medical solutions in offer, KIMS has tied up with Punarnava
Ayurvedic Pvt. Ltd., an Ayurvedic firm in Kerala. The Ayurvedic

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department at KIMS has consultation room (both for inpatients and


outpatients), beauty care centre, panchkarma theatres, with
specially trained Ayurvedic experts. The diagnoses at the
department are from basic fundamentals of Ayurveda, but made
out of modern techniques. With such facilities, KIMS is one of the
few institutions in India to augment the greatness of the holistic
science (Ayurveda) with the ultra-modern medicine.
The hospital has established over 30-branch network providing
round the clock specialist services, which has given the impetus
to establish KIMS as a referral center. Besides healthcare services,
KIMS gives paramount importance to health education and skill
development, through continuing medical education, organising
medical conferences for exchange of knowledge and ideas,
conducting medical camps / outreach programmes.
For the development of healthcare in the society, KIMS has
floated a charitable trust with the objectives of providing free /
subsidised healthcare for poor and needy. Through the trust, KIMS
aims to contribute to the medical / paramedical education and
research also.
KIMS management is of the opinion that modern nursing is a
dynamic, therapeutic and educative process in meeting the health
needs of the individuals, the family and the community. The nursing
department of the hospital functions in conjunction with other
healthcare agencies in assisting individuals, families and
communities to achieve and maintain desirable standards of health.
To achieve this goal, KIMS started a general nursing and midwifery
course, with on the job training in the hospital to help equip them
with professional expertise to meet the changing demands of the
society. The course is recognised by the Kerala Nurses and
Midwives Council.
KIMS’ advancements in medical science and its contribution
to health education has earned accreditation by the National Board
of Examinations, Ministry of Health, Government of India, for the
conduction of Post Graduate Diploma of National Board (DNB)
courses in cardiology, general medicine, general surgery, plastic
surgery, radio-diagnosis, paediatrics and paediatric surgery. In
addition, KIMS has been approved for conducting Para-medical
courses such as medical laboratory technology, medical imaging

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technology, health information administration, radiation techniques,


operation theatre technology, by various academic institutions /
boards.
KIMS, with the objective of sharing its expertise and
experiences, offers consultancy services in the fields of medicine,
finance and hospital management. The areas of consultancy
include hospital planning and designing, procurement and
management of equipments, setting up of clinical departments,
human resources development and training, quality improvement
systems, hospital administration and information systems, fixing
up of healthcare packages, and drawing up of promotional
strategies.

4.4 MANIPAL HEALTH SYSTEMS


The Manipal Group has used the model of reorganising and
consolidating its existing three major verticals, viz., health
education, healthcare and health research. The resultant of
consolidation is the formation of Manipal Health Systems, under
which, the Group has integrated hospital management and
operations of all its hospitals including the Manipal Academy of
Higher Education. Manipal Health Systems now has a combined
bed-strength of over 5,000, nearly 1,700 consultant doctors and
about 5,000 employees, making it one of the largest healthcare
companies in Asia.
Manipal Health Systems has presence in primary, secondary
and tertiary healthcare delivery systems catering to over 1.2 lakh
inpatients and over 11 lakh out patients every year. These include
9 primary centres at 7 rural locations, 8 secondary hospitals and
3 tertiary hospitals at semi-urban/urban locations. In addition to
hospitals and health centres, the group also has 14 medical
colleges with over 900 students and 275 faculty staff.
The Manipal Hospital, located in Bangalore, is the first hospital
of the group that was established with quality and affordable
healthcare. The hospital currently has a capacity of 600 beds with
referral centres for 43 specialties. The hospital has achieved the
quality standards of ISO:9001:2000 (India’s first hospital) certified
for clinical, nursing, diagnostics and allied areas. Supported with
hi-tech ambulance services, NABL accredited diagnostic services,

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pharmacy and blood bank, the hospital provides round the clock
consultation services as also telemedicine. The hospital has
received the Golden Peacock National Quality Award in 2005 - the
first hospital in the country to be bestowed with such recognition.
The centres of excellence in the hospital specialises in areas such
as heart, neurological disorders, nephrology and urology,
comprehensive cancer centre, andrology and reproductive services,
dentistry, liver and digestive diseases, sports and exercise
medicine.
The dedicated international patient-care centre has decades
of experience in handling all the requirements and special needs
of the visiting international patients, to ensure provision of smooth
and hassle-free experience. The centre extends a full range of
personalised services to the international patients as also the
accompanying persons. Most of the doctors in the hospital have
international affiliations. The hospital adheres to a transparent fee
structure. The share of international patients in total revenue of
the hospital is estimated at around 3%. Over the years, Manipal
Hospital has treated international patients from more than 55
countries including USA, UK, Malaysia, Oman, UAE, Tanzania, Sri
Lanka and Mauritius.
Telemedicine network established by the hospital enables
patients in remote locations in the country and abroad to see and
interact with the specialists at the hospital in Bangalore. Using
this facility, all the patient’s medical information including
investigation reports, and real time images like Angiogram can be
transmitted live, which the specialists at Manipal Hospital can view
along with the patient and decide on the course of treatment. The
facility helps to avoid the patient’s inconvenience in travelling all
the way to Bangalore for getting expert opinion.
Manipal Group entered into several strategic tie-ups with
various organisations in different countries. The Group has entered
into partnership with University of Minnesota aimed at increasing
scientific collaboration and training opportunities for students and
physicians from Minnesota and India, and to provide state-of-the-
art cancer care for patients in Bangalore. The University of
Minnesota has helped the Group in establishing a Blood and Marrow

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Transplantation clinic, as also support for developing transplant


protocol and on-site training for nurses in Bangalore.
The Group has tied-up with countries like Mauritius, Tanzania
and the Middle East. In Mauritius, the Group has opened a
telemedicine centre at Cliniq du Nord. The Group has also tied up
for treatment of heart patients from Mauritius. With the Ministry of
Health, Tanzania, the Group has tied up to treat 3000 high-risk
patients at a budget (of approximately US $ 5 million) that could
treat only 700 patients in Europe. The tie-up enabled Tanzania to
provide healthcare services to more number of patients at the
same cost and helped them to save on capital investment in
advanced medical care.
To give the patients (from Tanzania) homely atmosphere, the
tie-up permitted patients accompanied by nurses from Tanzania
National Hospital. The communication problem was resolved with
appointment of Swahili speaking interpreters and the problems
associated with tastes and preferences for food and beverages
were resolved with trained chef from Tanzania. The Group entered
into tie-ups with appointment of the neighbouring mosque for prayer
room services for the visiting patients.
The hospital has chalked out major initiatives to attract large
number of patients from Middle East region, especially, from UAE.
The Manipal Academy of Higher Education has also tied up with
Ras Al Khaimah, one of the seven emirates of the UAE to set up
a medical and health services university.
Manipal Health Sciences has plans to foray into retail health in
India tying-up with a retail major in India. Under this model, for the
first time, a pharmacy, consultation (in general medicine, paediatrics,
ENT, dermatology, ophthalmology and sports medicine),
cosmetology, optometry, dentistry, sports medicine and sports
rehabilitation will be offered under one-roof in a retail store / mall.
Manipal Health Systems is gearing towards provision of world-
class healthcare, by harnessing the state of the art technology in
medicine, education and research, with the vision of becoming
one of the top ten ‘most admired’ and ‘successful’ healthcare
systems in Asia, by 2010, dedicated to prevention, early detection
and treatment of diseases.

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4.5 MEDICITI HEALTHCARE SERVICES


Medicity Healthcare Services, popularly known as Mediciti Hospitals,
was promoted in 1994 with a capacity of over 200 beds. Over the
years, the hospital has acquired special character in catering to
more than ten super-specialties viz., cardiology, cardio thoracic
surgery, neurology, neuro-surgery, nephrology, orthopaedic, internal
medicine, gastroenterology, pulmonology, urology, and gynaecology.
Apart from catering to these super-specialties, providing state
of the art healthcare, the hospital has been in the forefront of
academics also. Mediciti hospitals may perhaps be the only hospital
in Andhra Pradesh to run Diploma in National Board training
courses in 5 specialties, viz., cardiology, internal medicine,
nephrology, pulmonary medicine and general surgery. The hospital
also runs two pot graduate courses in respiratory therapy. The
School of Nursing, which was started by the hospital in 1995, trains
around 60 nurses every year. The medical college (Mediciti Institute
of Medical Sciences) run by the hospital churns out around 100
medical professionals every year.
The hospital believes that quality of healthcare delivery is
possible only through a honest, sincere and ethical healthcare
practice. Using this philosophy, and instituting a support system, it
is possible to ensure high-quality patient care and to provide
smooth and comfortable experience to the patients. The support
system in the hospital has patient relations executives who
coordinate with various departments and patients / relatives of the
patients to ensure high level of satisfaction. Clinical coordinators
also form as part of the support system that enhances the patient-
care and their satisfaction levels.
The management of the hospital is of the opinion that nursing
department is the backbone to any hospital. Professionalism is
being inculcated to the nurses along with enhancement of
knowledge and skills. The hospital sources its nursing staff
requirements from its own nursing school and at present there
are 150 nursing staff in the hospital. In critical areas and ICUs,
the nurse-doctor ratio is 1:1. The hospital works with the concept
of rotation of departments for the nursing staff enabling them to
get full-fledged knowledge in various departments.

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Technological advancement, through procurement of quality and


speedy diagnostic and surgery facilities, is another strategy adopted
by Mediciti hospital. The hospital, to its record, has introduced for
the first time in India equipments such as 180 series Olumpus
Scope used for Gastro-entorology treatment, and in the process
of procuring advanced digital Cathlab and Flag Panel Cathlab used
for treatment of Cardiology, and 64 Slice CT Scanner. The
Department of Pulmonology is involved in clinical trials in
association with Ranbaxy Labs Ltd.
The hospital with the objective of attracting NRIs, has been
issuing NRI Patron Card to NRIs who are also donors of Mediciti
Charitable Trust. In coordination with local agencies in USA, Mediciti
organises conferences and seminars to increase the international
visibility of the hospital. In addition, the hospital proposes to target
international patients by offering value-added services by tying up
with hotels and tour operators.
Mediciti hospital caters to social healthcare focussing on rural
health, health education, and preventive health. The hospital is
associated with YSR Foundation with the objective of provision of
healthcare to poor and needy rural population.

4.6 P D HINDUJA NATIONAL HOSPITAL AND MEDICAL


RESEARCH CENTRE
Hinduja hospital was founded in 1951 and has grown from strength
to strength to become State of the Art multi-speciality tertiary care
hospital. With an inpatient capacity of over 350 beds, inclusive of
over 50 critical care beds, the hospital offers comprehensive
healthcare services including investigative, diagnostic, therapeutic
and post-operative care. The hospital’s inpatient services are
complemented with day-care centre, outpatient facilities and an
exclusive centre for health check-up for executives.
Hinduja Hospital renders its services with over 70 full time
consultants, which is a unique feature of this hospital, Various
specialty healthcare services offered in the hospital include
cardiology, cardiothoracic surgery, neurology, neuro-surgery,
orthopedics, oncology, ophthalmology, rheumatology, endocrinology,
ENT, gastroenterology, pediatrics, pediatric surgery, pediatric
neurology, urology, nephrology, dermatology, dentistry, plastic

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surgery, gynaecology, pulmonology, psychiatry, general medicine


and general surgery.
Adopting a three-pronged approach, viz., technological
advancement, quality accreditation and specialisation, the hospital,
over the years, has catered to over 1.5 million outpatients and
175,000 inpatients. The facilities of the hospital have been used
for conducting over 1 million surgeries / scopies, 1 million
radiological services and 7.5 million laboratory investigations.
The hospital has pioneered in introducing new concepts and
crossing several milestones. Introduction of Radial Lounge, a new
concept for carrying out coronary angiography and angioplasty
procedure; first in India to conduct awake craniotomy for an
epilepsy surgery; first in India to start a pain management clinic,
screening centre for breast cancer, vulvar clinic; first in Mumbai to
start a Home Care management unit; one of the few hospitals to
perform laparoscopic gall bladder surgery, cochlear implantation;
and first private hospital in Mumbai to perform cadaver kidney
transplant and peripheral blood stem cell transplant to mention a
few.
The hospital has pioneered in acquisition of latest and
advanced technology available in the medical field. To mention the
major ones include twin speed MRI (a revolutionary technology in
neurovascular and cardiology imaging), Gamma camera / PET
scan, Gamma knife, Bactec NR 730 analyser for micro culture,
Digital Linear accelerator, Vacutainer system for blood collection,
Holmium laser, Synchron CX-7, computerised Humphery’s
perimeter for early diagnosis of glaucoma, digital video ECG (which
is capable of recording the electrical events of the brain), and
viewing and navigation system to conduct minimal invasive neuro-
surgery procedures.
On the quality and healthcare delivery, the hospital has to its
credit having the first hospital based laboratory in India accredited
by the College of American Pathologists(CAP). The laboratory
department participates in International Quality Control programmes
conducted by the College of American Pathologists, WHO and
National Quality Control Programmes, where it has achieved and
maintained high ranking, consistently for a number of years. The
hospital was the first multi-disciplinary tertiary care hospital to have

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been awarded ISO:9002 certification from KEMA of Netherlands,


for its quality management system. The hospital was bestowed
with the prestigious ‘Golden Peacock Global Award for Philanthropy
in Emerging Economies, in 2006.
The Hospital’s main thrust areas in surgery are Neurosurgery,
Cardiothoracic surgery and Orthopaedic surgery. The hospital was
the first private hospital in Mumbai to perform cadaver kidney
transplant and peripheral blood stem cell transplant. The hospital
has also established a medical research centre in collaboration
with Massachusetts General Hospital, Boston.
Continuing medical education is an important element of the
hospital’s strategy to ensure quality and service delivery.
Workshops and seminars are conducted by the hospital regularly
on various specialty subjects and are attended by healthcare
professionals from different parts of India and abroad. The hospital
conducts special training sessions for executives, an ongoing
exercise for enrichment of working knowledge and thus resulting
in increased effectiveness.
Hinduja hospital offers round the clock ambulance services,
which ensures high quality care at par with a critical care unit of
the hospital. The ambulances are equipped with emergency unit,
including a two way communication systems, a telescopic
stretcher, shock-absorbers, manned by a doctor and trained para-
medical personnel. Emphasizing the importance of timely treatment,
Hinduja hospital has tied up with an Air Ambulance Provider for
seamless transfer of national and international patients.
The hospital proposes to adopt strategies such as: tie-ups with
healthcare facilitation centers abroad; leading healthcare service
providers abroad, for knowledge transfer in performing various
procedures; various international airlines for working out
comprehensive healthcare tourism packages; and embassies and
consulates of major target countries, in the short term. In addition,
it has been proposed that the capabilities of the hospital would be
projected through the website and brochures.
In the long term, it has been proposed to have a full-fledged
international marketing department that would ensure patient’s
satisfaction right from the initial query to post-operative departures,

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including arranging of tourism packages. The hospital has plans


to be more outward oriented and proposes to explore the
possibilities of tie-up with NRI groups and mandals abroad in order
to popularize its capabilities. Plans are there for introduction of all-
inclusive comprehensive medical packages with clear distinction
of inclusions and exclusions. The hospital proposes to explore tie-
up with National Health System of UK, directly for referring patients
to India wherever the waiting time is more than two months.
On the social front, the hospital runs a charity to the tune of
around 6% of the gross revenue of the hospital, every year. The
hospital is involved with creation of social health awareness through
health camps, induction of community health project, and
participation in emergency relief.

4.7 STERLING HOSPITAL


Sterling, a 304-bed multi-super specialty hospital in Ahmedabad,
is a corporate hospital promoted by Actis (private equity investor)
and Paras Pharmaceuticals (one of the leading health and personal
care entities in India). Sterling’s Mission and its efforts are constantly
aimed at providing comprehensive and prompt healthcare solutions
to the patients, synergising the expertise of leading health experts,
sensitised to the need of patient with state of the art medical
infrastructure.
With a networth of over Rs. 1 billion, Sterling has established
state of the art healthcare infrastructure to provide high quality
services across a range of specialties. The specialties include
cardiology, cardithoracic and vascular surgery, neurology, neuro-
surgery, paediatric and neonatology, nephrology and dialysis, renal
transplant, critical care and pulmonology, sleep lab, fibre optic
bronchoscopy, endocrinology, gasteroenterology, GI surgery,
radiology, physiotherapy, occupational therapy, rheumatology,
haemato-oncology, urology and surgical oncology. The hospital is
equipped with seven major operation theatres (all with HEPA Filters
and MAC laminar tents from USA and German lighting system)
and 85 intensive care beds.
Sterling’s major achievements include introduction / installation
of insulin pumps, continuous glucose monitoring system, CRRT
dialysis, and has pioneered in the technique of transradial

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angiography / angioplasty and thrombolytic therapy. The trans-radial


lounge, first of its kind in India provide stress free post-operative
atmosphere to the patients. The hospital has performed over 70
live kidney transplantation and 25 cadavers kidney transplantation.
The hospital has gained rich experience in beating-heart cardiac
surgery and has completed over 6000 heart surgeries.
Sterling is working towards continuous improvement of quality
in various fields, and is in the process of getting accreditation by
NABL and JCI. CRISIL has rated Sterling with Grade – B, under
its annual grading surveillance exercise, which reflects good quality
of delivered care. The pathology department of the Sterling hospital
is ISO 9001 certified and has been ranked as fourth in India and
19th in world by Bio-Rad Laboratories, under the external quality
assurance services programme. Sterling has implemented strict
blood safety and infection control protocols at par with world
standards.
To cater to the needs of people in distant places, Sterling
Hospital has developed its satellite clinics in various towns and
remote areas. In addition, telemedicine centres are established to
help facilitate remote diagnosis, consultation, administration and
monitoring of patients and will also help in telecast of live surgeries.
Sterling is also focussed on clinical research and medical education
through DNB programmes.
The hospital caters to the healthcare requirements of non-
resident Indians as also healthcare tourists from developed
countries such as USA, Canada and UK. Development of
packages such as NRI Platinum Profile, NRI Platinum Plus Profile
to cater to the NRIs for advance tests like cardiac and whole body
angiography is one of the strategies adopted by the hospital.
Sterling also caters to the healthcare requirements of patients from
developing countries of Africa (Kenya, Tanzania and Nigeria), and
Asian countries like Bangladesh. Around 20-25 foreign patients per
month visit Sterling hospital for various speciality treatments. The
revenue contributed by the foreign patients works out to around
2% of total revenue of the hospital.
Sterling is in the process of setting up a separate department
to cater to the international patients. The department, once set-up
is expected to bunch the healthcare and associated tourism

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services including airport pick-up/drop, translation, food and


beverages and post-operative recuperative tourism. To promote its
capabilities, Sterling plans to tie-up with tour operators, travel agents,
hotels and wellness centres in India and abroad, and through
participation in trade fairs and exhibitions.
Sterling caters to the in-country healthcare tourism with
thousands of patients from adjoining cities/towns of Gujarat,
Rajasthan, Madhya Pradesh and Maharashtra. To promote in-
country healthcare tourism, the hospital has tied up with insurance
firms like Medi-assist, Heritage and Paramount Health Services.
Sterling proposes to cross the milestone of 1000-beds by 2008,
with additional state of the art hospitals planned in Rajkot, Surat
and Mundra.

4.8 WOCKHARDT GROUP


Wockhardt, a renowned healthcare group in India, in association
with Harvard Medical International, USA, has set up a chain of
twelve super specialty hospitals across India. The network has
presence in major cities like Mumbai, Bangalore, Kolkota, Nagpur
and Hyderabad. The specialty areas catered by Wockhardt include
heart care, brain and spine care, eyecare, bone and joint care,
kidney care and minimum access surgery. The Group’s association
with Harvard Medical School and its affiliated institutions world-
wide is bringing in extensive learning and experiences.
Wockhardt heart hospitals are centers of excellence, where
comprehensive, end-to-end cardiac care services are provided by
best cardiac surgeons. The Centres have gained rich experience
over the years and have conducted so far over 25,000 cardiac
surgeries and have achieved international recognition for their
Cardiothoracic surgical expertise. Wockhardt has pioneered many
complex surgeries and marked its presence in the medical history.
The cardiac facility in Bangalore pioneered India’s first bypass
surgery using endoscopic radial artery harvesting. Other records
set by the Group hospitals include: first Awake Heart Bypass
Surgery with Aorotic Valve Replacement; first in Australasia region
to perform minimally invasive Beating Heart Coronary Artery
Bypass Surgery; first hospital in India to treat Chronic Atrial
Fibrillation using Maze III procedure and to perform Vertebral Artery
Angioplasty.

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The Group hospitals are dedicated in various specialties and


provide healthcare solutions in complex areas.
 The Bone and Joint Specialty hospital of the Group provides
treatment for all types of musculo-skeletal problems ranging
from Trauma Surgery to Minimally Invasive Arthroscopy
Surgery. The hospital is a Center of Excellence for Hip
Resurfacing Surgery, Joint Replacements, Ligament Repair,
Knee Surgery, Spine Surgery and Physiotherapy for
rehabilitation.
 The Brain and Spine Specialty provides healthcare services
for patients with disorders of the brain, spinal cord and
peripheral nervous system. Both invasive and non-invasive
procedures for treating back, neck pain and correcting spinal
deformities are provided. The specialty, using latest techniques,
provide solutions for replacement of Cervical Disc, Lumbar
Spine Fusion, with success rate comparable with world
standards.
 The Wockhardt Minimal Access Surgery Hospital provides high-
end solutions to perform precision surgery in various operative
procedures, such as nervous system, ENT, thorax, abdomen,
urinary tract, reproductive system and joints. The solutions not
only minimize surgical trauma, pain and blood loss to the
patients, but also shorten the hospitalisation period.
Wockhardt’s recently established 400-bed multi specialty
hospital in Bangalore is equipped with state of the art facilities
along with latest technologies to cater to the whole range of
specialties viz., cardiac, orthopedic, neurosciences, women and
child care. The hospital has 9 operation theatres, 52 OPD
consultation rooms, 72 critical care beds, 14 bed emergency room,
13 dialysis beds, and 12 day care beds.
The hospital has advanced diagnostics and support
infrastructure, equipped with 64 slice CT, high-end MRI, Neuro-
navigation systems, comprehensive blood bank, laboratory and
rehabilitation services. The hospital focuses on super specialty
areas such as orthopaedics, trauma and joint replacements;
cardiology and cardiothoracic surgery; neurology and neuro-surgery.
A dedicated center for women has also been set up in this
hospital.

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The Wockhardt Group plans to open new hospitals / facilities,


equipped with latest technology, multi-disciplinary capability, state
of the art facilities, world class infrastructure and excellent patient
care ambience and processes. The model being adopted by the
Group for expansion of hospitals network is through franchising,
hospital management, mergers and acquisitions. These models
are less capital-intensive, with an approach for technology, expertise
and revenue sharing.
The Group hospitals are receiving international patients from
diverse regions – America, Canada, Europe and Middle East. A
special division has been set up to look after the needs of
international patients, which is staffed with guest relations officer,
translators, specially trained nurses. International patient division
arranges for travel and accommodation for the patient and
accompanying persons, meets the requirements of shopping,
currency exchange and special food and beverages. International
accreditation is being looked at this Group vigourously. Wockhardt’s
facility in Mumbai is the first super-specialty hospital in South Asia
to get accreditation from Joint Commission International (JCI), USA.
Networking with international healthcare insurance agencies is
another strategy adopted by the Wockhardt Group. The Group has
tied up with American Blue Cross Blue Shield Association (first
hospital group in South Asia) as a participant in the network of
hospitals for health insurance coverage. In addition, the Group has
entered into a formal agreement with Philadelphia-based Cigna
Insurance for facilitating treatments under the Cigna International
Expatriate Benefits health plans. Cigna is one of the leading health
insurers in USA with a health insurance coverage of over 32 million
people in the USA.. Through this agreement, Cigna’s expatriate
members and the international travellers who have health insurance
coverage under Cigna’s designated plans will have access to
medical treatment at any of the Wockhardt hospitals across India
on cashless basis.

4.9 ART OF LIVING FOUNDATION


Art of Living Foundation was established in 1991 as a volunteer-
based educational and humanitarian organization. The objectives
of the Foundation include conducting programmes that eliminate

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stress, create a sense of belonging, restore human values and


encourage people from all backgrounds, religions and cultural
traditions to come together in celebration and service. The
Foundation offers programmes in over 140 countries and holds
special consultative status with the Economic and Social Council
of the United Nations.
Courses offered by the Foundation include the Art of Living
course, advanced programmes, youth programmes, corporate
programmes, and special programmes meant for prisoners and
for de-addiction. It is estimated that the Foundation has an outreach
of over 300 million people worldwide, covering every section of
society. In addition, many self-development modules are offered,
which can be practiced at home to calm the mind and heighten
the enthusiasm. Such programmes have helped many people to
combat depression and aggressive behaviour.
A wide range of social work is attended to by the Foundation,
such as efforts towards building violence-free, crime free and
stress-free society; conflict resolution; trauma relief and disaster
management; stress elimination; prisoner rehabilitation; youth and
women empowerment; education; community development; and
revival of ancient wisdom.
Through the establishment of Ved Vigyan Mahavidyapeeth, the
Foundation explores the linkages between ancient and modern
science. Ved Vigyan Mahapeeth has three wings, viz., Vedic
research, medical research and social research. Under the Vedic
research, resident Vedic scholars interact with modern scientists
to establish the linkages between Vedas and modern medicine.
The efficacy of Sudarshan Kriya and its effects on the mind and
body is studied under the medical research, while the effects of
such techniques on societies as a whole is studied by the social
research department.
Another objective is to improve personal skills, develop
capabilities and sustained improvement in well-being, through
education. As a means towards this goal, the Foundation aims at
providing informal education to the village population in general and
the provision of formal education to the tribal population. A range
of schools have been set up to offer value-based education that

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makes learning a joyful experience and provide children with


practical life-skills.
Sri Sri Ravishankar, the founder of the Art of Living Foundation,
has also established International Association for Human Values
(IAHV) in 1997 to internationally coordinate the social development
activities and disaster management including emergency and
trauma relief work. IAHV is engaged in work related to education,
tribal welfare, organic farming, micro financing, vocational training,
disaster relief and rehabilitation and programmes for prisoners.
Healthcare and wellness are propagated by the Foundation
through ‘Sri Sri Yoga’ and ‘Sri Sri Ayurveda’. Sri Sri Yoga offers a
multi-path approach for uniting body, breath and mind with
awareness. While emphasizing rigorous asanas for the body, Sri
Sri Yoga underscores the techniques that are meant for nurturing
mind and spirit.
Sri Sri Ayurveda is a combination of Ayurveda with Yoga and
meditation. The Foundation has an Ayurvedic center in Bangalore
offering Ayurvedic consultation and treatment. The center prepares
Ayurvedic medicines in-house, using the home-grown herbs and
automated processing technology. The Department of Scientific
and Industrial Research, Government of India has recognized the
Foundation for its research activities.
The Foundation aims to achieve uniting the world into a
violence-free global family through service and fostering human
values.

4.10 BABA RAMDEV ASHRAM


(KRIPALU BAGH ASHRAM)
Swami Kripaludevji Maharaj established the Kripalu Bagh Ashram,
in the year 1932. Baba Ramdev is the disciple of Swami
Kripaludevji Maharaj’s successor, Swami Shankardevji Maharaj.
Baba Ram Dev mainly teaches yoga at the Kripalu Bagh Ashram,
situated in Haridwar. Followers of Swami Ramdevji, visit Kripalu
Bagh Ashram in large numbers to learn yoga from him.
Baba Ramdev established Divya Yoga Mandir Trust in 1995
as a promotional vehicle for Yoga. The headquarters of the trust
is at the Kripalu Bagh Ashram of Haridwar. The Mission Statement

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of the Trust is to “establish a learning center wherein it will be the


prime objective to foster education based on modern scientific
learning; to promote a healthy mind and a vibrant body enabling
facilitation of spiritual development to rejuvenate latent noble virtues
in children so that their lives epitomize the values of beauty,
dedication, and rationalism thereby engendering a world of harmony
friendship, brotherhood, peace, and prosperity.”
Baba Ramdev is reportedly reaching millions of people with
his ‘yoga made easy approach’ using latest technological modes
— cassettes, CDs, books, televisions, and the Internet. The
Ashram combines the ancient science of Yoga and Ayurveda with
modern medical science. Consultations are done by the patients /
disciples through phones, emails and letters. Such communication
modes are used to provide counseling and long-distance therapy.
The Ashram runs an out-patient department with 40 doctors,
which is visited by around 2,000 patients every day, throughout
the year. Doctors in this Ashram are mostly qualified Ayurvedic
physicians and surgeons. Treatment is provided using medicinal
herbs grown in the Ashram’s Divya Medicinal Garden. The ashram
has a byre with 150 cows to provide milk, dung and urine for
preparing and conserving medicines. A farm inside the vicinity
grows vegetables and foodgrains.
The Divya Yog Pharmacy, a research and marketing unit of
Ayurvedic medicine, is equipped with sophisticated instruments.
The pharmacy adheres to strict quality control measures, right from
the collection of raw materials to the end-products. Some of the
popular medicines made in the pharmacy include Muktavati (for
hypertension), Madhunashinivati (for diabetes), Kayakalpvati (for
skin diseases) and Meghavati (memory enhancer). The details of
the drugs, its composition, the manufacturing date, bar code and
doses are displayed on bottle labels; tablets come in blister packs.
The pharmacy also conducts clinical trials on drugs to study their
therapeutic and side-effects.
Baba Ramdev, through the Divya Yoga Mandir Trust, is
implementing a dream project of setting up of Patanjali Yog Peeth,
a mega-University for Yoga at Bhadarabad, near Haridwar.

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The University is expected to have a large center for Yoga,


which would undertake research in Ayurveda. The University is
likely to have state-of-the-art library, research laboratories and
facilities for treatment. The treatment provided in hospital is claimed
to be through indigenous methods. The project is expected to be
a rare confluence of yoga for mental peace, Ayurveda for physical
health and spirituality to develop ‘sanskars’ (human values) based
on ancient Indian culture.

4.11 KOTTAKKAL ARYA VAIDYASALA


Kottakkal Arya Vaidya Sala (AVS) was established in 1902 at
Kottakkal in Kerala State by Shri Vaidyaratnam P.S. Varier. Started
essentially as a village clinic, AVS has now grown into a multi-
unit, multi-disciplinary and multi-segment organization attracting
patients from India and abroad. is a century old Charitable Institution
engaged in the practice and propagation of Ayurveda. AVS offers
classical Ayurvedic medicines and authentic Ayurvedic treatments
and therapies in different Ayurvedic segments. In addition to
Kottakkal, AVS has established Ayurvedic hospitals at Delhi and
Kochi.
The Kottakkal facility has over 160 rooms and provides all
Ayurvedic treatments including Panchakarma, with Ayurvedic trained
physicians. AVS offers a range of rooms to suit varied budgets. It
is reported that many patients find solutions in Panchakarma
treatment for various ailments like paralysis, arthritis, and
spondylosis. Other major treatments provided at AVS are:
Snehapanam Dhara (Oordhwanga Dhara & Sarvanga Dhara),
Pizhichil, Navarakkizhi, Sirovasti, Pichu and Sirolepa. Besides these
specialised methods, AVS offers Panchakarma treatments like
Kashayavasthy, Snehavasthy, Nasyam, Virechanam and
Raktamoksham.
Ayurvedic medicines prescribed in AVS hospitals are
manufactured in-house with two modern manufacturing units that
are equipped with quality control labs and R&D centers. Medicinal
plants, the basic raw materials for preparation of Ayurvedic
medicines, is also grown in the herbal gardens developed by AVS
as a part of a project for conservation and sustainable use of
medicinal plants. To facilitate follow-up treatment, AVS makes the
medicines available through its wide network of branches

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established in major cities across India and over 900 authorised


dealers network.
The R&D lab, set up by AVS, is actively engaged in research
work for modernization of production and quality control of Ayurvedic
drugs. AVS has on-going research programme with departments /
institutions such as Department of Science and Technology,
Council of Scientific and Industrial Research, and Indian Institute
of Chemical Technology, to evolve modern standards of materials,
processes and products.
Like some of the specialty hospitals, AVS has also contributed
to the propagation of Ayurveda as a course and medical practice,
through establishment of Ayurveda college. The college offers
graduate and post-graduate degree courses in Ayurveda. AVS
functions as a charitable trust and contribute to the healthcare
development of the country through charities. Free medical camps
are conducted wherein consultation, diagnosis and distribution of
medicines to the poor and needy people.
Another activity undertaken by AVS to propagate Ayurveda is
conducting regular academic seminars and meetings, which
provide a platform for scholars to get together and discuss
important academic / healthcare issues. AVS started holding an
Ayurveda Seminar since 1964, as an annual feature. Further, AVS
publish the proceedings of seminars, which are being extensively
used as reference manuals for professionals and students.
In order to propagate Ayurveda amongst international patients,
AVS has set up on-line registration facility through which the
patients will be in a position to utilize various services, including
appointment for consultation, purchase of medicines and room
booking. On-line questionnaire is also required to be filled by the
patients stating details related to their life-style, dietary habits, state
of body (digestion, appetite etc), past medical history and nature
of treatments undertaken.

4.12 INTER-FIRM COMPARISONS AND INFERENCES


FROM CASE STUDIES
The case studies analysed in this report presented an opportunity
to understand the trends and the practices adopted by Indian
healthcare service providers, including medium sized players.

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Box 20:
Taj Group of Hotels – Combining Leisure and Wellness
The Indian Hotels Company and its subsidiaries are collectively
known as Taj Hotels, Resorts and Palaces. Incorporated by
the founder of the Tata Group, Jamsetji N Tata, the company
opened its first property, The Taj Mahal Palace Hotel, in
Bombay, in 1903. Taj Hotels, Resorts and Palaces comprises
59 hotels at 40 locations across India, and 17 international
hotels in the Maldives, Mauritius, Malaysia, United Kingdom,
United States of America, Bhutan, Sri Lanka, Zambia, the
Middle East and Australia.
The company has been contributing to the continued
development of the Indian tourism and hospitality industry. The
company has developed resorts and retreats in tandem with
the tourism developmental policies of the Government of India.
In early seventies, the company has opened India’s first
international beach resort — Fort Aguada Beach Resort — in
Goa.
Taj Hotels Resorts and Palaces has also established the Indian
Institute of Hotel Management, Aurangabad in 1993. The
institute offers a three-year diploma, designed with the help
of international faculty and has affiliations with several American
and European programmes.
Taj Group of Hotels, in a unique manner, provides the
combination of leisure and wellness to its clients. Though the
company has established Spa facilities in several of its network
hotels, the Ayurveda Centres, located at the Taj Residency,
Calicut; and Taj Garden Retreat, Kumarakom offer Ayurvedic
treatments. It may be mentioned that the “Guardian” newspaper
in UK has rated the Calicut centre as one of the authentic
Ayurvedic centres. The Centre has also won the “Green Leaf
Award” of the Department of Tourism, Government of Kerala.
Ayurvedic packages such as Abhyanga, Swedana, Nasya,
Gandoosha, Danta Dhavana, Anjana, Karnapoorna, Snana,
Dhara, Pizhichil, are provided in this Centre. Trained physicians
are sourced from the Ayushman Ayurvedic Trust for provision
of services in the centre.

Source: www.tata.com / Indian Hotels/index.htm

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There are certain general practices being adopted by these players.


These include updation of technology, research in medical
sciences, continuous education and skill development. Majority of
the players have also contributed to the healthcare development
of the society in general, either through their own set-ups in remote
areas or through telemedicine. Some players have also formed
trusts to contribute to the society, especially the poor and needy.
Players in the traditional therapies / spiritual healers mostly operate
in the form of not-for-profit trust and contribute to the well-being of
the society. Specialty hospitals in the modern medicine, such as
Manipal Healthcare Systems has also established network of
hospitals in all the three segments, viz., primary, secondary and
tertiary healthcare.
In addition to skill development through continuous education,
few hospitals have also been concentrating in medical education.
Manipal Health Systems, KIMS and Mediciti Hospitals are running
medical / nursing colleges, with an intensive on-the-job training in
the hospital facilities. Others, such as KIMS, Sterling Hospitals,
as also Mediciti, are conducting government approved DNB
courses. Contribution to education and self-development is also
common with the players in the traditional therapies segment.
Tie-ups with healthcare service providers, tourism / travel
facilitators are other strategies adopted by these hospitals. Manipal
Health Systems (with University of Minnesota), Forntier Lifeline (with
Asahi General Hospital, Japan), Wockhardt (with Harvard Medical
International) are few examples of hospitals that have tied-up for
scientific collaboration and professional knowledge-sharing. Some
hospitals have tied up with Government healthcare departments
(Manipal Health Systems with countries such as Mauritius and
Tanzania) for catering to their national healthcare requirements, or
with insurance companies (Wockhardt with American Blue Cross
Blue Shield Association and Cigna Insurance) as participant hospital
for health insurance coverage. Under the traditional therapies
segment, tie-ups are not amongst institutions propagating different
therapies, but provision of services through complementing the
therapies. For example, Baba Ramdev Ashram and Art of Living
Foundation, both propagate Yoga for wellness, complement the

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wellness systems with Ayurveda. Similarly, Kottakkal Arya Vaidya


Sala combines Yoga with its prime therapy Ayurveda.
The firms analysed have also been providing impetus to quality
improvement and accreditation. While ISO certification is common
to most of the hospitals, one hospital has got accreditation from a
national accreditation agency, NABL, as also from Australian
Council for Health Standard International, and one of them from
Joint Commission International. One of the hospitals’ pathological
department is accredited with College of American Pathologists.
Leveraging the potential of Ayurveda with modern medicine is
not a general practice adopted by these hospitals. However, two
hospitals have tied up with Ayurvedic firms for provision of holistic
wellness services to their patients; others are seriously considering
such practices to attract more number of patients.
Some hospitals, like Wockhardt, are pursuing the franchisee
model, wherein they collaborate with clinics and nursing homes to
develop brand values and run the hospital on franchisee basis.
The strategies behind this model are sharing of technology,
expertise and revenue model. On the other hand, KIMS has a
different model of sharing the technology and expertise as a
consultancy firm, with one-off payment, without lending their brand.
While the model adopted by Wockhardt is low-capital intensive
expansion strategy, KIMS adopts it as revenue earning strategy.
Many healthcare service providers have established a separate
department to cater to the requirements of international travelers
through single window assistance. The range of services provided
start from provision of preliminary information to the travel related
arrangements.
Many players are in expansion mode, both in India and abroad.
Hospitals like Sterling and Escorts are establishing either full-
fledged hospitals or satellite clinics in various cities / towns
contributing to the in-country tourism movement significantly. In
addition to setting up of new hospitals and establishing a pan-
India presence, major players such as Escorts and Wockhardt
are expanding / have plans for expansion of their operations through
acquisitions or setting up of facilities abroad.

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Exhibit 22:
Common Services for International Patients

Source: Adapted from information provided by various hospitals

Under the umbrella of Indian Healthcare Federation, and with


the initiative of Ministry of Tourism, many hospital chains have
agreed to price band for key treatments including angiography,
angioplasty, knee replacement and chemotherapy. Besides, actual
surgery/treatment, the price package comprises all related tests
and scans, medication and hospital stay. Such price-banding help
establish transparency and increases the image of Indian players
in international market.
It may be concluded that there are certain generic practices
adopted by the players such as technology advancement, research
and development, continuous education and skill development. The
firm-specific practices / strategies adopted by these hospitals
include achieving international accreditation and quality standards,

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tie-ups for knowledge transfer and scientific collaboration, and


contribution to in-country healthcare development. Other firms may
learn from such successful experiences and endeavor to adopt
such practices to emerge as global players. In addition, the model
for expansion or healthcare-outreach adopted by various players
may also be considered for implementation by others, to make
India as an ideal provider of healthcare solutions, be it in India or
abroad. Exhibit – 22 depicts the common services provided to
international patients by the Indian healthcare service providers.

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