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Healthcare Industry
Largest in the world with revenues over $3 trillion Indian healthcare industry is worth about Rs.100,000 crores, accounting 5% of GDP
Hospitals & NH
Pharma & Supplies 20% 40%
Two thirds of beds in Govt. & local authorities (Total 630,000 beds)
MEDICAL TOURISM
HOSPITALS, NURSING HOMES, CLINICS, LABS
TPA
TRANSPORT
Hospitals
Govt, Corporate, not-for-profit, others Not-for-profit Sec 80G, Sec. 35AC, Sec. 35(1)(2) of Income Tax Act, Section 25 Company Hospital Management
Marketing Strategic Planning Finance & Administration IT HR Materials Quality New Project planning & execution (India & Overseas)
Secondary & Tertiary Care requires large investment, viable bed size, technological obsolescence Increasing corporatization Venture capital funding Slow, but emerging private health insurance/TPA Global alliances Listing of companies Felt need for professional management Sick hospitals Marketing of services M&A, Brand buying, Brand extension, franchising
Rating of hospitals (CRISIL, ICRA) Accreditation by TPAs Recertification of Doctors (in future) Spiraling hospitalization costs Epidemiology:
500,000 cancer patients added p.a. 40 million diabetics 60 million patients 70-80 million senior citizens Obesity, psychiatric patients.
Medical audit, accreditation & other standards Waste disposal (State Government) ISO JCAHO (USA Standard) NABL Blood Banking (GOI standards) Licensing & inspection (under consideration) Protocols for clinical trials Consumer protection act (private hospitals)
Elective
Tertiary Hospital
Capital Intensive Long gestation period Doctor-oriented Frequent up-gradation of technology Service organization
Patient focus Employee focus
Medical Tourism
Emerging opportunity
Hospitals Travel agents Airlines Hotels
Rs. 1500 Cr. Revenue in 2004 McKinsey projection Rs. 5000 to 10,000 cr. In 5 years Major Corporates
Tatas Max Piramol Fortis Wockhardt Apollo gearing up
Coordinated program : Airline tie up, pick-up, visa etc. subsequently general tourismpp
Pharmaceutical Industry
Bulk drugs, drug intermediates, formulations, generic & branded, OTC Bio-technology, Bio-informatics, neutraceuticals Annual turnover Rs. 23,000 cr. (5-6% growth p.a.) Employment Direct - 50 lakhs Indirect - 25 lakhs 20,000 units (300 in the organized sector) No. of hospitals 16,000 Retail chemists 6 lakhs 4th in the world (volume) 12th in the world (value) Significant exports from India
Many drugs off patent ($30-40 billion in the next 5 yrs) strategic marketing alliances Good manufacturing practices quality Industry research collaboration Ayurvedic drugs Bio-technology Only a small number of items under DPCO (40 or so) Spurious drugs in India Global R&D 18 year patent Upto 15 years from molecule to marketing
Siemens, Philips, Hitachi etc. New hospitals, modernization (technological obsolescence) Each new bed total capex Rs. 20-100 lakhs Equipment sales, AMC, Spare parts, training Rs. 8,000 to 9,000 crores p.a.
Public Sector
General insurance of India & 4 subsidiaries
Private Sector
Royal Sundaram, ICICI-Lombard, Bajaj Alliance etc. TPA - TTK, Heritage, Family Health Plan
Present coverage only about 3-4% of the population Govt. likely to allow separate health insurance co (Rs. 25 crores equity)
Members pre-pay a set amount (flat rate) Voluntary health insurance (VHS-Chennai) Co-operative, SEWA, Foundations Narayana Hrudayala Universal Health plan of the four insurance companies About 50 million covered In addition: ESI CGHS (Retired employees) Mediclaim
TCS, Wipro, Infosys, Cognizant, iSoft, Covansys etc. US, Europe, Australia clients, Govts. and private hospitals Global healthcare spend $5 trillion, US 1.7 trillion (15% of GDP) USA IT spend $25-30 billion Europe 800 billion Healthcare spend 12% to 15% of GDP (India about 5-6%) iSoft Healthcare 260 million, 4000 employees (950 application specialists) Cognizant : $600 million Of the above, 22% from healthcare and life sciences 3000 domain & technology experts
IT in Healthcare
Medical
Picture Archival & Communication System (PACS) DICOM (Digital Imaging & Communications in Medicine) Telemedicine Electronic Medical Records Clinical Decision Support Systems HL7 protocol Epidemic prevention software
Non-medical
Integrated hospital information system Web-enabled Appointment Scheduling Web-enabled applications for relatives to obtain conditions of the critical patients Multi-media applications for patient education Medical equipment management software Web-enabled CRM applications
IT (Healthcare) Projects
End to end product linking with provider, payer, patient HIPAA compliance
Data warehousing and decision support systems Electronic Medical Records
Healthcare CRM
Maintenance of systems
BPO
Areas:
Medical Transcription Claims processing Billing by Doctors (on insurance companies) Clinical documentation Clinical trials English language Cost arbitrage Time difference High quality (e.g. >99.5%) Multi-disciplinary teams
Clinical Trials Revenue Rs. 300-400 crores CII Projection : Rs. Cr. 2007 800 2010 4000 Large population Medical, Lab manpower
Healthcare Consulting Major areas: Hospital feasibility studies Funding of new projects Efficiency improvement Market survey & marketing of services Organization review Strategic planning Insurance products IT ERP, EMR, system integration
Healthcare Consulting Clients: GOI, State Governments. UNICEF, World Bank, ADB, DANIDA Corporate & not-for-profit hospitals Insurance Company Strategic investors IT Companies
Challenges Ahead
Structure and financing of healthcare is changing rapidly Future managers in healthcare sector to be prepared to deal with
evolving integrated healthcare delivery systems technological innovations an increasingly complex regulatory environment restructuring of work increased focus on preventive care improving efficiency in healthcare facilities and the quality of the healthcare provided managing finances including modernization, expansion plans and brand extensions optimizing efficiency of a variety of interrelated services (e.g. those ranging from inpatient care to outpatient follow-up care) managing the growing aspirations of doctors (compensation, revenue sharing, high-end equipment, specialized courses etc.) High turnover of para medical staff including nurses Social Marketing
To sum up
Wide ranging career opportunities in India and elsewhere Domain expertise healthcare management essential Growing sector Job satisfaction Socially relevant jobs