Association of Healthcare Providers (India) represents the vast majority of healthcare providers in India. It is registered under Society Registration Act- 1860 as “not for profit” organization. It educates to its members and at the same time, advocates with the government, regulatory bodies and other stakeholders on issues, which have bearing on enabling its member organizations in delivering of Universal Health Coverage to the community at large. AHPI has been working on building capacity in Indian health systems with focus on patient safety and affordability of healthcare services.
Founded in year 2012, AHPI has been organizing annual conclave, which is gathering of its members to deliberate on the current status of industry and find solutions to problems being faced by the members. This year it was 6th annual conclave, which was held during 15-16th FEB 2019 at NCR Delhi. The first conclave was held at Bangalore, followed by Hyderabad, Mumbai, Chennai and last one at Cochin. This gives opportunity for regional issues to get highlighted in addition to specific issues at respective locations.
Theme of 6th conclave was ‘Outcome Based Healthcare Delivery Systems’
TECHNICAL AGENDA: The conclave agenda included eight sessions, five of which were on day-one and three on day-two, followed by valedictory speech. The sessions were as follows;
1- Emerging Challenges; Road Ahead: This session was chaired by Dr YP Bhatia, CMD ASTRON with speakers, Dr Girdhar Gyani DG-AHPI, Mr Umesh Gupta HR-Fortis and Dr JS Thakur from PGI Chandigarh. Dr Gyani provided overall context of the session and presented current health status of country and compared with few indicators from SAARC and BRICS nations. Dr Gyani quoted from a WHO study on effectiveness of health systems from 191-nations and showed that effectiveness does not necessarily comes only from quantum of health spending and narrated the key factors which can deliver effective universal health coverage. Mr UMESH GUPTA brought out that healthcare reforms depend upon availability of human resources and went on to stress on need of developing human resource including doctor, nurse and allied health. Healthcare is indeed going to be the largest employer. Therefore, this sector needs specific emphasis and attention by government and all stakeholders. Recent initiatives by government on restructuring of MCI and Allied Health are pointers in this direction.
Dr JS Thakur elaborated on the nation’s disease burden in general and in particular the non-communicable diseases (NCDs). He presented the research work done at PGI and showed the factors which are largely responsible in spread of NCDs. He summed up with key mitigating factors by which country can cope up with the challenge and reduce the disease burden arising out of NCDs.
2- National Health Outcomes: Ms Elisabeth Staundinger, President Siemens Healthineers, Asia Pacific spoke on theme topic i.e. outcome based healthcare. Considering that cost and quality are currently the global key concerns in healthcare delivery, more so in developing countries, this session generated lots of interest among delegates. With her vast exposure, she outlined importance of outcomes in the healthcare delivery, more so when human safety was involved. Dr JL Meena, GM-National Health Authority presented PMJAY model of AYUSHMAN BHARAT, the scheme, which is by far the biggest social healthcare insurance scheme launched anywhere in the world. It is expected to cover 40% of India’s population with cashless treatment of 1350-secondary/ tertiary care medical procedures. It is going to empanel 20-25 thousand hospitals including private and public hospitals to provide services to beneficiaries. The third presentation was on very important topic i.e. ‘Patient Centric v/s Patient Driven Healthcare’ by Dr ABHA AGARWAL. She has long experience in working in USA, where she is known to have turned around low performing hospitals into competitive hospitals. She presented that patients will have decisive say in defining of care path and care plans along with principle doctor in future hospitals. Patient driven hospitals in that respect are one notch higher than patient centric hospitals.
3- Futuristic Models in Healthcare Delivery: Presently most developing nations including India is short on availability of healthcare structure. India for example has 1-bed per 1000 population as against the WHO norm of 3-beds per 1000 population. Under such circumstances we need to look for alternative modes to cater to healthcare needs of population. Col (Dr) Ashvini Goel presented practical model of telemedicine which can be every effective in delivering of care in remote areas. He presented that with little training and putting up of inexpensive infrastructure we can connect the population at remote areas with specialist sitting at urban headquarters. Ms Meena Ganesh presented home healthcare model, which is being projected as future of healthcare more so for chronic and geriatric patients. Both the presentation showed huge potential in supplementing of conventional infrastructure of healthcare and tide over the shortage of beds in the country.
4- Value Based Financing/ Sustainability: This is the area which is of great concern to industry. With the launch of Ayushman Bharat and along with existing state insurance schemes, it is expected that about 75% of population will be covered under one or other government supported scheme. While on one hand, it is big step in direction of providing universal health coverage to the population, the way reimbursement is being paid to hospitals, has raised serious concerns for the industry. Firstly the rates of medical procedures have been fixed without any scientific study and are found to be illogical and irrational. Over and above payment to hospitals is delayed for months. This has pushed hospitals to the brink of unsustainability. Mr Dilip Bidani CFO Radiant Health presented analysis of various financial heads in function of hospital and provided practical inside of innovative modes of futuristic healthcare financing. Ms Malti Jaswal from National Health Authority spoke on bundled payments, which is going to be futuristic way of reimbursement in general and government health insurance schemes in particular. There was widespread concern from delegates as they raised questions about costing of procedures in AYUSHMAN BHARAT. Ms MALATI presented NHA point of view and assured delegates that revision of costing was under way and stressed upon hospitals to partner in the scheme.
5- New Vistas in Hospital Management: This session had two of very senior speakers from industry including Dr Harish Pillai, country CEO of Aster Hospitals and Mr Vishal Bali, Executive Chairman Asia Healthcare Holdings. Dr Pillai spoke on ‘Transformational Leadership’ and stressed that healthcare industry was indeed passing through challenging time. Managing cost and quality were two conflicting challenges and require competent leaders to take charge. He stressed upon need of empowerment so as to motivate staff at all levels to take ownership of processes. Mr VISHAL BALI spoke about the present status of healthcare in the country and came out with some of the futuristic models by which country could achieve goal of universal health coverage. He also brought point of regulatory measures initiated by government, some of which were coming in the way of sustenance of industry.
6- Improving Clinical Outcomes: Healthcare quality is characterised largely by clinical outcomes and to secondary extent by managerial or service outcomes. The session was chaired by Dr Narottam Puri and Co-Chair by Dr Keshav Rao from Fortis Healthcare. Dr Sanjeev Singh, MS-AIMS presented all important talk on involvement of clinicians in undertaking clinical outcomes. He emphasised that clinician’s first need to be formally trained on doing clinical audit as this subject is not even covered in the UG/PG level curriculum. He raised concern that very few hospitals were able to undertake comprehensive clinical audit. He also suggested that there was time that clinical outcomes of hospitals should be made public and should become criteria for compensation like done in some of the developed countries under ‘pay for performance’ model. Dr Jothi Clara, Chief Clinical Governance Officer Kauvery Hospitals, presented role of nursing staff in improving of clinical outcomes. She suggested that nurses need empowerment at nursing council level so that they can be assigned with more responsibility to be partner with clinicians. Dr BISHNU PANIGRAHI, CEO Kalinga Institute of Medical Sciences presented model under which clinicians need to take leadership role for each speciality and develop team work between clinicians, nursing staff, administration, quality, pharmacy and diagnostic. He was of opinion that teamwork only can help in minimising medical errors and improve clinical outcomes.
7- Improving Managerial Outcomes: This session was all about improving service quality and operational efficiency. Dr ARATI VERMA Sr. VP Medical Quality MAX Healthcare chaired the session. There has been perception that healthcare industry was not focussed on efficiency unlike other industries like automobile, IT etc. AHPI invited KAIZEN institute to present their model of lean management, which has proven tools to cut down wasteful processes and streamline the workflow so as to add value. Presentation was appreciated and has given boost in the efforts to apply statistical and TQM tools in healthcare industry. Then there was presentation on green concepts by Mr Josh Karliner from USA, which once again focussed on effective utilization of precious resources like water, electricity and balancing of carbon footprint.
8- Hospitals of Future: Ms Unni Silkoset, Regional Director for South Asia, Laerdal Medical, made interesting presentation on ‘High Reliable Hospitals’. Future indeed belongs to technology driven hospitals including use of 3D printing, use of AI and making of Smart Hospitals. All these interventions are aimed at improving accuracy, ease of diagnostics and being patient centric. Mr Suresh Subramanian from BIOCON and Mr Krishna Chellapa from Fresenius Medical Care, were other speakers.
9- Valedictory: Dr Devi Shetty delivered the valedictory speech. He demonstrated using APP on his mobile the patient engagement and real time data sharing. This will help surgeon to have up to date information in real time, which can help him in taking critical decision in the midst of surgery. Dr Devi also highlighted need to increase number of PG seats without which no amount of finance can improve the health indicators like IMR/MMR. At this occasion Ms Ritu Maheshwari, IAS, DM Ghaziabad and Ms Kanchan Verma, IAS, VC-GDA were present as Guest of Honour.
10- AHPI Award for Excellence in Healthcare 2019: AHPI as representative body of healthcare providers had introduced awards for excellence in healthcare in the year 2014 to recognize and celebrate the excellence achieved by the hospitals in various fields. The 5th edition of awards were presented during this conclave. The categories in which AHPI recognizes the excellence are;
Best Hospital to work for
Quality Beyond Accreditation
Excellence in community engagement
Best State with maternal and child health services
The awards were designed on basis of objective criteria. Based on the application submitted by hospitals, field visit is made by the senior and qualified assessors to evaluate on ground the application and impact. The assessment reports are then evaluated by JURY. This year AHPI recognized 46 healthcare organizations which have achieved success in various fields.The award function took place at Hotel Radisson Blu, Kaushambi on 15th Feb 2019. Hon Minister of State for External Affairs Gen V.K Singh presented the awards to the respective healthcare organizations.