1.
CASE STUDY ON
EXPANSION AND ESTABLISHMENT OF
PATIENT CARE HOSPITALS
IN BIHAR, CHHATTISGARH, JHARKHAND AND
MADHYA PRADESH
SUBMITTED BY
SHUBHENDU CHAKRAVORTY

2.
Preface
like, Life Expectancy, Under Five Mortality Rate, Adult Mortality Rate and others well below the global and in some cases
regional average. While the Government is recalibrating its approach to lay more focus on Healthcare; factors like diversity,
administrative structure and vast geography makes the task more challenging. This presents a perfect case for a Public-
Private Collaboration to develop wherein the Private Sector can supplement the efforts of the Government with focused
intervention
The total Health Expenditure, including the Private Healthcare Systems today stand at close to 4% of the GDP which
is a further case in point for more such participations. The fast changing economic scenario of the country along with
rising aspirations of the people, both financially and socially, further develop a constructive environment for sustainable
intervention of the Private initiators. However, fast paced development often also creates disparity and inequitable
distribution of resources, which leaves the population venerable. While healthcare in India is expanding rapidly in the
metropolitans and urban centers, the rural and remote areas are still as dependent on Government services as they were
decades back. The dwindling health indicators of India are largely from these dark pockets of the country which even
today await a sustainable model of healthcare, which has till now been elusive and an expensive
The Government of India has articulated its long term goal in the Twelfth Five Year Plan of achieving ‘Universal Health
Coverage’. While the Government will lead the journey over the next decades, the private sector shall be presented with
opportunities to intervene with newer business models, especially, for the rising sections of the Society
In such dichotomy, innovation can step in and provide long lasting solutions which are both sustainable and expandable.
Patient Care aims to present a model of low cost-high quality Healthcare which, drawing on its key focuses, sustains
healthcare centers in states with particularly poor healthcare indicators in comparison to the national average and reduce
the inequity in healthcare access in the country
1.20% of the GDP in India is utilized for Public Health Expenditure. This in a country which has the key health indicators
.
.
.
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PATIENT CARE HOSPITALS
SEPTEMBER, 2014
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3.
The Case Study
Patient Care is presently operating 50 low cost-high
quality Hospitals in Patna, Bihar in and around the city
slums and now intends to expand the Hospital Model
into other states with similar health indicators. A total
of five hundred Hospitals shall be established in phases
across the states of Bihar, Chhattisgarh, Jharkhand and
Madhya Pradesh. This case study attempts to provide
blueprint for the expansion plan and its implementation.
Disclaimer: All the data used in this Case Study is
authentic and has been reffered to from various
Government and Non-Government sources. Please refer
to the Bibliography at the end for further details.
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4.
Contents
Page 4
Cornerstones of our Philosophy
Proposed Expansion Model
Focus Area Strategies
Innovation
Locations
Timeframe
Work Plan
Management Structure
Hospital Management Information System
Anticipated Challenges
Bibliography
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06-07
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09-10
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5.
Cornerstones of Our Philosophy
The cornerstones of the expansion journey for Patient Care from a chain of fifty successful Hospitals in Patna to becoming
a network of over five hundred hospitals in the four key states shall be the following.
Equitable Access
to
Quality Healthcare
High Quality
Healthcare
Community
Ownership Innovative Ideas
Low Cost
Healthcare
One of the founding Objectives of Patient Care to make access to quality Healthcare equitable and delink it from the
beneficiaries Social or Financial Status.
Equitable Access to Quality Healthcare
A pre-requisite to meet our overall objective of making healthcare access more equitable, low cost healthcare shall
be achieved through rigorous utilization of assets, leveraging Information Technology and constant monitoring of
operating expenses to ensure sustainability.
Low Cost Healthcare
One of the prime focuses of Patient Care is to ensure that the Quality of Healthcare is consistent with the acceptable
industry standards. Stringent control over the quality of healthcare shall be maintained and all the Hospitals since
inception shall follow the Pre-Assessment Guidelines of National Accreditation Board for Hospitals and Healthcare
Providers (NABH) and seek accreditation within 3 years of operation.
High Quality Healthcare
It is imperative that participants or beneficiaries are transformed into stakeholders for long term sustainability of the
Hospitals. Patient Care shall lead extensive outreach initiatives with community involvement in the geographical areas
around the hospitals.
Community Ownership
Innovative Ideas
Focus shall be on developing innovative ideas which shall bridge the gap between technology and the patients which
can initiate a social impact and further strengthen the economic model of the Hospitals.
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6.
Proposed Expansion Models
Three expansion models have been proposed with the Key Highlights and Drawbacks
MODEL A
PROFIT
NOT
MAXIMIZED
MODEL B
COMMUNITY
AS
STAKEHOLDERS
MODEL C
GRATIS OPD
AND
SUBSIDIZED
TREATMENT
MODEL A
PROFIT NOT MAXIMIZED
This model proposes establishment of ‘for Profit’ Hospitals which focuses on providing services on lowest possible costs
without maximizing the Profits.
Key Highlights
Specialized provision for Maternal and Pediatric Care. This will ensure a narrow focus in health care and directly
address the major challenges of reducing the Maternal Mortality Rate, Child Mortality Rate and the Child
Nourishment Ratio. The specific focus will also enable alignment of medical equipments and thereby contribute
significantly in streamlining the operating costs.
Partnership with the Government on various Health Services extension schemes like Janani Suraksha Yojna.s
Sustainable. A for Profit venture shall ensure sustainability of the Hospital while covering costs and not maximizing
profits. s
Drawbacks
Exclusion. Of the most venerable section of the Society which may be financially unable to even afford the lower
prices of the Services.s
Fluctuating External Factors. Like manpower cost, operational costs etc. may force the pricing to remain dynamic
which may affect the sustainability.s
The Internal Cross-Subsidization Model. Highly depends on the demography and financial strength on the region.
Unless the area is both financially and socially diverse this model may not be sustainable.s
Healthcare Activism and Community Outreach. May be non-compatible into the priority focus areas of the model.s
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7.
MODEL B
COMMUNITY AS STAKEHOLDERS (FOR PROFIT)s
The key element of this model is to develop the participating Community as Stakeholders contributing to of the Hospitals. The Hospitals shall be established on non-return profit franchise model wherein the 5-6 Village Panchayats could jointly pool in resources to contribute to the logistical expenses of the establishment of the Hospital and certain defined overhead costs of sustaining it while Patient Care shall contribute the medical infrastructure, Hospital management, manpower and all other aspects. Therefore, the service cost of the Hospitals can be significantly subsidized for the patients. All income from the Hospital shall be the rights of Patient Care while the subsidized services to the village residents shall be thePanchayat’s advantage. s
Key Highlights
Broader Base for Social Inclusion. This model shall include a broader base of the lower income population andthus further expanding the social base.s
Community Ownership. With deep involvement of the Community, the ownership and interest in its sustenanceshall be much higher.s
Health Activism. This model is compatible with the ideas of Health Activism and provides a chance to developcollaborations.s
Community Outreach. The key element of the Marketing Strategy shall be to introduce various initiatives betweentargeting communities.s
Partnership with the Government on various Health Services extension schemes like Janani Suraksha Yojna.s
Drawbacks
Village Panchayat Dynamics shall directly affect the functioning of the Hospital.s
The Social Dynamics of the villages shall become more significant as the Villages shall be contributory partners.s
The Income shall be on sustenance basis and any upgradation of medical equipments shall be Patient Care’sresponsibility. s
The Most Venerable Section may still remain out of bounds for the Hospital owing to social dynamics, servicecosts or other factors.s
MODEL C
GRATIS OPD AND SUBSIDIZED TREATMENT
The Hospital shall fully function on the funding available from external financial sources. The Out Patient Department shall function gratis; treating the patients without costs while having a layered service cost for admitted treatment which shallhelp the Hospital to break even within a targeted span.s
Key Highlights
Total Inclusion. The objective of total inclusion may be achieved as access to preliminary quality healthcare shallbe delinked from financial resources.s
Layered Service Costs. Higher social income groups could utilize the layered services which could expand thecustomer base of the Hospital.s
Health Activism. This model is compatible with the ideas of Health Activism and provides a chance to developcollaborations.s
Community Outreach. The key element of the Marketing Strategy shall be to introduce various initiatives betweentargeting communities.s
Drawbacks
The Model is entirely based on external funding which will be unsustainable and unstable.p
Expansion or Upgradation shall be based on the funding available and thus render the model dependent.s
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8.
Focus Area Strategies
Patient Care Hospitals shall have a three prong approach which shall focus on Maternal Care, Pediatric Care and Out
Patients.s
MOTHER AND CHILD
Maternal and Pediatric Health are most
venerable with the key health indicators
indicating critical attention needed in these
areas especially in central-eastern India where
the population does not have immediate access
to quality healthcare. Patient Care attempts to
step into this void to develop specialized care
for maternal and pediatric care.s
OUTREACH
Patient Care shall depart from the
usual strategy of awaiting patients and
reach out to Communities (Women and
Children) partnering with institutions like
Schools, Anganwadis, Mahila Kendras
and conduct awareness workshops and
other Outreach Activities.s
OUT PATIENT DEPARTMENT
This shall further objective of maximized
inclusion and provide common healthcare
facility to the residents. Patient Care shall
collaborate with nearby multi-specialty
hospitals for referral of patients under
mandatory admission to EWS (Economically
Weaker Section) patients and with other
Government Hospitals.s
56 48 UNDER FIVE
MORTALITY RATE
PER 1,000
LIVE BIRTHS
India Average Global Average
Only about52%Patients having
diagnosed for any kind of Chronic Illness in Bihar,
Chhattisgarh, Jharkhand and Madhya Pradesh are
getting Regular Treatment.s
ONE
TWO
THREE
54is the Average Infant Mortality Rate
is the Average Infant Mortality Rate in the four Focus
states of Bihar, Chhattisgarh, Jharkhand and Madhya
Pradesh. S
While the National Average is .s 44
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9.
Innovation
OPERATIONAL
STANDARDIZATION OF PROCESSES
All operational processes shall be centralized and standardized. For instance, procurement shall be made
through the dual channel of Central and Local Procurement. While infrastructural material shall be procured
centrally, operational material shall be procured locally. s
LOW CAPITAL EXPENDITURE MODEL
The Hospitals shall be developed to be ‘No-Frills’ hospitals. A series of measures will be taken to implement
the low capital expenditure model including seeking a long-term lease of the land, restricted spending on the
non-necessary fixtures like Air Conditioners etc., Streamlined design and utilization of space etc.s
INTERNAL CROSS-SUBSIDIZATION
Layering of the accommodation being provided in the Hospital with Private wards available at market prices.s
CLUSTER APPROACH
To better utilize resources and create a common pool of central resources for a District the cluster approach
shall be adopted in establishing the hospitals which shall further intensify healthcare access and streamline
utilization of resources. s
OUTREACH
EMERGENCY RESPONSE MECHANISM
This mechanism seeks to address the emergency requirements of the villages in 10kms. or more of the Hospital
at any time of the day. The average Telephone/Mobile Density in the urban areas of Bihar, Chhattisgarh,
Jharkhand and Madhya Pradesh is 73.65% while in Rural areas it is 39.40% .s
SERVICES
A community plan could be proposed which provides emergency response service of a semi-equipped
ambulance for providing initial treatment, transport to the Hospital and services of a trained medical
practitioner. This would essentially link the villages beyond the catchment area to the Hospital and increase
the customer base.s
COMMUNITY SCHEME
This scheme could be implemented at a community level to pool in resources and minimize costs which would
mean that this service can be opted for by a village or a significant % of the village and not individual persons.s
COSTING
The objective being to provide an emergency response mechanism to those beyond the catchment area of
the Hospital the costing could be to cover the operational and sustenance cost than the establishment cost.
A model costing is presented for reference:s
Average Households per Village
Average No. of Personsper Household
Total Persons per Village
Subscription to Emergency Response Mechanism Scheme
Service Cost
Per Household Cost per Month
Per Vilage Cost per Month
Note: All Data has been reffered from Annual Health Survey Factsheet, 2010-11
300
04
1200
50%
Re1
Rs. 120 per Household per Month
Rs. 18,000 per Village per Month
Households range from 150-2000 homes
Persons
Persons
Per Person per Day
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10.
SCHOOL HEALTHCARE OUTREACH PROGRAMME
Healthcare with the aim of wellness is not practiced in India generally, primarily due to immense strain on existing resources which prioritize treatment of chronic diseases. The average percentage of Children attending School in the targeted four states is 87.75% in Rural areas and 91.55% in Urban areas . Patient Careshall attempt to launch a School Healthcare Outreach Programme which shall have the following objectives:s
-Ascertaining the Health Status and identifying children with health deficiencies ranging from minor to critical
-Screening for deficiencies, diseases and disabilities
-Conducting Vaccination Drives
-Providing Training on First Aid
HEALTH PROBLEMS IN SCHOOL CHILDREN
The health problems of school children vary from one place to another. However, the main emphasis will fall inthe following categories:s
-Malnutrition
-Infectious Diseases
-Intestinal Parasites
-Diseases of Skin, Eye and Ear
-Dental carries
COMMUNITY VOLUNTEERING
The School Healthcare Outreach Programme shall be implemented on the ground under the supervision of the trained medical practitioner by a team of Volunteers from the villages who shall be provided adequate trainingand given know-how.s
Eventually a cadre of part time Volunteers shall be built who shall act as a link to the village and further act asHealth Change Agents in their villages and implement the various social initiatives of the Hospital over time.s
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11.
Locations
One of the cornerstones of our Philosophy is to provide equitable access to healthcare and delink it from the beneficiaries
Social or Financial status. This is the central guiding principal while the locations of the Hospitals have been proposed.s
All data being presented below is original and has been referred from the Annual Health Survey Factsheet, 2010-11
conducted by the Office of the Registrar General and Census Commissioner, India.s
METHODOLOGY
A three step method has been followed to identify locations for the Hospitals. The locations have been limited to the
Districts of the States.s
STEP 1
PROFILING THE HEALTH STATUS OF THE STATES, DISTRICT WISE
The Annual Health Survey Factsheet profiles all the District of the State across 152 Parameters in 29 Categories (Annexure
1). A statistical comparison on 25 Parameters across 7 Categories has been drawn of the four Target States of Bihar,
Chhattisgarh, Jharkhand and Madhya Pradesh which is presented below:s
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12.
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13.
STEP 2
IDENTIFICATION OF THE CRITICAL DISTRICTS IN THE STATES
In the second step the most critical districts on more than 4 and 3 parameters are identified and assigned Zone A (CapitalCity, except Bihar), Zone B and Zone C respectively.d
The State Capitals (excluding Patna in Bihar) have been marked as Zone A and have been identified for the inaugural intervention in the State. The critical Districts of the State(s) categorized in Zone B for higher Critical Districts and ZoneC for Medium Critical Districts in order of their health indicators.s
BIHAR
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14.
CHHATTISGARH
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15.
JHARKHAND
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16.
MADHYA PRADESH
STEP 3
SHORTLISTED DISTRICT RATIO
BIHAR
CHHATTISGARH
JHARKHAND
MADHYA PRADESH
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17.
Timeframe
The Hospitals which have been categorized in three Categories shall be launched in separately in the same sequence as
detailed below:s
RATIO
The following Ratio has been proposed for establishment of the Hospitals:s
ZONE A: INAUGURAL INITIATIVE IN THE STATE
Each state Capital has been included in Zone A irrespective of the Social Indicators since the inaugural intervention in
the state shall be a replicated model of the cluster Hospitals close to the Slums in Patna. The inaugural initiative shall
establish itself as the pilot project in the State and provide Patient Care an opportunity to understand the State dynamics
and develop further collaborations.s
Number of Hospitals
Cluster Hospitals are opened in the City Slums, 10
surrounding areas and in the residential areas of the Lower
Income Group.s
Incubation Period
Two years is the incubation period of each Hospital to break
even.s
Launch Month
March 2015
ZONE B: HIGHER CRITICAL DISTRICTS
Half i.e. 50% of the allocated Hospitals shall be established in the higher critical districts of the State in cluster of 10
Hospitals. s
Number of Hospitals
Hospitals in clusters of 10 are opened in each of the Zone
B Districts.s
Incubation Period
Three years is the incubation period of each Hospital to
break even.s
Launch Month
October 2015
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18.
ZONE C: MEDIUM CRITICAL DISTRICTS
A total of 40% of the allocated Hospitals shall be established in the higher critical districts of the State in cluster of 10Hospitals.s
Number of Hospitals
Incubation Period
Three years is the incubation period of each Hospital tobreak even.s
Launch Month
May 2016
Hospitals in clusters of 09 are opened in each of the ZoneC Districts.s
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19.
Work Plan
The Expansion Project shall be conceived and implemented by the Project Management Team which shall oversee all
aspects including Strategic, Planning and Implementation.s
OBJECTIVES OF THE PROJECT MANAGEMENT TEAM
The Objectives of the Project Managment Team shall be:s
Need Assesment
Review of Existing Facilities
Role of the Patient Care Hospitals in the local
context
Deciphering any specific local dynamics
Implementation of the Project
COMPONENT OF PROJECT MANAGEMENT
Feasibility Study
Identification of the Break Even Period and Expense
Model
Commissioning
Strategic Planning
FEASIBILITY STUDY
Data Collection
Demographic Pattern
Need Assessment
Transport and Communication
Site Selection
Environmental Study
Village and Panchayat Dynamics
Market Cost Analysis
DATA COLLECTION
Demographic Data
Geographic Data
Analysis of the Utilization of Present Healthcare
Facilities
Disease Pattern
Existing Facilities and User Feedback
SITE SELECTION
Availibility of adequate land as per the size of the
Hospital
Approach Raod
Suitable Soil Condition
Suitable Drainage System for Disposals
ENVIRONMENTAL STUDY
Moderate Climate
Non-existance of any Waste Dumpyard in the
vicinity
Away from the Main Road and Heavy Traffic flow
PHASE 1: PLANNING
NEED ASSESSMENT
Type of Healthcare already existing - Preventive,
Rehabilitation, General Care, Special Care etc.s
Economic Status and Source of Earning
Motivation for Utilization of Private services by
people
Housing, Education and Awareness among the
people
CONNECTIVITY
Access from the main centers of the City, Village
Availability of Private Taxis and other means of
Transport
Easy access to Transmission Towers for
uninterrupted communication
..
......
...
..
....
.
...
...
..
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..
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20.
PHASE 2: STRUCTURAL IMPLEMENTATION
LAND SCOUTING
The Project Management Team shall, based on the Reseach parameters as mentioned in Phase 1 shall scout for the Landand seek a Long-Term Lease from the owner.s
RESOURCE ALLOCATION
An estimated Resources Allocation Chart detailing the Financial and Operational Resource requirements for theincubation perriod shall be prepared for implementation.s
EQUIPMENT & OTHER ITEM SOURCING
The Central Procurement Team shall take over all the Procurement requirements and start negotiations with theVendors.s
STRATEGIC PLANNING
The Project Management Team taking into account the various Factors from the analysis reports obtained in Phase1 plan for the following aspects:s
Staffing
Medical Doctors, Techinical Staff, Nursing Staff, Administrative Staff etc.s
Machinary Equipments
Priority Equipment, Heavy Equipment, Investigation Machines, Instruments, Drugs and Disposables, Furniture, Linen, Other Items
.
.
COMMISSIONING
Aspects like refurbishing of the Premises, Recruitment ofStaff etc.s
PHASE 3: INCUBATION PERIOD
The Project Management Team shall be responsible for Monitoring of the Project through the incubation period for requirements like liaison with other Units and any other requirements. During this period the Project Management Team shall handover the Operational Responsibilities of the Hospital to the local team and exit day-to-day Operations within adefined period of time.s
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21.
Management Structure
Patient Care operates thorugh three layer Management and Reporting Structure of Central, State and Unit Level teams
working in tandem.s
CENTRAL TEAM
The Cenral Team is madated to oversee the strategic direction, overall implenetation and monitoring of the Units and to
ensure that the cornorstone of the Groups philosophy is rigorously followed. The Central Team shall primarily facilitate
and enable the State and Unit Level Teams and work through the following departments:s
VISION & PLANNING
Often operating as a think tank, this team shall be responsible
for envisaging the vision of the organization. The team would
be involved in strategic planning of the broader vision of
the organization. s
PROJECT MANAGEMENT
This team shall be responsible for implementation of
different projects undertaken by the organization. The
project team has a complete overview of the requirements
of the different projects and works towards its completion.
s
CENTRAL PROCUREMENT
The Central Procurement Team shall be responsible for all
the major, centre-related procurements for all its hospitals.
This shall bring in standardization and uniformity. s
EQUIPMENT & INFORMATION TECHNOLOGY
This team shall be responsible for carrying out research on
the new forms of medical equipment available. The team shall
also be responsible for assessing the needs of every hospital
and recommending the suitable medical equipment. They
would also find ways of integrating information technology
with the hospital requirements for better implementation of
the Low Cost-High Quality model.s
LEGAL & COMPLIANCE
Responsible for all legal matters, audit, submission of
documents etc. Weekly and monthly reports would be
compiled and sent. s
HUMAN RESOURCE AND TRAINING
Responsible for all the staff members of all the centres of
this hospital. This team would be involved in not only hiring
and recuditruitment, but also in providing necessary support
to all the staff members as well through workshops. s
ADMINISTRATION & GOVERNMENT LIAISON
This team would be responsible for overall administration of
the Group and shall look into matters of government liaison
at the central level. It shall stay in touch with government
offices, health officers etc.s
MANAGEMENT INFORMATION SYSTEMS
The MIS team is crucial in any organization. This team
shall monitor and analyze data being recorded at the Unit
Level and be responsible for the overall management of the
integrated Hospital Management Information System.s
QUALITY CONTROL & AUDIT
The quality control team needs to ensure that all the hospital
are following the given’s guidelines and procedures. It may
conduct special check on hospitals from time to time, which
may be informed to the hospital or otherwise. s
FINANCE MANAGEMENT
This team looks into the financial aspects of the organization.
Budgeting, analyzing financial data, bringing out financial
advisory and notifications falls into their purview.s
MARKETING & COMMUNICATION
This team is in charge of both internal and external
communication. Through marketing, they generate grants
and funds while the communication team sets internal
communication processes and also organizes outreach
campaigns in schools and villages. s
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22.
STATE TEAM
The State Team shall be the coordinating unit between the Central and the Local Unit. The State Team shall be a compact team of professionals functioning under a State Programme Manager to monitor the functioning of the Hospitals within the State, Monitor the Strategic Intervention of Patient Care in the State, Porject the State Expansion Plans and coordinate withthe State Government for collaborations and partnership. The State Team shall work through the following Departments:s
STATE MANAGEMENT TEAM
The State Management team is responsible for heading the state units of the organization. It is responsible for theactivities of all the hospitals in a particular state. s
STATE PROCUREMENT
The state procurement department shall procure according to the requirements of the hospitals of the state and mandategiven by the Central Procurement Department. s
MONITORING
The Monitoring team would be monitoring the working of different people in the company. Continous monitoring, providing feedback review and evaluation would hel[p thehospital keep a check on itself and evolve. s
GOVERNMENT LIAISON
Coordinate with the State Government for Collaborations and Partnerships in the State. Monitor the State Health Policy and work on the areas of expansion for Patient Care’sintervention in the State.s
HOSPITAL TEAM
The Local Unit of the Patient Care Group, the Hospital Team shall be the on-ground team. The Medical and Operational Roles of the Team shall be segregated distinctly for better implementation. The Hospital Team shall work through thefollowing Departments:s
MEDICAL SERVICES
OUT PATIENT DEPARTMENT
The Out Patient Department, meant to provide immediatemedical care and attention. s
MATERNAL CARE
One of the main wings of the hospital, this will be responsible for providing maternal medical care, which shall be one ofthe Key Strategies of the Hospitals..s
PEDIATRIC CARE
Our focus remains women and children. This departmentprovides medical attention to children. s
EMERGENCY RESPONSE MECHANISM
A unique initiative of this hospital, people in this department, work to provide access to immediate medical care tovillagers living in remote corners. s
COMMUNITY OUTREACH
This department heads community outreach initiatives like taking healthcare to the schools, addressing sanitationissues with people etc. s
NURSING & SUPPORT SERVICES
This department consists of the Nurses and Support Staffwho work across departments to provide their services.s
ORGANIZATIONAL SERVICES
HOSPITAL ADMINISTRATION
Responsible for the overall working of the hospital, this team looks after day to day administration needs includingScheduling etc. and MIS requirements for the hospital.s
MARKETING & PUBLIC RELATIONS
As a subordinate group of the main marketing team, this team is responsible for setting up collaborations with localinterested partners and formulate Outreach Activities.s
QUALITY MANAGEMENT
Working as a subordinate Group of the Central Team, this team shall be responsible for Quality Adherance and Auditat the local Unit level.s
FINANCIAL MANAGEMENT
This group shall be responsible for the Financial Managmentof the Hospital.s
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23.
Hospital Information Managemeng System
Record Management and Reporting of the Hospitals shall be through an integrated Hospital Information Management
System which shall link all the Hospitals to the Cenral and State Teams. The HMIS shall provide layered access to the data
being generated for various purposes.s
The local Hospital Unit shall be responsible for Data Entry into HMIS and its local management while the Central and State
Teams shall be repsonsible for Data retrieval and analysis.s
DATA ACCESS AND RETRIEVAL
PRIMARY MODULE: MEDICAL SERVICCES
Patient Administration, which includes:s
Registration
Admission
Tereatment Records
Discharge
Tracking of Patients
Programmes, whcih includes:s
Maternal Care Patient Profiling
Pediatric Care Patient Profiling
Emergency Response Mechanism
Scheduling, whcih includes:s
Doctor Schedule
Nurse and Support Staff Duty Roster
Procurement, which includes:s
Tracking of consumable Medical Iteams for
Procurement purposes
SECONDARY MODULE: HOSPITAL ADMINISTRATION
Performance Analysis
This module shall compile and analyze performance reports
of the various units based on common factors like footfall
etc. This module shall also have an integrated Feedback
System for recording response of the Users.s
Fixed Asset and Inventory Management
This module shall manage the Fixed Assets and Inventory of
the Hospital as per the Statutory requirement .s
Profiling: User Demographics and Disease Database
This module shall profile the Users and provide insight
into the profile and prefrences of the returning Users.
Additionally, the Module shall maintain a central database
of the Diseases being diagnosed.s
REPORT MANAGEMENT AND UTILIZATION
The Reports being generated thorugh the above mentioned modules of the Integrated Hospital Information Management
shall be utilized for various Strategic Decionmakings, Compliences, Doner Requirement and any other requirements.s
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24.
Anticipated Challenges
Since the Hospitals are envisaged to be Local Intervention Units in the Healthcare Delivery Mechanism in India, it is
anticipated that these Units will function in close coordination with the Village/City level institutions. Therein lies the
Challenges, some of which have been articulated below:s
SOCIAL AND VILLAGE LEVEL SUPPORT AND ACCEPTANCE
The Hospital will have to consciously to work in developing Trust of the Community which shall be the core factor for
sustenance and positive intervention. Community Outreach and long term goals to develop General Health aspects of the
Community shall assist in developing mutual trust and respect.s
RECRUITMENT OF QUALIFIED DOCTORS
The Hospital will have to recruit on a larger and central level to inspire qualified Doctors to serve in remote locations which
may not be the nerve centers of medical traffic but pockets which require dedicationa and sustained intervention.s
SUCCESS OF THE FINANCIAL MODEL
The Hospital will have to extensively reach out to the local Community and the Government to collaborate on Health
Schemes etc. to ensure that the Financial Model is sustained.s
BALANCING THE VILLAGE DYNAMICS
Since the Hospital will work closely with the Village Panchayats, Opinion Makers and other Village Institutions, it is
imperative that a fine balance is maintained in the existing dynamics of these institutions and remain focussed on the
primary objective of providing low cost healthcare. s
FOCUS
It is also imperative that the Focuses identified are taken forward without any new dimensions being added so that these
focuses are given time and resources.s
ACCEPTING THE EXISTING SITUATION
While working with the Community, the Hospital staff will have to accept the sitution on the the grond as it is which at times
may be difficult to comprehend. It is essential that the culture, priorities and difficulties of the Users are understood in
detail after commencement of operations.s
These are a few of the major Challenges anticipated during implementation of the Project . There shall be many more
Challenges which shall have to be dealt with once the Project has been initiated.s
ADHERING THE TIMELINE
This being a Mega-Project of implementation of 500 Hospitals in 4 States, one of the important Challenges shall be to
maintain the Timeline of the lanuch of these Hospitals. The flow of funds and a dedicated team at various levels will have
to ensure timely monitoring of activities to anticipate any hurdles slowing down the pace.s
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25.
Bibliography
The following sources were referred for the purpose of the Case Study:s
Website of Ministry of Health and Family Welfare, Government of India
Website of Department of Health of the States of Bihar, Chhattisgarh, Jharkhand and Madhya Pradesh
Apollo Hospitals Case Study
Bio-IT and Healthcare in India, Deptment of Biotechnology, Government of India
Delivering World Class Healthcare Today, Harward Business Review
Enhancing access to Healthcare through Innovation, PricewaterhouseCoopers Private Limited
Good Health at Low Cost 25 Years On, General Briefing
Good Health at Low Cost 25 Years On, Tamil Nadu Success Story
Healthcare in Developing Countries, A Presentation
Healthcare in India, Vision 2020: Issues and Prospects by R. Srinivisan
High Level Report on Universal Healthcare in India, Planning Commission, Government of India
Human Resource requirements for Healthcare Industry, National Skill Development Council
India Healthcare, McKinsey & Co.s
Medical Technology Industry in India, Deloitte
New Horizons in Indian Healthcare, Parthenon Group
Providing Low Cost, High Quality Healthcare: LifeSpring: A piece by Anant Kumar
Quintegra Hospital Information Management System
Smile on Wheel Programme Brochure
BCTA,LifeSpring, Case Study
Innovative Pro-Poor Healthcare Financing and Delivery Models
LifeSpring Backgrounder
STATISTICS
Census, Key Findings- 2001&2011
Key Health Indicators for India, World Bank
India Health Profile, WHO
Census District-Level Household and Facility Health Survey
Annual Health Survey Factsheet 2012-13
Annual Health Survey Factsheet 2010-11
Various other related Websites, Blogs and other Online Resource Material.s
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