Rapid Expansion….3 Healthcare is one of India’s largest sectors, in terms of revenue and employment, and the sector is expanding rapidly. The sector is more than $34 billion, translates to $34 per capita, or roughly 6% of GDP. This year, India’s healthcare sector is projected to grow to nearly $40 billion. The private sector accounts for more than 80% of total healthcare spending in India. One driver of growth in the healthcare sector is India’s booming population SLIMS 10/20/12
Expanding Middle Class-An opportunity5 By 2025, an estimated 189 million Indians will be at least 60 years of age—triple the number in 2004, thanks to greater affluence and better hygiene. The growing elderly population will place an enormous burden on India’s healthcare infrastructure. Expanding middle class- SLIMS 10/20/12
Changing Scenario of Service6 More women are entering the workforce as well, further boosting the purchasing power of Indian households- changing composition of healthcare sector workforce. Many of these women are highly educated: the ratio of women to men who have a college degree or higher level of education is 40:60 Lifestyle diseases are faster than infectious diseases in India Result - increase in cost per treatment, wellness programs targeted at the workplace. Could help to reduce the rising incidence of lifestyle diseases. SLIMS 10/20/12
7 Service Marketing Mix… In Different view… SLIMS 10/20/12
8 Price- The government uses price controls to ensure that vital drugs are affordable to the Indian population. It is an ongoing challenge to balance the commercial interests with the broader social objective. Physical environment- The physical infrastructure is woefully inadequate to meet today’s healthcare demands, much less tomorrow’s. Of the 15,393 hospitals in India in 2002, roughly two- thirds were public. SLIMS 10/20/12
9 Place- The number of public health facilities also is inadequate. For instance, India needs 74,150 community health centres per million population but has less than half that number. In addition, at least 11 Indian states do not have laboratories for testing drugs, and more than half of existing laboratories are not properly equipped or staffed. SLIMS 10/20/12
10 Place Telemedicine—the remote diagnosis, monitoring and treatment of patients via videoconferencing or the Internet. Telemedicine is a fast-emerging trend in India, supported by exponential growth in the country’s information and communications technology (ICT) sector, and plummeting telecom costs. Many hospitals have developed public-private partnerships (PPPs), among them Apollo, AIIMS, Narayana Hridayalaya, Aravind Hospitals and Sankara Nethralaya for Telemedicine. SLIMS 10/20/12
Do Bharat baste hai India mein…11 Process The healthcare divide- When it comes to healthcare, there are two Indias: the country that provides high-quality medical care to middle-class Indians and medical tourists (25% Indians), and the India in which the majority of the population lives with no access to quality care. Mission- the government is working to increase the capabilities of primary medical facilities in rural areas- free medicines. SLIMS 10/20/12
12 Promotion The emergence of India as a destination for medical tourism leverages the country’s well educated, English- speaking medical staff, state-of-the art private hospitals an diagnostic facilities, and relatively low cost to address the spiralling healthcare costs of the western world. Western tourists coming to India to pursue Ayurveda (Kerala). SLIMS 10/20/12
13 PEST Analysis…. SLIMS 10/20/12
Political Analysis: The government is reducing its hold on subsidies. There are particular pressure groups which tend to have an influence on government hospitals The cost of medicines also tends to affect hospitals besides affecting the pharmaceutical industries Relationships between neighboring countries also affect the hospital sector
15 Economic Analysis: Increase in income would lead to an increase in the standard of living. Thus people’s lifestyles changes and health is better understood. Thus there is a room for specialized treatment, doctors, and hospitals Government has made loans easily available and thus people with limited means could avail better/specialized treatment SLIMS 10/20/12
Social Environment Analysis: Medical facilities have increased since there is more awareness of healthcare among the population Certain percentages of beds have to be kept for poor people. E.g. in Bombay 20% of beds has to be kept reserved for poor people. Look after the needs of local poor people. Teach hygiene, sanitation among the poor masses. Safe disposal of hospitals wastes like used injection needles, waste blood etc. and taking due care of environment. Spreading awareness about various diseases through campaigns and free medical check ups.
17 Technological Environment Analysis: Breakthrough innovation in the field of specialized equipment Communication has managed to bridge the gap between places located at long distances Test tube babies Mobility of medical services Mobile phones, credit cards (for payment purposes) etc have made doctors and medical facilities easily available SLIMS 10/20/12
CHARACTERISTICS OFHOSPITAL INDUSTRY 1) Intangibility: Health care services being highly intangible, to beat this intangibility the irony of modern marketing takes place such as use of more tangible features to make things real and believable. Ways to overcome this drawback: Visualization: The industry has to make available visualization so that, search and experience qualities are crystallized. E.g. Press releases, distribution of brochures and leaflets, newsletters, digital marketing and media campaigning.
19 SLIMS 10/20/12
2) Inconsistency: Quality of service offered differs from one extreme to another. This is because of total dependence on human interactivity or playing human nature, i.e. because human beings can never mechanize or replicate themselves. Ways to overcome this drawback: Training: A scheduled Training of the employees in respect of the work/service can prove to be the best solution to this drawback. E.g. American Medical Association makes it mandatory for its member doctors to undergo 6 weeks of training every year or 6 month of training every 6 years. Automation: The service providers analyze that, human quality deteriorates with repetition of work; this has an ill effect during the final delivery of the service. E.g. Automatic blood testing equipments ensuring safety and accuracy
3) Inseparability: Service transaction becomes unique because it mandates, during transaction, the physical presence of the provider and the consumer. Ways to overcome this drawback: Training: This is the best way out for the setback. As the provider of one service can not be made available at two different places at the same time if the situation demands so, unlike, in the case of products where the producer of the same need not be present at all times where the transaction takes place. E.g. Wockhardt & Duncans Gleneagles International as set up a dedicated teaching centre for paramedics, particularly, nurses and also provide higher-end courses for doctors.
4) Perishability: Services are intangible, they cannot be packed & neither can be stored nor can they be inventoried. The implication is that the service has to be produced and consumed instantly; there is no scope of storage. Ways to overcome this drawback: Managing demand & supply: That is to say that, there has to be provision for all sorts of stipulations at all times to the greatest possible extent. E.g. Service developments according to market needs.
Service Flower CORE PRODUCT Treatment of human ills EXPECTED PRODUCT Infrastructure to support reasonable number of beds Operation theatres Equipments – like Cardio-respiratory supportive equipment AUGMENTED PRODUCT Ambience: Central Air-conditioning Automation equipments (X-Ray Scanners, Printers, Photo Scanners, etc
25 Blueprint…. SLIMS 10/20/12
CIMS International Patient Services Teamwill take care of the following: Appointment Scheduling Treatment Packages in Advance Visa Assistance* Airport Pick-n-drop facility Hotel reservations assistance International newspapers Ambulance pick-up, if required Assistance for dining services Follow-up assistance for future appointment schedule after discharge
Testimonial Our stay at the Hospital has been excellent. Our room has been kept clean by men and women who were very charming and who take their work seriously with a lot of humbleness. This group of people was a team that demonstrated to us the warmth of this place. This team of Doctors was just wonderful. They were more than what I have ever seen before. Patient & Relative: Ambale Johnston Samwel & Obanda Jedidah Awaor
INNOVATIONS IN HOSPITAL INDUSTRY• Auto check-in and check out• Specialty hospitals• Aromatherapy at Apollo.• Biventricular pacing.• Bone bank at AIIMS.• Hospital administration.• Medical records management.• Oxygen under pressure treatment at Apollo.• Waste management.• Telemedicine.• Virtual Hospitals
TECHNOLOGIES IN HOSPITALINDUSTRY• Same day OPD• Online reports• Imaging/ MRI Scan• Key Hole Surgery• Medical transcription• Biotechnology• Nanotechnology• SST: Self checking Machines/ equipments
MAJOR CORPORATE PLAYERS The Apollo Group of Hospitals Fortis Healthcare Max India Escorts Wockhardt & Duncans Gleneagles International
MEDICAL TOURISM Medical tourism (also called medical travel, health tourism or global healthcare) is a term initially coined by travel agencies and the mass media to describe the rapidly-growing practice of traveling across international borders to obtain health care. Such services typically include elective procedures as well as complex specialized surgeries such as joint replacement (knee/hip), cardiac surgery, dental surgery, and cosmetic surgeries. As a practical matter, providers and customers commonly use informal channels of communication-connection-contract, and in such cases this tends to mean less regulatory or legal oversight to assure quality and less formal recourse to reimbursement or redress, if needed.
• Leisure aspects typically associated with travel and tourism may be included on such medical travel trips.• Prospective medical tourism patients need to keep in mind the extra cost of travel and accommodations when deciding on treatment locations.• Factors that have led to the increasing popularity of medical travel include the high cost of health care, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries.
PROBLEMS FACED BY THE INDUSTRY• Low public spending on health• Lack of adequate beds in the hospitals• Lack of emphasis on prevention• Enforcing standards of medical care rendered by hospitals and private health practitioners• Extremely low bed : people ratio• Dominated by Government and Charitable Hospitals• Excessive overlap across primary, secondary and tertiary care• Skewed towards urban populace• Lack of adequate corporatization• Insurance to provide financial protection from catastrophic events• More research, awareness and communication and greater public involvement in understanding health issues.
41 SWOT SLIMS 10/20/12
• Strengths 1. Low cost of production. 2. Large pool of installed capacities 3. Efficient technologies for large number of Generics. 4. Large pool of skilled technical manpower. 5. Increasing liberalization of government policies.
Opportunities 1. Aging of the world population. 2. Growing incomes. 3. Growing attention for health. 4. New diagnoses and new social diseases. 5. Spreading prophylactic approaches. 6. Saturation point of market is far away. 7. New therapy approaches. 8. New delivery systems. 9. Spreading attitude for soft medication (OTC drugs). 10. Spreading use of Generic Drugs. 11. Globalization 12. Easier international trading. 13. New markets are opening.
Weakness 1. Fragmentation of installed capacities. 2. Low technology level of Capital Goods of this section. 3. Non-availability of major intermediaries for bulk drugs. 4. Lack of experience to exploit efficiently the new patent regime. 5. Very low key R&D. 6. Low share of India in World Pharmaceutical Production (1.2% of world production but having 16.1% of worlds population). 7. Very low level of Biotechnology in India and also for New Drug Discovery Systems. 8. Lack of experience in International Trade. 9. Low level of strategic planning for future and also for technology forecasting.
Threats 1.Containment of rising health-care cost. 2. High Cost of discovering new products and fewer discoveries. 3. Stricter registration procedures. 4. High entry cost in newer markets. 5. High cost of sales and marketing. 6. Competition, particularly from generic products. 7. More potential new drugs and more efficient therapies. 8. Switching over form process patent to product patent.
In few words...46 The Indian healthcare sector can be viewed as a glass half empty or a glass half full. The challenges the sector faces are substantial, from the need to improve physical infrastructure to the necessity of providing health insurance and ensuring the availability of trained medical personnel with the opportunities available equally. SLIMS 10/20/12