India has had notable health achievements since independence in 1947. Life expectancy has doubled and infant mortality and crude death rates have been greatly reduced.1 Some diseases, such as small pox and guinea worm, have been eradicated. Leprosy and polio, have been nearly eliminated. And India’s doctors and hospitals are increasingly receiving recognition for the quality of care they provide.
Nevertheless, India faces considerable challenges. For example, the country accounts for a relatively large share of the world’s disease burden. And while India’s burgeoning middle class has greater access to excellent healthcare, the vast majority of citizens still have limited access to basic care. The quality of care varies significantly, as well.
An examination of healthcare systems in other countries underscores the importance of achieving a value-based, affordable, sustainable healthcare system in India. Unrelenting pressures are pushing many healthcare systems along an unsustainable path. What does this mean for India?
Despite significant investments, the healthcare infrastructure will likely remain fragmented, focused on acute, reactive, episodic care and will be inaccessible for many, particularly in rural areas. And the insufficient healthcare delivery capacity would be exacerbated, as providers are burdened by such issues as workforce shortages and overcrowding.
There are clearly two kinds of healthcare organisations that will thrive; those that focus on bringing world class standards and ‘set new benchmarks in best practices’ in terms of technology, training and patient care and disseminate this knowledge to the younger generation passing out of colleges. These organisations cannot compromise on training and quality in the face of any amount of pressure and I would like to add that, will over time contribute to sensitising people about ‘newer definitions of accepted standards of quality’. This is easier said than done. We have recently faced considerable problem with our nursing staff and explaining to the local media that commitment to quality is not lip service; but an exacting everyday affair.
Asian Heart Institute is India’s only cardiac hospital with JCI and NIAHO certifications. This puts it among a handful of hospitals in the world that are trusted by patients who care for the very best treatment – among our patients are numerous heads of state, who depend on the very highest standards of medical service and treatment. We save lives that cannot be saved elsewhere due to our “insane commitment” to processes; and all progress happens because of the insane and irrational man, as Bernard Shaw would agree.
We have had to create and invest in our own training program for all levels of staff. Special emphasis has always been given to our nurses training – because they are the essential interface between what our expert doctors recommend and the on-going treatment experience our patients receive. This training is not just an expensive investment by us- indeed, unlike other places, we don’t charge our employees for the training, but it is well-recognised overseas too – many of our nurses in the past have received lucrative offers among the worlds best hospitals.
The other kind of healthcare organisation that will thrive is that which expands the reach of healthcare itself with the use of technology. Fortunately, a more positive scenario is possible. Some fantastic work is being done by organisations such as GV Meditech and Vatsalya in ‘rural India’ led by visionaries such as Vineet Rai. The visionary Sam Pitroda speaks of a Digital Knowledge Network, that enables institutions to share information for inclusive growth and development. India is a country of 800 billion cell phones, 70 billion dollars of IT exports and yet the reach of medical services is poor.
So what needs to be done. Healthcare providers have to expand their current focus on episodic, acute care to encompass the enhanced management of chronic diseases and the life-long prediction and prevention of illness.Suppliers work collaboratively with care delivery organizations, clinicians, and patients to produce products that improve outcomes or provide equivalent outcomes at lower costs, particularly for diseases endemic to India. Society has to make rational decisions regarding lifestyle expectations, acceptable behaviors and privacy policies. Healthcare itself should be a societal right versus a market service to provide all Indians at least environmental and basic healthcare.
Looking forward to a better healthier India.
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