Life Insurance Marketing Strategy Inindia

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					Precincts, people and places
Forging New Partnerships

Innovations in India’s
healthcare journey
Sangita Reddy
Executive Director-Operations, Apollo Hospitals
In 1889 Herman Hollerith decided
to work on a fresh new way of
data collection. He developed a
mechanical tabulator based on
punch cards in order to rapidly
tabulate statistics from millions
of pieces of data.

This lead to a company he
called IBM. And the rest, as it
is fashionable to say, is history.
Larry Page and Sergey Brin started a company in their Stanford days, with
the aim to organize the world's information and make it universally accessible
and useful .They named this company Google.

Today there are a good number of people, across the world, who cannot
perceive a life without the magic of Google.
Innovation is
always the result
of a very clear
and present need
The story of Indian healthcare
is no different. There was a
dire need to innovate. And
innovate we did.
The start point of Indian
healthcare was defined by
its limitations
   The limitation of infrastructure

   The limitation of access

   The limitation of affordability

   The limitation of quality and research

   The limitation of manpower

   The limitation of poor demand management
India has 600,000 villages…
Rural Healthcare gets a push


• The National Rural Health Mission (2005-12) seeks to
provide effective healthcare to rural population throughout
the country by raising public spending on Health from 0.9%
of GDP to 2-3% of GDP.

•Rajiv Arogyasri scheme in the state of Andhra Pradesh
seeks to improve access of Below Poverty Line families to
quality medical care for treatment of identified diseases
involving hospitalization, surgery and therapies, through an
identified network of health care providers.

•The 108 and 104 facility seeks to provide healthcare to the
doorsteps of then people, specially in the rural areas.
                  Indian healthcare market is undergoing 
                                     structural changes…

    Increase                     Changing disease
                                                                    Health Insurance                    Consumerism 
        inPopulatio                 demographics
        n

                             •   Life style diseases i.e.,    •   Potential 300‐400 million    •   Increased health 
•   Currently 1.1b;                                                                                awareness and spends 
    increasing at 2%             disease with higher cost         insurable lives
                                 per episode                                                       on health 
    annually                                                  •   Increased utilization of 
                             •   Increased demand for             healthcare services          •   Empowered patient 
•   More no of 
    hospitalizations             tertiary care services             – <5% at present           •   Demand for high quality 
                             •   Emphasis on latest                                                services 
•   Increased utilization 
    of equipment                 technologies                                                  •   Emergence of offshore 
                                                                                                   medical services 
Mission
“To bring Healthcare of international
standards
Within the reach of every individual.”
ACE @ 25
Apollo Clinical Excellence Model

ACE @ 25 follows a weighted
scoring system

25 quality indicators from among
the world’s best with
international benchmarks

The cumulative score
achievable is capped at 100
 Connecting them up is a challenge


The remoteness of Indian villages is a
challenge for Indian healthcare sector.

Absence of primary healthcare makes it
difficult to provide in-time care.

Apollo has bridged the gap to some extant
using Telemedicine and Reach hospitals.
Bridging the accessibility gap


Telemedicine helps in
the evolution the virtual
healthcentre
Leading the transformation with
Apollo Telemedicine
              Apollo Telemedicine Networking Foundation
              was incorporated in 1999

              Apollo Hospitals has over 100 telemedicine
              centres, in India and overseas

              Baghdad and Kabul opened last week

              Our pioneering efforts at Aragonda in India,
              has been widely endorsed as the telemedicine
              template that others should be following.

              The ambitious PAN AFRICAN e-Network Project

              Recent alliance with Ericsson
Bridging the affordability gap

Innovative finance
to work around the
affordability gap
Bridging the demand management gap


Prevention is always
better than cure.
It is cheaper also.
             The Indian health scenario


• Aging population
• People with multiple diseases
• Cost associated with treatment
• Productivity loss
                             Paradigm shift

                  Current                 Future                    Predict,
          Model   Illness              Model                       monitor &
Chasing                                Genetic        Stratified    prevent
disease                             Predisposition    Population
          Symptom-based Diagnosis

                                                                      Find &
                Treatment             Monitoring and Prevention         treat
                                                                      disease
             Recover or Revisit               Diagnose                 earlier


                                         Treatment Selection
                                                                       More
                                                                   targeted &
                                              Treatment
                                                                   streamline
                                                                   d treatment
                                         Treatment Monitoring
Bridging the quality and research gap

Nurturing a culture of
excellence and research
Nurturing a culture of
excellence and research
7 JCI accredited hospitals, the largest by a private provider
in the world

Apollo Hospitals Education and Research Foundation
(AHERF) is involved in pioneering research in epidemiology
and disease management

200 clinical trials

Phase 1 clinical trial centre

Centre for genomics and stem cells
Bridging the manpower gap

Future-proofing the
healthcare industry in
India
Apollo’s milestones
in nurturing skill
Apollo Hospitals Group made its own
initiatives towards education and training
of health personnel.

The Apollo Medvarsity and AHERF
are major milestones in this quest.

Apollo has 11 nursing schools and
accreditation for about 20 DNB
training courses for doctors.

600 fellows and post graduate trainees.

Played a major role in reversing
the brain drain.
The solutions are out there.




                          Apollo Health Knowledge City – A state of the art centre
               that will be developing 25,000 skilled healthcare workers per year
Collaboration is a
way of life for us
          The Apollo Hospitals Group
                       BPO and IT
                                           E‐learning
       Telemedicine                                     Pharmacy 
                                                        Retailing 

                                                               Insurance

                                                                            CSR

                                                                       EDUCATION
Clinical Trials
                                                                        RESEARCH

                  Wellness                                     Hospitals 
                                Clinics           Project 
                                                consultancy 

         Unmatched Breadth and Depth in Healthcare Space
Towards touching
a billion lives
• 40 Hospitals (over 9000 beds)
• 50 Clinics
• 600 pharmacies
• 10 nursing colleges
• Largest private sector employer of healthcare professionals in India
• Joint Commission International (JCI) accreditation


•And now …….. HEALTH HIWAY………….
HCIT Applications & Integration

                                          Information Technology
                                          • HIS & EMR
                                          • Biology, disease, clinical models
                                          • Biostatistics – genomic, proteomic
                                          • Decision support tools

                              Imaging and Intervention
                              • Imaging agent discovery
                              • Agent efficacy
                              • Bio-distribution

                 Molecular Analysis
                 • Assay development
                 • DNA Enzymology
                 • Molecular biology

Pharmaceutical Solutions
• Antibodies, proteins, nucleotides
• Synthetic organic chemistry
• Diagnostics biomarkers
                    IT begins at home
                Apollo Hospital, Hyderabad




• ERP inspired SOA based comprehensive HIS
• 370 man months of technology design and coding
• Over 150 hours of healthcare specialist input
• Went live on 1st July 2009
                                EHIS – Integrated Enterprise Examples
     Employee Cycle                                                                                       Customer Cycle
                                                                                                                Patient Retention
   Appraisal Management

                                                   EMR                                                         Disease Management

Skill & Will           Performance
                                                                                                        Patient Relationship Mgmt
                                       Doctor’s Module
               Potential
                                                                                                         Calls / Query Management
                                Clinical Support Systems
                                                    t
                                                men




                               Radiology, Laboratory, PACS,
                                               e
                                          anag




                                        Wards, OT
Duty Roasters
                                         ce M




 Scheduler                                                                                                           CRM
                           Operations and Ancillary Functions –
                                    kfor




                            Registration, Admissions, transfers,
                                   W or




Credentialing                   Housekeeping, F&B, CSSD
& Privileging
                                            Employee Database         Referral Doctor’s Database

                                            Competency Matrix           Corporate Database
  Recruitment Management                    Appraisal Management             Patient Relationship Management     Sales Management
  Payroll & Benefits                        Time attendance & Leave          Marketing Management                Call Management
  Training                                  Organization Management          Claims Processing                    Quotation
  Exit Management                            Employee Self Services          Management Web Interface
               Enterprise HIS Examples– Patient Safety




          Token Tagging
Packing                                                       Drug Administration


                                         Token Verification



 Pharmacy

      Indent

                                             • Drug-drug interactions
                                             • Allergy alerts
                          Unique Token
                                             • Medication History
                                             • Standard Dosages
   Prescription                              • Digital Signature / Biometrics
                                                                                    34
 Cradle to Grave EMR




                                         National
                                       EMR Repository

       Apollo Hospitals




                            Printed Medical
                                Records
UHID




       Apollo’s EMR Repository       Clinical Research
                                     Disease Management
               Integrated Health Delivery Network
                                                            Integration of
                                                              • Main Hospitals
                                                              • Satellite Centers
Integrated                                                    • Clinics
                                                              • Telemedicine Centers
Health Delivery                                               • TPAs
                                                              • Pharmacies
Network                                                       • Plus more...need based




                                      Dhaka
               Datacenter

                                          Satellite Centers Connectivity




Mauritius
                                                      Main Hospital
                                                      Satellite Center
                            Colombo                   Clinics
                                                                                         36
       Datacenter – Hosted Application Delivery Model
Apollo Hospitals Network   Global Datacenter                        Global Customers




                                                                         Other Hospitals


                           • Patient Demographics
                             Repository
                           • Doctor’s Repository
                           • Electronic Medical Records
                           • Payment Gateways                        Clinics      Clinics
                           • Interfaces – Insurance,
                              Telemedicine, Pharmacy               • Disease Management
                           ____________________________________
                                                                     Programs
                           • HIS Application                       • Customer Relations
                             Management                              Management
                           • Service Level Agreements              • Disease Surveillance
                           • Disaster Recovery
                           • Data Analysis Tools                  Customers to have choice of
                                                                  financial software


                                                                                                37
                                              Apollo’s Strategy for connected health




                                                                                                                  Data  Aggregation  &  Consolidation
                                       Datacenter                         DR center
Health provides / Govt. 




                                                                     Blood bank
                                                    Hospitals                     Emergency 
                           Hospitals                                               Services
       Schemes




                                                                                                Rajiv Arogyasri
                                                                      Other Health services     Other schemes
                            PHC           PHC        PHC




                                  Patients           Medical Staff       Administration        Medical Students
    Apollo Health Street-Across the Healthcare Continuum

                                    PROVIDER & PAYER SERVICES
               Patient Access & Eligibility                       Claims Management

P                          FBO                               Provider Contract Management
R                                                                                                   P
O               Coding / Medical Records                         Provider Credentialing
                                                                                                    A
V                                                                                                   Y
I     Govt. & Commercial A/R Collection Follow Up         Maintenance of Medical Information
                                                                                                    E
D                                                                                                   R
E         Self Pay & Patient Balances Follow‐up               Network / PPO Management
                                                                                                    S
R
S         Transactional Services – Charge Entry,          Inbound / Outbound Contact Center
                        P.Posting
                                     Full Business Office Outsourcing 

                                  IT & STRATEGIC SUPPORT SERVICES
Software Development Life Cycle       Implementation / Integration       Product Support and Help Desk

                       End‐to‐End IT & Strategic Support Service Solutions



                                                                                                         39
                        Apollo Health Street
                      Bloomfield NJ

                                            New York, NY


   Conshohocken, PA
                                                           Delhi, India




   Springfield, IL




                                           Americus, GA
                                                                            Hyderabad, India
                                                                               (2 Offices)




Los Angeles, CA
                                      Sunrise, FL
                                                                          Chennai, India




                                                                                               40
                                                                                               40
                 Moving ahead with Health Street IT
Software Development
New Product Development. HER. EMR. RIS. Enhancements &
    Maintenance. Legacy Modernization. Systems Integration

QA & Testing services
Integration testing. Functional testing. Verification & Validation as
    per ISO and FDA standards

Implementation Services
Business Analysis. Business / Clinical Process.
    User Training. Product Configuration.
    Application Build. Table. File. Profiles.
    Go Live Support

Integration & Interfaces Services
EDI Integration. HL7 Interfacing. Data Migration.
    Product Support & Help Desk.

Service Desk
L1 / L2 / L3 / L4. Incident. Management. Change Management.
     Configuration Management. Release Management. Upgrade
     Management. Product Maintenance.
      Bring forth the International Experience – the AHS way


Best-Shore Delivery Model                      Performance Improvement


  Crunching turnaround                           Process excellence
  times                                          Becoming the client’s
  Access to well trained                         “extended office”
  healthcare                                     Quality as a way of life:
  talent                                         Six Sigma techniques
  Seven operations centers in
  the U.S. and four off-shore


                                               Partnering Mindset


Technology Advancements                          Synergistic partnering
                                                 with clients
                                                 Beyond “seller-buyer”
  Proprietary systems across revenue
                                                 relationship
  cycle continuum
                                                 Unique FBO capabilities
  Leveraging “best-of-breed” third-party
  technologies to augment AHS solution




                                                                             42
Moving into the next generation

From a local road,
to a street and now
On the global highway
HealthHiway.. Linking Care delivery




            HEALTH HIWAY




                                      44
           A patient’s journey today

       Clinician   Hospital




                                          Labs




Hospital                                         Pharmacy
                              Clinician
                      A patient’s journey today
                                                            Financial
                                         Clinical
                                                                                                         Financial

       Clinical   Clinician              Hospital

                                                                                         Clinical
                                                          Policies
                                                                                   Financial
                         Policies     Research Admin                                                              Policies
             Research
                                                        Clinical
                                                                       Labs                   Research         Admin


                                                                                 Policies
                          Financial
                                                               Research Admin

Clinical
           Hospital                                                           Clinical     Pharmacy
                                            Clinical    Clinician

                        Policies

     Research Admin                                                                                 Policies
                                                                   Policies        Research
                                                    Research
 Centralized patient centric architecture
              Clinical   Research       Policies   Financial   Admin




Hospital                            `


Clinics




Insurance




Pharmacy




Lab




            Streamlined patient information indexed and stacked
               Touch a
               Billion Lives

Touch Points                   Beneficiaries



                                     Patient




                                     Provider




                                     Pharma




                                      Payor



                                      Govt.
Equitable, sustainable, quality healthcare




                 Software as a Service
                    Interoperability
                    Governance
                    Health analytics
                    EHR/EMR




                                 Domain
                                                  hy
                                          Geograp
                     f
                ck o ss
              La ne
                  re
              awa
                        Technology Trends
• Toward Patients
  • Increased patient responsibility and power

• Toward Prediction
  • From post-symptomatic diagnosis to pre-symptomatic
    screening
  • Genomic revolution and molecular imaging

• Clinical Convergence
  • Diagnostic tests (in-vivo and in-vitro)
  • Diagnosis linked to therapy
  • Convergence of pharma and diagnostic industries

• Productivity Driven
  • Payors demand rigorous cost/benefit analysis and
    health technology assessments

• Information Driven
   • Integrated, accessible, personalized and actionable
     patient information
An emerging economy like
India has significant
opportunities, inspite of the
myriad challenges and
current low adoption of
IT. Benefit would spread to
one-sixth of humanity.
Moving into the next generation

When you are an
innovator, the world
waits for the next step
Leapfrogging technology



                          From fragmented
                          silos to Shared,
                          Digital centralized
                          Information
                          management
                          through Health
                          Information
                          Exchanges




                                            54
    Health Information Exchange            Health Information Exchange            Health Information Exchange         Health Information Exchange




                                                      Region 1, State, and Information Exchange Infrastructure

Health Information Exchange
Health-care Enterprise                                           Interoperability Stack                     Health-care Enterprise




                                                                         Record Locator
                 RIS               Picture-
                                                                         Service
                                   Archiving and                                                                 EHR Interface
                                   Communicating
                                   System




                                                                         Master Patient Index


                 EMR System              Repository

Create Patient                    Find Available
Information                       Patient Information
                                                                                                                Health-care
                                  4. Obtain credentials
 1. Obtain                                                                                                      Enterprise
                                  5. Find unique                           Authentication
    credentials
                                     patient identifier                    Authorization
 2. Find unique
                                  6. Add new pointer to
    patient identifier               patient information                                                        Public Health
 3. Add new pointer               7. Retrieve a record
    to patient                                                                                                     Entity
                                     for patient
    information
                                                                 Audit
                                                                 Logging
             The Global Health Hiway
                                               ePR


                     PACS
                               Govt                                                  ePR
                             Exchange


                                                     PMS

                                                                        HH
                       HIS        Claims                             Exchange


Web-based Platform
                                                              Enterprise
                                                        ePR                 Claims




                      PACS
                                   Private
                                  Enterprise



                      HIS                      Claims
                                                                                                               Touch a
                                                                                                               Billion Lives




                                     Software as a Service – Browser Based Applications

                                       Standards | Regulations | Security | Processes

                                                       Infrastructure



                                               Emergency                                                                CS 
CliniConnect         Tele‐Medicine                                Health Analytics           Home Care
                                              Management                                                             Solutions 

  Personal                                                                                                          TCS‐Apollo 
                      eDiagnostics           Contact Center             hSCM               ePrescription
Health Portal                                                                                                        Solutions

                                                                    Personal                                         Wellogic 
      RCM ‐ Billing | Claims                     F M S                                      eBloodBank
                                                                 Medical Assistant                                   Solutions

                                            Command & Ctrl                                Pharma | Clinical 
                …                                                       eDoc                                       TeleRadiology
                                               Center                                        Analytics




Touch Points
                        IT Healthcare- Industry Insights




Source : IDC Feb 2009



       8/20/2009

				
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