July 2009

Towards Patient-centered Care

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Established in 1990, Kovai Medical Center andHospital is a 350-bed super-facility corporatehospital located in Coimbatore on a sprawling 20acre site. It has over 50 medical disciplines with100 full-time medical consultants,11 operationtheatres with the most modern medical equipment,such as, 64 slice CT, cathlab, state-of-the-artlaboratory equipment and EBUS equipment. KMCHhas been a forerunner in adopting technology indiagnosis, treatment and and in every facet ofhospitals operation to optimise cost and improvedelivery of care to patients.

In an interview with eHEALTH, U. K.Ananthapadmanabhan, President, KMCH, talksabout recent health initiatives taken by the hospitaland how technology has revolutionised healthcarein the country and around the world. Excerpts:

What are Kovai Medical Center andHospitals signifi cant achievements inrecent years?

Dr Nalla G Palaniswami, Chairman,KMCH, established the hospital in 1990with 250 beds and 17,000 shareholders.We became the second corporatehospital in the country and the firstsuch hospital in a second-tier city likeCoimbatore. We added 100 beds inthe year 2000 along with other satellitecenters in the Coimbatore district. Weare in the middle of a huge expansioninvolving an addition of 250 beds,10 more operation theatres, cancertherapy units with Linac and PET scanequipment, with cost outlay of morethan 200 crores.

The work is expected to complete by2010, which will make Kovai MedicalCenter and Hospital one of the largesthospitals in the corporate sector inSoutheast Asia.

Currently, we treat over 1000inpatients and outpatients a day andit is expected to double in the nexttwo years. We are getting a largenumber of patients from north-easternstates like Meghalaya ,Assam ,Tripuraand Manipur and their number isincreasing by about 20 to 30 per centevery year. The patronage from the localdistricts has been overwhelming due towhich patient load has tremendouslyincreased during the last 5 to 6 years.

We have now emerged as one ofthe leading centers in InterventionRadiology in the world and a teachingcentre in this discipline. We haveexpert consultants who perform SingleIncision Laproscopic Surgeries (SILS)and Endoscopic Spine Surgery andSpine Correction Surgery involving20 to 22 hours of meticulous surgicalwork, which very few hospitals in thecountry are doing.

What has been your most recentprofessional milestone?

I distinctly remember 20 years ago wedid most of our transactions like billing,registration, taking in diet order orsterilisation of linen manually, but overthe years I have been able to automateevery transaction in the hospital. And,I have been mentoring many of myjunior colleagues in adopting the latesttechnologies in their hospitals. I feel veryproud when doctors, administratorsand patients tell me that our hospitalis one of the fi nest hospitals in termsof care, treatment, technology andcost-effectiveness.To me it is a constant learning processby visiting hospitals, conferences andwriting examinations and teaching.

What have been the important initiativeson the Health IT front in the pasttwo years?

Our hospital is truly a paperless hospitalwhere all the laboratory equipment likeauto analyzers, blood gas analyser,blood cell counters are networked.Central sterilisation equipments arealso completely automated. Pharmacy,laboratory, dietary requests etc aredone through computer networkwithout involving any paperwork.

We have empowered the patientsby providing touch screen facilities atvarious locations within the hospitalpremises. The touch screen informationfacility provides various details likegeneral enquiry, facilities of KMCH,tariff etc. An in-patient can also view billing information and medical detailswith his unique identifi cation number.

We are now working on providinga facility to order meals through the mobile phone. We have also focusedour attention on energy management which involves energy monitoring,energy conservation and use of alternatesources of energy. We have installed14,000 litre solar water heating systemwhich has resulted in huge saving inenergy costs and has also provided 24-hour hot water supply to the patients.We have connected all our highenergy loads to a Local Area Network(LAN) through which we monitorvarious electrical parameters likevoltage, current , power factor, energyconsumption. By this we have saved Rs10 lakhs in a year on energy. The cost ofthis solution has been a fraction of thesavings made last year. In appreciationof this work, we were awarded TheMost Eco-friendly Hospital Building ofthe Year by the RACC Association and the British scholars of India.

Any new initiatives taken by thehospital in academics?

Ever since the hospital started, teaching,training and research have been partof our clinical practice. KMCH haspost- graduate DNB programmesin various disciplines like radiology,cardiology, anesthesiology, cardiothoracic surgery, ENT, germedicineand surgery, orthopedics, paediatricsand obstetrics and gynaecology.Hospital under its research and
education trust has graduate andpost-graduate programmes inall paramedical disciplines likephysiotherapy, occupational therapy,nursing, pharmacy. Apart fromthese programmes we also have skilldevelopment programmes at the levelof the technicians like respiratorytherapy programme, operation the atretechnician programme, dialysistechnician programme and so on. To promote professional hospitalmanagement we also have postgraduateprogrammes in hospitaladministration affi liated to the stateuniversity at Coimbatore.

What challenges does the hospital facein achieving its goals?

The biggest challenge that the hospitalface is the non-availability of skilledmanpower at all levels. Today, majorityof the skilled manpower prefers to workin metropolitan cities because of whichavailability of manpower is in shortagein tier 2 and 3 cities.The other challenge that thehospital face is the high cost of medicalequipment, and the rate of obsolescencein the medical equipment which putstremendous pressure on the overallcost of medical treatment.

Indian Governmentshould realise thatit is not possiblefor them to developinfrastructure andtalent pool to caterto the needs of 1.3billion people of thecountry and, therefore,allow more private-publicpartnershipin building upIndian health caredelivery system.

According to you, what are the reformsneeded in the Indian healthcareindustry?

Firstly, there is a need to bring a changein the mindset of people. People shouldsee healthcare as a service that needs tobe paid for.

And, the government should realisethat it is not possible for them todevelop infrastructure and talent poolto cater to the needs of 1.3 billionpeople of the country and, therefore,allow more private-public partnershipin building up Indian health caredelivery system.

Health care must be treated as apriority sector and certain facilitieslike lower electricity tariff, land atsubsidised rates should be provided.Tax sops, custom duty exemptions mustbe liberally provided to individuals andinstitutions coming forward to establishaccredited hospitals.

Lastly, efforts must be taken topromote indigenous manufacturingof medical equipments which makemedical care very expensive to thecommon man. Government shoulduniversalise health insurance for BPLfamilies and also promote medicalinsurance in the private sector byallowing foreign companies to comein, and raise the insurance premiumlimit for income tax exemption forindividuals to Rs 50,000.

Are there any schemes/programsstarted by the hospital to provideaffordable healthcare facilities tothe poor?

We provide concession to childrenfrom poor families, senior citizensand Army personnel at the hospital.We have performed over thousandfree open heart surgeries on the poorchildren, in and around Coimbatoredistrict. We have established 6 ruralhealthcare centers in villages likeThekkalur, Annur, Veeriampalayam,where we provide medical treatmentat a very nominal cost for the benefitof the poor. We have also establishedTrauma care centers which operate24/7 . We transport patients not only toour hospital but also to other hospitals.The patients, who aretransportedto government hospitals after fi rstaid treatment, are not charged forthe service.

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