Whole world is witnessing an unprecedented times in the form of Corona which has hit hospital business hard. At one hand it has affected the revenue part, on the other hand safety of staff and patients have to be managed. In addition, lots of additional costs like PPE, masks and other operational expenses have exacerbated woes. In this wake, technology proves to be game changer. In addition, innovations, prudent management, and strategic moves may help to overcome the crisis. A panel of experts highlights these issues in a webinar moderated by Dr Ravi Gupta, Founder Publisher & Editor in Chief Elets Technomedia held on April 29, 2020.

Dr Rakesh Gupta, Chairman, Sarvodaya Hospital, said: “Primary and secondary healthcare will suffer the most. Tertiary care may sustain to some extent. Small nursing homes and primary centres will suffer a lot and some of them may be closed because of a lesser number of patients. Tertiary care with larger capacity & team can handle the situation. Revenue of tertiary care will be hit as a major chunk of cash flow comes from elective surgeries like Neurosurgery and all. There will be a lull for some time. Cost structure has to be restrategized. We have to be mean in management. We have to be more efficient in human resource management.”

He further stated, “Technology has to play a big role as an enabler & facilitator. Telemedicine can be leveraged to connect patients with doctors or among staff members. For covid patients having mild symptoms, technology can be used to check vitals, keeping them quarantined at home. Training and awareness programmes can be conducted through technology. Robotics can be useful to perform various tasks like to monitor patients in isolation wards and all. Operational cost has to be reduced to survive in this tough time.”

Yateesh Wahal, Director, Nayati Healthcare & Research Pvt Ltd., said: “Nayati is a tertiary care hospital, having operating facilities in Mathura, Agra, and Delhi. OPD, radiology, elective surgeries are stopped. At the same time, staff have to be around taking care of emergencies. While doing so, they have to be given all the paraphernalia to protect themselves, which is adding to the cost. Tests have to be done for asymptomatic patients and staff at the same time. These things add up to additional cost. Suddenly the cost of surgery is also going up as additional burdens have to be managed. Protective care is equally eating the margin of hospitals.”

“Two three months of revenue dip would eat the reserve that hospital generated in years. Hospitals are working at 15 percent EBITA. We also have to safeguard the interest of healthcare workers. Cost has to be reduced and at the same time morale has to be up. Those who are of a certain age, have to avoid coming to facility. Cash flow cycle has gone for a toss.”

Dr Sunil Kumar Saggar, CEO, Shanti Mukand Hospital, said: “We are a community hospital, specialised in cancer care. At the moment, the hospital is non covid, treating other emergency patients. Most of the patients we receive are asymptomatic, though we take all precautions to keep them safe from coronavirus. Wearing masks, social distancing, and all other guidelines are being followed upon. We have a dialysis centre. Dialysis patients are vulnerable for infection.

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“Economy is going to be the worst hit. The survival has to be there. Revenue has been hit due to cost incurred on masks, PPE and other precautionary measures. Multi-tasking role will hold huge significance. We have to resort to technology which could prove to be a game changer in these tough times. Infection control takes a toll on revenue. We have introduced an initiative to sanitize each and everything in the hospital premises to keep patients and staff safe.”

Dr VP Singh, Addl Chief Medical Superintendent, Subharti Medical College, said: “Subharti Medical College is one of the prominent private medical colleges in UP with 150 UG seats and 100 PG seats. We have a OPD strength of 2,000 per day.To tackle covid patients, initially we started with 200 isolation beds with 20 beds with a ventilator in ICU.Currently, we are looking after only covid patients. We are facing challenges, but putting a brave face to facilitate best care.”

“Situation at medical college associated hospitals is different due to limited resources. Such colleges are not in profit even in the normal situation. We face challenges on front of human resources pertaining to PPE. There was fear about the quality of PPE. Third level PPE was very uncomfortable to wear and perform tasks,” he said.

Dr Swapan Sood, Medical Superintendent, Patel Hospital, Jalandhar, held the viewpoints : “We have dedicated 50 beds to the civil authority for covid patients. We are taking precautions to prevent infection. Corona and fear of the virus are impacting lots of our decisions. Four areas like to face the brunt. There would be impact on hospitals–revenue to hit as occupancy has gone down to 20-25 percent. The Paramedic workforce would also be affected. They are experts in their own ways. They could move out to keep themselves safe and it will be difficult to get replacement.”

“80 percent of the cost of hospitals are non reducible–salary, CMC, AMC, and electrical cost and all. Doctors would also face a tough time on the revenue part due to the decrease of incoming patients. Their salary will be at stake–either it will have to be deferred or deducted permanently.”

Gaurav Arya, General Sales Manager (North & East), Advanced Sterlization Products, said: “Advanced Sterlization Products(ASP) deals in infection prevention and sterilization solutions. We have a flagship sterilization product Sterrad. This is indeed a tough time for all of us. We are one of the few sterilization companies which has received US FDA and EAU to reprocess respirators. This pandemic shows how deeply the world is interconnected. Earlier, we were reaping the benefits of the global economy like some part of a product is being manufactured in some country and being assembled in some other countries.”

“COVID is a glaring example of how life is interconnected. We can’t keep ourselves isolated if something occurs in any part of the world. Our lives are bound to be affected. Hospital acquired infection is reality today which increases length of stay and cost of care. CSSD plays a critical role in managing infection in hospitals.”

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