Sound Leadership at the Helm of AMRI’s Outbreak Control
By Rudrani Ghosh
AMRI’s 360 degree approach to COVID management involved caring for patients, their family member and staff alike.
Last year when the entire healthcare industry was under a tumult, there was no slowing down for AMRI Hospitals. AMRI’s spirit and commitment to provide quality care has been at the helm to fight the deadly virus. By introducing robots to interact with COVID patients, AMRI hospitals not only translated the adoption of technological support but also reflected sound leadership to protect the doctors from risk transmission. The hospital has even organized ‘Virtual Visiting Hours’ so that the patients could keep in touch with their family members even from isolation.
Mr. Rupak Barua, Director and Group CEO, AMRI Hospitals, talks about how digitalization and artificial intelligence are vital to improve healthcare delivery. Below are the nine pertinent questions which broadly capture the journey, learnings, and the way forward for AMRI Hospitals.
Mr. Rupak Barua, Director and Group CEO, AMRI Hospitals
What are the lessons (few important things) that your hospital has learned from practicing medicine in 2020and how are you making sure that you are prepared for next time?
The COVID-19 pandemic has been a great eye-opener for us in the healthcare sector, along with everybody else around the world. Even though no one could have pre-empted a pandemic, we all realized there was a serious lack of critical care infrastructure, something that was crucial for treating patients affected by COVID-19. We needed more ICU beds, ventilators, and trained manpower, which all hospitals had to develop. Also, PPEs for doctors and other frontline healthcare workers were short during the initial days of the pandemic.
Over the first few weeks, we had to learn how to fast adapt to the unfurling crisis and despite hoarding vital equipment like PPEs, masks, and sanitizers, we managed to cultivate supply chains and put things on track. Also, a lack of knowledge regarding the virus caused some concern among physicians at the beginning, but as days passed and they learned more about the disease's medical management, doctors started gaining an upper hand and successfully sent back home even those patients who had spent weeks on ventilators.
Although we initially felt somewhat overwhelmed, we landed on our feet and now we are much better prepared to handle a pandemic. We have put several failsafe measures in place that will help us in managing situations much better. We have put in place SOPs and conducting regular reviews of these systems & processes, making both our medical and non-medical teams better equipped now than we were in early 2020.
Telemedicine got the clinical spotlight due to COVID. Has the system adapted to telemedicine?
While at AMRI Hospitals we already had started telemedicine services in different parts of Eastern and North-Eastern India, at our outreach clinics, we could take advantage of telemedicine during the pandemic, when people were scared of visiting hospitals. Our OPD services were mostly run through telemedicine, with doctors counseling patients, who were sitting in the comfort and safety of their homes. We spruced up our infrastructure and ran OPD services through email, WhatsApp, calls, and video calls. We even ran COVID ‘Home Care’ packages by developing an exclusive online platform, so that COVID-positive patients, who did not need hospitalization, could access our doctors and nurses from home. Overall, the pandemic period also gave us insight into how we could better use our telemedicine platforms and provide additional services and benefits to our patients.
How has the pandemic impacted your financial bottom line? How can one mitigate such risks in the future?
The growth story we had foreseen since the beginning of 2020 would have been extraordinary and would have had far-reaching effects but the pandemic pushed the economy towards a corner and almost every industry faced a serious setback. Contrary to popular belief, even the healthcare sector faced a significant stumbling block and had to undergo several changes.
Initial capital expenditure was needed in improvising existing infrastructure to suit the needs of COVID-19 treatment, including isolation wards and other protocols, which was not part of the planned budget and put pressure on our resources. We faced further bleeding as we had to develop increased infrastructure for telemedicine and home care services.
During the first few weeks since lockdown was imposed, the supply of essential commodities like masks, PPEs, and sanitizers were in short supply, with the situation being made further difficult by a section of suppliers hoarding and selling these at exorbitant rates in the black market. Even though the situation changed as we worked out a supply chain through our usual vendor network, the drain on our resources was significant. Poor footfall at hospital OPDs and severe drop in elective surgical procedures also made things difficult, which improved only around November.
What changes do you foresee in the healthcare delivery business model?
Change is taking place not just in healthcare, but in every aspect of our lives. It's inevitable but sometimes we don't notice it because it's happening silently. While the use of technology is increasing and digitalization of healthcare has been happening over the last few years, this can only be scaled up, as earlier treatment platforms are upgraded and more advanced ones are introduced.
Already much of our products for patients are on digital platforms, and our teams are actively encouraged to decrease carbon footprint, besides looking at more sustainable solutions. I have always believed that the healthcare sector should come up with initiatives that have more acceptability to the public, besides being sustainable and affordable. I feel the future will be completely rewritten by digitization and artificial intelligence.
The focus will be on quality healthcare at an affordable cost, which will be further aided by the use of various digital tools. Healthcare delivery during the pandemic has taught us that we need to take a multi-disciplinary approach towards such treatment, with a focus on developing better critical care management protocols, so that any patient coming into a hospital will get the advantage of being cared for by a group of doctors, who can address almost any issue and can provide exemplary clinical solutions.
Enumerate 3 structural changes to improve healthcare delivery in India?
Three structural changes that could help improve healthcare delivery in India are:
Raise awareness and put more focus on preventive healthcare instead of spending more on treatment
Increased focus on digital technology to better manage people’s health
Introducing value-based care models to bring down healthcare costs
What role should the Government play going forward?
Throughout the pandemic period, both the State Government and the Central Government have been monitoring and upgrading treatment protocols at regular intervals, and the private healthcare sector welcomed the advisories and notifications because the battle against COVID could only be won with everybody joining hands.
Now that COVID-19 is on the wane, we expect the Government to help us move forward by providing more support to the private healthcare sector, which plays a crucial role in delivering healthcare to almost 70% of Indians. While Budget 2021 has made significant allocations for healthcare, the Government needs to scale up its allocations over the next few years to make the public healthcare delivery system more robust.
Transformation in the healthcare sector is often bogged down with redundant regulations, complicated governance structures, and is slow in adapting to new tools. We hope that while the Government will act as a regulator, it will also help us provide some leeway in terms of tax benefits and duty reliefs so that acquiring advanced technologies and state-of-the-art equipment can become easier.
Further, the Government should look at sprucing up the healthcare delivery network right from the district stage and look at better management of primary and secondary levels to ensure there is no unnecessary crowding at super-specialty and multi-specialty hospitals to reduce out-of-pocket expenses. Another area that needs a boost is the health insurance by making it more accessible to the general public.
What are the measures you are adopting in your hospital to protect against COVID beyond masking and social distancing?
Ever since the pandemic hit Indian shores, not only did we put in place the usual social distancing measures across all four of our hospitals – three in Kolkata, one at Bhubaneswar -- we introduced strict safety protocols for doctors, healthcare workers, non-medical staff, and visitors, in keeping with WHO guidelines. Besides installing hand-washing stations and sanitizer dispensers at all public access areas, safety protocols at OPD areas and Emergency Rooms, we also changed our ‘visiting hour’ rules in non-COVID zones by reducing time for visits and by allowing only one visitor per patient at a time, to lessen exposure to infections for visiting family members. We also arranged for guest houses for our medical and non-medical staff, who were directly involved in dealing with COVID-positive patients, so that they did not have to risk spreading the infection to their family members back home.
What were some of the tech innovations that helped your organization in the battle?
Besides the usual digital tools that we have been using for some time to ensure faster and more accurate service delivery, we deployed the latest equipment like ECMO (Extracorporeal membrane oxygenation) machine for better clinical outcome. ECMO is the latest in heart-lung treatment, where blood is drawn out and then oxygen-rich blood is recycled into the body and is particularly used for patients who have suffered serious respiratory issues due to COVID-19. ECMO has been a game-changer for us, providing us the ability to treat and even cure patients who showed no signs of improvement even after being on ventilator for days, and in cases, weeks.
We also introduced robots equipped with video calling features so that family members can interact with their admitted relatives through video calls. Doctors can also keep themselves updated about individual patients, even when they are away from the hospital by just making a video call and connecting with healthcare workers at isolated wards. While we also ran telemedicine services and home care packages for mildly symptomatic and asymptomatic COVID patients, we also used a variety of social media tools and platforms to spread awareness among not just our patients and their family members but also to the community, which we found showed good results in making people safer.
Anything that you want to acquire or that is on your wish list…
In terms of the acquisition, we are always looking out for fresh talent and state-of-the-art technologies, so that we can keep providing world-class treatment and the best clinical outcomes to our patients. Since much of quality healthcare is dependent on technological platforms and advanced equipment, we would like to keep ourselves updated, as we have always done, and we hope to acquire the best machinery and human resources to provide the best service.