Will Covid finally transform the obsolete healthcare industry?

It is rather frightening that the urban healthcare sector is still following a century-old template and not responding to the needs of patients and opportunities of technology. The focus of innovation has been restricted to medical equipment and surgical techniques while the customer journeys have not been updated.

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Healthcare, more specifically hospitals in urban centres, still follows a blockbuster model where a physical brick and mortar hub is the basis of diagnostics, advisory and intervention. This superstructure is supplemented by local clinics for consulting-only services as well as basic investigation hubs, ranging from MRI to USG to blood tests; while ambulances in various formats still serve the role of ferrying patients to the hospitals, a function otherwise served by private or public vehicles. Problem is, this is an ecosystem that is as old as the First World War and thus painfully obsolete, showing no signs of customer-centric evolution.

For starters we need to segment customers into three clear categories – Emergency, Elective and Evaluation. Evaluation clearly being the patients seeking consultation and diagnostics, Elective being those with scheduled pre-planned surgeries or procedures, and Emergency implying everybody requiring urgent time-bound life-saving support. It is important to recognise the journeys of each of these segments and accordingly draw a solution road map, which will then lead to the infrastructure development, both virtual and actual. Currently they are still being dictated by the whims of the industry management, being asked to follow the convenience of the creator and not the best interests of the customer.

It is valuable to start with Emergency, the need to save lives urgently and immediately. Currently the entire process is counter-intuitive as the patient has to travel to the hospital, which often diminishes precious minutes from the Golden Hour. The future is a network of highly equipped ambulances, which will be on duty across locations, their placement determined by AI-based data on past instances. Which may also vary by density of senior citizen occupancy and accident-prone highways, but in each case the ambulance is fully equipped for high-end life-saving treatment. You may argue that it is not possible to equip every such vehicle with appropriate specialists but this is where GPS tracking technology will play its role. A pre-enlisted range of experts will be paged quite like Uber taxi drivers and the closest one to respond, either in a static or a mobile location, will rush to the spot in a personal or automatically summoned vehicle. Thus, there is a timely convergence of patient, equipment and specialist and the ambulance will naturally have its trained paramedics. This service can be provided by hospitals in solo or consortium mode or perhaps, a brand new aggregator model can emerge only for Emergency services, which finally converges in a conventional hospital.

It is then prudent to move on to Elective — surgeries for hip replacement, general surgeries and the whole list of pre-planned interventions. Here the customer is willing to both wait and travel a bit, as long as the outcomes are high quality. So instead of bundling a whole range of specialties in a single building, the future is the highly focused category specific unit attracting the best talent and facilities. Quite like how cardiac care or cancer care has evolved, we can envision efficient setups for Orthopedics, Obstetrics, Neurosurgery and so much more, where the customer has a choice of multiple doctors and price points. As implied, instead of two blockbuster hospitals, a brand may wish to establish a dozen centres across disciplines, spread conveniently but suitably separated. Those from the Emergency segment may naturally end up here only, once the mobile infrastructure does the life-saving act successfully. Quite obviously the size of these establishments will depend on customer demand and business potential and thus they become sustainable propositions.

Finally, when it comes to Evaluation, there is a strong opportunity for technology and logistics to come to the party. Specialist doctors can be centrally located and conduct video call consultations to a geographically diverse customer base, who can be supported by an open source panel of nurses or paramedics sourced through Urban Company. So if the doctor wants a physical examination or an ECG via a mobile machine, then the local support system can accompany the patient at home or some convenient location. Else of course, the doctors will have chambers in the specialist hospitals for those who need and wish to travel. For pathology, a similar open source network can be operational with partners collecting samples and couriering it to the closest central diagnostic centres. Mobile X Ray machines with reports uploaded via mobile can complete this loop in tune with allied paramedical services. Thus, patients across geographies can access doctors of choice in collaboration with a low skill local eco system, taking the pressure off the blockbuster hospital infrastructure.

For any industry which is science-intensive, the journey to customer centricity is never easy. In Healthcare, a simple segmentation of Evaluation, Emergency and Elective can help transform business models and build efficiency for all. To stay healthy we need to think afresh and the customer is a great place to begin.

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