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[Music]
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Sanita thanks very much for joining us
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today what would you say is the most
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critical problem facing Healthcare in
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India
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today I'd really say the biggest one is
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the lack of facility just the lack of uh
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of good
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infrastructure and then this is
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compounded by the lack of access whether
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it's Financial or Geographic access to
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the infrastructure that exists where
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would you and is that access sort of the
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weakest in rural areas would you say is
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that one of the biggest problems
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absolutely absolutely it's and you I was
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reading that you are you headed up
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Apollo reach M uh can you describe that
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program for us okay reach is actually a
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new model of Healthcare delivery that uh
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the Apollo team innovated on it's um at
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our 25th anniversary um you know Dr
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Eddie addressed a senior group of the
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hospital xx and uh we were in this
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boardroom and we thought that he's going
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to say you know good job guys you've
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you've delivered on my vision and he
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actually told us that um do you
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understand that the Apollo hospitals
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model is relevant to about 300 to 400
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million people but you know 600 million
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people or a significant number of
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India's population is getting denied
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healthare and what are you going to do
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to change
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this so we went back to the drawing
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board on you know Innovation um clearly
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in terms of financial access and
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Geographic access we have worked for the
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last 10 years on these two fronts of
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pushing
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Insurance uh whether it was our own
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small insurance that we did in our
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village where for one rupe a day or you
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know 365 so it's for less than $10 an
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individual have would have access to
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high-end Healthcare and we've proved
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that that model was possible that it was
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relevant and based on the learnings of
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that model many others have evolved in
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our country today um you know whether it
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was the yeses in Karnataka that we
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continue to administer whether it was um
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you know now we've seen arogas Shri in
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Andra where 80 million lives are covered
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you see RSP so so Financial access is
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increasing and we're happy for that we
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think it's a positive trend lots more
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needs to be done but at least it's a
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movement in the right direction the next
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one we did was teley medicine because
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when 80% of the doctors are living in
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the urban areas and 70% of our
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population is in the
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rural you need to find ways to connect
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technology is affording some solutions
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we've tried to use that effect
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effectively the last one because
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ultimately um you know um we we strongly
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believe in M health and the convergence
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of healthcare it and the mobile phone uh
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we we've tried to drive new models we're
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bringing out a lot of Innovations but
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end of the day the mobile phone cannot
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do a bypass surgery or do a hip
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replacement so we try to build on um you
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know a a mechanism or a scheme or a
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program which takes Advanced Healthcare
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facilities into B and C-Class cities uh
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we hope that one day we'll be able to do
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this in every District headquarter so
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that today um the average rural Indian
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seeking Healthcare travels about 54
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kilomet for care uh we want to cut this
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down significantly by building these
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models we know we cannot build for the
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entire country but what we have done
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effectively over the last 27 years is
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really be a thought leader and a
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catalyst towards a positive progress and
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Direction so what reach hospital is is
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it's um higher secondary and tertiary
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care it's uh it's clean practical cost
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effective
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environments uh it uh we we reengineered
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everything from the air conditioning to
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the design to the infection control to
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the doctor's module uh to the way we
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interact with patients we re-engineered
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that and worked on Bringing Down the
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cost per bed uh by almost 20
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25% and the operating cost by another
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15% uh this combination has helped us uh
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be able to reach out to a lot more
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people so now we have seven hospitals in
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the reach model uh three are open uh the
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next four will open in the next 60 to 90
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days we'll do about 25 of them over the
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next 18 to 24 months and then we'll
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reevaluate the model so reach is really
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our initiative towards rural empowerment
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and access to Quality healthare and do
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you see one day um the ability to sort
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of reach the most remote
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people absolutely absolutely but see the
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thing is our thought process is that um
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no single initiative can really solve
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all the problems It's a combination so
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you put up um a Quality Healthcare
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environment in a rural setting you put
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mobile Vans around that you connect the
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mobile Vans through tele medicine you
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put uh technology to ensure that you've
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registered these people you focus a lot
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on preventive Healthcare so your cost or
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the disease burden comes down because
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you've spent money appropriately on
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preventive Healthcare you try to
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propagate through government agencies a
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holistic model which looks at clean
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drinking water better sanitation
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appropriate immunization so once again
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you've impacted the disease
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burden uh and then you try once more to
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push a new paradigm which is that
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Healthcare should not be about episodic
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treatment of single ailments it should
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be about proactively creating positive
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Health in an environment about
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stratifying vulnerable groups and going
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to them before the problem exists
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because if you've had a generation or
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two generations of diabetes and
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cardiovascular disease in your family
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the likelihood of the kids getting it is
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a lot more what can you do is there a
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huge educational push on on Apollo's
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part and other organizations to sort of
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communicate that to people in remote
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areas how is that how is that knowledge
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spread I guess is what I'm asking um I
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see a few things one is that
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um you know in a country like India
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there's so much to be done so many
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dimensions on which you can do them so
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some we do directly
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some we work in propagating thought
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leadership so that we create One Pilot
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and hopefully others will follow three
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is I think we are fairly active in
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multiple governing bodies and voices of
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the with the government so on the health
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information side we have created a
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framework for uh a Joint Task Force
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which is working with the ministry on a
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patient India Healthcare portal which is
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a multilanguage information portal which
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will be launched fairly soon so we've
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been the thought leadership behind that
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we've worked on content we've given
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ideas from our own um like we have a
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patient portal for our population AP poo
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life so we've taken those Concepts and
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learnings we've worked on making it more
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than just a static content but
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connecting that via cell phone facts SMS
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whatever you can do to make this alive
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and push into the community so we've put
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some of those models out there I think
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in the next 12 to 24 months you'll see
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some of the impacts of these interesting
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there's a it sounds like there's a huge
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amount of innovation taking place to
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reach people to educate them uh you know
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and very often people you know in the
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west will look at a country like India
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and say the healthare healthcare is so
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poor it's backward um but what I'm
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hearing is there's probably a lot of
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lessons that a country like the United
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States could learn from India in terms
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of reaching people you're so right and
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what do you think what are some lessons
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you think that that other countries
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should probably
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absorb see um I think there a range of
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them so let me go through um some one is
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that if you look at a from a quality
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perspective we've done about 990,000
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open heart surgeries
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99.6% success rate this is is world
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class then you go one dimension deeper
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and you say that we want quality
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healthare but we want it at sustainable
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costs
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and we want Equity we want everyone in
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society to get it so what can you do to
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bring down these costs we do a
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significant number of our surgeries as
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beating heart surgeries when you do
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Beating Heart um the skill set of the
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clinician and the team needs to be far
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greater but it brings down the cost of
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the material input you don't use an
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oxygenator it also reduces the recovery
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time so I mean this is the they they
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pockets of this type of innovation
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across our system and we believe that
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the healthcare delivery system where uh
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the backend cost of administration like
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we do I mean it's less than 6 to 7%
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versus about you know 25% in in in these
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economies and you know so we understand
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things like that and we want to create
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this convergence of Technology of
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knowledge of of capability to build new
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models I I think that's some of the
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greatest learning but having said that I
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I really want to car at this to say that
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I believe uh despite everything that's
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going on that the American healthcare
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system has some amazing capability they
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have taught the rest of the world
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Advanced
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Healthcare the design and the backend
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administrative problems should never um
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you know kind of make people forget the
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fact that some amazing medicine is being
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practiced uh the ability to save lives
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to do heroic things to push research to
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create Innovation um liver transplant
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everything that's happened and
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everything that the rest of the world is
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is is emulating has emerged out of great
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institutions in the US and um in India
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we're we're very at a poloo we're
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extremely um you know grateful and we
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admire the work that's happening in many
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Great American Healthcare
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institutions I think that the US
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probably faces a similar situation to
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India and that you know to incent
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doctors doctors to move out of large
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urban areas with large institutions to
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more rural areas or or poorer areas it's
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a hard thing to do so how are you or or
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or what kinds of incentives um Can the
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industry offer to medical personnel who
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are highly trained to move out of urban
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areas and to move into rural areas to
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address some healthcare needs because as
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you said there is a limit to what
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technology can do a cell phone can't
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actually do an operation you need
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qualified people to make the cut and to
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do the actual surgery so is there any
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sort of um movement or or activity
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around generating interest in in work in
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rural areas see I think one of the big
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ones is actually by uh the ministry and
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the medical Council of India to create a
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new CER of uh medical professionals who
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are um um done Medical School within 3
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to four years so they're they're trained
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uh they their costs are lower and they
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stay in the rural environment for four
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to 5 years that I believe is a big one
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one of the other ones which I I think is
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is relevant is that you do traveling so
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I don't think we can ask um many people
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to go and live in rural environments
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unless the rural environments have
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schools colleges you know social
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infrastructure but what we can do is and
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what we have been doing for the last 27
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years is every weekend somewhere you
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know in the rural parts of India will'll
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be teams from Apollo hospitals Chennai
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Hyderabad Delhi going out traveling
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overnight by train or by car traveling
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into rural India conducting medical
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camps operating in theaters over there
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or you know doing consulting and
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bringing the patients back so
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combination of Technology tele medicine
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preventive healthare training of the
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district healthcare workers and their
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doctors supporting them by specialist
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visits as well as telec consults it's
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it's a combination no single thing can
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really solve the entire problem uh but
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one of the things is that I believe
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rural
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India will become when connected
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see as is moving into an Information
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Society when connected with the
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appropriate bandwidth rural India will
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become the back office of urban India
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when that happens then the the economic
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capability of those environments will
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improve when the economic environment
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improves the quality of life improves
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when that improves then people move
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because you have social infrastructure
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developed so a combination of the the
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information drive and uh the insurance
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which is insurance is very much becoming
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in India uh the fuel which pushes the
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engine of healthcare so when you put
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fuel into that engine you will see more
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and more infrastructure being developed
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so um many interesting things on
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different dimensions happening I think
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so uh and and so entrepreneurial in
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nature as well I think so so I guess my
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next question is how much of um India's
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health Care Solutions you think will
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will come out of the private sector
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ultimately as opposed to the public
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sector see today about 80% of uh
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Healthcare is in the private sector
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about 60 to 65% of the beds are in the
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private sector but 80% of the Care is
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delivered by the private sector um if
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you look at the uh the budget allocation
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or the spending the outof pocket
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spending is also approximately only 30
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to 40% of the budget is is is
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government-driven 60% of it is again uh
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private I think these Trends will
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continue but what I'm hoping will happen
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is that there will be a new and
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interesting uh and genuine model of PPP
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which is public private participation so
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far it's been Pockets I think Apollo did
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one of you know the first ppps we've
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done quite a few of them but I believe
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that when private sector hospitals
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support government insurance programs
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effective and a partnership model you've
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worked towards creating a provisioning
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of care uh and the government has worked
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towards creating a financial access to
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that care and this is PPP but um even
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more in the build of infrastructure
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because we do need we need about 100,000
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new beds per year for the next 8 years
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to reach wh's requirement in terms of
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bed numbers so um I think we need to
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find new models of building right now
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now um very few Hospital groups are
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economically attractive and foreign
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direct investment is going into every
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other sector in India uh and not so much
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into Healthcare so to do that we need to
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evolve these new models uh we have to
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push uh this whole concept of PPP into
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uh newer
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Dimensions but also most importantly I
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keep bringing this one back up because I
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truly believe in it and I think that uh
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it's because
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today's models of
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healthare are not the solutions for
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tomorrow's Healthcare scenarios and
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problems we need new innovation and one
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of them is the ability to do preventive
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healthare and predictive healthare in a
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whole new way riding on this concept of
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an Information Society and a connected
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world and a connected
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environment uh will be this ability to
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tap the capability of the fragmented
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healthare system in India or the
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GP um very few people know I mean when
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you talk about Healthcare in India you
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think of Apollo or you know the max or
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the large institutions or even all-
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India Institute but actually 70% of
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Indian hospitals are less than 50
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beds so how do you tap that
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entrepreneurship of the individual
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doctor to really stay relevant to
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increase the quality of care that he
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does and create uh more effective
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integrative programs so does the AIDS
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and the TB and the malaria and the
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immunization programs of the government
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or even the moves towards reducing
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maternal mortality do they tap private
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healthcare in the most appropriate way
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those are the type of interesting new
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PPP models that I think we will be
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pushing and uh that I hope will really
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make an impact on positive Health
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indices great thanks very much for
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talking with us today thank you it was a
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pleasure bye
