Healthcare Loyalty Programs

 I must confess that without making any serious effort I have become  a member of various loyalty programs and I bet this will be the case  with most of you. I earn reward points whenever I use my credit  cards, shop at my favourite store, fly my preferred airline or buy  books at the corner bookstore chain. I was recently offered    membership of another ‘club’, when I opted to purchase medicines for my mother at the local pharmacy, which seems to have suddenly gone a little high tech and dare I suggest become more customer friendly. Loyalty programs are suddenly everywhere.

I believe time has come for healthcare services to embrace the concept of rewarding loyal ‘customers’.

What is a loyalty program?

A loyalty program involves identifying and rewarding ‘loyal’ customers, who keep coming back. Now I know this sounds a little weird in the context of a hospital, where at one level the objective is to ensure that the patient never comes back again. While no hospital wants to see patients coming back, the fact of life is that everyone needs care at different points in our lives.    

The High Tech Story

 I recently came across an intriguing piece of news on  the online WSJ about the efficacy of the 64 Slice CT  Scanner. I am familiar with this piece of high tech  gadgetry because I was tasked with marketing the  benefits of CT Angiograms, when Max Hospital had installed it at the Max Devki Devi Heart and Vascular Institute. I recall we were in a race with Apollo Hospitals, who had also bought  a similar machine and both of us wanted to claim that we were the first to offer CT Angios in the city of Delhi.

The WSJ piece titled ‘Doubts grow over High Tech CT Scans of the Heart’ refers to a study published in the Journal of American College of Cardiology and concludes that ‘in more than 50% of the subjects, CT angiography ‘detected’ coronary obstructions that simply were not there’. The study was  funded by the Dutch government and used CT scanners made by Siemens, Philips and Toshiba.  

Healthcare in ‘Real’ India

 The Healthcare Services as we know it and most of what  I have been writing on this blog I must confess applies  to the metropolitan India, largely comprising of a  handful of large cities. The real India, which still  continues to reside in smaller cities and villages has  very poor access to good quality healthcare. In rural India the healthcare services are almost non existent.

My mother who lives in Lucknow, which is a the capital of the most populous Indian state Uttar Pradesh often needs to travel to Delhi for her cardiac care needs.  Lucknow is a large city with over 7 million people. It has a famous medical college the King George’s Medical College as well as a Post Graduate Medical Institute named after Sanjay Gandhi. These institutes are owned by the government and have great facilities, but they are like any other government institute, filthy, overcrowded, staffed with callous and poorly paid doctors and medical personnel.

Why Hospitals are not Transparent?

As a consumer of healthcare services and also as a keen observer of the drama that unfolds in a hospital everyday, I have often wondered at the extent of opacity that I see around me. A hospital is usually as transparent as a black hole. Ironically most hospital swear by the maxim of ‘complete transparency’. This is rarely true.

Try getting a straight answer from a hospital executive or a doctor and you will straightaway run into a wall.  They are just not programmed to answer straight. Many a times, I would accept that it may not be feasible or advisable for a doctor to be completely transparent. However, there are times when a doctor must look the patient in the eye and say as it is.

Delivering bad news is never easy. It takes a lot of character and compassion to tell another individual that he is terminally sick. However, not telling or beating around the bush, while doing so is far worse. Than there is the matter of giving hope to those diagnosed with a rare condition, telling them that, while they are gravely ill, they need to put up a fight and the doctors, the hospital and everybody else responsible for their care will walk with them every step of the way.  I would like to believe that the ability to communicate and connect with the patients is a wonderful gift to have and it makes for some very happy patients.  

Patient Centric Healthcare

Patient Centric Healthcare is fast becoming a much abused term . Most hospitals that I know here in Delhi prefer to call themselves Patient Centric, but none really is. Many, I suspect do not know what it means to be truly ‘Patient Centric’.

Patient Centric to me would imply a hospital, which has systems, processes and people oriented towards patients. The people including the medical folks are trained to understand that the Patient and his needs must come first. The hospital processes and workflows  are designed around patients and their needs. And most importantly their are systems in place, which monitor the efficacy of these processes, capture patient feedback and cycle them back as implementable inputs. A truly patient centric hospital would be the one, where the responsibility of patient care lies not only with medical folks, but with each and every individual working in the hospital.

Will you call a hospital patient centric if it refuses patients for elective surgery on Sundays? I recall the great fuss I had had to encounter, when I asked that a surgery be posted on a Sunday because the patient wanted it that way. All hell immediately broke loose. How dare I do something like this? Docs and OT staff need rest on Sundays and if it is not an emergency there is no reason for the surgery on a Sunday. How dare I call surgeons and anaesthetists on their day off? What about the incremental costs?  My plea that a patient is a customer and if he wants his surgery on a Sunday, than we may as well do it, did not work. Even the CEO, who also happened to be a surgeon (and his wife the anaesthetist) rapped me on the knuckles and instructed that I dare not do something like this again.  

Marketing Maternity Programs

Fortis La Femme, a boutique hospital for women is running a promotional campaign on a local radio station for their IVF program and the venerable Moolchand Hospital has launched ‘Mother’s Nest’ a maternity services program targeting would be parents. A full page advertisement announcing the new program was carried in HT City a few days ago.

Fortis La Femme, which was known as Cradles earlier was a brain child of Ratan Jalan, the CEO of Apollo Health and Lifestyle Ltd. (AHLL) who was my boss, when I headed marketing at AHLL. The Cradles was set up as a franchised operation and was later bought over by Fortis. It was conceived by Mr. Jalan as a high end birthing centre and has now been repositioned a s a hospital for women, with Maternity Services being one of the several service lines.

Moolchand Hospital has of course been a fixture in Delhi’s firmament for decades and is undergoing a complete makeover under the guidance of Shravan and Vibhu Talwar, the present owners. Both of them are well known to me.  

The Ills of Health Insurance

 I have been reading posts on what ails the American  Healthcare System and how the president elect Barack  Obama wishes to attempt to fix the problems on a high  priority basis.

The more I read the more I am realising that the American Healthcare System has been crippled by an health insurance system, which has grown to an extent, where it interferes with the delivery of care. 

Health Insurance Companies need to make profits to remain afloat. The only way they can do it is by ensuring that the premiums they collect are more than the claims that they pay out. Thus, to ensure profits they have to ensure high premiums (as high as the market can bear) and try and limit claims as far as possible.  

The Idea of a Healthcare Resource Centre

 Having worked in hospitals in Delhi for many years I am often required to help out friends and relatives when someone in their family needs medical attention. I am supposed to be the guy who can recommend a specialist, fix an appointment, advise on the choice of a hospital, help folks seek a second opinion and in general be the knowledgeable person around for matters medical. 

This has often made me wonder if there is a need and possibly a business opportunity in developing a large resource base of information and knowledge, which most people can access with ease and use without worrying about the reliability and authenticity of the information.