Pramod

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Privatization of healthcare services with strong governance is the best way forward.
However the private operators taking over should have the right experience otherwise the privatization could lead to a disaster. A strong emphasis on the Quality of Care rendered is essential.
Health system financing (Universal healthcare models ) like the ones implemented in Abu Dhabi are best suited for the region, but with better governance on the Payers (e.g avoid monopolies) and Providers (curb over utilization, monitor quality).

I think the maths should be fairly straight forward for RPCI.
Simply look at the present value of discounted cash flows of the RPCI for 10 years (without the new businesses added, local and international joint ventures, and strategic partnerships) – i.e had the department not existed, and then compare that with the current i.e with all the new ventures bolted on. The difference is the incremental value created by the team !
From the incremental value if you reduce the opex cost of the department, that should simply tell you how valuable the function is.

Or simply incremental revenue X gross margins attributable to the new ventures (less Opex cost of the department) should be good enough.
it is important that these numbers are regularly compiled and reported otherwise the value of such functions go unnoticed !

On May 12, 2017, Pramod commented on Cultural Change in the Transforming Health Care Industry :

Should employees and managers in a company start feeling that they are only fire fighting and not creating value, the root cause is either a lack of a clear vision or poor cascading of the vision down the line.
The next indication is that company lacks a clear strategy to overcome its issues on a sustainable basis, or that it has a strategy but that has not been communicated clearly down the line.
Around the Company Vision and Growth strategy are a series of sub-strategies what help deliver the boarder vision and strategy.
For instance the HR department in turn would develop its own strategy to help deliver the broader company strategy – which includes recruitment, comp and ben strategy, training and development, organization alignment plans/ change management where needed, to cater to the changes/growth plans.
Healthcare can easily learn from what happens in other industries like Hospitality and FMCG and adopt some of their models of Company Growth strategies and tweak them to healthcare industry needs.

On May 12, 2017, Pramod commented on Team Development :

Managing teams of people with low skills is a challenge. However it is all down to good leadership.
Managers with good leadership skills are essential to make a big difference -regardless of the teams skills.
1. Strong leadership skills -traning for the Manager is essenital.
2. Effective communication with the team -regular briefings by the Manager is a must.
3. The Manager must set a common vision and set of values with the team (or simply rigorously adopt the Company Vision and Values)
4. Setting clear individul and team goals, monitor performance and give feed back both individually and to the team is essential
5. Build trust, and a sense of belonging in the team
6. Gradually enhance people skills with proper training and development plans.

As healthcare moves to a new digital era the role of doctors as true care providers will be significantly enhanced, provided they embrace technology.
There are a small group that are apprehensive, but that is more because of poor education or fear of being replace by a robot some day !

Doctors need to be taught how to embrace the benefits of mhealh/ ehealth/ tele-medicine by what ever name it is called.
Ultimately the goals of digital health are no different from the doctors own goals i.e improve outcomes, lower the cost of care, improve patient access, improve patient experience, improve physician productivity, expand doctor reach, enable better work-life balance for doctors etc.
Training doctors to embrace the new technology is important, for ensuring their buy in.

In any IT /EMR/ tele-medicine implementation, it is also important to make sure that the doctor is not reduced to a data entry operator and seen wasting time hammering away at a key board, but his knowledge and time should be spent “facing” /treating the patient.

On May 12, 2017, Pramod commented on Strategic Decision – Merge or Stay Independent :

Looking at some the facts you have presented. You really have no choice but to find a way to merge with a bigger group otherwise you will end up loosing all the value you have created this far in the business.

Establishing a small operationally efficient unit of your size with high quality outcomes should not be difficult for a larger group,
Which means your very existence is at risk in the medium and long term.

The fact that you continue to grow and have a loyal physician /patient base is not enough. Hospital Group with deep pockets can quickly replicate your model, should they see the necessity to do so.

Therefore strategically the smarter step to take would be to plan your merger with a larger group in a manner that your existence is assured, Your company’s skills are valued, and you are seen as adding value to the larger group.

Here is what you could suggest to your board –
-Explain to them that the status quo is not an option and that the larger fish could easily swallow you, and what ever shareholder value exists in the business today could easily disappear.
-Suggest to your Board that you should start looking for a suitor to join forces with, and that your company should get ready to go on a road show !

1. Identify your strengths and be ready to present them to groups that need your strengths or access to your markets.
2. Carefully look at what the gaps are there in these potential suitors and how you could address them (do your home work well)
3. Ofcourse value your business for what it currently does (and if it continued to grow without outside help)
4. Value the business on the basis of what incremental value you could create for the larger group (make sure the delta is meaty !),

-this way show your board the route to preserving and enhancing shareholder value.

On May 11, 2017, Pramod commented on Patient Experience :

I do believe that there is no need to compromise on operational efficiency to enhance patient experience. On the contrary operational efficiency only goes to enhance patient experience. As an example if the processes are oiled well to facilitate a quick discharge of a patient – it is being both operationally efficient and enhancing patient experience.
Staff acceptance is a different issue all together. The staff no doubt have to buy into the importance of patient experience as means to sustenance i.e building a sustainable business model. Poor experience means migration of patients to the competition and ultimately loss of jobs or shut down. Hence the importance of patient experience needs to be emphasized regularly with staff as an absolute necessity.