The Modi government’s insistence on the use of Aadhaar, India’s biometrics-based unique identification project, to weed out “ghosts, fakes, duplicates” from social welfare schemes is counterproductively excluding genuine beneficiaries from the programmes.
In Andhra Pradesh, an official audit conducted after ration shops adopted the Aadhaar system revealed that many genuine ration card holders couldn’t collect food grain due to fingerprint authentication failure and a mismatch of Aadhaar numbers. The audit was undertaken at five ration shops in three districts of Andhra Pradesh in May this year. At three of the stores, more than half the legitimate beneficiaries had to turn back without any ration.
The audit findings reveal the flaws in the Aadhaar project which the government obdurately maintains is essential to target subsidies for the deserving. Even though the Supreme Court, in August, ruled that enrolment for Aadhaar can’t be made mandatory for government benefits, the order was challenged by the Unique Identification Authority of India, the Reserve Bank of India and other regulatory bodies.
On October 8, a Supreme Court bench headed by Justice J Chelameswar refused to modify the August order. It referred the matter to a larger bench.
Biometrics fail beneficiaries
Amid this uncertainty, there’s evidence of Aadhaar’s ineffectiveness.
Earlier this year, the Andhra Pradesh government adopted the Aadhaar system and installed electronic point-of-sale machines at fair price shops, or ration shops, to verify beneficiaries’ fingerprints. To get ration, every ration card holder now has to provide valid Aadhaar numbers for all members of the household, and then authenticate her fingerprints on the scanner in the point-of-sale device. (The device is connected to the database of biometric information collected during Aadhaar enrolment.)
The Andhra Pradesh Civil Supplies Department started distributing ration through this process in May this year. That month, at 5,358 ration shops, 6.87 lakh ration card holders of the existing 31 lakh beneficiaries (or 22%) didn’t take ration. At 125 ration shops, the figure was higher at around 58% – 50,151 of the total 85,589 card holders didn’t collect their ration.
Faced with such a difference, the Society for Social Audit, Accountability and Transparency, a body set up by the Department of Rural Development to conduct social audits for government programmes, conducted a survey. It audited five ration shops in the districts of Anantapur, Prakasam, and Nellore, taking 20% of the “left over ration card holders” as the sample size.
The society found that in Cheemakurthi in Prakasam district, 69 of the surveyed 82 beneficiaries said their fingerprints didn’t match. In Allur in Nellore district, this problem was cited by 106 of 203 ration card holders. In Ongole in Prakasam district, 50 of 93 beneficiaries blamed the same problem.
Besides this, there were other failures. The survey discovered 35 beneficiaries from two slums who earlier used to get relatives to collect ration on their behalf because they worked in neighbouring villages. Under the new system, they missed out since it is mandatory for the beneficiary to be personally available to collect the ration.
In one instance, a ration dealer in Mudigubba allowed the beneficiaries to collect their rations manually without Aadhaar authentication, but in the system they showed up as beneficiaries who did not collect their rations. This opens the possibility of them being incorrectly getting counted as “fakes or duplicates”.
While the government wants to extend Aadhaar to a number of schemes and services, the findings in Andhra Pradesh show that the system requires more scrutiny before it can be termed as a fool-proof way of welfare delivery.
Putting the patient first - insights for hospitals to meet customer service expectations
These emerging solutions are a fine balance between technology and the human touch.
As customers become more vocal and assertive of their needs, their expectations are changing across industries. Consequently, customer service has gone from being a hygiene factor to actively influencing the customer’s choice of product or service. This trend is also being seen in the healthcare segment. Today good healthcare service is no longer defined by just qualified doctors and the quality of medical treatment offered. The overall ambience, convenience, hospitality and the warmth and friendliness of staff is becoming a crucial way for hospitals to differentiate themselves.
A study by the Deloitte Centre for Health Solutions in fact indicates that good patient experience is also excellent from a profitability point of view. The study, conducted in the US, analyzed the impact of hospital ratings by patients on overall margins and return on assets. It revealed that hospitals with high patient-reported experience scores have higher profitability. For instance, hospitals with ‘excellent’ consumer assessment scores between 2008 and 2014 had a net margin of 4.7 percent, on average, as compared to just 1.8 percent for hospitals with ‘low’ scores.
This clearly indicates that good customer service in hospitals boosts loyalty and goodwill as well as financial performance.Many healthcare service providers are thus putting their efforts behind: understanding constantly evolving customer expectations, solving long-standing problems in hospital management (such as long check-out times) and proactively offering a better experience by leveraging technology and human interface.
The evolving patient
Healthcare service customers, who comprise both the patient and his or her family and friends, are more exposed today to high standards of service across industries. As a result, hospitals are putting patient care right on top of their priorities. An example of this in action can be seen in the Sir Ganga Ram Hospital. In July 2015, the hospital launched a ‘Smart OPD’ system — an integrated mobile health system under which the entire medical ecosystem of the hospital was brought together on a digital app. Patients could use the app to book/reschedule doctor’s appointments and doctors could use it to access a patient’s medical history, write prescriptions and schedule appointments. To further aid the process, IT assistants were provided to help those uncomfortable with technology.
The need for such initiatives and the evolving nature of patient care were among the central themes of the recently concluded Abbott Hospital Leadership Summit. The speakers included pundits from marketing and customer relations along with leaders in the healthcare space.
Among them was the illustrious speaker Larry Hochman, a globally recognised name in customer service. According to Mr. Hochman, who has worked with British Airways and Air Miles, patients are rapidly evolving from passive recipients of treatment to active consumers who are evaluating their overall experience with a hospital on social media and creating a ‘word-of-mouth’ economy. He talks about this in the video below.
As the video says, with social media and other public platforms being available today to share experiences, hospitals need to ensure that every customer walks away with a good experience.
The promise gap
In his address, Mr. Hochman also spoke at length about the ‘promise gap’ — the difference between what a company promises to deliver and what it actually delivers. In the video given below, he explains the concept in detail. As the gap grows wider, the potential for customer dissatisfaction increases.
So how do hospitals differentiate themselves with this evolved set of customers? How do they ensure that the promise gap remains small? “You can create a unique value only through relationships, because that is something that is not manufactured. It is about people, it’s a human thing,” says Mr. Hochman in the video below.
As Mr. Hochman and others in the discussion panel point out, the key to delivering a good customer experience is to instil a culture of empathy and hospitality across the organisation. Whether it is small things like smiling at patients, educating them at every step about their illness or listening to them to understand their fears, every action needs to be geared towards making the customer feel that they made the correct decision by getting treated at that hospital. This is also why, Dr. Nandkumar Jairam, Chairman and Group Medical Director, Columbia Asia, talked about the need for hospitals to train and hire people with soft skills and qualities such as empathy and the ability to listen.
Striking the balance
Bridging the promise gap also involves a balance between technology and the human touch. Dr. Robert Pearl, Executive Director and CEO of The Permanente Medical Group, who also spoke at the event, wrote about the example of Dr. Devi Shetty’s Narayana Health Hospitals. He writes that their team of surgeons typically performs about 900 procedures a month which is equivalent to what most U.S. university hospitals do in a year. The hospitals employ cutting edge technology and other simple innovations to improve efficiency and patient care.
The insights gained from Narayana’s model show that while technology increases efficiency of processes, what really makes a difference to customers are the human touch-points. As Mr. Hochman says, “Human touch points matter more because there are less and less of them today and are therefore crucial to the whole customer experience.”
By putting customers at the core of their thinking, many hospitals have been able to apply innovative solutions to solve age old problems. For example, Max Healthcare, introduced paramedics on motorcycles to circumvent heavy traffic and respond faster to critical emergencies. While ambulances reach 30 minutes after a call, the motorcycles reach in just 17 minutes. In the first three months, two lives were saved because of this customer-centric innovation.
Hospitals are also looking at data and consumer research to identify consumer pain points. Rajit Mehta, the MD and CEO of Max Healthcare Institute, who was a panelist at the summit, spoke of the importance of data to understand patient needs. His organisation used consumer research to identify three critical areas that needed work - discharge and admission processes for IPD patients and wait-time for OPD patients. To improve wait-time, they incentivised people to book appointments online. They also installed digital kiosks where customers could punch in their details to get an appointment quickly.
These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott is working with hospitals and healthcare professionals to improve the quality of health services.
To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.
This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.