In the news: Death in a cash crunch, the fight against pneumonia and why measles isn’t history yet

A wrap of health news over the past week.

Infants die due to lack of payment for medical aid

Demonetisation of Rs 500 and Rs 1,000 notes compounded by callousness on the part of doctors and medical workers have resulted in at least three deaths in the past few days. On Tuesday, Prime Minister Narendra Modi announced the sudden move aimed at flushing black money out of the economy. By the weekend, at least three people waiting in long queues outside banks and ATMs collapsed – two from seemingly exiting medical conditions and one from falling in an unsafe bank building – according to news reports.

But at a time of severe inconvenience, three other deaths have been reported because medical services could not be paid for. On Thursday night, a couple from Rajasthan’s Pali district lost their newborn son because they could not find and ambulance that would accept their Rs 1,000 and Rs 500 notes and take their child from a district t a city hospital. The boy developed breathing difficulty son after he was born and had been referred to the bigger hospital. But by the time his father gathered Rs 100 notes to pay the ambulance, the boy died, reported the The Indian Express.

In a similar incident, a newborn died in Mumbai’s Govandi after a doctor refused to treat the child after his parents ere unable to pay the nursing home’s deposit in currency other than Rs 500 and Rs 1000. Hindi newspaper Amar Ujala reported on Friday that doctors at the FH Medical College at Tundla, Uttar Pradesh turned off the life-supporting ventilator for a patient after refusing to accept the requisite payment of Rs 10,000 that the patient’s relatives offered in Rs 500 and Rs 1000 notes.

India is failing against pneumonia

India has made no progress in fighting pneumonia and still registers the highest number of deaths from pneumonia and diarrheoa among 15 countries with significant pneumonia mortality at more than 2,96,000. Last year and in the years before too, India consistently took this dubious distinction, conferred on it by the Pneumonia and Diarrhoea Progress Report published by the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health. In 2015, these two diseases together were responsible for nearly one of every four deaths among children under the age of five.

But even 15 years since its introduction, five countries with the highest pneumonia burden, including India, are still not using the effective pneumococcal conjugate vaccines in their routine immunisation programmes. India’s health ministry only recently announced a partial introduction of the vaccine in five states from 2017.

This year, however, the report indicates that India has improved its action plan to prevent and control pneumonia along with 12 other countries.

Measles deaths due to immunisation gaps: report

Children continue to die of measles due to lack of political will to get each and every child immunised, says a new report by the United Nations Children’s Fund, the World Health Organisation and other global bodies.

Although the number of deaths due to measles has fallen by 79% since the year 2000, some 400 children still die from the disease every year. More than 20 million children have been covered in mass immunisation drives and routine vaccination coverage between 2000 and 2015 but large immunisation gaps remain in several African and Asian countries, including India. About half of the world’s unvaccinated babies and 75% of measles deaths occur in the Democratic Republic of the Congo, Ethiopia, Nigeria, Indonesia, Pakistan and India.

Global health organisations have called for national governments to boost routine immunisations and surveillance to eliminate measles.

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What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, 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 marketing team and not by the editorial staff.