The Daily Fix

The Daily Fix: Rajnath’s backing for Article 35A is meaningless if the Centre speaks in two voices

Everything you need to know for the day (and a little more).

The Big Story: Doublespeak

Much of what Home Minister Rajnath Singh said in Kashmir over the last few days should come as a positive sign. Singh said he went with an open mind and was willing to meet anyone who wants to help resolve the problems of Kashmir. He insisted that anyone detained under the age of 18 should not be treated as a criminal, but dealt with under the Juvenile Justice Act. He promised to visit Kashmir not just five “but 50 times a year” if necessary. He claimed that the situation in Kashmir had “greatly improved”. Most significantly, in response to a question on the legal challenge to Article 35A, which bars outsiders from acquiring immovable property in Jammu & Kashmir, he claimed that the Centre would not do anything that went against the sentiments of the people.

All those assertions give the impression that the Bharatiya Janata Party-run Centre has realised how badly it has failed in creating the political space that could lead to a peaceful solution in Kashmir, despite being in power in the state in alliance with the People’s Democratic Party. Yet, a closer look at every one of those statements reveals troubling realities.

Singh said he was willing to meet anyone with an open mind, yet as he visited, the authorities had placed several key separatist leaders either under house arrest or put them in jail. He claimed that the situation had greatly improved, even though police had to impose restrictions in some places in Srinagar to prevent protests during his visit. He spoke of not putting youngsters in jails, where they are often radicalised, but did not mention the plight of the juvenile justice system in the state. Though he claimed that the Centre would not go against people’s sentiments, it was the Union Attorney General KK Venugopal who, in July, told the Supreme Court that a “larger debate” on Article 35A is needed.

That last point is a perfect example of the dangerous game the BJP calls its Kashmir policy. When visiting the Valley, the Centre says everything is fine and it will not go against the people’s wishes. Yet, step into Jammu and the invective against Article 35A is being fueled by the BJP. Across the country, Central and BJP leaders have ramped up their criticism of Jammu & Kashmir’s special status, a development so serious that it brought the ruling People’s Democratic Party and arch-rivals National Conference onto the same platform to defend Article 35A.

If there is anyone Rajnath Singh should be conveying a message about Article 35A to, it is his party members, his fellow ministers in the Cabinet and his Attorney General. Simply promising to not go against the people’s sentiments is meaningless unless backed up by the rest of the government and conveyed to the right-wing ecosystem. If, indeed, the Centre was trustworthy on this matter, it would have backed the state government’s position on a challenge to Article 35A in the Supreme Court, instead of calling for a larger debate.

If all the Centre wanted from Singh’s visit was a photo-op and positive headlines, it has got that, even as some parts of the Valley shut down in protest, while the alliance agenda of the BJP-People’s Democratic Party government lies in tatters. Only when Singh’s comments to Kashmiris are repeated and amplified – in Jammu, Delhi and for the benefit of BJP members around the country – can there be any question of trusting the Centre’s promises to do as the people of the state wish.

The Big Scroll

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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.

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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.