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An overview of preventive healthcare in India

Kirandev Hiremath
Wednesday, April 5, 2017, 08:00 Hrs  [IST]

Healthcare in India is largely perceived as a science of treatment and blissfully ignores it as a science of prevention. Our behaviour over ages has accustomed us to believe that only a sickness deserves doctor’s appointment, and we conveniently overlook preventive healthcare owing to trivial reasons such as cost, time and lack of trust in our healthcare system. However, what we collectively fail to acknowledge is the fact that diseases don’t develop overnight and millions of people die of preventable deaths year after year. A survey by Cardiology Society of India corroborates this notion with its findings that one-third of adult population in India suffer from hypertension. The staggering number is followed by a startling revelation that two thirds of that number isn’t even aware of it.  Now substantiate it with the fact that India’s population is going to surpass China’s in 2022 with approximately 8% of the total population falling under geriatric care; the population explosion is going to result in over 57 million people being diagnosed with diabetes and over 200 million with hypertension by 2025 and in all likelihood we might record the highest number of cardiovascular deaths by 2020 if the current trend continues. To begin with, the said statistics is just a snippet from a long, well researched and exhaustive data that clearly points towards an epidemic rise of ailments in the near future. Sooner rather than later, preventive healthcare will find its prevalence in an otherwise growing healthcare industry that is expected to touch US$ 280 billion by 2020.

A shift of attitude - demand & supply gap

The chaos of urban living, the pressure of competing in the rat race, the pleasures of fast food culture has made us adopt a sedentary and unhealthy lifestyle, which has given rise to many lifestyle diseases such as Hypertension, Diabetes, Infertility and Cardiovascular diseases with many instances of death being recorded in an otherwise seemingly healthy individual.  Fortunately, the advent of technology has made information easy and accessible and the penetration of technology is on an all-time high.  Increasingly, more and more people are relying on internet to clarify their doubts and queries which would have otherwise necessitated a visit to the doctor.  The information though deals with general healthcare in large; there is clearly a shift of attitude, especially among urban dwellers and slowly preventive healthcare is emerging as a primary line of treatment.  Conversely, the growing demand is met with disappointing short supply, owing to lack of relevant information coupled with under equipped diagnostic tools and lack of qualified preventive healthcare facilities, which has invariably made access to preventive healthcare a pricier affair. Today, people want to know their numbers, be it their blood pressure readings or blood sugar values but a common question blankets all, where to begin and how to begin as a visit to the diagnostic centre is most often prescribed by a doctor.  The ideal solution to address this question is by establishing holistic preventive healthcare centres that would encourage and educate people on preventive healthcare, which would result in increased spending by the public and over the long run cut down the cost to access preventive healthcare.

Investment opportunity

Indian healthcare industry, currently approximating to roughly $35 billion or 5% of the GDP, is expected to grow to $50.2 billion &  $78.6 billion in 2011 & 2016 respectively, according to a report by E&Y. While the untapped potential of preventive healthcare in India presents itself as an exciting business opportunity; unfortunately, more than 90% of the lab/diagnostics industry is unorganized and only a handful of preventive healthcare centres are built on substantial and sustainable business models with expansive penetration.

The investment trend in the healthcare portfolio clearly points that capitalists are keen to invest on regional players with strong brand credibility and who are on an aggressive expansion mode as the focus is targeted at specialization in a particular field. As the demand for preventive healthcare continues to grow, it is the right time for venture capitalists to set an example by investing in a responsible preventive healthcare centre and take the first mover’s advantage, which in the not too distant future is going to emerge as a competitive healthcare sector.

Significance of supply chain management
Supply Chain Management (SCM) is the process of planning, implementing and controlling the operations of the supply chain for analyzing the labs/hospitals requirements as efficiently as possible. It involves the planning and management of all activities involved in sourcing and procurement, verifying and all logistics management activities. An integrated SCM for healthcare solution will enable lower fulfillment costs, shorter delivery time and improved ability to focus on service delivery rather than administrative processes. Labs/hospitals today are looking for opportunities to improve operational efficiencies and reduce costs without negatively impacting patient care. Creating a robust supply chain that connects labs, builds collaboration and offers labs/hospitals access to time bound and quality service, there by reducing overall costs.

Collaborative planning
Collaborative planning, forecasting and replenishment is a concept that aims to enhance supply chain integration by supporting and assisting joint practices. Information shared between labs/hospitals aids in planning and satisfying demands through shared information. The route map is discussed depending on the need of the client’s requirements and is geo tagged to individual riders with help of GPS enable bikes, the riders would be visiting the said routes on the specified timings, in case of emergency samples, the rider nearest to the lab/hospital is intimated by the logistics manager who will be monitoring it all. The rider will collect the samples with appropriate documentation from the labs, specifying the TAT for the samples. This allows us in continuous updating of inventory and upcoming requirements, making the end-to-end supply chain process more efficient.

Forecasting and replenishment mentioned in the topic is beyond the scope of supply chain management but on macro level very integral part to our lab, so as to maintain the inventory of reagents and consumables based on the management information system, trends of various clients.

Procurement is a method by which samples are procured from labs/hospitals. The procurement management process involves managing the samples, receipt, review and approval of samples condition from labs/hospitals and transportation to lab. As pre-analytical involves sample transportation, errors at any stage of the transportation process can potentially lead to a serious patient misdiagnosis. Errors during the transportation process are not inevitable but can be prevented with a diligent application of quality control, education and effective collection systems. Ensure to observe all blood collection tubes need to be filled to the correct volume. This will confirm proper amount of blood for the amount of additive in the tube. For example, if a 5 ml draw heparin tube is only filled with 3 ml of blood, the heparin concentration is erroneously high and may potentially interfere with some chemistry analytes, tube for coagulation test incomplete filling, results in specimen dilution and erroneous prothrombin and APTT test results.

Riders are trained to collect requisition forms with clinical history of the patients from the labs/ hospitals detailing the name, age, sex, surgical history, timings etc.

Inventory management supervises the flow of samples from labs/hospitals. A key function of inventory management is to keep a detailed record of each new sample or final report as it enters or leaves lab/hospitals. In the context of this topic, the details of the samples collected from various labs/hospitals are entered into the system and billed against the unique ID created for the client with barcodes. Inventory control is beyond the scope of transportation of samples, but it is concerned with minimizing the total cost of inventory while maximizing the ability to provide clients with service in a timely manner.

Integration is a process of attaining close and seamless coordination between collaborative planning, procurement management, inventory management and co-ordinating with the inter department teams of billing, processing and dispatch.

(Author is co-founder & director - marketing & business development, Trident Diagnostics)


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