using innovation to increase accessibility

8/3/2019 Using Innovation to Increase Accessibility

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Using innovation to

increase accessibility

www.pwc.com/india

Dr. Rana Mehta

IFC International Private Healthcare Conference 2011Washington D.C.26 May 2011


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Agenda

1. What drives innovation in healthcare?

2. How easy is innovation?

3. Innovators and their mantras

4. Flipping the current business model

5. Learning's for providers in the developed world

6. Can innovation be taught?


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What drives

innovation inhealthcare?

1


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What drives innovation in an emerging market?

Large and exponentially growingpopulation base creating a hugedemand

Government unable to cater todemand

Rising incomes allow patients toswitch to the private sector

A dual burden of diseases

Inadequate access to capital andtalent

Access to healthcare is limited byaffordability

Accessibility is

primarilylimited byaffordability


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Hospital beds and physicians per capita


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Innovation= value-creating novelty

A new idea or product becomesinnovative only when it createsvalue.

Not all innovation is equal. Based

on the amount of value itgenerates, innovation can beclassified as:

Incremental Adding a newfeature to an existing product

Substantial Next generation

Radical Revolutionary

0-20%

20-50%50%+

Classes of innovation

Incremental

Substantial, next generation

Incumbents

New Entrants

Newvaluecreated


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How easy is

innovation inhealthcare?

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Barriers to innovation

Highly fragmented industry

Multiple stakeholders

Government

Providers

Medical Profession

Equipment Suppliers

Insurance Companies

Financers

Consumer

Ability to replicate and scale upoperations

Funding innovation

Highlyfragmentedindustry


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Where the emerging markets lead:

Huge market

No legacy systems Rising incomes

Demographic dividend

Access to human capital at a low

cost

No legacysystems


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Innovation: A dynamic process

Radical redesignof the delivery

process

Ability to survivein an uncertain

environment

Process innovation

Product innovation lags behind


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Innovators and theirmantras

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Innovators have found ways to deliver care effectively atsignificantly lower cost while improving access and

increasing quality (1/3)

Radical redesign of delivery process

Emergency Management and Research Institute (EMRI), India A

centralized emergency response service addressing the challenge of pooror non-existent access to emergency support across India.

Health Management and Research Institute (HMRI), India An easilyaccessible digital health platform integrating a medical advice hotline, amobile medical outreach component, and telemedicine solutions.


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Dissecting process innovation chain

Economies of scale Narayana Hrudayalaya follows a factory like approach, uses highvolumes to reduce healthcare costs. In 2008, Narayanas 42 cardiac surgeons performed3,174 cardiac bypass surgeries which is more than double of 1,367 performed at the

Cleveland Clinic, a U.S. leader at the same time. Each of these surgeries at Narayana costsaround $2000, compared to $5000 in any other private hospital in India, whereas in theU.S. it costs somewhere between $20,000 - $42,000.

Use of technologyAravind Eye Care uses Aravind Telemedicine Network to supportvideo conferencing for 3000 rural patients.

Right Skill the workforce LifeSpring uses midwives to provide most of the care attheir maternity hospitals, thereby linking skills and training requirements to the task athand. This allows a just a single doctor to oversee significantly more patients by focussingon tasks that specifically require a doctors attention. LifeSpring only charges $40 for anormal delivery, rather than a typical $200.


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Dissecting process innovation chain

Standardize operating procedures Aravind Eye Carestandardizes the entire end-to-end patient pathway from initial

diagnosis to surgery, recovery, and discharge with high efficiency. In aconventional Western hospital an eye operation would typically take 30minutes Aravind Eye Care does it in 10 minutes.

Borrow someone elses assets HMRI takes advantage ofestablished supply chains by operating medical convoys, mobile health

facilities from public hospitals.


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Ankur Project, Gadchiroli The hope of saving the new

borns

Community consent andinvolvement of stakeholders

Orientation, training of thetraditional birth attendants andhealth workers

Data collection, quality control, andmonitoring of the systems

Home basednewborn care


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Aravind Eye Clinic, Madurai In service for sight

Standardization and engineeringcataract surgery for high volumeproduction

Added key elements dedicatedfactory for producing lenses,training center to provide key skills,specialist ophthalmic researchcenters, and an international eye

bank

Process Innovation

Eliminateneedlessblindness


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Narayana Hrudayalaya, Bangalore Walmartisation of

cardiac care Better purchasing power Narayana

Hrudayalaya is Indias largestpurchaser of heart valves

Cost Innovation: Redesigningproducts and processes from scratch

Doctors on fixed salary, notcompensated on per surgery and are

required to perform more surgeries bringing down the cost per procedure

Economies of

Scale

Processinnovation


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Shasthya Sena (Health Force), Bangladesh

A program designed to improve thequality of the services provided by

informal providers in ruralBangladesh and integrate them intothe countrys health system bynetworking the providers andestablishing quality monitoringmechanisms.

Improving the

performance ofinformal

providers


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MicroBusiness for Health/ HealthKeepers, Ghana

A social microfranchise programthat applies tested business

methods to provide poor ruralcommunities with access toaffordable healthcare products,services, and information.

Applying

businesssolutions forbetter health


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LivingGoods, Uganda

An Avon-like network offranchised community healthpromoters who provide healtheducation and earn a living sellingessential health products door-to-door.

Delivering

affordablebasic health

products door-to-door


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Smile-on-Wheels Program, India

A national mobile hospital programcatering to underprivileged

children and women in remoterural areas and urban slums usingprimarily volunteer physicians andnurses.

Reaching the

poor throughmobilesolutions


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Greenstar Social Marketing, Pakistan

A comprehensive socialfranchising and marketing

program increasing access to anduse of health products, services,and information among lowsocioeconomic population groupsthrough an extensive privateprovider network.

Harnessing the

private sectorto reach the

poor


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Flipping the currentbusiness model

4


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Flipping the current business model

Reinventing systems ofproduction and distribution

Scaling out rather than scalingup: involving varied stakeholdersfor expansion

Redefining roles both clinicaland managerial

Straddling the pyramid Keeping the human touch

intact


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Mobile Healthcare: Physician perspective

Source: PricewaterhouseCoopers HRI Physician Survey, 2010

56%

39%

36%

26%24%

Expeditedecisionmaking

Decrease timeit takes foradministrative tasks

Increasecollaborationamongphysicians Allow more

time with

patients

Have notaffected my

day-to-daywork


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Learnings forproviders in the

developed world

5


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The key lessons

Redefine your core competence

Driving efficiency and creatingvalue with a network of partners

Simplify procedures so that theycan be replicated easily

Collaboration: Internal andexternal

Develop the capability toreconfigure in an adverseenvironment


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Involve external partners


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Can Innovation betaught?

6


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Paradigms of innovation

Thrift not waste Inclusion notexclusion Bottom upparticipation Flexible thinkingand action


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Can we measure innovation?Dimension Key questions

Input

Resources Does the institution have adequate funding to drive innovation?Does the institution invest in innovation by providing adequate gap development funding?Does the institution invest in innovation by supporting a high performing TTO?

Workforce Is the TTO large, experienced and focused enough to sufficiently support the faculty?Do licensing managers receive the support they need from specialists and interns/fellows?How large is the pool of faculty members with active research funding?

ActivitiesServices What services does the TTO provide to the faculty and the institution?

In/Outreach How active/strategic is the TTO in reaching out to the internal and external communities?How transparent are the processes, procedures, activities, and outcomes of the TTO?

Output

Productivity How efficient and resourceful is the TTO in transforming inputs into outputs?

Yield How effective are the offices technology transfer efforts in producing results?

Impact

Institutional How does success in technology transfer benefit the institution?How stable are the revenue flows from licensing and royalty payments?How engaged is the faculty/ inventor community?

Market How does success in technology transfer benefit the external community (i.e. patients, economy,external research community, etc..)?


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Scoring innovation

Source: PwC Internal Analysis


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Creating a culture of innovation

Revamping the organisation forinnovation

Using technology to driveambidextrous innovation

Innovation begins withconsumers

Making innovation local

Giving consumers their say Opening innovation to supply

chain partners and beyond

Source :Growth reimagined Prospects in emerging markets drive CEO confidence PwC 14thAnnual Global CEO Survey


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Running to stand still ....


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Contact us

For further dialogue, pleasecontact: Pradip Kanakia

Healthcare Leader, PwC India

Phone: +91 98450 57163E-mail: [email protected]

Dr. Rana Mehta

Healthcare Advisory Leader, PwC India

Phone: +91 9910511577E-mail: [email protected]


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Thank You

2011 PricewaterhouseCoopers Private Ltd. All rights reserved. PwC, a registered trademark, refers

to PricewaterhouseCoopers Private Limited (a limited company in India) or, as the context requires, othermember firms of PwC International Limited each of which is a separate and independent legal entity

using innovation to increase accessibility

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