Balancing Human Effort and Technology in India's Healthcare | Abrarali Dalal | TEDxSydenhamCollege

Healthcare Management in India

• Healthcare management is a complex system that involves various aspects, including hospitals, pharmaceutical companies, and medical equipment companies.
• The speaker defines healthcare management as creating a system that delivers good patient outcomes at an affordable cost, with human effort backed by technology.

The Role of Hospitals

• The speaker emphasizes the importance of hospitals in the healthcare management system in India.
• The speaker presents statistics about the current state of healthcare management in India, including the low number of hospital beds per thousand population and the need to build 2.4 million more beds.

Human Effort in Healthcare

• The speaker highlights the need for human effort in healthcare management, despite the increasing use of technology and AI.
• The speaker emphasizes the importance of trained manpower in achieving the goal of building more hospitals and improving healthcare infrastructure.

The Doctor's Perspective

• India has 13 lakh registered doctors, which translates to one doctor for every 1,000 people.
• This ratio meets the World Health Organization's recommended ratio.
• However, 70% of India's population resides in rural areas, while only 20% of qualified doctors practice there.
• This disparity leads to a significant influx of patients from rural areas seeking healthcare in urban areas, putting a strain on urban doctors.
• A typical day for a doctor involves a demanding schedule, including surgeries, patient visits, OPD consultations, documentation, and staying abreast of medical advancements.
• Doctors are also on call 24/7, responding to calls from hospitals, other doctors, and nurses.
• Effective communication with patients is crucial, especially during difficult situations.
• A case study highlights the importance of compassionate communication, where a junior doctor's insensitive delivery of news about a baby's passing led to a security situation.
• The incident emphasizes the need for empathetic communication, even in challenging circumstances.
• The text discusses the challenges of balancing human effort and technology in India's healthcare system.
• It highlights the heavy workload faced by doctors in India, leading to potential compassion fatigue and a lack of empathy towards patients.

Technology in Healthcare

• The text emphasizes the importance of technology in supporting doctors, particularly through AI for diagnostics and documentation, robotic surgery for increased accuracy and efficiency, navigation technology for real-time information during surgeries, and electronic medical records (EMR) for streamlined prescriptions and medication management.
• The text acknowledges that while these technologies are being implemented, there are still challenges in fully integrating them due to factors like training requirements and doctor familiarity with EMR systems.

The Role of Nurses

• The text emphasizes the crucial role of nurses in healthcare, highlighting their constant presence and interaction with patients compared to doctors.
• It points out the severe shortage of nurses in India, with only two nurses per thousand people compared to the World Health Organization's recommended ratio of three per thousand.
• The text attributes the nurse shortage to factors like higher salaries offered abroad, leading to attrition, and the short-term nature of the General Nursing Management (GNM) course, which does not encourage long-term careers in nursing.
• The text also mentions the low healthcare rates in India compared to other countries, making it difficult for hospitals to match the salaries offered abroad.
• A significant shortage of nurses exists in India, with 35% of the total nursing workforce employed by G&M hospitals.
• Nurses spend 35-40% of their time on documentation, including filling discharge files, writing reports, and indenting medicines.
• Nurses often work 16-hour shifts, leading to exhaustion and inefficiency.
• Automating documentation and indenting systems could significantly reduce the time nurses spend on administrative tasks.

Challenges in Billing and Insurance

• The billing department in hospitals is often perceived negatively due to high costs and complex insurance processes.
• 70% of India's population has some form of insurance, but a large portion of insured individuals rely on government schemes that are not accepted by all hospitals.
• The remaining 30% of the population, representing 40 crore people, are uninsured and must pay for medical treatment out of pocket.
• The insurance claim process in India is manual and time-consuming, taking 5-7 hours to discharge an insured patient.
• This delay is caused by the need for pre-authorization from insurance companies and the lack of automation in the claim process.
• The manual process leads to chaos in hospitals, with insured patients occupying beds for extended periods, preventing new admissions and causing frustration among patients and staff.
• Automating the insurance claim system could significantly improve efficiency and reduce wait times for both insured and uninsured patients.
• The implementation of such a system would require collaboration between different insurance providers, including private, government, and GPSA schemes.
• The National Health Authority (NHA) could play a role in facilitating this collaboration.
• Hospitals are working towards automating the claim process to decrease discharge taxes, increase bed turnover, and make more beds available for patients.

Marketing and Technology in Hospitals

• Hospitals are marketing themselves by promoting their doctors as the product, as patients seek treatment from specialists.
• Hospitals are using technology to improve sales and marketing efforts, including patient apps and chatbots.
• Patient apps allow users to book appointments, see doctors, pay for services, and view doctor profiles.
• Chatbots can answer questions that would typically be directed to busy call centers or hospital receptionists.
• Technology is seen as a support system for human effort in healthcare, as doctors, nurses, and non-medical staff treat patients daily.
• The speaker emphasizes the importance of providing good technology to healthcare staff to support their work and improve patient care.