CX Speak

Improving Every Patient’s Experience – CX Insights by Mr. John Punnoose, Independent Director and Mentor, Hospitals and Health Systems

At Customer Guru, we believe that Customer Experience (CX) should be the number one priority for all the Indian businesses so that they become more sustainable and successful globally. Thus, we are on a mission to spread this awareness, inspiring and guiding professionals to adopt and inculcate a customer-centric approach. We are certain that this is a first step to help organizations WOW their customers and create raving fans for themselves.

Continuing with our initiative of sharing experiences of top-notch CX experts across India, we have another gem of an interview with Mr. John Punnoose. Mr. Punnoose is a senior healthcare management professional who has been associated with several innovative social enterprises and tech-based start-ups in both the education and healthcare sectors. He has been advising, consulting, mentoring and managing various healthcare start-up and non-start-up organizations across Asia, Africa and Europe for over twenty five years.

In this candid interview with Customer Guru, he talks about the past, present and future of the healthcare industry and how it has evolved over the time, especially in India – patient experience has become a key focus-point for all the institutions. He also discusses how technology can come into play for overcoming the problems that still remain in the healthcare industry.

We invite our readers to comment and ask questions on similar challenges that they might be facing in their organizations when it comes to setting up systems and processes to deliver a great experience. This article is framed in a question-answer format; please feel free to share your feedback on the article too.

How do you see patient experience evolve over the last few decades?

Healthcare is a very complex sector as it deals with human lives. From a hospital’s perspective, it is not just one individual or one caregiver who touches the patient’s life when he is in the hospital; there are several players who interact with the patients when they walk into the system – front office, doctors, nurses and paramedics, housekeeping, food and beverages and even the security guard. The complexity lies in all the units working in tandem with the common goal of ensuring that the patient who walks in is being taken care of, mentally, physically, and emotionally. After all, he is going through a traumatic time; he has not come into the system for fun or for leisure. Thus, the system must ensure that anything and everything revolves around ensuring that the customer/consumer/patient is fully at the core of the entire process of care giving.

Healthcare has changed in last the two decades for the simple reason that the consumer today is well aware of his options, of the various players in the market, and of the technology that is now available. Healthcare has also evolved because of accreditation, quality standardization and adoption of best practices from sectors like hospitality and aviation industries. Sometimes, the customers/patients even travel across countries to receive medical aid. Since today the customer is well-travelled, he is well aware of his rights of choosing a certain doctor or an institution, which complicates the situation even more. Thus, to overcome this, customer-needs and responsibilities have become the core of any healthcare institution. Healthcare providers are now aware of the fact that they need to customize care based on where the customer/patient comes from.

Since we are treating a larger audience now, systems had to evolve. With the evolution of technology, it has added a new dimension. This will make healthcare delivery in the next 10 years totally different from what it is today. We are entering into a new era now.

Can you share an example of a challenge that was faced by a brand that you were working for and the initiative that you took to overcome it? Could you also tell us the impact that it eventually had on the experience that was being delivered to patients?

One of the issues that the healthcare sector still faces is that physicians are considered to play the central role in the delivery of healthcare. As the customers have become aware of their rights, doctors have also started realizing that they are not the sole players in the working of the system. A lot of other players need to work in tandem to ensure that the best is given to the patient. Allied fields such as rehabilitation, radiology, diet and nutrition, and social workers have, thus, evolved. It has now become a team initiative to ensure that the patient is getting the best. The emphasis on “The Strength Of The Chain Is Only As Good As The Weakest Link” is easily seen in the healthcare industry today. Over a period of time, I have witnessed this transformation of the healthcare industry from being doctor-driven to being team-driven.

What would be your recommendation for brands to loop in all the stakeholders in becoming customer-centric?

The successful models in the global as well as the Indian markets are models that are based on group practice and team practice, such as CMC Vellore and AIIMS. They always come on the top of the pile whenever it comes to choosing the best institutes of healthcare because they are predominantly based on institutional practices or group practices. However, some problems still persist, primarily for the reason of demand and supply. In the Indian subcontinent especially, the struggle is because of shortage – low doctor-patient ratio, low number of specialists such as oncologists, neurologists, and psychologists. Thus, the specialists tend to run around multiple places, not spending sufficient time with each patient. It becomes all the more important now for the team to be aligned and trained. That’s where the system practices and engineering practices come in play. This is exactly why institutions such as CMC Vellore are still reckoned as the top guns in the industry, where the patients don’t know the name of even a single doctor. This is exactly where technology can come into play.

What role do you think technology can play in solving such problems?

Technology can bridge this demand-supply gap. The concept of telemedicine has actually changed the doctor-patient interaction. A doctor is now able to treat a number of patients situated at different locations. If we can bring that doctor through technology into the realm of the consumer, it eases the travel on both the ends. Telemedicine has proved to be one of the biggest tools used in recent times to reach out to communities that have no access to quality healthcare.

The other major intervention is happening through the power of mobile technology. The penetration of mobile technology is so amazing that it can actually be a health tool. It can be used to transmit medical data, and it is improving to a level of even capturing and transmitting ECG, checking blood pressure, and pulse rate. This is evolving and growing in leaps and bounds. I believe amazing things can be achieved in a matter of days, and not years, with the usage of technology. Imagine what it is going to do in the next 10 years.

The cost of technology is easily affordable even by the vegetable vendors and the like. mHealth is going to change the way healthcare is delivered. It is a tool that is accessible to everyone. So, if knowledge can be directed in the right way to the people, I can see immense value coming out of it. In fact, we have used it recently in a company that I was a part of. It is an app called MUrgency. This is used to alert the first responders. In case of an emergency, one just needs to push a button and almost immediately a doctor, nurse or paramedic in their vicinity could rush to that place.

The leapfrog in technology is already evident in the operating rooms and in the diagnostic biomedical equipment area. Surgeries are done today much more efficiently, with lesser number of post-surgery issues, and discharges take place within the same or the next day, ensuring shorter hospital stays and lower infection rates. It also makes business sense, as hospitals make most of their revenue in the early days of the admission. And it is also much better for the patient to go back to a familiar environment when the process of healing begins. Technology is truly making its presence felt.

What is the difference in the way patient experiences are perceived based on geography? Please share your experience with our readers.

I have worked in a 7-star luxury hospital in Kuwait. So, I know that every society has its own definition of quality. A Mercedes Benz could be a common thing in a particular community whereas in a community like ours, Maruti 800 is a quality car. Quality is just a perception. In India, we are striving to make healthcare, which already is 1/10th of the cost of the global world, to be more affordable and accessible to people. It is amazing that we are already able to breakdown cost to the level we had in the past. Because of the share volumes, we are able to achieve more cost effectiveness. That may not be the case with other communities, where there are less number of patients to treat. However, their patient recovery may be very high because of, what they say, the kind of quality healthcare that they provide. A normal delivery could cost up to 40-50k in India, depending on the health and well-being of the mother, whereas the same would cost up to 5-10 lakhs in the Middle East when similar kind of technology is used. Further, I believe the skill set of our care providers is as good as, or even better than, any other region. Even in complex procedures, like a heart surgery, we are today able to conduct a surgery at 1/10th the cost of the global market. And I don’t think the healthcare system is given enough credit for that. Still, the people consider the private healthcare industries to be expensive. So, I would rather not compare the healthcare system in different places. However, I would compare the outcome because our outcomes are as good as or better than other regions.

What would be your word of advice for a healthcare brand that is trying to embark on this journey of customer-centricity?

We are working in an environment where there is a tremendous gap between demand and supply. In a population of over 130 crores, every day we are faced with new challenges, new epidemics, new health-related issues, or issues like lifestyle diseases. Already, India is home to the largest population of patients with cardiac ailment, diabetics or lifestyle-related diseases. We will soon have the largest population of both young and elderly population. The shortage of hospital beds and skilled professionals, the rural-urban divide, the lack of social security, etc. are all putting tremendous strain on the health system. I believe now is the time for new innovations, new thinking and opportunities for entrepreneurs to take up challenges in the health sector. Preventive healthcare and wellness will open new vistas of opportunity.

My only advice to entrepreneurs who wish to enter the sector would be “Think Globally But Act Locally” and not to transplant something from another world. India is known for its values, culture and rich tradition. We need healthcare systems that are true to Indian values. That would be the key. Health is a very emotive subject and solutions will have to be found, clearly keeping the customer in mind at all times – his wellness and total well-being will be paramount.

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