Patient-centric approach and sustainability

Dr. Sivakumaran Janakiraman is a seasoned healthcare executive with 30+ years of experience, currently serving as the Chief Operating Officer at Kovai Medical Center and Hospital. Based in Southern India, he oversees administrative and supportive departments, optimizing stock, and consumables. Driven by a commitment to operational efficiency and cost-cutting, he has a proven track record in equipment procurement, vendor management, and strategic planning. Dr. Janakiraman has a Ph.D. in Management from Guru Jambheshwar University, an M.Phil. in Management from Alagappa University, and an MBA from G.R.D. College of Arts and Science. He engaged in a conversation with India Pharma Outlook magazine in order to tell about patient-centric approach and sustainability.

The general population is much health conscious and is curious to know about their health status, prevailing diseases, implications, complications, and treatment modalities available. They are very eager to be part of the decision-making system to get better results. Awareness of facilities and infrastructure has increased the patients’ expectations from the service provider. When there is a mismatch between the expectation and actual delivery, patients get dissatisfied.  The level of dissatisfaction varies depending upon the degree of mismatch. When most of the hospitals have equal infrastructure, the only differentiating aspect is service differentiation. Unless the approach and process are user-friendly, patients don’t prefer to choose that hospital and hence sustainability is in question.  Hence healthcare leaders are focussing their attention on patients and finding ways and means to reduce their dissatisfaction level.

Globally healthcare system is facing common challenges like a service gap between expectations and delivery, shortage of talent, and an excess workload for existing manpower. With these deficiencies, the service outcome results in patient dissatisfaction and compromised quality. One of the suggestions given to improve the service quality and satisfaction of the patients, by experts, is to modify the approach of the service provider towards the patient.  Traditionally, the treatment planning was based on the doctor’s convenience and availability of infrastructure. It was either doctor-centric or hospital-centric.  However, the modified approach is to listen, inform, and involve patients in their caretaking and make them a stakeholder in the decision-making process. Prioritizing patient’s convenience and comfort is the prime object.  Research shows that while patients are involved, the satisfaction increases and individuals take a more active role in shaping the services. The caring should be meaningful and valuable to the individual patient. The Institute of Medicine defines patient-centered care as: “Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.” Patient-centered care is a win-win deal for both the patient and the service provider.

It is reported that in this approach, patients get higher satisfaction, improved outcomes, better experience, and closer relationship with the service provider but with the same money and time spent.

In the proposed approach, the patients are grouped not based on specialties but on the basis of stay, extent of nursing assistance, and degree of equipment dependence. This will avoid duplication of resources at different locations and efficient usage of available resources. The new approach focuses the healthcare delivery system to be around the requirements of patients instead of doctors or hospital cantered. The patient need not have to search for his needs but the system will take care of the needs by default.

In this model, the service provider will not only collaborate with the patient in the care but also explain the options available for the patient so that the patient can choose the best option.

Apart from the patient, the relatives and friends are also taken as stakeholders so that they serve as additional care providers when needed.  Some of the non-technical services can be taught to them to develop confidence by the patient. To have continuity of care, even after discharge, a follow-up mechanism needs to be developed to know the progress, follow-up of medications, diet restrictions, etc. so that the patient feels confident and feels free to raise any questions. The more the patient has access to their care better they are equipped with health decisions.

Though few hospitals have feedback mechanisms to check the conditions of the discharged patients, the system is not strong enough in our country and is not equipped.  Many apps are being developed for functions of the healthcare system right from appointment to admission to enhance their experience. There is a need for developing a robust app to monitor discharged patients right from their day-to-day medication to their vitals based on which the app will forecast their probable ailment. Patients or relatives can proactively contact the service provider for further course of action.

A study reveals that the cost of acquiring a new customer is costlier than retaining an old customer.  However, retaining old customers is not that easy.  Unless and otherwise he is satisfied and gets a good experience with a service provider, the customer may not revisit.  Especially in the service industry, unless the experience is excellent, the customer will look for an alternate.  Hence improving the satisfaction level should be the main focus of this business.  Unlike products, the choice of selecting a service provider is not always with the customer.  Many times, relatives and friends decide which hospital to go or they influence their decision with the patient. It becomes necessary for the service provider to keep the relatives and friends also satisfied to revisit the hospital so that sustainability is ensured.  Another aspect is that due to rapid changes in medical technology, it is essential to keep updated technological equipment, infrastructure, and talents to enhance the confidence level of the patients.

When a hospital is patient-centric and technologically advanced talents are available, and a transparent ethical system is in place, there will be a better flow of patients and sustainability will not be a question.