A Harvard review by Vijay Govindarajan and Ravi Ramamurti (2013), very aptly described the Indian healthcare system and its innovation for survival. Despite rapid growth in economy over the last two decades, the infant mortality rate has been extremely high; less than 5% of the patients out of two million get a heart surgery; over two million cancer patients, sixty-three million diabetics have not been diagnosed (Govindarajan & Ramamurti 2013); There is a short supply of hospital beds, outdated facilities, unhygienic conditions and patients have to pay 60% of health expenses from their own pockets but seem to be setting a good example to the world in dealing with challenges.
They identified three trends, what they describe as ‘the hub and scope design’ having smaller clinics/centres in the periphery/rural areas and having hubs located in towns/cities where expensive equipment is available; rural areas feeding the hub. The second innovation Govindarajan calls is ‘task shifting’, where certain tasks are handed down to staff with lower skills, doctors having to handle more complicated cases (Govindarajan and Ramamurthi, 2013). According to their review, India chronically deals with a shortage of high skilled doctors; hospitals have had to maximise the duties they perform; The third is frugality, fanatic about shepherding budget resources, for example, sterilising and reusing surgical products and spending less on asthetics of the hospital.
Here though, it is important to note and remind ourselves, that they talked about the innovations to meet the challenges of the healthcare system; much needs to be done; Many issues need to be addressed such as the pressures that the doctors and healthcare workers face or that 70% of the population is yet to receive basic quality healthcare delivery. Healthcare basks in complexity, and the change process requires more doctors to take administrative roles and roles of physican leaders to help facilitate change.
Dr Pallavi Hoskote