“Today, the challenge in cancer care is to make it accessible and affordable,” says Dr BS Ajai Kumar, the Chairman and CEO of HealthCare Global (HCG). “My vision is to have one standard of high end care across centres in India and the emerging market.”
The group is India’s largest provider of cancer care, with over two dozen cancer centres in the country and beyond. But with rising costs of healthcare globally, it is challenging for any provider to continue to deliver services at the same quality while managing costs.
HCG seems to have a formula for achieving this in India, and even in markets in emerging countries such as Africa, according to Dr Kumar. He shares his high-tech vision with Hospital Insights Asia.
Managing cancer with tech
To ensure “uniformity of care”, the HCG group runs “virtual tumour boards”. Oncology specialists discuss patient care and treatment in these weekly virtual meetings, to establish protocols and care plans for their patients.
These weekly meetings help to ensure that patients get the same level of treatment across HCG’s cancer centres, and serves to boost patient centricity, Dr Kumar says. “We are very much into measuring outcomes. They are all about how we bring about uniformity in care across 25 centres.” The group may not be able to assign experts to all its centres, so this is one way to ensure that patients in tier 2 and 3 cities benefit too, he adds.
A great deal of work goes into planning cancer care for patients. “It takes hours of work and a multi-team effort to give the right treatment. In Bangalore we might have 100 people to treat one patient,” Dr Kumar explains. But this creates challenges in delivering care at scale.
For HCG, it is about using “centralised planning” for the complex and intricate treatment plans that cancer patients need – from surgery and radiation to chemotherapy and immunotherapy. “Most important in cancer care is giving the right treatment at the right time and right staging,” Dr Kumar remarks.
Centralised planning, empowered by cloud technology, means that patients in places such as Baghdad, Nairobi and Ho Chi Minh City get the same level of cancer care as those in Bangalore, where HCG is headquartered. “Up to 30 physicists in Bangalore plan for all the patients, the details of the actual delivered treatment. This is one way to improve care delivery and precision,” Dr Kumar says.
The group also uses technology in other innovative ways in the journey towards uniformity of care. Teleradiology and telephysics – centralised radiologist and physicist services – allows patients in other cities and countries to benefit from the expertise in the India centres.
For a fixed fee, HCG provides telemedicine, teleradiology, and telephysics to hospitals outside its geographic scope, such as rural areas and other emerging markets. In African countries, in particular, governments paid the cost of HCG‘s telemedicine services as part of a project which provided videoconferencing training and consultations to African doctors, according to a Harvard Business School case study.
Value in care
The key to providing “value-based care” is to specialise, Dr Kumar continues. A dedicated oncology group like HCG can focus on various modalities for cancers, create precision medicine, and still manage costs of healthcare services without sacrificing patient outcomes, Dr Kumar notes. “This is what Harvard calls a focused factory approach.”
“This is what Harvard calls a focused factory approach.”
The backbone of his vision to standardise care is data. HCG has rolled out an EMR system across a few centres so that the group can collect data that helps in centralised planning. It would not be possible without EMR systems, Dr Kumar believes. “Once you have a central system, you are able to collect data on a day-to-day basis. Centralised is what works.”
“We’re currently developing new models whereby data is already collected for over 200,000 patients,” he goes on to say. “In about 18-24 months EMRs in all centres will be rolled out.”
Other hospitals keen to roll out EMR systems of their own need to first think about the types of data they want to collect, and how – and proceed accordingly, according to him. “The system should not be off the rack, it should be custom-made for your requirements,” Dr Kumar advises.
It is evident from HCG’s experience that with the right operating model, cancer care can be made accessible and affordable. There are lessons here for any hospital to deliver healthcare services while managing costs and improving outcome.