Transform Indian Health Care through Agile Scrum

- By

Krishnamurty VG Pammi

CSP, CSM, PMI-ACP, PMP, ITIL, MCTS

Family doctor in ancient India was treated equivalent to “God”

Service to mankind .. True Examples

Family doctor in ancient India was treated equivalent to “God” Service to mankind was service to God….True Examples

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5 Indian Health Care Sector- Current State of Affairs

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9Patients' Challenges

Doctors try their best to convert short term treatments into Long Term treatment scenarios

Doctors do not disclose the disease details in their exact form and shape

Doctors are not approachable

Doctors do not provide sufficient time to counsel patients

High Cost Factor – Sometimes Hospitals create scenarios to charge more

10Patients' Challenges continued…

For the patients with insurance coverage, hospitals try to squeeze entire insured high slab rate amount for the prescribed disease that patient is covered with

Doctors prescribe wide list of medicines. They are ignorant of the side-affects

Paying money does not guarantee good healthcare. The private healthcare system largely treats patients as revenue generators, without rationality or medical logic

11 Doctor’s Challenges

Patient does not trust Doctor prescription and does not show up on the prescribed follow up dates

Pharma companies are giving foreign tours and junkets to doctors. It happens under the pretext of medical study. Unfortunately, some doctors eagerly wait for the pharma company invitation for foreign tours

Corporate hospitals only want doctors who can help them earn more money

Frequent irrational procedures and surgeries, the distorting influence of corporate and multi-speciality hospitals on ethics of the medical profession, and the growing grip of pharmaceutical companies on private medical practice.

12 Doctor’s Challenges Continued…

Lack of adequate regulations on Fee and quality of medical service in private sector

Wealthy patients are admitted directly into intensive care and several thousand rupees are pocketed by the doctors

Corruption, kickbacks and the nexus between Hospitals and pharmaceutical firms

High work load avoid doctors to counsel patients to the best of their ability

Half Knowledge Patients - With advent of Internet, patients browse the internet and comes to doctors to test their skill and ability

Complete lack of regulation of the private medical sector

Usage of unsafe injections and medicines

13 Indian Health Care Sector- Current State of Affairs

Voices of Conscience from the Medical Profession: Revealing testimonies by rational doctors about the reality of private medical practice in India http://www.sathicehat.org/

Published by SATHI (Support for Advocacy and Training to Health Initiatives).

The sensitive “Trust Layer” between Doctor and “Patient” communities has been consistently tested in the past 15 years on the negative side.

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15 Root Causes For This Disconnect… The distorting influence of corporate and multi-specialty hospitals

on “ethics” of the medical profession

The growing grip of pharmaceutical companies on private medical practice

Government’s Successive health policies and resource allocation exercise has allowed degeneration of public health infrastructure and actively encouraging private sector

Frequent irrational procedures and unnecessary surgeries

More focus is given on “Following the set plan” over “responding to change”

More focus is given on “Fixed and non-cooperative attitude” over “Flexible, accommodating and stakeholder collaboration”

More Focus is given to compliance with documentary admitting procedures over talking to patients and counselling them

Success is measured on motivated Documented facts over healthy patient

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Accou

ntab

ilit

y

Accountabilit

y

Communication

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Restore the Trust – For God Sake!....

Rational

Doctors

Government Policies

External

influence

Non inclusive Working

Methodology

Monitory Attractions

Trust Restored

Accountable

Approachable

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Proposed model hospital “Trust Re-invented”a non profit Hospital where “care”, “counselling” and “value” are our motto.

Service Mindset – Management

Rational and Ethical doctor community

Care Value Counseling

Government Policies

Regulated pharmaceutical Companies

Distorting influence of corporate and multi-specialty hospitalsGrowing grip of pharmaceutical companies

Monitory Aspects

Hospital “Trust Re-invented” Addresses Cost Factor through

Money Pooled up from Volunteers /Charitable volunteers/sources

Fee charges as per regulatory norms

Transparency on the balance sheet every quarter.

Pass on the profit gained (after keeping minimum reserve for future sustenance) to the patients through decreasing fee rates for major diseases

Fall back support from government in-case of no/less reserve funds

21 Hospital “Trust Re-invented” – 5 Scrum teams

Development Team - Each team consists of 6 Doctors.

Scrum Master - “Hospital Customer Service Contact”

Area Product Owner –Senior Doctor who can mentor / help prioritize

Chief Product Owner – Resolve dependencies among Area Product Owners.

22 Scrum Artefacts

Patient Backlog Release Backlog Sprint Backlog

23 Nurture Trust and Accountability through…

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Scaling…

25 Scrum Implementation – Key Insights

Value Driven Planning using techniques

Value Stream Mapping

Patient Value Prioritization

Inspect & Adapt after every iteration

Information Radiators

Patient Recovery Burn Down

Value Points / Patient Satisfaction Index Delivered

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Proposed Benefits

A thrust for India’s much needed national movement begins for “building more number of rational and ethical doctors” for better health care

Restore the trust, communication between Doctor and Patient Community

Monitory factor removed from Patient and Doctor communities

Influence of corporate and multi-specialty hospitals nullified

Influence of Pharmaceutical companies nullified

India starts experiencing the art of pure “health care”

27Thank You

Krishnamurty VG Pammi

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