Vrajesh Shah Dr. Vrajesh Shah

Chairman and Managing Director Apex Group of Hospitals Mumbai

Co-Owner HCG Apex Cancer Hospital Mumbai

Healthcare Challenges

like Google to search about best solutions for disease and which leads to misguidance. In era of technology anyone can find answer of their question. Access to health information through the Internet has the potential to create better-informed patients and to enable them to become engaged in caring for their health; at the same time, health information on the Internet is often inaccurate or incomplete. There are risks and benefits associated with the availability of health information on the Internet do not result only from the content of this information, but also from how patients process it. And because of difference of opinion there is a high chance of misguidance.

One of the biggest challenges to hospital is to control the HAIs. As medical care becomes more complex and antibiotic resistance increases, the cases of HAIs will grow. One of the most common wards where HAIs occur is the intensive care unit (ICU), where doctors treat serious diseases. About 1 in 10 of the people admitted to a hospital will contract a HAI. They’re also associated with significant morbidity, mortality, and hospital costs. Symptoms of HAIs will vary by type. The most common types of HAIs are: pulmonary infection in ventilated patients, urinary tract infections (UTIs), surgical site infections, gastroenteritis and meningitis.

Person who are involved in patient care directly or indirectly a biggest challenge to make them safe from infections of various patients. Even in case of Disaster management Hospitals face both internal and external disasters. The impact of internal disasters such as a fire, hazardous material exposure, utility failures, etc., is typically limited to the hospital/healthcare facility while external disasters include scenarios such as earthquakes, mass casualty events or epidemics where the hospital itself may or may not be affected but is a critical part of the larger response. In such case evacuation of patient, transfer of critical patients to networked hospitals, scenarios also demand a high degree of preparedness on the side of the hospital administration and staff, as well as a speedy response from the surrounding community and hospitals.

Hostile/violent/aggressive behavior of relatives or mob psychology, mostly because of inability to pay bonafied and justified medical bill.

Employee retention is a critical issue for health care business especially skilled & qualified manpower like nurses and M.B.B.S RMO. Healthcare faces some of the lowest employee retention rates of any industry, which leads to poor customer satisfaction and decreased profitability.

Due to clinical establishment act it is mandatory for each and every clinical establishment including every individual clinic, consulting chamber, laboratory or any other investigative or treatment place without indoor beds, nursing homes, hospital etc. by whatever name it may be called to register and follow minimum standards of infrastructure i.e. of space / equipment and qualified para-medical staff. There are many different acts coming under this like PCPNDT, Pollution control Board and many more. And as per the act it is a huge task and challenges to fulfill all compliance, medical records & data management.

NABH including ICD coding and standardize process. In today’s era we needs to focus on quality standard and in health care to get the certification of standards like NABH, JCI which are not very easy. For this, hospital has to do many changes in their existing system and processes and infrastructural changes which requires lot of energy, cost and time. And on the other side, we have compulsion of cost effectiveness.

Any small set up who needs to get the tie up with TPA and corporate has to fulfill certain criteria like; minimum bed strength, different license requirement, certain inhouse facilities etc.

At the time of buying insurance policy, patient generally don’t read the full terms and condition of the policy, even insurance agent doesn’t guide patient about the same and when he/she gets admitted in the hospital, he has to pay for non-admissible charges, co-payment which leads to dissatisfaction of patient.

As per the TPA/Insurance and corporate terms at the time of discharge of patient hospital has to send final bill with discharge summary and even after sending the same TPA takes 2-3 hours to process it and because of the same reason discharge gets delayed and even in certain cases TPA company send query on discharge which leads to delay discharge by 4-5 hours and if not satisfied with the query answer they may reject the full case. If case is rejected by insurance company, hospital has to suffer due to nonpayment or short payment of bill by patient and which leads to arguments and dissatisfaction of patient.

No direct approach of patient which leads to cost of intermediaries. All health care providers are facing problems to satisfy the needs of referral. This cost has big impact on the final cost of treatment to the patient. As patient is not approaching directly to hospital due to fear of cost and many other reasons. It’s a biggest challenge for health care how to nullify the referral cost?

Innovation of new technology requires extra energy, money and time and also to make it viable is a big challenge to the health care providers.

patient expectations are increasing due to many new players are coming with new infrastructure and technology. Also awareness has increased due to various media & sources. And on the other side cost of resources and technology up gradation are high. It is become very challenging to maintain the operational cost and fulfill the needs to customers at competitive rates.

Introduction of many government schemes like Rajiv Gandhi Jeevandayee Arogya Yojana (In Maharashtra), ESIC, CGHS, (Central Government Health Scheme), ECHS and Maternity quota by government to cater the poor class of the society. Generally their packages are very low and hospital needs to cater all class of people under the same infrastructure so again there is question of quality management and cost cutting.

Individual’s awareness about the Medi claim has increased and people are getting themselves covered by buying mediclaim policy. On the other side corporate employee already have medical facility from the company so due to all these 60-70 percent businesses of the health care are on credit basis so to manage day to day working capital is also a new challenge to the hospital.

Government intervention to reduce the all over cost of medical including price of medicine, stent and various implants also demotivates the healthcare provider to upgrade the health care system.