Apollo Hospital Group is one of Asia’s largest healthcare groups with over 9,000 beds across 64 hospitals, and the world’s largest private cancer care provider and runs the world’s leading solid organ transplant program.

Hospital Insider spoke to Prof. Anupam Sibal, Group Medical Director and Senior Pediatrician for the group, on the major challenges in hospitals across the Asia Pacific and the role of hospitals to provide the best patient care for the community.

What are the major hospital challenges that you see in Asia Pacific?

Hospitals in Asia Pacific have to face the dual challenge of managing both non-communicable Diseases (NCD) and infectious diseases.

The incidence of NCDs is increasing at a dramatic rate, and this necessitates the need not just for curative care but also preventive care. The shortage of trained healthcare professionals and inaccessibility of healthcare facilities are major challenges as well.

While affordability has increased through insurance programmes in several countries, healthcare remains inequitable. There has been a greater focus on patient safety and quality improvement, but there is still much that needs to be done.

What do you think can be done to address these and improve patient outcomes?

Hospitals have a major role to promote preventive health to help reduce the burden of NCDs and infectious diseases. They need to reach out to the community and promote a healthy lifestyle. One of the initiatives implemented by Apollo Hospitals is the ‘Billion Hearts Beating Program’, aimed at promoting awareness about cardiac health in the community.

The use of information and communication technology is enabling better access to healthcare. Telemedicine and mobile applications are linking specialised healthcare services with underserved populations. Apollo Telehealth Services has provided unique innovative models to deliver healthcare services to remote populations, including those in the Himalayas and the state of Andhra Pradesh.

Public-private partnerships between the government, hospitals and solutions providers are now inevitable for improving healthcare. Hospitals need to work on innovative models that improve access to care and also ensure safety, quality and improved patient outcomes.

To improve quality and patient outcomes, hospitals should be strengthening the patient safety culture, teamwork and communication to bring about systematic improvements in their daily processes. This is possible with a strong clinical governance structure.

Reforms in medical education, nursing education and education of healthcare professionals are necessary not only to address the problem of scarcity but also to fulfill the rapidly changing needs of the community.

How can international guidelines, benchmarking, technology and other innovations play a role?

Guidelines enable hospitals to emulate best practices for patient care. Benchmarking our processes with the best hospitals in the world facilitates introspection and sustained improvement.

ACE@25, the clinical balanced scorecard of Apollo Hospitals, underscores this. It focuses on clinical excellence and incorporates parameters which are mission critical for the clinical milieu of our organisation. It focuses on providing evidence-based quality care and a safe environment to our patients and strengthening the functional efficiency of our hospitals, stimulating quality improvement while reducing variations.

ACE@25 incorporates 25 clinical quality parameters covering key specialties like Cardiology/CTVS, Neurology, Neurosurgery, Orthopedics, Transplantation, Oncology, Nephrology, Urology and Gastroenterology. Complication rates, mortality rates, hospital-acquired infection rates, one year survival rates and average length of stay are some of the parameters. These parameters have been benchmarked against published results of reputed international institutions including Cleveland Clinic, Mayo Clinic, National Healthcare Safety Network, AHRQ US, NY State Deptt. of Health, National Kidney Foundation, University of California and the US National Average.

There are weighted scores for outcomes which are colour-coded in green, orange and red. The cumulative score achievable is capped at 100. The numerators, denominators and inclusions and exclusions are defined lucidly and methodology of data collection is standardised. The data is reported through an internal website every month. There is an “ACE” Champion Award for the highest scoring unit of Apollo Hospitals.

What are the new technologies that you are looking to implement in the near future?

The Apollo Clinical Innovation Group scouts for technology that needs to be adopted in each of the Apollo Hospitals units, depending on their strengths, available specialties and patient needs.

In January 2019, Apollo Hospitals launched Southeast Asia’s first Proton Therapy in Chennai, India. The Apollo Proton Cancer Centre (APCC) is a 150-bed integrated cancer hospital that offers state-of-the-art comprehensive cancer care. It is a major milestone in India’s concerted focus to battle and conquer cancer. Powered by a cutting-edge multiroom Proton Centre, APCC is revolutionising radiation oncology in India and across the region.

What is one thing that you hope to achieve this year?

This year, we are focusing on further strengthening the clinical governance structure for improved patient outcomes and achieving high reliability.

What do you think would be the “next big thing” in healthcare?

The next big thing in healthcare in India is improved access to healthcare through universal coverage.

The Government of India has launched the Ayushman Bharat-National Health Protection, the largest health protection scheme in the world.

Ayushman Bharat is slated to cover 100 million poor and vulnerable families, approximately 500 million beneficiaries, by providing coverage up to $7,100 per family per year for secondary and tertiary care hospitalisation. Benefits of the scheme are portable across the country and a beneficiary covered under the scheme will be allowed to take cashless benefits from any public or private empanelled hospitals across the country.