Exclusive Interview: Chief Business Transformation Officer, Bumrungrad Hospital

By Nurfilzah Rohaidi

David Boucher shares his transformation vision for the year, and how the hospital is using robotics to cut waiting times.

Bumrungrad International Hospital is a private multiple-specialty 580-bed hospital in central Bangkok, Thailand. It is known for being a key player in medical tourism in the region. Hospital Insider speaks to Chief Business Transformation Officer David Boucher on how robotics is being used in spine surgeries and to cut waiting times, and efforts at closing the gap between care teams and patients.

What is your vision for Bumrungrad this year, and what role does technology play in that?

My vision for 2019 is to really support the overall hospital vision, which is to provide world class holistic healthcare with innovation, and improve customer stickiness. One of my personal visions is to continue to support the excellent doctors, nurses and other caregivers that we have - the actual folks that are hands on - as they offer a safe service to our patients.

At a high level, I will continue to support our shift to robotics, everything from prostate surgery to joint care, or makoplasty with robots. Those are some of the things we are doing in the pharmacy and lab with robotics and of course, with artificial intelligence as well.

Key to my role here is to really accelerate our pivot to become much more consumer-focused, to really respond to the whole Insta-culture, the on-demand culture in the world in which we all live now.

How are you using robotics in the management of the hospital and making things more efficient?

On the surgical side, we have a centre of excellence for robotic spine surgery. We also use 3D monitoring - it really helps to reduce the surgery time and the patient's blood loss while encouraging a fast recovery. Most patients are walking after spine surgery practically right away. And they're in the hospital for nine to 12 hours, and then they're on their way. That helps us to provide safer medical surgical care, but again, lower anaesthesia time and blood loss and that is better for the patient.

Secondly, I believe Bumrungrad was one of the first hospitals in the world - certainly one of the first in Asia - to have a fully robotic inpatient pharmacy. Everything is bar coded, the meds and everything else. It's helped us to really lower our medication error rate and of course reduce the whole throughput time.

"By 2020, we will be implementing a fully robotic outpatient pharmacy." On that note, one of the couple areas we hope to improve is that outpatient pharmacy patients do complain about how long they have to wait to get their meds. By 2020, we will be implementing a fully robotic outpatient pharmacy, which I believe will be the first in the world.

The intent of that really is not only to maintain a very low error rate but also to really cut the time that our patients have to wait. It could reduce waiting time by well over 65%. That really helps to get patients on their way to where they need to go.

How are you using technology to improve patient experience?

One of those things I recognised when I started last year in July is that none of the hospitals in Thailand were involved in telemedicine when increasingly, the 3G and 4G networks are great, and 5G is coming.

We will launch in the very near future a mobile app that will include telemedicine. Bumrungrad has made a significant investment in a company called Doctor Raksa, the leader of telemedicine here in Thailand.

The app will start with telemedicine function, which will be live by the end of April. The functions will morph in an iterative fashion to include online appointments so that consumers can make their appointments online; retail pharmacy; and then over the next few months and years, we will continue to add functions. And we are in the process of integrating the mobile app with our EMR system so that our telehealth physicians will have access to key points in the patient's history.

For our foreign patients, we have already launched a programme where we do second opinions through telehealth. Specifically with a clinic that we own in Yangon, Myanmar. We started that about a month ago. That allows, for instance, our orthopedic surgeons here to actually talk to and work with the patient before they get on a plane to come here. There is no point people having to get on planes and coming here, if they don't really need to.

One of the other things from a patient service perspective is that we have worked on reducing our lag time for patients making appointments. As of today, we are completing probably about 70% of all of our patient appointments requested through email or telephone within about four hours. For us, that's a dramatic improvement over the last quarter.

Another thing I am hoping to lead this year is the ability for our patients to make near real time on-demand patient appointments, right through our app.That is certainly where we aspire to go.

How you are improving the patient-doctor relationship, and what sorts of tools are you using there?

We are keen on being able to use data from patient wearables and implantables. I can't expand a whole lot just yet, but we will start with one or two particular disease states. At a high level, potentially, our kidney centre of excellence.

For diabetics, certain devices such as home monitors, bathroom scales, blood pressure cuffs, could potentially feed data directly into our patient portal. Both the patient and the attending physician and nephrologist can access that data as well.

It's about convenience for the patient. In this particular case, the patient doesn't necessarily have to deal with Bangkok traffic to get here. But it will also allow us to think long term, with a physician and health coaches, to help that patient avoid a diabetic coma and issues around that.

Finally, where would you recommend for lunch in your home city, or anywhere in the world?

I'm a runner and run every day; my number one lunch recommendation would be a hot dog at Boston’s Fenway Park.

Boucher will be speaking at Hospital Management Asia, happening on 11-12 September 2019 in Hanoi, Vietnam. Register to gain insights on how to lead digitalisation and transformation to elevate your hospital's standing and service quality.

Images from David Boucher and Bumrungrad International Hospital Facebook page