The Healthcare Industry in India

In India, the Healthcare industry is split into a public sector, a private sector and a wide
network of informal healthcare providers operating together in a large and unregulated
network. This irregularity has caused wide disparities in access, especially in regional and
rural distribution of healthcare infrastructure. Currently, the Indian healthcare sector is valued
at Rs.1, 360 (US $34) billion roughly 6 per cent of GDP. The healthcare business is projected
to grow to over Rs.1, 600 (US $40) billion or 8.5 per cent of GDP by 2012, according to
Price Waterhouse Coopers (PwC) report, 'Healthcare in India: Emerging market report 2007'.

INFORMATION TECHNOLOGY IN HEALTHCARE INDUSTRY

The healthcare industry today after twenty five years, since computers started influencing our
society, is standing at the threshold of a world of possibilities thrown up by technologies such
as Virtual Reality, Cyber surgery, Micro - robotic Surgery and 3D image modeling. It is said
that the Internet should be used for the benefit of mankind. Internet pundits have always felt
that development and delivery of Medicine will be one area where this medium is likely to
have immense benefit to mankind.

For e-healthcare and telemedicine to emerge as a viable alternative modality for delivering
medical care and expertise there are a few preconditions that are to be met. Some of these are,

1. Adaptation of Information technology by hospitals especially in terms of

networking and Hospital Management systems.

2. Increasing awareness on IT among medical professionals.

3. Better Internet access; possibility the madvent of broadband in India that can
transfer video files faster.

4. Standardization of various protocols (like DICOM in teleradiology) and

acceptance of these protocols by the relevant equipment manufacturers.

5. Decline in the cost of telemedicine hardware to make it more financially viable.

6. Govt. encourages a Public – Private enterprise.

7. Large Corporate leading in overseas healthcare contracts - TCS, Cognizant, etc.

At present, the major constraint is in terms of the financial viability of e-healthcare initiatives.
However there have been several isolated initiatives from various organizations and hospitals
for implementation of projects. For example The Indian Space and Research Organization
has today 32 telemedicine location in India and is investing heavily to help Indian healthcare
to graduate in this technology and then use it for its own purpose in the future to monitor
Indian astronauts who undertake journeys in space. Most of the developments in this field are
likely to focus around the needs of ISRO. The answer to make projects financially viable also

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probably lies in pooling together resources by various facilities within a geographic locality
and sharing the benefits and revenues thus created. To elaborate on this point, several
hospitals within a city like e.g. Salem can share a common Tele-pathology service or
Teleradiology service. The benefits of such a pooled service are obvious. Investigations can
be viewed by a group of expert consultants. Such a model will reduce the initial project costs
and with the patient traffic from several affiliated hospitals can achieve economy of scale and
thus reduce costs of trained manpower and material costs and also provide a very efficient
and optimal service to the community.

Healthcare

India is well placed and potentially the ideal location for experimenting with e-healthcare
solutions for the following reasons:

India has best computer Technocrats India has a very skilled medical fraternity private
healthcare emerging as a key-player in the country Indian Healthcare spending likely to
increase to 200,000 crores by 2012 from present 86,0000 crores. Potentially India a very
suitable location and resources pumped in this sector now are likely to be of great benefit

Fortis Healthcare is engaged in providing the latest in internationally recognised medical care
to patients with a variety of ailments and medical conditions.

Fortis HealthCare’s Network consists of Super Speciality Hospital Hubs that concentrate on
one or more specialities. These hospitals are interconnected to a larger network of multi-
speciality hospitals that ensures patient access to expert care for any speciality.

This unique network architecture provides expert care to our patients and a level of
confidence in receiving the latest medicine has to offer.

Telemedicine

Telemedicine in principle is well suited for countries like India, Africa and South America
where there is a large rural based population separated by large distances and needing access
to regular medical care of quality. The telephony revolution of nineties of India has linked
most of our smaller towns and villages with rest of the world. The railway also has a vast
network of fibre-optics cables already laid out on many of its routes. The Space scientist of
our country have placed strategic satellites of communication making a broadband network
not too difficult to achieve with expenditure of minimum resources, These gateways of
communications should be all used to help with the project of telemedicine and hence reduce
applications costs. Even subsidies could be incorporated to facilitate telemedicine projects in
our country.

Fortis Healthcare has built a tele-medicine network, which connects each of its facilities, so
expert care is never out of reach. In addition, Fortis Healthcare facilities are also working

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with both private and public partners in the Indian Healthcare industry to provide Super
Speciality and quality healthcare services.

Fortis Healthcare provides services covering ICU Management, ER Management, OPD

Management, Radiology Reporting, Pathology Reporting as well as Training and Education
Opportunities.

Utilising our strong HIS backbone, and PACS technology, we are able to seamlessly transmit
patient information in a secure and confidential environment. The use of tele-medicine has
provided a much-needed boost to the Indian Healthcare sector. It has also allowed our
network to expand its presence by extending quality healthcare treatment to the remote areas
of Northern India as well as overseas

Fortis Healthcare network structure ensures quality healthcare and utilizes

 VPN - Virtual Private Network

 Firewall protection
 Data transfer speeds of 128Kbs or higher
 Security : Encryption and Confidentiality
 Alternate pathways
 Web access for clients
 Use of IHE and HL7 framework
 Integrating Healthcare Enterprise
 Health Level 7

Fortis Healthcare Tele-medicine Software are:

 Browser based
 Built on HL7 and DICOM standards
 Open Source Technology Linux
 Offers Real time and delayed Access
 Streaming without transfer, real-time ECHO, US
 Statistical Reporting
 Interface with Legacy Machines
 Flexible clinical reporting formats

Security

 User authentication by individual usernames and passwords

 Restricted study access for users and groups
 Extensive logging for system audit
 Automatic log-off
 Self-defining and self-expiring passwords for maximum privacy

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  Data encryption

Five force model:

Threat of
New
entrans

Compititive
Bargening Bargening
rivalery
power of power of
within the
supplier customer
insdustry

Threat of
substitutes

Key points:

Porter's Five Forces Analysis is an important tool for assessing the potential for profitability
in an industry. With a little adaptation, it is also useful as a way of assessing the balance of
power in more general situations.

It works by looking at the strength of five important forces that affect competition:

• Supplier Power: The power of suppliers to drive up the prices of your inputs; eg: 1. brand
reputation. 2. Geographical coverage. 3. product/service level quality etc.

• Buyer Power: The power of your customers to drive down your prices, eg: Buyer choice
buyers size/number , change cost/frequency , product/service importance, volumes, JIT
scheduling
• Buyer Power is strong, again implying strong downward pressure on prices; and

• Competitive Rivalry: The strength of competition in the industry; eg: number and size of
firms, industry size and trends, fixed v variable cost bases, product/service ranges, etc.
• Competitive rivalry is extremely high: if someone raises prices, they‟ll be quickly undercut.
Intense competition puts strong downward pressure on prices;

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• The Threat of Substitution: The extent to which different products and services can be
used in place of your own. eg: alternatives price/quality, market distribution changes, fashion
and trends, legislative effects.
• There is some threat of substitution.Ex Telemedicine or shifting to other medicine like
ayuraveda or natural care.

• The Threat of New Entry: The ease with which new competitors can enter the market if
they see that you are making good profits (and then drive your prices down). By thinking
through how each force affects you, and by identifying the strength and direction of each
force, you can quickly assess the strength of the position and your ability to make a sustained
profit in the industry.
• The threat of new entry is quite high: if anyone looks as if they‟re making a sustained
profit, new competitors can come into the industry easily, reducing profits; Ex.- Apollos ,
Max, Escort , WOCKHARDT and DUNCANS GLENEAGLES INTERNATIONAL

Worries Fortis hospital:

Unless it is difficult to find some way of changing this situation, this looks like a very tough
industry to survive in. Maybe he'll need to specialize in a sector of the market that's protected
from some of these forces, or find a related business that's in a stronger position.