Case Facts :1. 1.

Elements of a strategic service vision, the following are the factors applicable to the Apollo Hospitals of India

Target Market segments Population Statistics : Population above 920 mill. people with wide variety of economic levels, social statuses, and cultures. Lowest per capita GNP $255, population growth 2% p.a. Growth real GNP 4.5%. Middle class 270 mill. Wealthy 30 million people. Target Market Segment : Upper middle class, the wealthy, and company employees with health insurance (108 million in 1994 ). Half of the middle class able to pay for private health care. Current Market Status : Most hospitals are state run at very low cost, low tech, and low quality. Private medical facilities are available - highly specialized, charging market rate (not latest technology but provides privacy and intimacy). Treatment of a complex ailment in a private institution is more time consuming and expensive. Economic liberalization : domestic and multinational companies - more competition Demography : urban, high income as dictated by upper middle class and elite class, neighboring countries. Psychography : Targeting people who can afford comprehensive high quality service; who are ready to pay more money for the comfort and treatment by more reputed doctors. Market Growth (income + segments growth) : Sizable market of 30 million (wealthy ) and 135 million upper middle class person. Proposed Plan : Comprehensive hospital emphasizing on tertiary care -- advance therapy and surgery, complicated medical problems. Primary care is stressed mainly through preventive measures. High quality medical care through the latest medical technology and the best qualified staff. Service Concept The aim is to provide outstanding value to patient through superior medical results, quick treatment, and a low total cost of care relative to competitors. This can be achieved through the Five stars management philosophy : medical personnel, medical technology, employees, value and hospitality. Customers' perception : high quality, comprehensive service at 10-15% below than the top hospitals in Bombay and Delhi in a shorter time period (on average 7 days versus industry's average of 9-12 days). Superior medical treatment: success rate at par with highest international standard, competitive total cost of care. Operating Strategy Hospital operates under the Five Stars philosophy.

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General information about Apollo Hospital:

Founder Dr. Pratap Reddy in 1983 in Madras First corporate hospital in India Offers : sophisticated treatment in comprehensive range of medical specialties and state of the Art medical technology, skilled and motivated and dedicated technicians, superior highly skilled/ foreign trained and famous in their fields doctors, supporting staff. Providing top quality medical care

Does Apollo Hospital Madras provide superior value to its customers, shareholders, and employees through a well designed service system in other words is it a breakthrough service organization?

Value for Customers Trends during the case study Customers in India for the first time were provided a premium health care service by a private organization. Customers got an opportunity to have quality health care in India without the need to make trips to abroad for treatment for complex medical conditions like cardiac and urology. Prior to 1983, most of the health care was provided by the state and was in nursing homes which does not have the adequate medical personal or medical equipments for handing the need for customers. These nursing homes privately run would have less than 20 beds and would refer to bigger state run hospitals for complicates health procedures. But Apollo became the first comprehensive, for-profit hospital in India and having the capability for advanced medical procedures and health. Dr. Reddy wanted to give patients the most advanced medical care possible at high quality and with a human face

Latest trends after the case study

E-Doc All online appointments can be booked from Apollo edoc website. For immediate appointment (within 1 hour), call our health lines 6600 1066, Ahmedabad 6670 1880, Kolkata 6450 0844. 2. Apollo Prism Apollo Prism is a patient-controlled Personal Health Record with which the users can import and manage health records created during various doctor visits and can also access their online health record and medical reports anytime and anywhere. 3.Apollo Telemedicine Telemedicine brings healthcare within reach of population residing in medically inaccessible areas. They will also be able to share their medical reports and images to ensure an all round investigation and an accurate diagnosis . Doctors can get in touch with their peers to discuss complicated cases or to get specialized help remotely. 4.B positive BPositive, a health and lifestyle magazine, initiated by Apollo Hospitals Group, was launched in 2008. B Positive conforms to the mission of empowering the people to conquer the world with a positive attitude, by creating awareness about health. 5.Sunshine store Apollo Specialty Cancer Hospital, Chennai has launched a special "Sunshine Store" - a retail outlet catering to the needs of cancer patients. It has products like wigs, prosthesis, pressure garments, cds, scarves and innerwear that would make the journey to better health just that much easier.

6. Apollo - Aircel Mobile Health Care Aircel customers can call 55104 from their mobile and talk to Health Experts from Apollo for any health related queries and get interim relief for life's little health urgencies - anytime, anywhere and for anyone!!! 7. Apollo Lifeline Lifeline is accessible and is capable of meeting consumer queries on all possible aspects. It is an iterative process and is constantly upgrading the capabilities. Apart from voice calls, the unit will be the one-point contact for emails and fax as well. 8. Apollo Sugar Clinic The concept of "Sugar Clinics" is an effort on behalf of Apollo Group of Hospitals to increase awareness on diabetes and provide world class care within your reach. The health care team at our "Sugar Clinic" will provide you with the best insights in handling diabetes. 9. Conversation Therapy Conversation Therapy, a patient community platform is an online initiative of Apollo Hospitals where you can bond with other patients and caregivers for information, remedies and guidance. The community currently features Orthopedics, Diabetes and Child Care. 10. Virtual ICU Visit 'I _ SEE _ YOU' technology helps relatives virtually visit the patients who are in the ICU. Doctors can also monitor from a remote location to check on the patients. 11. Apollo WHITE Dental Spa Apollo WHITE Dental Spa is a one-of-a-kind 7-star dental spa in India that brings you world-class dental care and top of the line indulgences under one roof. On board are the best doctors and cutting-edge equipment that come together in a luxurious, sophisticated, and calm ambience to make you feel special.

Value for Shareholders Apollo created a great value for its shareholders, 40 % of the shareholder of Apollo are people from the medical background and colleagues who had worked with Dr. Reddy in US. These shareholders along with generic public were able to reap benefits due to increased spending in health care. The balance sheet in the case also shows that just after 4th year of operation Apollo was able to break even and by efficient management & operational principles, Apollo Hospital Madras was able to reduce the operating code and improve the operating margin and creating the value for shareholders. Values for employees Dr. Reddy wanted to run Apollo based in the Five star principles. Employees and Medical personal formed 2 stars in this philosophy. The basic idea was those respects the individuals and encourages individual growth, open and constructive organization culture and decentralized management and a personal rapport with management and all employees. Many employees have very strong sense of culture and community with in Apollo. Employees were encouraged to celebrate functions with family and built personal rapport with other members of the business unit. Apollo Hospital Madras was a truly breakthrough service organization. Apollo Hospital Madras not only provided quality health care for customers, but was able to motivate employees and create value for shareholders but as a whole create value for the nation. As a corporate hospital, Apollo did not have any model to emulate but still it was able to import the knowledge and expertise on medical practice from western countries and bring quality health care sector. The recent trend of quality & premium health care in affordable prices is possible due to the pioneering contribution.

What are the key elements (Basic and Integrative) of Apollo Hospitals Madras Strategic Service Vision?

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Apollo Hospitals madras strategic service vision was based on Five Stars These Five stars are: Medical personnel : Highly skilled and experienced doctors mostly returning from western countries (well known both academically and clinically). Well trained and motivated junior doctors, technicians, nurses, and other supporting staff. Medical technology: Latest available technology, constant and quick update, high utilization and availability. Large capital investment emphasis in this area Employees: Constant interaction between all levels. The environment promotes a sense of family/community. Upper management recognizes attendance, punctuality, achievements in sport, and honesty through awards. A 10-20% higher wage for the employees than local, private hospitals. Flexible atmosphere, free medical care, and other economic benefits (loan, wedding gift, subsidize meals) attract competent employees. Hospitality : Customer oriented/centered service, 30 hrs/year training, well established guidelines (Induction manual) Value : Care/contact after even being released from the hospital. Guest relations department improves quality of service and maintains relationship with patients. Apollo hired top quality doctors as consultants and specialist and always made sure that the support staff as medical personnel are very important for the quality of the service and focused in hiring them and training Apollo had also set very standards not only for medical and patient care, but also on the non-medical services provide din the hospital The presence of the top specialists in Apollo garnered referral not only from India, but other parts of Asia for advanced treatments. Apollo also enabled and motivated the employees to participate and present in seminars and share the innovations and new medical practices. Medical technology was seen as one of the most important pillar of strength required for quality health care Apollo expects employees to have a Personal value and to take responsibility for meeting each patients need and desire. Employee training programs were specifically designed to impart this value in the workforce Employees in all levels were trained every year Apart from the above said basic elements of service vision, Apollo has also integrative service vision which included quality assurance, decreasing total cost of care which is below other nursing homes in the local community Apollos focus on basic and other integrative service strategy vision helped it to provide quality health care for its customers after so many years of growth and changes. Apollo with these clear visions of high end service was able to stay ahead of other competitors and new private hospitals even in the growth stages

What accounts for Hyderabad Apollo Hospitals disappointing performance and what are its future prospects?
Hyderabad Apollo Hospital had not been as successful as the Madras hospital. Some of the primary reasons for this were as follows: Commitment from Consultants: One of the issues Hyderabad Apollo hospital faced was the reluctance of the consultants to commit exclusively to Apollo. Most of the consultants at Apollo Hyderabad were already attached to other hospitals and went to Apollo only on a part-time basis. As a result there was a delay to build up the reputation of the consultants, which the Indian patients had always looked for very keenly. In addition to the consultants, there was an issue with the commitment from the local doctors. Several local doctors perceived Apollo medical center as a threat and hence did not refer patients to the hospital. Private Competition: Unlike Madras, several other private hospitals preceded Apollo in Hyderabad. These hospitals typically offered lower prices to the generally price-sensitive residents of Hyderabad. Hence Apollo had to come up with measures to handle this competition that it had not experienced in its setup at Madras. In order to handle this, Apollo Hyderabad took several initiatives such as expanding its target customers to outside Andhra Pradesh, targeting corporations that paid for their employees and identifying profitable operations. Quality of operations Hyderabad Apollo Hospital also faced criticism with the quality of its non-medical operations. This resulted is several customer complaints and dissatisfied customers. The CHANGE program that Apollo had successfully implemented at its Madras operations failed to work here and as a result Apollo Hyderabad had to come up with a re-engineering process. Accessibility Unlike the Madras facility, Hyderabad Apollo Hospital was located outside the city that resulted in accessibility issues for several patients. Transportation was an issue and hence it was a challenge to reach out to several prospective patients. However despite the aforementioned worries, Hyderabad Apollo hospital management continuously worked to address these issues. Its marketing department initiated measures to build relationships with local referring doctors and some well-known consultants. These initiatives would definitely help address doubts patients had about the reputation of doctors and consultants at Apollo Hyderabad. The launch of Apollo Medical Center would also expand Apollos geographic reach and help Apollo expand its customer base. Also with the expected growth of Hyderabad, Apollo Hospital attracted several

What expansion vehicle promises most effective to enhance Apollo Hospitals profits while expanding recognition of the Apollo name?

1. Consulting service: Indian Hospital Corporation (IHC) which share experience in hospital management, license Apollo trade name to doctors and entrepreneurs and quicker expansion.

2. Health maintenance organization (Insurance and medicare HMO) which promote high quality health care through a large network of doctors and hospitals.