The New Norms of Hospital Operations

December 11, 2020

Technology, adaptation of design and patient focused care will be the new mantra for 2021

The Covid-19 outbreak has made the general public vary of visiting the hospital due to the fear of infections and has made them resort to tele consultations. Number of people visiting out-patient divisions (OPD) has narrowed down in the few months and this segment is operating at a meagre 20% – 30% of the earlier base case expectations, majorly owing to lockdown and the anxious public.

In-patient division has also taken a hit due to government’s notification to postpone non-essential and elective surgeries. This has impacted the revenue generation of hospitals across the country and it is estimated that this trend is likely to continue till early FY 2021. Although, there is a change in the trend of elective surgery and hospital visit, the momentum is yet to gather.

Impact on Net Revenue & overcoming challenges

Generally, revenue and cost budgets are analysed, reviewed and finalised by the month of February to make plans and execute for the next financial year. However, by the end of March 2020, the entire scenario started changing. The inflow of patients, surgical-medical mix, out-patients, elective procedures started declining. Everything impacted the Net Revenue, even though the fixed costs were reduced to optimum levels.

Going forward, the healthcare industry will have to adapt to a new normal for operations and project expansions. Many hospitals generally have essential replacement Capex, which has been used to sustain operations.

More focus on modernisation & reduced human interventions

Now the emphasis will be more on the patient centric care and modernisation with less human intervention. Patient centric digital platforms will be given more importance for accurate results. Flexible design and construction of greenfield facilities will be done to enable faster re-purposing of beds. The new designs would provide more effective infection control with facilities such as more single rooms, flexible HVAC systems and closed ICU beds. We would also be providing flexibility of converting step-down beds, which could be easily converted into ICU beds.

At Columbia Asia, the clinical areas are designed such that one function easily shifts into other clinical areas without any infrastructure changes with the ability of scaling up when required. Even the intensive care unit (ICU) set-ups have central hubs for excellence. This centralisation helps in remote monitoring technology that improves economies of scale for scarce skills.

While elective care is restricted across many countries, patients requiring high risk/complex care, such as those with cancer may not be able to wait for treatments. Columbia Asia hospitals are designed in such a way that areas dedicated for treatment of patients suffering from infections such as COVID-19 19 can be blocked without affecting other areas treating patients needing elective care and procedures. Such infrastructure facilities may become a permanent feature in the near future.

The new norms of digital care

Virtual care supplemented with new age technology like artificial intelligence is going to be the first point of interaction for noncritical care.

A single, digital-first “front door” for health services has already started establishing. In many hospitals now, the patient journey starts with an app or online and is then redirected to the optimal care setting regardless of physical or virtual modality.

Home-based care likely will be supplemented with artificial intelligence (AI). Virtual care via AI, phone-based diagnostics, and other virtual patient engagement platforms are expected to be part of hospital operations and expansions.

Growing categories of remote/online services will naturally require more input of clinical information. Some basic services can be fed through home-based devices, but more is expected to be collected through specialised facilities available in convenient locations, such as pharmacies, imaging centers, and pathology labs.

Patients may choose to avoid hospital stays whenever feasible, accelerating the transition to ambulatory care settings for increasingly complex care and procedures. We will also see more and more day care procedures being conducted followed by remote monitoring of patients.