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What’s Keeping Hospital CEOs Up at Night

Five hospital CEOs share their thoughts on the biggest challenges Hospitals face in 2023 and how to get ahead of them

Leaving COVID-19 behind, the past two years have been surreal. Understandably so, for the healthcare workers who have been on the front line in this global battle against the COVID-19 pandemic. Initially, the hospitals  struggled to make sense of the situation, like everyone else, but with time their focus turned towards patient care  and all hurdles were managed.

As we move towards the new normal in 2023, there are some old and some new challenges that the hospitals  will grapple with. However, the goal of running a successful hospital remains the same. We asked five healthcare leaders to share their insights on the challenges hospitals face in 2023 and how they can overcome these challenges.

Top challenges in 2023
Hospital CEOs in India face several challenges that can impact their ability to effectively run their organisations  and provide high-quality care to patients. Here are the most talked about issues CEOs will have to counter in healthcare.

Funding and resource constraints: Hospitals in India often face a shortage of funding and resources, which can limit their ability to invest in new equipment, hire additional staff, and provide high-quality care to patients.

Quality of care: Ensuring high-quality care for patients is a constant challenge for hospital CEOs in India,  particularly in light of limited resources and the need to keep costs low

• Regulatory compliance: Healthcare regulations in India can be complex and challenging to navigate, requiring
hospital CEOs to stay up-to-date with changes and ensure that their organisations comply.

• Staffing challenges: Finding and retaining qualified staff can be a challenge for hospital CEOs in India,  particularly in rural areas where there may be a shortage of healthcare professionals.

• Technology adoption: Incorporating new technologies into healthcare  delivery can be a challenge for hospital
CEOs in India, particularly for those in rural areas where access to technology may be limited.

• Competition: Competition among hospitals for patients and resources is intense in India, requiring hospital CEOs to be strategic and innovative in their approach to business.

• Infrastructural constraints: Hospitals in India often face infrastructural challenges, such as outdated facilities
and a shortage of space, which can limit their ability to provide high-quality care to patients.

Ishiqa Multani, President, Sagar Group of Hospitals

Among the most significant challenges that India’s healthcare CEOs face is a shortage of efficient and trained
personnel. Currently, there is an acute shortage of trained personnel in the Indian medical stream, including
doctors, nurses, and primary healthcare workers. The shortage is evident in the fact that there is a significantly low doctor-to-patient ratio, which remains at a mere 0.7 doctors per 1,000 people compared to the WHO’s minimum average requirement of 2.5 doctors per 1,000 people. This shortage’s effects are highly felt, particularly in the rural areas where approximately 66 per cent of the Indian population resides, leading to poor healthcare outcomes. The most viable solution to this problem is taking a long-term approach by increasing the number of medical colleges, nursing colleges, and allied health sciences programmes.

Also, increasing the capacity of existing teaching and training institutes can enhance their ability to produce more healthcare personnel which will help neutralise the challenge. Another challenge facing CEOs in India’s
healthcare facilities is the inability to optimise clinical workflow due to employee resistance. Although multiple healthcare technologies such as EHR have emerged and are revolutionising the clinical workflow, clinicians and other healthcare staff are not fully utilising them, arguing that they are complicated and time-consuming.
Since most employees have minimal technological know-how of using the new systems, they experience the fear of failure and prefer using the old systems. Notably, these employees are accustomed to the old healthcare delivery systems, as they can predict their outcomes, reducing the chances of making mistakes.

The solution to this challenge is employee training which should focus on enhancing their knowledge of the importance of using the technologies and their effects on workflow. The training will help ensure that employees understand why the new change is necessary, which will contribute towards adapting to it more
effectively and reduce resistance.

Dr Thomas Chandy, Chairman and MD, Hosmat Hospital

I expect accelerated improvement efforts to help the industry address these challenges in 2024 and beyond.
The healthcare industry faces demanding conditions in 2023, including recessionary pressure, job losses,
continuing high inflation rates, labour shortages, and endemic COVID-19.

1. Cybersecurity

Although ransomware, data breaches, and other cybersecurity concerns are nothing new to the healthcare industry, the COVID-19 pandemic revealed just how vulnerable sensitive patient health information is.
The recent growth of digital health initiatives- like telehealth doctor visits is a major contributor to the severe
increase in breached patient records.

As more healthcare functions move online over the next year, it’s extremely important to ensure these processes are protected from outside threats

2. Telehealth

Although many patients returned to in-office healthcare visits in 2022 as covid-related isolation became less necessary,telehealth use remains higher than pre-pandemic levels. In fact, the telehealth market was evaluated at $49.9 billion in 2019, but is estimated to reach $194.1 billion in 2023, and eventually a
massive $459.8 billion by 2030.

However, the telehealth sector still faces major issues like the deceleration of digital health funding and an uncertain regulatory future.

3. Invoicing and payment processing secure mobile payment

Medical practices are citing patient collections as their top revenue cycle management struggle as patients are becoming responsible for a larger portion of their medical bills. To help encourage patients to submit payments on time, providers must adhere to patient payment preferences.

4. Price transparency

Besides a lack of patient payment options, another leading reason for consumers failing to pay their medical bills is confusion due to a lack of price transparency. In fact, as of January 1st, 2021, CMS implemented a new rule requiring hospitals to publish the prices they negotiate with insurers for various medical procedures. While some healthcare systems are opting to make their service prices accessible – resulting in benefits like a reduction in
patient confusion and surprise billing issues- most are still failing to comply.

5. Patient Experience

The medical insurance landscape experienced some significant changes in recent years. As more patients are
responsible for a larger portion of their healthcare bills, an improvement in experience is expected. Healthcare organisations will face tougher competition in attracting and retaining patients who demand an experience that matches the level of customer service they expect from other consumer brands.

Behram Khodaiji, CEO, Ruby Hall Clinic Healthcare institutes were already under significant pressure from
overwhelming patient loads even before the COVID-19 pandemic. Furthermore, providing adequate healthcare  facilities for a population of 1.4 billion is a herculean task in itself. Therefore, in the year 2023, it is essential to implement technology wherever feasible to simplify operational and clinical processes, ensuring an efficient patient flow. Additionally, there is a continued need to overcome traditional thinking and promote telehealth services to alleviate the burden of patient loads significantly. We are also continuing to maintain high standards of patient safety and quality to ensure positive outcomes and patient satisfaction.

At Ruby Hall Clinic, we believe that technological change is an accelerator that drives our future, and our need
to embrace it. We are leveraging data analytics and emerging technologies such as artificial intelligence to  improve care quality and safety, and to expand our reach to remote or underserved populations. By prioritising patient- centred care, fostering innovation and collaboration, and developing a culture of continuous improvement, we are navigating the challenges of the healthcare landscape in 2023.

Jasdeep Singh, Group CEO, CARE Hospitals Group

Healthcare is a dynamic and ever-evolving industry, constantly facing new challenges and opportunities. As
we enter the year 2023, the healthcare landscape is rapidly changing, with significant advancements in  technology, changing regulations, and increasing demand for healthcare services. As a result, hospital CEOs are facing unprecedented challenges that require innovative and strategic solutions to ensure they can continue providing high-quality, affordable, and accessible care to patients.

Our margins are affected by inflation and the increasing costs of manpower and  material. We are also unable to raise prices. Adopting a sustainable approach and inculcating habits of reuse and waste reduction among staff
and patients is necessary to address this issue at the micro or hospital level. To overcome the shortage of trained healthcare workers and high attrition rates, hospitals can form partnerships with educational institutions to increase the inflow of talent. Creating long-term career paths at various levels and offering attractive rewards and
recognition programmes can help retain healthcare workers.

Patient loyalty is declining in a highly competitive healthcare industry, and pricing pressure is increasing.
Aggressive marketing tactics and job movement add to the challenge, but competition also drives the quality
of care and increases patient access.

Hospital CEOs can address this challenge by investing in innovative technologies, adopting patient-centred policies and practices, improving service levels and patient experience, and using effective marketing strategies to attract and retain patients.

Misleading health information on the internet poses a significant risk to public health. To address this,  government and healthcare agencies must differentiate between authentic and deceptive service providers. Educating the public about good health practices by trusted medical professionals can help raise awareness of this issue and ensure access to reliable information for informed decision-making.

Dr Santy Sajan, Group COO, Paras Healthcare
COVID-19 has exposed the various vulnerabilities of the Indian healthcare system, it has brought about a  renewed focus on healthcare. Appropriate policy reforms along with adequate planning can guarantee a more robust public healthcare system and lead towards a more healthy population and productive economy – along with resilient cities in the process. If we look at this year’s budget, it is futuristic with a focus on collaborative research and innovation.

We applaud the government’s decision to open 157 new nursing colleges, this will provide a strong impetus to the healthcare ecosystem. The establishment of centres of excellence in Artificial Intelligence for healthcare
will enable the nation to develop tech-based solutions domestically. Overall, hospital CEOs in India must
navigate a complex and challenging environment to provide the best possible care to patients while balancing the need to stay financially viable.

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