Transcript
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00:08
Venky Ananth:
Hello, and welcome to the next edition of Pace Setters. This edition is special this time. Usually I have one guest, but now we have a double, I would say festival, because we have two very senior gentlemen from IHH healthcare. To start with, let me talk about IHH Healthcare. They are the healthcare provider with about 89 hospitals, 190 facilities.
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00:40
Venky Ananth:
I think about ten countries with huge presence in Singapore, Malaysia, India, Turkey and even China. And for our guests today, we have Dilip Kadambi, Group CFO, and Linus Tham, the group CIO. Welcome, gentlemen. Thank you for making it.
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01:00
Dilip Kadambi:
Thank you.
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01:01
Linus Tham:
Thank you for the invite.
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01:02
Venky Ananth:
So let's start with you, Dilip. I gave that introduction of IHH Healthcare. But I would love to hear from you from your own words. What is IHH? What is the history of IHH and how do you see IHH from a go forward perspective? And you have a fascinating statement called care for good. I want to understand the vision and what is the lived commitment behind that. If you could share, that would be great.
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01:29
Dilip Kadambi:
Sure. Thank you, Venky. Thank you for having us today here. IHH, like most other healthcare organizations, has grown over a period of time. We started with what used to be the Parkway Group in Singapore many, many years back, acquired or merged with the Pantai Group in Malaysia and later on again acquired a group called Acibadem Group, which is also a very dominant healthcare group in Turkey. With these three countries, we went IPO in the year 2012. On dual exchange, we were listed, and we are probably the largest by market cap as well in Asia for a healthcare provider. So we currently are about roughly 20 billion US from market cap standpoint.
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02:24
Dilip Kadambi:
After IPO, of course, we acquired a few other assets. Fortis, which is the asset here in India, is an acquisition that we did as well. And with that, we kind of established a clear presence in four home countries. So ,we have a big presence in Turkey and an offshoot of that where we have what we call as the beachheads in Eastern Europe, as well as parts of Europe, from where a lot of patients do come into our Turkish hospitals as well. Then, the second big home country is India, between Gleneagles and Fortis, we have 35 facilities and a little over 76,500 beds, somewhere there. And the aspiration is really together to get to about 10,000 beds over a period of time in India. So we are a top three player in India with clear market share. Singapore. Again we have four hospitals and we have the largest private healthcare delivery platform in Singapore.
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03:30
Dilip Kadambi:
Likewise in Malaysia, we operate under different brands. We have our medical center, Pantai Gleneagles Island Hospital, and together again we are one of the largest operators in Malaysia. So these are the four home countries that we operate in. And then of course, we have our newer facilities in Hong Kong and Shanghai and have presence in Brunei, and to support Turkey, we have also presence in faces like Macedonia, Bulgaria, Amsterdam, Serbia, etc.. So that's how we look at IHH. So we span from Amsterdam in the west to Shanghai in the east.
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04:10
Venky Ananth:
Wow. That's truly quite a breadth in terms of global footprint. Fascinating. And tell us about care for good. What does that entail? What do you mean by that tagline.And it is a lived commitment every day, you know, just enlighten us on that.
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04:27
Dilip Kadambi:
Sure. So care for good is our aspiration. So ,we are guided by our aspiration of care for good, which really means putting patient in the center of everything that we do. Even a technology decision that we take is guided by our aspiration of care for good.So whatever can better outcomes, whatever can better patient experience. All of that together is what we call a scare for good, and to do it in a sustainable and a long lasting manner is what we call as care for good.
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05:01
Venky Ananth:
Awesome.
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05:02
Linus Tham:
I think maybe we should add to that as well. The patient is key. That’s always at the center, but care for good actually goes beyond just the patient because we also have the broader aspiration which talks about what about employees, our doctors, the payoffs, the regulators, the community. So care for good actually carries all of that. So which is where you see us actually actively involved in the community other than the outright patients that we have, right. There's also sustainability, which is also an important thing for us. So all of that comes under the umbrella of care for good.
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05:45
Venky Ananth:
Wonderful. So you have all stakeholders in the community along with the patient being the middle of it all. Wonderful. So you spoke about 2012 was the IPO. You have grown significantly through a lot of acquisitions. Pan country. Now what has driven that growth beyond just acquisition and what's the secret sauce of IHH, you know what is IHH so great at that's powered that growth. And how does the future look like. Dilip, I would like to hear from you and Linus, off course, you know, like to love to hear your perspective too on that. Tell us about the growth story in that.
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06:23
Dilip Kadambi:
Acquisition is one way of growing. But we've also built and enhanced our existing facilities.That's one area of growth. And you can grow. But if you don't have clinical excellence and clinical quality, then there is no meaning to that growth, really. So there's been a lot of focus and effort around our clinical excellence being at the cutting edge of clinical quality. And that really builds trust with the patient because over a period of time the outcome speaks for themselves. So that's the way we really grow in the business by building trust, building patient outcomes, and of course, building the physical infrastructure to take care of patients who come in. Going forward, the way we look at it is one is obviously physical infrastructure, but also looking at new care models, whether it is an perambulatory care facility to complement our tertiary care facilities or whether it is using technology to try and take care of patients wherever they are. So there are various forms of growth, and the idea is really to focus across each of these pillars to see how we can drive further growth.
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07:41
Linus Tham:
I think as Dilip was talking about, the new care models, our group CEO. Doctor Prem has also said that, look, the future of healthcare is not necessarily in hospital beds. Yes, we will need more beds, but it's also reaching out to the community post post-surgery, post care, community care, primary care and how technology can enable that. And that's another part of the growth, right? We don't always have to add more beds if you could use your current beds better. And that also contributes to growth without necessarily adding a whole lot more capacity. Right. So there's a mix of physically adding capacity, looking at new care models that we can do, and then using technology to enable the connectivity, and also using technology to enable us to better use the actual facilities and capacity that we already have.
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08:30
Venky Ananth:
Which is a good segue for my next question, which is what are your two, three big bets going forward from an organization perspective, and especially with you being responsible for technology and the fast changing environment we are living in, in terms of AI, what are those big focus areas and and of course, love to hear from you from an overall perspective too, Dilip.
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08:56
Linus Tham:
I think that the three umbrella areas are tech, data ,AI. They work together. And in fact, what we are trying to do in terms of new care models, employee and doctor engagement and payer, regulatory relationships, driving operational excellence, driving clinical excellence, we are underpinning that with a tech roadmap, data and AI roadmap, and they build on each other to support those pillars that we are trying to go. Because you need the basic tech, right? So we need to evolve that. We need to make sure that it's well protected and secure, collect the right data. We need to then analyze that data to drive AI models, apply them in our setting, plug the AI models back into the tech. And that becomes really that virtuous circle that then supports these pillars that we want to grow. So, really, at least from my perspective, those are the key things we're trying to do. And as Dilip shared, we've grown since our IPO very much through M & A, but we've not really pulled it all together. And that's really where we are on this journey now to drive that roadmap, to really get to common tech platforms, common data platforms, to then have those proper models that help us transform the business.
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10:19
Venky Ananth:
Sure. Well, I want to throw a curve ball there for you. Generally, for consumers, technology has driven a lot of friction free interactions; like today, if I want to book an airline ticket or if I want to shop something on Amazon, I can track things in real time. Everything is at fingertips. Things kind of work end to end, you know, literally friction free. But if I take a health care, the moment health care kicks in, from taking appointment to even a discharge process at hospitals, there is a lot of friction points. And health care obviously is personal for everybody. Everybody deeply cares about it because a loved one is at stake. So how do you play that over the advancement in technology that's actually genuinely, if not completely eliminated the friction, at least get to that consumer grade experiences that we are all now got used to in other industries. But when it comes to healthcare, it doesn't still seem to be there.
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11:37
Linus Tham:
So I think the key thing, you're absolutely right. And in fact, the friction is not about the technology. It's how are we looking at the way we deliver healthcare. Healthcare, as you pointed out, is a very personal thing. And as much as we automate, as much as there is AI, as much as the doctor can operate remotely through a robot, you can't have a virtual operation. You still must physically get into the hospital. What technology and the technology already exists is there to support us. What we have not done as well to remove all that friction is to look at the whole business process. And it's not about deploying technology for technology’s sake. And really that's I guess, my challenge together with my counterpart who is overseeing data in AI have this challenge: how do we work with the business, to put business first, to encourage them, challenge them, and maybe sometimes slap them to tell them, look, you've got to just think out of that box. It's not it's not the same world anymore, right? You yourself as a consumer would expect that frictionless journey booking an airline ticket, booking a hotel, checking into a hotel. Why are we happy delivering a friction laden process for our customers? So we have to change that mindset ourselves. So that is that journey we have to go through. And then of course, on the technology front, we just have to make sure that as much as possible, the technology doesn't get in their way.
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13:12
Linus Tham:
To be absolutely honest, sometimes technology, we were just talking about how we are making doctors sit there and key in the data, right? So how do we make that seamless, facilitate that process so that the care comes back and is not about typing things into a computer. That part is needed. I need to find a better way of capturing that data, but allow the doctor to focus on the care and the nurse to focus on the care. So that's the bridge that we have to actually create and help them cross.
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13:44
Venky Ananth:
Dilip, I saw you kind of smiling. I want to get your perspective. And you also wear a unique CFO perspective. I would love to hear from you the CFO perspective on this.
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13:56
Dilip Kadambi:
Absolutely. Why can't a patient experience in a hospital be same as checking into a hotel and checking out of a hotel? Why is it got to be any difficult than that ? Today, you walk into a hotel, you don't even check in at the front desk. You go straight to your room and everything is done. And likewise, when you check out, you just drop your keys or whatever, and you just walk out. So why can't it be as simple as that? Obviously there is a medical and clinical element to it, right? But the idea is it has to be as seamless as checking in and out of a hotel. So having said that, patient experience is one of the key focus areas. And it's a holy grail. Everybody is looking at patient experience. And we are all trying to see how to enhance patient experience. So, at IHH the management met together and we were trying to do this envisioning exercise to see what are the key things that we need to focus on let's say five years seven years out. What are those key pillars which are key focus areas for us. And the top one is patient experience.
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15:03
Dilip Kadambi:
We have patient experience. We have clinical excellence. Operational excellence. What is our employee and doctor value proposition? How do we engage with our payers better? And what are the new care models that we can embrace? But the fundamental thread across all of this is how do we adopt technology to make some of these enhancements seamless, right? So that is where our journey is currently. So our entire transformation journey is underpinned on these key pillars that I spoke about and how technology can really facilitate, accentuate and hasten the speed of development across these focus areas I just talked about. So that's where we are in our journey. And obviously from a transformation perspective, tech-your source systems, harmonizing your source systems, harmonizing your processes, all that would go towards removing friction in the overall patient journey as well. And our job here is really to look at and focus on patient care and patient experience, not to run a back office shop. So the focus is all around the patient, as I said. And that's where we headed towards.
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16:29
Venky Ananth:
Brilliant. Linus, earlier in the day you kind of mentioned this and it just really caught my attention. You said blow up things, right? Drive step change. Don't look at incremental stuff. Right. So how do you practically look at it in terms of some of the transformations that's ahead of you to kind of drive that step change and make it real? It's easy to say those things, but actually hard to actually make it happen in real world. And you even mentioned Elon Musk and you seem to be inspired by him, which we are all, because he really kind of epitomizes that kind of mindset. Anything that's coming up the pipe to kind of drive those kind of step changes?
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17:16
Linus Tham:
Well, I think certainly us embarking on the whole ERP journey was one. And related to that, let me just give you an example as to some thing we want to blow up. It's a very small thing, but it gives us a lot of frustration. And Dilip knows this. We have an internal procurement mechanism to buy a laptop, and historical way of doing that is someone raises a requisition, gets free quotations, and then from the quotation, they pick one, it gets circulated to the HOD for signing off, and then it goes through an approval process. So in HQ after that, then the department head signs it off and then the function head signs it off. So the laptop is a technology item. My department where my staff asked for a laptop, I was signing it off as a HOD. Then it comes back to me to sign off as the function head, to say you can buy an IT equipment. Then, depending on which level of low goes up. So we kind of asked ourselves what is wrong with that. So someone will say okay, let's tweak this, let’s improve that. But do we really need to go through all that right? A laptop is a tool for someone to do this job. It should be part of his entitlement to do his job, what kind of category he needs.
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18:38
Linus Tham:
We have standard machines available and it should be provisioned as part of the whole cycle. And why do we need to even go through all the steps? You hire somebody, you expect to give them a laptop. How do you then just blow up the whole process and rethink it, and then build it into the solutions that support that process? So it's down to the minutiae of this. But then even at a bigger level, how do we engage and do things differently? How do we do billing and payments? We run significant lab businesses in Singapore, in Malaysia and India, and they do billing for the lab, does all these tests and then they do aggregate billing for the clinics. How do we even relook at the whole process? How do we connect with the doctors in this case, who may not even be doctors in our hospitals because they are outreach clinics? How do we connect the whole cycle and present them with the service, and seamlessly have the bill, and then make sure that they have..if, let's say they have good pay off, they have good credit, we can do more things with them. How do we engage them or give them the results better? So that's I think, where we need to look at really blowing up all of our processes and relook at the whole, what is the value we're going to bring to these people and looking at how do we implement the systems for that?
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19:57
Dilip Kadambi:
Just to add to what Linus said- If you think about it, one small process in one small hospital, let's say you blow it up and accentuat it to a different level, and now multiply that into thousands of processes that you run in a hospital, then take that into a full country and then accentuate it to a full country, and then look at the scale of our platform, and you standardize those and run it across all our countries. You are asking me what the financial view of this is. The value unlock is tremendous. Yeah. It's tremendous. And that's really what we focus on.
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20:43
Linus Tham:
I was also reading a statistic recently. Nurses- 30% of their time is not spent for patient care. ICU doctors, 30% of their time is also not spent for the patient care. Why are we hiring the nurses and doctors? For patient care. If a third of the time is not for patient care, that's value lost.
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21:04
Venky Ananth:
So I want to come back to.. briefly, you mentioned this, Linus, which is AI and data, right? How are you ,you know, operating and bringing that to the forefront in IHH healthcare, given your massive footprint and the number of hospitals and the number of countries you operate in. How are you thinking of driving that strategic agenda of leveraging AI? I mean, we of course, spoke about trying to make it friction free, but how does it fit into the overall strategic agenda for the company?
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21:42
Linus Tham:
Let me first start with what we have now and then maybe back up a bit. So we've actually decided that we really need to embrace that significantly. Doctor Prem made it a major goal. So we developed a data and an AI roadmap. Right. When we first look at how do we guide and govern the use of AI. You need to have the guardrails in place. We need to make sure that we're doing it ethically and appropriately. And then how do we enable them? Right. And the one element in terms of adopting AI is always the people. How do we train our people to know what you can do with AI and then put the technologies and the tools in place? So a roadmap is developed. In fact, it was developed shortly after the IT roadmap and we presented that to the board. So we've got that roadmap. Now having said that, it's also not the first time we're dabbling in AI. Prior to even that roadmap done last year we have many AI projects, and in fact, some of the AI projects have recently won significant awards. We've done something for nurse rostering. We've done a build a bill view estimator to actually give patients peace of mind. In Singapore, we have to do financial counseling, so we've improved accuracy from being wrong. The bill always comes out twice as much, and we were almost only accurate 50% of the time. So to bring that up to a 50%, 80% accuracy. So we've done those AI projects. Now the thing is how do we run doing pockets of AI? How are we now pulling it together. Support it with the right data roadmap and the right data platforms, and then building the AI use cases and for the whole franchise by having common IT platforms? We can then after experimenting with location, deploy it. So that's the spread which without a proper AI IT roadmap, we couldn't spread in the past. So we've done a pocket here that was successful. Then we tried to transplant to another country. We realized that data formats were all different, the interface systems were all different. Training became a problem because the data formats could not be..it's a different language. So the data was speaking a different language. Right. So the model was not working anymore. So that broke that cycle. So we realized that yes, we have successful AI, but we actually need to put it as part of the overall roadmap with an IT, dat, AI roadmap. And that's how we're pushing it forward.So we now have a roadmap to say, look, everything we do, we have a platform, we have councils that know what's going on. Try it out, then rapidly deploy it to the rest of the group so the benefits actually get multiplied much faster.
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24:21
Dilip Kadambi:
And some of the use cases we identified are use cases that are bottom up. So people who are frontline operationals, the troubles that they face, like for example, the nurse rostering is a great example where it was a bottleneck for a nurse manager who used to spend half the shift, probably trying to look at the roster and trying to get it ready for the next day. Now you unlock so much a value doing that, and now we are scaling it across various countries as well. So these are solutions that need to address a problem that is out there and help people unlock value for themselves.
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25:02
Venky Ananth:
How do you look at AI as beyond operational efficiency? Are there opportunities to make that as a core differentiator to build the brand itself, how does it fit into the overall corporate strategic agenda on growth or even, you know, staying relevant for the future?
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25:25
Dilip Kadambi:
So it is not just about operational efficiency, right? As I said, some of the key focus areas that I kind of mentioned about as to how the business would look a few years out and those key focus areas was clinical excellence. So what do we do with clinical excellence? We have the right data. And if you have the right tool, is it possible for us to look at medical data? Is it possible for us to look at value based care. And some of that is part of our current program we've already started to do. So that's on the clinical excellence side. On the patient experience side, can we have a common experience wherever you go within our facility, how do we map it out? Can we have common care protocols even? So how do we map that out? So there are various of these pillars under which definitely an AI solution would definitely help some of these areas. So it's not just operational efficiency. Yes. Operational efficiency would probably be a byproduct of some of these as well. But it's also looking at whether it is, as I said, employee and doctor value proposition. What do we do with that? What kind of data do we have? How do we improve our FTE efficiency within our hospitals? Do we really need as we grow our network, do we really need to proportionately grow people? How do we make them efficient and unlock that? So there are in each of these pillars, there are various use cases that can definitely be used for our AI future.
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27:13
Venky Ananth:
Got it. I want to switch gears and talk about the Infosys partnership that we just announced today. How do you see that partnership? You know, an intrinsic part of your own transformation journey, and how do you see the future unraveling with this partnership? What is the expectation of that?
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27:37
Dilip Kadambi:
Sure. So look, one of the things that we liked about Infosys is, as I mentioned earlier, the value systems are, I would say, very aligned with Infosys and IHH. So that's a very important I would say criteria first to ensure that we work together as partners and not as a vendor and a customer. And we look at Infosys again from a growth perspective. Both of us have undergone similar growth journeys in terms of expansion. So again, there's a lot that we can leverage upon one another to learn. So I think that's another big area as I see it. And innovation, you guys are constantly innovating. And you have demonstrated that by implementing some of these projects at scale and size, and that's exactly what we want to do as well. We want to try and see how is it that we can innovate as we go down our roadmap and how do we stay agile and keep innovating as we go along implementing the roadmap with you.
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28:56
Venky Ananth:
I echo that sentiment, Dilip. And as you know, we also recently announced the successful acquisition of Optimum Healthcare that focuses exclusively on providers and HER, EMR implementations. So our focus is we want to double down on this space and drive that growth. The transformation growth that you spoke about, grow that globally, bring best practices from different regions to other regions. And by virtue of the fact that we have an exposure across the globe on various aspects of EHR, EMR implementations, or for that matter, ERP implementation that we are working on. The idea is to kind of turbocharge your own innovation journey, right? Because nobody can do it on their own. Right. The change, the pace of change is so fast that it's just that it's impossible to just do it all alone. But I want to hear your final thoughts on the partnership, Linus. How you see it and what your expectations are?
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29:57
Linus Tham:
The key word is really, as you have just pointed out, your reach and your investment in optimum, for example, and also your own investment in other healthcare innovations and examples you showed us. It's a partnership as big as IHH is. We are ultimately in the healthcare delivery business. We will never be able to build enough of the know how and the capability and the growth path for technology experts. We will have to have some of them, that's for sure. But I will not have the ability to be as attractive as an Infosys to bring this best talent together. So yes, we will have some capabilities, we will have some of the smarts. We have access to our doctors and nurses. But to complete that is where I look to that, that that partnership with a provider like Infosys who can bring the other part and bring it together to us. So if not, then the challenge for us is I personally, I can't deliver what the company wants of technology. As you say, we can't do it alone, right? And that is where I see the importance of having the right partners-to be able to bring those people together and complement and work with them. And it's very important that it's seen by the other side as a partnership and not a vendor relationship, because I can't always have a conversation about a bill size with you. Right? It's got to be something that we are working together for hat common outcome that we agree with. I think that's the key thing.
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31:40
Venky Ananth:
Brilliant. On that note, we will wrap up. So thank you gentlemen. Truly appreciate your perspectives. We covered quite a bit of an agenda in terms of your history, how you have grown, what your strategic imperatives are. What is the transformation agenda. We spoke about technology, the evolving space in AI, how you plan to incorporate that into your day to day workflows, how to make that part of the patient journey that matter. You spoke about the care for good concept, which is a fantastic way to kind of look at all constituencies and make sure all of them you are delivered to. So thank you so much. Truly appreciate your time and your perspectives.
