Medical error is one of the biggest causes of hospital deaths worldwide. Close to 140 million people die due to medical mistakes in economically poor countries every year. Incidence levels are estimated to be even higher in India. This makes the need for upskilling our healthcare professionals — including practitioners, nurses and technicians — critically important in this country. When such a conviction underlies an entrepreneurial idea, especially when it emerges from a shocking personal experience, the impact of the venture can be very powerful.
When Sameer Shariff, Founder & CEO of US-based Impelsys — a leading provider of technology solutions for digital content publishers, learning providers and enterprises — conceived of iPC Health, he was literally pursuing the dream of helping Indian hospitals to enhance their biggest asset — their people — to ensure patient safety and standardised care and thereby address the menace of medical errors in his home country. In Straight Talk with editor, Shariff explains how technology, with the right kind of content to train people, can also cut inefficiencies in the workflow of a traditional hospital and help reduce overall costs.
As a successful serial entrepreneur in the area of technology, e-publishing solutions and online learning platforms for diverse fields, what was your trigger to look at the training and upskilling of healthcare profession as a potential new business?
We incubated iPC Health, the technology-enabled healthcare training and skilling content platforms company, within the parent—Impelsys. This was the first one in my ventures that really looked at India as a market. Of course, there was a trigger — a shocking incident, behind this idea. One of our employees—very young and incredibly talented, who went for a dental procedure at his hometown while he was on a break, died instantly at the dental chair as the procedure was on. That was a terrible incident and a real eye-opener. Looking at this issue closely, we were reminded of the fact that medical error is the reason for a substantial number of deaths in hospitals and clinics in India. One of the main reasons for this is inadequate training and skilling of medical staff, including the practitioners and nurses, in error-free and safe patient care. This has made us really think about using our expertise, learnings and capabilities as an e-learning platform provider for many medical content providers to address this issue back in India. As a medical e-publishing and learning provider in the US and European markets, where healthcare infrastructure and services are much superior, we have our partners and collaborators directly involved with credible medical content for the practice, healthcare standards and hospital management. These include best-known institutions like American Heart Association, Royal College of Nursing, Reed Elsevier (RELX Plc now) and several other reputed medical associations and societies. So, we decided to utilise their experience and synergies to help Indian hospitals upskill their employees to ensure better patient safety and care. That was the beginning of this journey, and I can tell you that we have invested a lot of money in creating the suitable and right content using these resources, and to blend them with the right kind of technology to make it more user-friendly and easily adoptable in the Indian hospitals. Thankfully, the healthcare industry here has been responding to it very positively and we could actually see the change. We have already partnered with more than 100 hospitals and are really hopeful of achieving the targeted 1000 hospitals by 2022.
iPC Health, as a training and learning platform for healthcare professionals, has certainly contributed its bit to the standardisation of care that India is catching up on of late. What has been your biggest challenge in this regard, given the typical Indian healthcare setting?
Healthcare is such a broad industry and there are a lot of elements involved in it. If you look at the use of technology in this industry, it has been traditionally very slow in India. Adoption of technology to better manage resources and services has been incredibly slow. This has been one of the big challenges in the Indian scenario. When we did a market research, we observed that there is an increasing trend among the hospitals in India to go for NABH accreditation. But a lot of time and resources are being wasted even in the process of this quality accreditation because many of them manage this inefficiently. Lack of standardisation in the content for the accreditation process itself created a major inefficiency; training thousands of employees on the new quality aspects in a typical “pen and paper” system created another big wastage of time and money. Even after this, analysing whether the employees have actually learnt it or not is again another big problematic area. Leveraging today’s best technologies can actually simplify the whole process and stop these inefficiencies and wastage forever, though it may initially need some capital investment. But making the hospital managements understand this quality transformation and about the long-term savings involved in it was the real challenge in the Indian context.
Indeed, the mindset is often the biggest obstacle towards adopting quality care standards in Indian hospitals, which can be addressed via continued education and training. But doesn’t India’s economic and regulatory environment also pose an obstacle to bringing about a change of mindset?
A poor economy or lower spending capacity of patients, mainly due to the out-of-pocket spending by a large portion of the population, is an issue in India. But I see this as an opportunity as well for technology to come in. In fact, the right kind of technology can be rather an enabler of cost optimisation in hospitals as it can eliminate inefficiencies. Through smart training programmes, it can also reduce the wastage of time and the resources consumed between the onboarding of employees and making them really productive. So, I believe the economic situation should never be a cause for resistance to technology adoption or ensuring quality of care in hospitals. It is largely the mindset that resists the change. That needs to be changed to welcome positive changes in terms of quality care. Similarly, technology and training can also help hospitals get adapted to quality standards fast and to become easily compliant with quality certifications and accreditations such as NABH and others. For example; when we did market research here, it was proven without doubt that many of the hospitals which are in the process of getting NABH certification inadvertently end up spending much more money, time and resources in this process because they don’t do it efficiently. Lots of resources and efforts are wasted by inefficiently training the employees, imperfectly analysing their learning and misjudging their performance as they did not have the right content and proper system in place for these. Then the next option is to take external help and they come with their set of content. So, there is no standardisation in content and systems. The other challenge is in training a large number of employees in the physical format, which is time-consuming and often not uniformly imparted to all employees. But, a learning and training content tailor-made for the quality certification process, which is readily available on a smart technology platform with user flexibility, makes the process more efficient and you actually save a lot of cost and time too. That way, iPC health has a lot of tools all around talent management and quality metrics that help the hospitals to manage the regulatory aspects.
What is the most promising trend that you see in Indian healthcare as far as professional skill sets and capability building are concerned?
I am an optimist and super excited about India, looking at the sheer scale of work that needs to be done in the area of healthcare, a vast industry with various elements in it. A number of positive changes are imminent in this market. The economy ought to progress significantly in the next couple of decades, making the people richer. The country needs to take care of over a billion people and the GDP is going to grow. Along with this, healthcare will emerge as one of the most demanding service areas. Though India’s public healthcare spend is currently the lowest in the world in proportion to GDP, I am sure this is going to increase multifold, especially with schemes like Ayushman Bharat and other state insurance covers. The number of beds, doctors, nurses and allied professionals, which is grossly inadequate today, has to increase in multiples. As a medical skilling and training platform provider, this increase in demand and supply is going to help us grow and become more relevant. The increased number of graduates and postgraduates coming out of the medical and nursing schools will all need to be prepared for a highly competitive work environment. There is always a wide gap between the learning at the medical school level and the skill sets that make them ready for work in the real world. Companies like ours can help to fill this gap, and there is a lot of innovation already taking place in the area of content creation and dissemination. Telemedicine is another area that will expand by leaps and bounds and where content and technology companies will have a substantial role to play. The application of artificial intelligence, virtual and augmented reality in medical and healthcare training is going to become much more dominant.
The COVID-19 pandemic, with its unprecedented spread, complex symptoms & comorbidity risks and an unknown treatment regime, has destabilised existing concepts of standardised care in hospitals. In this context, what is the new learning that you want to incorporate in the training and skilling of healthcare professionals?
Yes, that’s very relevant because the pandemic has directly affected the healthcare delivery sector in many of the critical areas of service, care and training, and even in the overall workflow management. We have already developed and rolled out exclusive content for helping hospitals and healthcare staff prepare for the COVID-19 situation. We have also provided free platforms for the hospital professionals and managements to create relevant content and modules to help get their employees geared up for the pandemic. Our resource centres have already created several COVID-19 courses, white papers and materials collating important information and datasets from the CDC (Centre for Disease Control and Prevention of the US government), WHO and our own webinars focused around various critical areas of the pandemic. The other areas where we could help hospitals in this situation are in virtual training and even digitally driven workflow management using our innovative technology and content platforms.