Case Study on Apollo Hospital, Chennai, (India)

Student ID-1209675

Submission Date: -1st May, 2014

**

MASTER OF BUSINESS ADMINISTRATION

MBA 4056- Managing Business Performance & IT Case Study on Apollo Hospital, Chennai, (India)

Student ID:

1209675

Marking lecturer:

Dr. Mathew Shafaghi

Date of Submission:

1st May 2014

Word Count:

4,771

1

Student ID-1209675

Submission Date: -1st May, 2014

AbstractApollo Hospital located in Chennai, India is a high quality medical private hospital. From its humble beginning, it has grown into one of the best hospital in Chennai competing with other Hospital’s. This paper is to study how it becomes successful and continue its journey to become the best in India. The four tasks required as emphasize as follows: Task A: Apollo hospital case study covers following aspects:  Company profile of Apollo hospital  Product & customer/Patients providing by Apollo hospital Apollo hospital  Apollo hospital overall business processes  Product pricing of Apollo hospital  Financial investment of Apollo hospital  Business performance of Apollo hospital  IT and E-business provided Apollo hospital Task B: This task is the investigation on the Apollo hospital environment internally and externally using analytical tools in the past but can Apollo hospitals develop a coherent strategy for its long-term plan to meet the challenges of globalization, technological development, and the ever changing environmental factors. Task C: To discuss the main components of Apollo hospital of E-Commerce and general strategic vision of Apollo hospital using mobile vision and well-defined goals is considered a prerequisite for the successful development and implementing a mobile commerce strategy. Task D: To relate to Apollo hospital customer/patients, company, and employees. Demonstrating the positive and negative impact of social networking on Ebusiness.

2

Submission Date: -1st May, 2014

Student ID-1209675

TABLE OF CONTENT List of Figures..........................................................................5 1.Introduction........................................................................................................6 1.1 Indian Health Care Overview Task A.....................................................................................................................7 1.Company Profile 2.Products & Costumers 3.Business Processes 4.Product Pricing 5 Capital Investments 6.Performance Measurement 7. IT & E business Task B...................................................................................................................16 Introduction 1.SWOT Analysis 2. Porter’s five forces analysis 3.McFarlan’s Grid 4. PESTELC Analysis 5. Michael Porter’s Value Chain Analysis Task C...................................................................................................................28 1.Apollo hospital mobile vision and Objectives 2.The virtual clinic 3.M-Health Value Proposition 4. M-Health Challenges

3

Student ID-1209675

Submission Date: -1st May, 2014

5. M-Health Applications 6. The Mobile Vision’s Fit with the M- Commerce Framework Task D...................................................................................................................36 1.Impact of Social Networking on E-Business Conclusion...........................................................................................................40 Reference.............................................................................................................41 Appendix..............................................................................................................47

4

Student ID-1209675

Submission Date: -1st May, 2014

List of Figures Figure 1: Healthcare Process Flowchart Figure 2: Apollo hospital Business Evolution Figure 3.Organization flow chart Figure 4: Technological Excellence Figure 5: Business process Figure 6: Apollo hospital Estimate Costs for Selected Procedures Figure 7: Apollo hospital Cost Issues Figure 8: Strategy Figure 9: Hospital & Medical Services Figure 10: Leading Hospital Players in India Figure 11: A graphical representation of SWOT Analysis Figure 13: Porter’s Five Forces Figure 14: McFarlan’s Strategic Grid Figure 15: PESTELC Analysais Figure 16 Investments in the Health Care Industry Figure 17: Porter’s Value Chain Figure 18: A Proposed Mobile e-Health Model to accelerate Healthcare delivery Importance. Figure 19: Social media

5

Student ID-1209675

Submission Date: -1st May, 2014

1. IntroductionInformation Technology (IT) is closely associated with the health care industry. The use of information technology (IT) enables the communication to be vastly improved in the processes of decision support and accuracy in patient’s administration (Leiner, B .et al., 2002). The use of IT to advance the medical science has also been evidently through the use of expensive equipment and technology that helped to increase the chances of recovery (Accenture, 2001). 1.1 Indian Health Care OverviewIndia health care industry has three major players, namely public hospitals, private hospitals, international hospitals (Fulcrum and Deloitte, 2001). Figure -1 illustrates the importance of the India health care industry

through

stakeholders,

its

suppliers/

providers

and

patients (see Appendix -1) Figure 1. Healthcare Process Flowchart, Source: Healthcare market landscape (Adapted from: Schwartz, 2002)

TASK A1. Company profile-

6

Student ID-1209675

Submission Date: -1st May, 2014

Apollo Hospital, Chennai IndiaIts founder and chairman, Dr. Prathap C Reddy, has big dreams for Apollo Hospital Enterprise Limited (AHEL) when it was established in 1983. It is also the first private hospital to be public listed in the Indian Stock Exchange to have hospital corporate entity in Asia to provide health care services from its humble beginning, the Apollo Hospital (AH) now has sixty departments helm by experts in their respective fields together with the development of international patient specialized care. It is opened to public and international patients. (Apollo Hospital, 2013). Industry Location Established No of employees Annual turnover Market

Healthcare Chennai, India 1983 10,000 + US$530 million Mumbai plus international patients

As of March 31, 2013, Apollo Hospital operates fifty-one (51) hospitals worldwide with a total of 8,420 beds. Its overseas hospitals are in Sri-Lanka, Pakistan, Bangladesh, and Mauritius (Apollohospitals.com, 2013) .It also has 1,364 retail pharmacies supporting the health care sector (Babu, 2014)

Figure 2: Apollo hospital Business Evolution, Source-http://www.apollohospitals.com/apollo/Apollo _Investor _Presentation_August_2013

Based on the business application, CEO (Dr.Reddy) and its board members ensure an effective business strategy to move the hospital forward. In addition, the various hospital set-up designed by the management team play crucial roles in the medical fields (See Appendix -1)

7

Student ID-1209675

Submission Date: -1st May, 2014

Figure: 3 Organization flow chart, Source-http://www.medvarsity.com/dha.aspx

One of the important areas in the health care organization at Apollo Hospital is the quality of care by the medical staff to the patients through the use of high tech IT equipment’s (Gupte, 2013). In addition, Apollo Hospital also offers

!

Independent pharmacies,

!

Medical insurance services

!

Telemedicine services and research,

!

Implementing educational programs and training

!

Medical business process outsourcing services

!

Third-party management, and business support services (Anonyms, 2014)

2.Products and customers2.1 Apollo hospital, Chennai products Using CT Scan  Ct-Angio scan

8

Submission Date: -1st May, 2014

Student ID-1209675     

16 slice PET CT scan Cyber knife Robotic Radio Surgery Digital Mammography with Tom synthesis (3 D). Apollo Telemedicine The virtual clinic

 Technical consultation  Web Broadcasts (Apollo hospital, 2014)  Customer or patient came to Apollo hospital, Chennai for (education and business platform). For further more detail see (Appendix-1) 2.2 Customer or patient came to Apollo hospital, Chennai for (education and business platform such as)       

Feasibility studies, Infrastructure planning, Design and advisory, Human resource planning, Recruitment and training services, Medical equipment planning, sourcing, and installation services; Post-commissioning consultancy services consisting of management

contracts, and  Franchising  Medical

business

process

outsourcing

services

and

third-party

management, and business support service (Finance.yahoo.com, 2014). One of the areas in the health care organization at Apollo hospital is that medical staff and patients will always be the main focused of quality patient care through the use of high tech IT equipment’s (Gupte, 2013).

9

Student ID-1209675

Submission Date: -1st May, 2014

Figure 4: Technological Excellence, Source-http://www.apollohospitals .com/apollo /apollo_Investor_Presentation_August_2013.

3. Business ProcessThrough the Chennai Business Process and Information Technology, Apollo Hospital is able to compile with the health care laws and results in quality care and extensive cost saving. Proven ability to accelerate hospital revenue cycle hospitals through the followings are practiced by the hospital:    

Increase Productivity hospital Speed of payment Cost reduction and Improved patient services (Apollohospitals.com, 2013).

Figure-5.Business process. Source- http://www.promantra.net/Hospital_RCM_Services.html

10

Student ID-1209675

Submission Date: -1st May, 2014

Through the AHEL team, the process shown in Figure-5, the account and finance department uses the Explanation of Benefits (EOBs) programmed is able to carry out their task more efficiently. The hospital is then able to focus on the primary care for the patients (Apollo Hospital Enterprises-2014). The model used by the Apollo Hospital in India concentrates on the active maintenance contract basis. In other words, the management team will fix an annual management fee plus a percentage of additional revenue earned in excess of the contract (Apollo Hospital Enterprises-2014). 4. Product PricingTogether with the strategic management team, Dr. Reddy and its management team, is responsible for developing the hospital marketing strategies, forecast and sales that will ensure the right pricing policies is in place. The pricing system will monitor the competitive strategies to be applied by Apollo Hospital (Apollo Hospital-2014).

Figure-6: Apollo hospital Estimate Costs for Selected Procedures Source: - http://emedtravel.wordpress.com/2010/03/17/medical-travel-ireland/

Note-(*) Estimate pricing, Formula: Traditional pricing formula: Cost + Profit = Price Delivering value: (Access + excellence + efficiency + outcome) — cost

11

Student ID-1209675

Submission Date: -1st May, 2014

Figure 7: Apollo hospital Cost Issues, Source-http://www.hindustantimes.com /lifestyle/wellness/patientsparadise/article1-951097.aspx

Just as a well-established reputation for quality products and service, flexibility and speed to respond to customer requests and requirements, Apollo Hospital is mindful of the intense competition in the India market. Therefore, it has to have strong competitive advantage compared to its competitors (Bhalla, 2014).

5. Capital investmentRevenue for April Apollo hospital in September 2012/13 is USD $ 30.83 million, up 22 percent compared with a year former. Organization predicts that this rate will continue to expand (Sharma, 2012).

12

Student ID-1209675 Figure-8:

Strategy,

Submission Date: -1st May, 2014

Source-http://businesstoday.intoday.in/story/apollo-hospitals-challenges-in-

new-market-realties/1/190446.html.

On November 27, Apollo Hospital's shares hit a record high of USD $ 15.10 million, afterwards increasing 60 percent in 2012 (Sharma, 2012). The benchmark Sensex raised 19 percent during this period. An analyst, who did not wish to be named, said the strong market reaction is due to strong profit growth, mainly from the business of hospitals and in the area recently. Management continues to monitor operations and strategic planning to be effective (Babu, 2014). The aim is to improve the number of clinics and regional diabetes center from the current 100-250, and dental clinics from 20 to 100. Pharmacies will increase to 2,000 in three years from now in 1400. (Note: - US-1.00 equiv. to Rs -60.13 (9-Apr-2014). 6. Performance MeasurementAnnual review is carried out by Apollo Hospital to ensure that review performance measurement at the highest level. This will gauge the hospital aims to achieve business goals and its objectives (Quality at Apollo: Apollo hospital, 2012). Due to the sensitivity of the nature of its hospital businesses, the measurement focus on financial indicators is dominated by the cost of the process and operational costs. Measures of financial and non-financial aspects are carried out on a monthly basis. A consolidated report is sent to the owner of the hospital. ( Quality at Apollo: Apollo hospital, 2012). Measurement of performance covers the followings:   

Decision-making Performance evaluation and Responsibility

The CEO initiates the system. Leading services and medical services offered by Apollo Hospital is shown in Figure-8. Apollo Hospital is the market leader at 889.00 Rs although it has a change of a negative 0.41. Overall Apollo Hospital is

13

Student ID-1209675

Submission Date: -1st May, 2014

still the health care market leader in market capitalization (Top Companies in India by Market Capitalization -2014)

Figure- 9: Hospital & Medical Services Source-http://www.moneycontrol.com/stocks/top-companies-in-india/market-capitalisationbse/hospitals-medical-services.html

In Figure-9 and10 showing, It main competitor, Fortis Hospital, is also another strong medical services provider in the industry that Apollo Hospital must compete directly. (Babu and Narasimhan, 2012).

Figure-10 Leading Hospital Players in India, Source- http://www.apollohospitals.com/apollo _pdf/Apollo _Investor _Presentation_August_2013.

7. IT and E-Business-

14

Submission Date: -1st May, 2014

Student ID-1209675

In the ever-changing landscape in the health care industry, Apollo Hospital management must take advantage of its IT and E-Business. It can be seen from the business plan that a new project of USD $ 376.097 million investment plan to upgrade

the

doctors

professionals exchange

and

information

project

is

in

place

(Narasimhan, 2013). Doing

so

will

enhance Apollo

Hospital E-business in the virtual clinic for the future. A look at the company's website indicates Apollo Hospital offers a wide range of online services including virtual nurse services. These strategies adopted certainly appear to be consistent with the mission and goals of the company (B.S, 2014). This alignment is to better serve the patients and expand the medical service sector (Appendix -2). Failing to do so, Apollo Hospital will face serious competition and the end result is a loss of business and patients. Future damage will be loss of experience doctors and staff to its competitors (Medvarsity.com, 2014). Task-BFigure: 11-A graphical representation of SWOT Analysis Source: Mishra, 2005.

IntroductionIn this section, the overall objective of Apollo Hospital is to enhance and grow its e-business to cater for the future of this industry. Areas of concerns include Information Systems (IS) and Information Technology (IT) that will enable Apollo Hospital to create added values and find new opportunities to its patients (Patra et al, 2009). Such additional though costly will enhance and improve the hospital capabilities against its competitor’s and serve the patient’s well (Mishra, 2005).

15

Submission Date: -1st May, 2014

Student ID-1209675

The five analytical tools used by Apollo Hospital are: 1) SWOT Analysis Using the SWOT analysis, Apollo Hospital can effectively gauge, the challenges in enhancing its strengths and opportunities while handle its weaknesses and threats effectively. Obviously it is not an easy task because the medical industry is evolving all the time (Mishra, 2005). As shown in Figure: 12 SWOT: Apollo Hospital, is able to enhance its effectiveness in its strengths, the opportunities are chances that Apollo Hospital must seize to consolidate its position in Chennai (Apollo hospital-2013).

Strengths

Weaknesses



The first hospital in India to use



“telemedicine” Strong pharmacies network of



track the sale of medicine and 

Apollo hospitals, both in the



care employees to as compared

with Chennai Pharmacies are also located



to developed countries High barriers of entry



new/latest medical equipment Lack Investment to increase the

Efficient administrative storing Fast

downtime

for

retrieving



patient’s data 

supply chain management No comprehensive use of IS/IT in the supply chain management

Able to invest heavily in latest medical equipment



to

additional use of IS/IT in the

data 

control of medical inventory Lack of knowledgeable health

hospital and at strategic outlets

countrywide 

The need to have a system to

Invest in the latest medical

16

Student ID-1209675

Submission Date: -1st May, 2014

technologies 

Adopt the Institution of Health insurance which benefits both,

hospital and patients Opportunities  



Threats

Potential growth in the industry Increase in the growth of



Major head on competition from

overseas patients to India



Fortis Guaranteed

 

cost without success High maintenance cost for IS/IT Hacking/virus attack issues to



personal data Health care competition from

(medical tourism) New technology in the industry to aid expansion in treatment of patients through use of highly



sophisticated medical equipment Increase in the use of IS/IT in



the industry Laws are relax for the import of



medical equipment Apollo Hospital education

other

high

countries.

investment

(Medical

Tourism Continues to Flourish as U.S-2014)

centers to aid upgrade the skills and knowledge of doctors and 

nurses Use of IS/IT to promote its ecommerce, m-commerce, and website Figure: 12 Apollo Hospital- SWOT Analysis

2) Porter’s five forces analysisBased on Porter’s Five Forces analysis, the key objective for Apollo Hospital is to achieve its objectives: patient’s satisfaction and quality health care resulting in positive revenues. Specifically more attention must be spent in its effort to push for m-commerce in the industry. Although cost will be a factor, the positive outcome outweighs its cost factor (Manjunath, 2007).

17

Student ID-1209675

Submission Date: -1st May, 2014

A. Threat of new entrants Apollo Hospital has advantages because of the high entry barriers to this industry. Therefore, the hospital should leverage on this to exploit the market through its m-commerce investment. Although its nearest competitor, Fortis also has the same situation, Apollo Hospital can edge by committing more funds to hire highly skilled employees to strategies its future plans (Investor presentation Aug-2013). In addition, more emphasis must be placed on training the doctors and medical personnel to be handy handling the m-commerce. Training on a regular basis will also enable Apollo Hospital to ensure quality over quantity outcome (Apollo hospital-2014).

18

Student ID-1209675

Submission Date: -1st May, 2014

Figure: 13 Porter’s Five Forces. Source:-http://hbr.org/2008/01/the-five-competitive-forces-thatshape-strategy/ar/1.

B. Threat of substitute products or services Two important considerations in this category are the need to ensure continuous new quality medical services and the threat from its immediate competitor Fortis (Fortis healthcare ltd. March-2014). Another underlining consideration is the cost of maintaining such operations. Therefore, it is paramount that Apollo Hospital Pharmacy network will enable the hospital to have a competitive advantage over its current competitors. In turn, this will lower the cost of operations, saving pass on to the patients (Fortis healthcare ltd. March-2014). Substitutes, or alternative health services, include: i. Public Hospital: One of the major direct competitors is the public hospital in Chennai although the quality of public hospital is lesser than private hospital; nevertheless there is an imminent to the market because patients can switch to public if there is a need to. Around sixty to seventy percent of the public hospital still needs government support to keep it running efficiently (Harvey, 2012).

19

Student ID-1209675

Submission Date: -1st May, 2014

ii. Use of Technology: Using of technology will leads to E-Technology, which should be the aim of Apollo Hospital. The efficiency of E-Technology will save cost and result is a faster way to get information and data on a timely basis (Webster, s., 2014). Another area where technology used is the Mobile Health, which allows patients to interact with hospital on their health status. It is good to be able to access although cost might be a factor if there is insufficient numbers of patients using this method (Harvey, 2012). C. Bargaining power of customers/(buyers or patients)Apollo Hospital main patients are usually the middle income or higher. As such, the management must be able to provide higher quality of medical care (Govindarajan and Ramamurti, 2013). Although the public hospitals are available, public servants can use private hospital services with added payment. As such the role of private hospital is greatly in demand Thus, the demand exceeds supply resulting in shortages. This is where the private hospital plays an important role. D. Bargaining power of suppliers The two main suppliers that greatly affect Apollo Hospital situation is the supply of medicine and equipment. As there are many suppliers for the medicine, the bargaining powers of suppliers are less. It is also true for the suppliers of medical equipment. However, if such suppliers approach the retail pharmacy direct, they may be in a better position (Porter, 1979). E. Intensity of competitive rivalryThe intensity of competitive rivalry in the industry is very small for Apollo hospital. Generally speaking, there are not many hospitals in a given area. Even if they are, they will provide different types of products and services to the people (Porter, 1979).

20

Student ID-1209675

Submission Date: -1st May, 2014

3) McFarlan’s Strategic Grid-

Figure: 14 McFarlan’s Strategic Grid,Source: http://www.12manage.com/description_strategic_grid_it.html

Based on the McFarlan’s strategi grid, Apollo Hospital should be focused on the High (impact on business operations) and High (impact on strategy). This allows the management to plan high emphasis on the IS/IT in the hospital. Major focus areas include:  Use of Electronic clinical notes/electronic methods to record patient data/information  Efficiency through the use of IS/IT for management and operations  Faster response to lab results and evaluation by doctors and team of experts  Increase in the use of IS/IT and use of medical robotics  Enabvle cost saving in operations and increase in productivity  Minimise the use of “paperwork” through electronics communication in Ecommerce and M-commerce

21

Submission Date: -1st May, 2014

Student ID-1209675

 Faster way to dispense medicine to patients through the DSS (Decision Support System) 4) Theory Application: PESTELC AnalysisPESTELC as developed by Francis J. Aguilar in the 1967 is for companies to ensure that they cover the broad areas of politics, economics, social, technology, environment, legal and culture so that they can compete in the market (Scholes and Johnson, 2005). i. Political Factors Despite being the biggest democracy country in the world, the bureaucratic process is hindering the political will of the government. Apollo Hospital has to work within the constraints of such system. According to the World Yearbook of Education (Education in Times of Transition -2013), India scores 6.6 out of 10. (Appendix 3) Figure -16, PESTELC Analysais

Figure-15. PESTELC Analysais, Source: http://www.abilitysuccessgrowth.com/2011/12/pestelanalysis-snapshot-of-your-world-2/

ii. Economic Factors

22

Submission Date: -1st May, 2014

Student ID-1209675

Apollo Hospital should be mindful of the followings:    

National growth (GDP) Market size Lack of government spending Medical Tourism

The management must target the healthcare IT market, which is worth U$78.6 billion, an increase from U$45 billion in 2008 (Ibef.org, 2014) .The current rate of this industry is about 3.6 percent annual (Ibef.org, 2014).

Fig-16.

Investments

in

the

Health

Care

Industry

Source-

http://www.ibef.org/industry/healthcare-india.aspx

iii. Social factors Through the use of social public interaction, Apollo Hospital can use such measures to aid its social obligations. Currently, the Apollo Hospital IT service is able to: 

Add on quality on specialist heath care



Track survey from patient’s response (Apollohospitals.com, 2014)

iv. Technological factors23

Student ID-1209675

Submission Date: -1st May, 2014

The use of IS/IT for M-commerce is the right direction for Apollo Hospital to take for its long-term objectives. It is also a source of revenue for future expansion (Somvanshi, 2011) 

IS/IT aids the incoming flow of patients to the hospital resulting in higher revenue



Use of Cyber knife, surgical Robotic enables better quality patient care



Technological advances in medical field helps to get faster and better results



Development of technology, patents and licensing protects the hospital competitive advantages



Developing innovative technologies are needed to earn a significant

 

revenue stream. Advancements in technology such Technology access, licensing, patents (Apollohospitals.com, 2014)

v. Environment factors

To effectively handle the sanitation and waste treatment and used medical materials



Emergence of Superbug



Good economic growth for the medical industry in 2007 ($34 billion) to 2012 ($77 billion)



To expand and build additional hospital beds, up by 450,000 in 2010,



There are rapid improvements in technology being used in the healthcare sector

vi. Legal factors

To push for medical industry deregulation

24

Student ID-1209675

Submission Date: -1st May, 2014



Increase in allocation of budgets for medical industry



Focus on rural healthcare



Provide safety net for poor under the Health Insurance



Exemption/concessions for import duties for medical equipments and supplies



Lower taxes for FDI in medical industry



Promote and provide incentives for investment in healthcare.



To extend visa for international medical patients

vii. Culture factors

To be able to handle international medical patients



To handle the international difference in medical practices



Able to provide step-down care for patients



To provide close to international standards in health care

5) Theory Application: Michael Porter’s Value Chain AnalysisRightfully, it is a strategic move for Apollo Hospital to apply the Michael Porter’s Value Chain Analysis because this theory takes into the account of the whole process of hospital operations. By being able to efficiently carry out the process, the patients will benefits at the end of the process (Prakash, 2010), Thus the outcome will enable Apollo Hospital to have added competitive advantages over its nearest rivals.

25

Student ID-1209675

Submission Date: -1st May, 2014

Figure 17: Porter’s Value Chain

Both, the primary and secondary activities carry significant factors for Apollo Hospital. Firstly, the primary activities enable the hospital to concentrate its business directly to patient care at all times. The design and operations of the medical care must be geared towards the ultimate recovery of patient care. Using advanced technology coupled with quality and skilled medical personnel will add the process. In addition, the pharmacy division offering the medicine must also take advantage of the technology to consolidate the process (Prakash, 2010). Another area of importance is to make sure the staff must be reminded of its company mission that is “Our mission is to bring healthcare of international standards within the reach of every individual Develop enthusiastically satisfied customers all time ". Doing so, ensure that quality customer services are maintained at all times (Prakash, 2010).

26

Submission Date: -1st May, 2014

Student ID-1209675

Under the secondary activities, the major areas are HRM (Human Resource Management),

R&D

(research

&

development),

Financial

Management,

Education Marketing and Advertising. These are mostly internal attributes that when done effectively will bring results to Apollo Hospital, Therefore, the management must strive to inculcate dignity and mutual respect between staff to ensure a healthy and wonderful working environment of world-class (Scholes, 2005). Such attributes include:  Health care benefits to all staff regardless of level of entry  Periodic training for all staff  Continuous upgrade of organizational activities for all staff (Scholes, 2005) Proposed strategy (5- analytical tools)  Work closely with the India’s medical board to upgrade its currency in 

the industry Devise improvement to the current IS/IT development to challenges



the future in terms of customers services and medical treatment To be efficient in implementation to lower cost so that more revenues

 

will be realized To provide a first class hospital environment to patients To develop a 5-year plan and 10 year plan to target specific goals for

  

the hospital and stakeholders. More demand for low-cost quality health care services Tailor to handle special medical needs in disease control To increase in specialist care treatment nationwide

Task-C-

27

Student ID-1209675

Submission Date: -1st May, 2014

1. Apollo hospital mobile vision and Objectives Based on the recent development in the medical industry, Apollo Hospital CEO, Dr. Reddy must decide the next course of action for the hospital. As the Mcommerce is fast picking up in India, Apollo Hospital must redefine its vision for M-commerce (Apollo Hospital Enterprises-2014). A suggested M-vision theme by the author should be, “Healthcare Anytime Anywhere” ObjectivesI. II.

Become leader in medical IS/IT Enhance the customer/patient’s

III.

satisfaction Increase revenue by 10% annually by

IV.

the help of M-commerce Recruit trained and retain top-notched doctors and nurses.

In addition, Apollo Hospital should continue to work closely with Tele Triage, a solution company that specialized in medical patient heath care (Himssanalyticsasia.org, 2013). Through the collaboration, the service provider can provide a structured medical approach to the overall operation efficiency and effectiveness of the hospital. It approach of “low-cost, High-quality innovative healthcare solutions” is targeted at M-users. The use of the OTC (over the counter) services is also another area that can tap the M-users on the society. This way, doctor’s help will only be minimal when the ownership of getting the medicine is transfer to the patients. It is through effective and visionary management thinking that M-commerce is possible (Wickramasinghe, 2002). As a market leader in Chennai, Apollo Hospital

28

Student ID-1209675

Submission Date: -1st May, 2014

is a front-runner in using M-commerce that is able to provide solutions for the 21 st century (Wickramasinghe, 2002). The focus is on targeted on solution that increases the M-commerce importance. The use of electronic medical record (EMR) applications can surely aid the patient’s confidence. Study emphasized the way Apollo Hospital should use the M-commerce to hedge its competitive advantages. In the long run, the hospital should adopt a wireless environment mobile Internet (Wickramasinghe, 2003). Another strong evidence is that patient’s information should be given on a timely basis, “anywhere, anytime without failed”. The use of PDA is another added advantage in the medical industry as compared to the paper work generated (Brody, 2001). The main advantages using PDAs are: 

System in place - Complete and standardized work.



Better efficiency – faster response



Diagnostic checks - More interventions



Patient’s satisfaction – Better and faster results



Work flow – Higher productivity

A word of cautious is that sensitive information may be violated if the security levels are not foolproof (Coursaris et al., 2002). Coursaris et al., 2002 rightfully pointed out the privacy protection is still paramount.

2. The virtual clinic-

29

Submission Date: -1st May, 2014

Student ID-1209675

The virtual clinic is one further exciting part of the M-commerce. Apollo Hospital should be working on this for the future in the medical industry. This type of approach

will

definitely

help

reduce

operating

cost

in

the

industry

(Apollohospitals.com, 2014).

3. M-Health Value Proposition As patient’s demand increase, so will the M-Health value proposition. Time is essence in this aspect, so Apollo Hospital must invest financial to succeed (Coursaris and Hassanein 2002). Areas are: 

Connectivity Needs: The importance of connectivity is paramount to the hospital because of the physical environment in Chennai. The wireless network system is evolving and will definitely take time to mature.



Communication Needs: To connect is to succeed. Therefore the hospital must tailor its operations to communication needs by the patients. Both parties will use the information flow effectively.



Information Needs: Another important area is the information needs by patients. Therefore, the database used by the hospital must be up to date and reliable. Thus, the M-commerce must be applicable to the hospital.



Entertainment Needs: Users who want to switch their mobile devices to obtain useful solutions, entertaining and practical, such as games or access to information leisurely. From this demand aimed at consumers, it does not apply to health care.



Commerce Needs:

30

Student ID-1209675

Submission Date: -1st May, 2014

Two main variables are obliged to allow the mobile phone buyers to implement e-commerce transactions m: display data / government; and a remote component installation. The value of the purchase in remote parts emerging from the comfort it provides from. To display, mobile customers cannot force the coins / bills to make a point to buy physical (Eg. from candy machine), buy computer products, (eg, purchase of a remote site), or actually paying bills, (for example, mobile phones and Bill presentment contribution). While the use of remote utilities can encourage strengthening of shares to the vendors of the treatment center, the requirements by means of remote utilities will doubtlessly be connected to a arrangement of network management in place inventory in general. According to Reddy (2002), the notification services are paramount to both patients and medical service providers like Apollo Hospital. They are:  Critical laboratory alerts  Critical trend alerts  Dynamically-adjusted alerts  Exception condition” alerts  Medication alerts: M-health initiative is only useful if M-commerce is used effectively. Based on the doctors/physicians using the relevant information, the flowing classification will be added-value portfolio for Apollo Hospital (Ammenwerth, 1999):    

Medical knowledge Mobile documentation Patient information General information

4. M-Health ChallengesWhile the positive use of M-commerce is evident, there are also concerns as to how patient’s information is protected (Coursaris and Hassanein 2002). 31

Student ID-1209675

Submission Date: -1st May, 2014

Key concerns include: 

Privacy protection as highlighted in the use of electronic privacy (Agranoff,



1993) Security protection and application as the need to keep patient’s records



properly (Kalaja, 2000). Reliability to use as time is essence when abstracting the information



(Nielsen, 2000) Faster download times for doctors/physicians to get the data required



(Cole, 2001). Lower cost of using such applications as to saving versus time to get the



data. Usability of information for all parties concerned including patient’s (McGinity, 2000).

5. M-Health ApplicationsAs an effective leader in the medical field, Apollo Hospital must engage actively in the M-Health areas such as: 

Able to get real-world applications intact



Able to get real-time application ongoing



Effective communications for both parties (hospital and patients)



Use of Digital Assistant Support to work on patient database applications



Able to integrate Healthcare applications in areas such as: ER: Emergency Rescue Department, Patient order entry, Medicine ePrescribing, Patient point-of-care, Clinical trial processing, Billing and Administration, Patient information processing and Update of information of patient (Cole, 2001).

As shown in Fig 18, Apollo Hospital must be willing to commit financial

32

Student ID-1209675

Submission Date: -1st May, 2014

investment into the process so that it can compete effectively. In US, almost ninety-five percent of healthcare practitioners are using wireless devices to operate effectively (Anon, 2013)

Figure: 18. A Proposed Mobile e-Health Model to accelerate Healthcare delivery Importance

6. The Mobile Vision’s Fit with the M- Commerce FrameworkTo successful carry out the use of M-commerce for Apollo Hospital, there are important considerations that the management must handle.

I.

Patient’s perspectives

The number one priority is to ensure that patient recovery. As patients are also tech savvy; the burden is on the hospital to keep up with patient’s demands. As the mobile/wireless usage is still in the infant stage, the hospital must continue to invest in this technology to get the maximum outcome. II.

Hospital: Management perspectives

33

Student ID-1209675

Submission Date: -1st May, 2014

As a leading hospital, the management must be willing to commit financial investment to ensure the development of M-commerce, including the mobile wireless solutions take place according to their plan. From the Apollo management, the initial investment must be significant so that the business model can be achieved (Apollohospitals.com, 2014) III.

M-Commerce portfolio

The success of M-commerce is paramount because the medical field in India is developing rapidly (Apollohospitals.com, 2014). Therefore Apollo Hospital must design a robust M-commerce solution to handle the ever-changing landscape. The issue of IS/IT will enable Apollo Hospital to specifically hedge its competitive advantages to advance its operations. IV.

Relevance and Resistance from Patients/Medical staff

As with any business, the resistance from patients and medical staff on new MCommerce may be real. As such, the management must have a systematic programmed to inculcate all parties to adopt such progress (Agranoff, 1993). As highlighted by Dr. Brian Yemen at Hamilton Health Sciences on the demands on radiologists, he stated that, “… the possibility of transmitting radiology reports between hospitals and physicians on-demand is exciting. It will mean less time and travel for busy doctors, but more importantly, it will mean faster turn- around and quicker results for patients”. This is indeed a positive statement to reflect on the importance of technology usage. As for the overall assessment of M-commerce, the signs shown are positive to move forward. The result is lower cost in the long run through investment and a higher quality healthcare approach. The success of M-commerce through the mobile/wireless solutions adopted will give the industry a higher and better competitive edge than others in the market. Therefore, if Apollo Hospital invests for the future, then the quality healthcare will

34

Student ID-1209675

Submission Date: -1st May, 2014

rings in more revenue for the hospital.

35

Student ID-1209675

Submission Date: -1st May, 2014

Task-D-

1. Impact of Social Networking on E-Business Without a doubt, social networking on E-Business is here to stay. Through education, proper dissemination of information, and rules of usage, social, the EBusiness will flourish.

As this is a new phenomenon in the industry, the lingering question is that is it stills a good investment for the future? From the way IS/IT has progress, the bet is that this is the business for the future (Kalaja, 2000). When IS/IT is carried out correctly and responsibly, the exponential growth is great. However, there is also negative outcome if the intended is not clear more detail in see Appendix-4.

36

Submission Date: -1st May, 2014

Student ID-1209675

Fig-19. Social media, Source-http://socialmediatoday.com/syed-noman-ali/608781/social-mediagood-thing-or-bad-thing

1. CompanyPositive impact

Social networking on e-business  Efficiencies resulting in Revenue Growth such networks increase the productivity in the medical 

business regardless of size. Without a doubt, E-businesses gain more efficiency than

non-IS/IT

approach.

(Lovering,

2014).

Therefore, Apollo Hospital should be able to compete directly with all its competitors in the region especially against Fortis (Lovering, 2014)

Negative Impact



Many studies have shown that the widespread use of social media can actually be addictive to users. During their day, they feel something to write on their site or check out the other posts, because it



has become an important part of our lives Nucleus Research highlighted that 1.5% of work productivity was loss in office, a very high number to start with. Another source, Morse stated that 37

Student ID-1209675

Submission Date: -1st May, 2014 US$2.2 billion were lost on British companies (Lovering, 2014).

2. Customers/Patient

Social networking on e-business  The increased in social networks also enable friends and relatives to get in tune with the rest of the users. Through such awareness,

the

usage

will

expand

exponential resulting in greater awareness Positive impact

(Noman, 2014). The masses of users will definitely be able to identify with the market The case of the rape on the medical student in New Delhi is a case in 

point (Social Media@ NYUPraha, 2013). The use of social networks has opened new doors and opportunities to the markets. Apollo Hospital must make use of such platform to engage both patients and

stakeholders

to

crease

bigger

opportunities for growth (Klein, 2008). The management must engage and continue to create potential business growth. The use of customized applications in the medical industry will enable the patients to feel positive and happy with the quality medical services provided (Klein, 2008). 

The social networking site to encourage people to be more open about their

Negative Impact

personal lives. Because of the intimate

38

Submission Date: -1st May, 2014

Student ID-1209675

details of our lives can be registered easily, users easily overlooked filters they can use when talking about their private lives. Moreover, what they write is still available indefinitely (Jung, 2014).

3. Employees

Social networking on e-business  The increased in social networks also enable friends and relatives to get in tune with the rest of

Positive impact

the

users

(Webster,

2014).

Through

such

awareness, the usage will expand exponential resulting in greater awareness. The masses of users will definitely be able to identify with the 

market. Feedback is almost instant in the use of such technology. It is also a great platform for the exchange of information in the market. As for the medical suppliers, the use of positive and effective communication will enable the users to be aware of the message posted (Webster, 2014).



This may become serious problems if employees spend time using the technologies for personal use rather than work based. In the long run, poor performance from them will be the end results. Therefore,

the

hospital

management

must

constantly remind staff on the proper use of IS/IT in the work place (Lovering, 2014). As shown in many reports, (Cohen, 2014),

39

Student ID-1209675

Submission Date: -1st May, 2014 Advertisements can be a double edge sword.

Negative Impact

People, in general do not take social media seriously although it is a cheaper platform to advertise (Lovering, 2014). Therefore, using Ecommerce will be a better choice for Apollo Hospital to succeed rather than using social media. However, due to cost, the hospital must make a final decision on its application

ConclusionIn conclusion, the hospital has been very successful in recent years. Its emphasis to update its IS/IT and its applications have enable Apollo Hospital to provide quality medical care services to its patients. More importantly, the hospital continues to invest and increases its capacity to cater to the ever-changing medical landscape for the future.

40

Student ID-1209675

Submission Date: -1st May, 2014

References1. Accenture, (2001). “The Future of Wireless: Different than you Think, BolderthanYouImagine”,Accenture:http://www.accenture.com/xdoc/en/idea s/isc/pdf/Future_of_Wireless. 2. Apollo hospital lines

up

-2013.Available

from

http://articles.economictimes.indiatimes.com/2013-0121/news/36462931_1_apollo-hospitals-cancer-treatment-expansion-plans. 3. Apollo hospital enterprises Available fromhttp://www.moneycontrol.com/india/stockpricequote/hospitalsmedicalservi ces/apollohospitalsenterprises/AHE. 4. Apollohospitals.com, 2014. Apollo Hospitals | Community Initiatives | Apollo Telemedicine Health Care Hospitals | Best Cancer Care Hospitals in

India.

[online]

Available

at:

[Accessed 19 Apr. 2014]. 5. Apollohospitals.com, 2014. Apollo Hospitals Group | Health Care Hospitals - Health and Lifestyle, Consulting and Solutions, Disease Management. [online] Available at: [Accessed 22 Apr. 2014]. 6. Apollohospitals.com, (2013). Apollo Hospitals Group | Health Care Hospitals - Health and Lifestyle, Consulting and Solutions, Disease Management.

[online]

Available

at:

http://www.apollohospitals.com/about_across.php [Accessed 22 Apr. 2014] 7. Apollohospitals.com, 2014. Apollo Hospitals News & Events | Top Hospitals in India | India Best Hospitals | Super Speciality Hospital in India. [online] Available at: [Accessed 22 Apr. 2014]. 8. Ammenwerth, E. et. al. (1999). “Mobile information and communication tools in hospital – results of a simulation study.Part 1: Study design, realisation and results.” International Journal of Medical Informatics, 1999 9. Agranoff, M. H. (1993). "Controlling the Threat to Personal Privacy."Journal of InformationSystems Management, Summer 1993

41

Student ID-1209675 10. Anon,

(2013).

Submission Date: -1st May, 2014 1st

ed.

[ebook]

Available

at:

http://thisisarrow.com/brochures/Mobility.pdf [Accessed 28 April. 2014]. 11. Babu, Gireah (Ed.) “Apollo Pharmacy bets on large stores”. Business Standard, April 21, 2014, Chennai, India. Source-http://www.businessstandard.com/article/companies/apollo-pharmacy-bets-on-large-stores112080300067_1.html. 12. Babu, G., 2014. CLSA sells majority stake in Apollo Hospitals. business standard. [online] Available at: [Accessed 22 Apr. 2014]. 13. Bhalla, jaya (Ed.) “Patient’s paradise”. The Hindustantimes, October 27,2012.Source-http://www.hindustantimes.com/lifestyle/wellness /patients-paradise/article1-951097.aspx. 14. Brody JA, Camamo JM, Maloney ME. Implementing a personal digital assistant to document clinical interventions by pharmacy residents. Am J Health-Syst Pharm2001;58(16): 1520–1522. 15. Babu and Narasimhan (Ed.) “Apollo’s mission to serve the masses”. April 4,2012.Source-http://www.business-standard.com

/article/companies

/Apollo-s-mission-to-serve-the-masses-112040400061_1.html. 16. B.S (Ed.) “Apollo hospital launches virtual clinic in apartment complex”. April

1,2014,Chennai,India

source-

http://www.business-

standard.com/article/companies/apollo-hospitals-launches-virtual-clinic-inapartment-complex-114040100750_1.html. 17. Coursaris, C. and K. Hassanein (2002). "A Framework for m-Commerce: A Consumer'sPerspective".3rd World Congress on the Management of Electronic Commerce, Hamilton, Ontario, Canada. 18. 14Cole, C. (2001). "5 things I want from my mobile." m-Commerce World :http://www.internetworld.co.uk/mcomm/vRoot/articles/article.cfm/B6D4AC E6-D1D4-11D4-BEE900B0D0A143DF 19. Education in Times of Transition, (2013), World Yearbook of Education 20. Fulcrum/Deloitte (2001). “TAKING THE PULSE: V2.0 Physicians and Emerging Information Technologies”, Fulcrum Analytics Inc. and Deloitte Research 2001.

42

Submission Date: -1st May, 2014

Student ID-1209675 21. Fortis

healthcare

ltd.

March-2014

Available

from-

http://economictimes.indiatimes.com/fortis-healthcareltd/quotecompare/companyid-16648.cms. 22. Finance.yahoo.com, (2014). APOLLOHOSP.BO Profile | APOLLO HOS E Stock

-

Yahoo!

Finance.

[online]

Available

at:

http://finance.yahoo.com/q/pr?s=apollohosp.bo [Accessed 22 Apr. 2014]. 23. Gupte, pranay (Ed.) “Transforming India’s health-care landscape”. The Hindu,

February

5,2013.

Source-

http://www.thehindu.com/todays-

paper/tp-opinion/transforming-indias-healthcarelandscape/article4380445.ece. 24. Govindarajan, V. and Ramamurti, R. (2013). Delivering World-Class Health Care, Affordably. [online] Harvard Business Review. Available at: http://hbr.org/2013/11/delivering-world-class-health-care-affordably/ar/1 [Accessed 23 Apr. 2014]. 25. Harvey, J., 2012. Why Government Should Not Be Run Like A Business. [online]

Forbes.

Available

at:

[Accessed 20 Apr. 2014]. 26. Himssanalyticsasia.org, (2013). HIMSS Analytics Asia Pacific - About Us Press

Releases

-

Press

Release

9.

[online]

Available

at:

http://www.himssanalyticsasia.org/about/pressRoom-pressrelease9.asp [Accessed 25 Apr. 2014]. 27. Investor presentation

August

2013

Available

from-

http://www.apollohospitals.com/apollo_pdf/Apollo_Investor_Presentation_ August_2013. 28. loutan, l., 2014. GHF2008 – PS08 – Hospitals and Health Systems: Only High

Tech?.

[online]

Ghf.globalhealthforum.net.

Available

at:

[Accessed 20 Apr. 2014]. 29. Ibef.org, 2014. Healthcare Industry in India, Indian Healthcare Sector, Services. [online] Available at: [Accessed 18 Apr. 2014]. 30. Jung, B. (2014). The Negative Effect of Social Media on Society and Individuals.

[online]

Small

Business

43

-

Chron.com.

Available

at:

Submission Date: -1st May, 2014

Student ID-1209675

http://smallbusiness.chron.com/negative-effect-social-media-societyindividuals-27617.html [Accessed 23 Apr. 2014]. 31. Kalaja, S. (2000). “Security in Mobile Health Care Work”. Citeseer: http://citeseer.nj.nec.com/kalaja01security.html. 32. Klein, K., 2008. Are Social Networking Sites Useful for Business?. [online] Businessweek.com. Available at: [Accessed 22 Apr. 2014]. 33. Leiner, B. et. al. (2002). "A Brief History of the Internet." Internet Society, http://www.isoc.org/internet/history/brief.shtml. 34. Lovering, c., 2014. Negative Effects of Social Media on Business. [online] Small Business - Chron.com. Available at: [Accessed 20 Apr. 2014]. 35. Mishra, S. K. (2005). Current status of E-health in India. HealthCom2005: 7th. 36. Medical Tourism Continues to Flourish as U.S-2014.Available from http://www.darkdaily.com/medical-tourism-continues-to-flourish-as-u-spatients-seek-lower-cost-healthcare-in-overseas-countries207#ixzz2zUNexRyG. 37. Manjunath, U., Metri, B. A., & Ramachandran, S. (2007). Quality management in a healthcare organisation: a case of South Indian hospital. The TQM Magazine, 19(2), 129-139. 38. McGinity, M. (2000). "Bumpy Road Ahead for M-Commerce." Inter@ctive Week: http://www.zdnet.com/intweek/stories/news/0,4164,2445298,00.htm l. 39. Medvarsity.com, 2014. Medvarsity Online Ltd - Stay Ahead, India's first virtual Medical Educational Portal, A venture by Apollo Hospital. [online] Available at: [Accessed 21 Apr. 2014]. 40. Narasimhan (Ed) “Apollo hospitals board approves Rs 2,250 crore investment

plan”.

July

8,2013

44

Chennai,

India.

Source-

Submission Date: -1st May, 2014

Student ID-1209675

http://www.business-standard.com/article/companies/apollo-hospitalsboard-approves-rs-2-250-crore-investment-plan-113070800181_1.html 41. Nielsen, J. (2000). Designing Web Usability: The Practice of Simplicity. Indianapolis, Indiana, New Riders Publishing.14Cole, C. (2001). "5 things I want from my mobile." m-Commerce World: http://www.internetworld.co.uk/mcomm/vRoot/articles/article.cfm/B6D4AC E6-D1D4-11D4-BEE900B0D0A143DF. 42. Patra, D., Ray, S., Mukhopadhyay, J., Majumdar, B., & Majumdar, A. K. (2009, December). Achieving e-health care in a distributed EHR system. In e-Health Networking, Applications and Services, 2009. Health.com 2009. 11th International Conference on (pp. 101-107). IEEE. 43. Prakash, S., (2010), Delhi Times, issue dated January 12, 2010, Published from New Delhi, pp12 44. Quality at Apollo: Apollo

hospital

2012.Avaliable

from<

http://www.apollohospitals.com/international_patient_services/quality_at_a pollo.php>. 45. Sharma, E. (2012). Apollo Hospitals gears up for new market realities, tweaks strategy - Business Today. [online] Businesstoday.intoday.in. Available

at:

http://businesstoday.intoday.in/story/apollo-hospitals-

challenges-in-new-market-realties/1/190446.html [Accessed 20 Apr. 2014]. 46. Somvanshi, K., 2011. Expansion to exert pressure on Apollo Hospital’s margins.

[online]

The

Economic

Times.

Available

at:

[Accessed 18 Apr. 2014]. 47. Social Media@ NYUPraha, (2013). Our sister Nirbhaya. [online] Available at: http://socialmedianyu.wordpress.com/2013/12/12/our-sister-nirbhaya/ [Accessed 24 Apr. 2014] 48. Scholes, K., Johnson, G., (2005), Exploring Corporate Strategy, 6e, pp 4346 Correspondent, S., 2010. Aircel to offer Apollo healthcare services. [Online] The Hindu. Available at: [Accessed 19 Apr. 2014].

45

Student ID-1209675

Submission Date: -1st May, 2014

49. Top Companies in India by Market Capitalization -2014.Avaliable fromhttp://www.moneycontrol.com/stocks/top-companies-in-india/marketcapitalisation-bse/hospitals-medical-services.html>. 50. Wickramasinghe, N. & J.B. Silvers 2002 "IS/IT The Prescription To Enable Medical Group Practices Attain Their Goals" forthcoming in Health Care Management Science. 51. Webster, s., 2014. What Are the Positive & Negative Effects of Using Technology to Communicate?. [online] Small Business - Chron.com. Available at: [Accessed 22 Apr. 2014].

Websites1. http://chennai.apollohospitals.com/. 2. http://www.apollohospitals.com/value_added_services.php 3. http://www.apollohospitals.com/news_detail.php?newsid=100 4. http://www.wipro.com/documents/the-mHealth-case-in-India.pdf

Appendix -1i.

Suppliers /Stakeholder: This is the company that provides the back-end of a health care system to provide supplies ranging from hospital beds to

ii.

the drug, all that is needed to address the needs of patients. Providers: This is the organization's mission as personal happiness, and they're in front of a health care system. Each target market for their patients, providing expertise and support in the course of treatment

iii.

needed (Schwartz, 2002). Patients: This is the party responsible for paying the health care provider when using their services. Watch this high level of support in the market

46

Student ID-1209675

Submission Date: -1st May, 2014

understand the structure of the industry of international health care by eliminating the specific details involved in any specific country.

 Other Apollo Hospitals In Chennai(India) Apollo Specialty Hospitals  Apollo First Med Hospital  Apollo Children's Hospital  Apollo Specialty Hospitals, Vanagaram (Apollo hospital, 2012) 

Apollo Hospital, Chennai Services giving to the patient-

       

Oncology, Orthopedics, Neurology and Neurosurgery, Head and Neck surgery Reconstructive and Plastic surgery Apollo Pharmacy



Apollo Hospital, Chennai Services giving to the patient-

       

Oncology, Orthopedics, Neurology and Neurosurgery, Head and Neck surgery Reconstructive and Plastic surgery Apollo Pharmacy

47

Student ID-1209675

Submission Date: -1st May, 2014

48

Student ID-1209675

Submission Date: -1st May, 2014

Appendix 2Apollo Hospital: CriteriaI. II.

To have a commitment to operating and investment prudently. Appear to have a significant advantage compared with competitors for patient safety, clinician support, physician recruitment, and competitive

III.

marketing for both consumers and nurse recruitment. Has almost fully automated / medical records paperless when they made

IV.

their IT applications on the basis of most inpatient care. As one of two starts to evaluate their data for care delivery process

V.

improvements or have documented significant improvements in this area?. Have made investments in the reach of most hospitals and recognize the strategic value of improving patient care with the EMR. (Electronic health

VI.

record). Have begun to create strategic alignments with their medical staff to effectively use information technology to improve safe environment for

VII.

patients. It is positioned to provide data to stakeholders, such as payers, government, physicians, consumers and employers, to support the environment of electronic medical records and health information

VIII.

exchange. Hospital retail pharmacies - Apollo has a vast network of drugs in India, helping them accumulate more revenue and market share.

Appendix 3-

49

Student ID-1209675

Submission Date: -1st May, 2014

(World Yearbook of Education: Education in Times of Transition 2013) .    

The Government's policy Sponsorship Funding and Initiatives Government / political stability

Appendix-4-

50

Student ID-1209675

Submission Date: -1st May, 2014

The first step in dealing with negative comments on social media is the focus of your criticism you get. Negative reactions to the distinctive flavor and a perfect alternative care: I.

Straight up problem: A patient or referring physician had a problem with the clinic or your administrator and has distributed a summary of what has happened. This type of reaction draws your clinic in a particularly poor light. As it can be, what kind of reaction may be particularly useful in the detection of certification issues need to be managed and eliminated? Results: Whether your reaction is a private message or open based on how extensive the problem is and the number of individuals tested it. In any case, if a genuine problem exists, steps should be taken to change it, and patients should be informed that these steps, no doubt, and you 're done listening to them. There will be times when feedback is the result of an obvious problem as opposed to a real problem (for example, someone just did not like the technique that you do a certain strategy.) I suggest that this kind of opposition should be given a formal response, regardless of the fact that just to say, " Thank you for bringing it to my review, but here 's why we do it that way. "

II.

Feedback value: The best kind of feedback is the moment to accept that sentiment comes with a suggested connection. Many patients, including the most reliable, will use Twitter, Facebook or your online magazine to propose courses that you can improve your office, or the management thinking before. During this critics point out imperfections, it may be particularly useful to get. Results: feedback constructive forces a formal response. Implementation of the project was to build understanding and trust by consistently

51

Student ID-1209675

Submission Date: -1st May, 2014

responds to negative feedback with positive announcement. Remember to thank those patients who took the time to provide you with a proposal. III.

Strikes reasonable: In this kind of criticism, while the negative reviews it cannot be supported, the issue that started it without merit. You, your doctor or health care provider 's what you did wrong, and someone is angry. Results: Warranty ambush difficult to handle and clarified in light of the fact that they do not like the cover at gatherings in various medical establishments. Try to remember that kind of feedback, as barbaric as it may be to check the contents, there is a premise of a genuine issue. It is best to respond quickly and with a positive way. Thank commentators for their feelings and reassure them that further steps are taken to amend this problem or alleviate their problems.

IV.

Wildcat: This is a kind of stimulus negative criticism. The contrast between a wildcat and a strike is reasonable wildcat no real purpose behind the base 's anger at doctors. This input is a waste of everyone's chances. Results: This new type of negative criticism is the main class that is not required for a response to recovery basis of the doctor's reputation. In all honesty, it's just better not to react with wild cats. Kind of language is not to criticize any media and are designed to trap you into an unnecessary war damage and even scandalous. Skip this kind of criticism and pluck it from your Facebook page.

52