Category Archives: Entrepreneurship
According to the independent and professional investment information and credit rating agency, ICRA Limited (ICRA), the long-term outlook for the Indian hospital sector is stable with annual revenues likely to grow at 12-14 per cent over the next five years on account of rising demand and medical tourism. The hospital industry in India stood at Rs 4 trillion (US$ 61.79 billion) in 2017 and is expected to reach Rs 8.6 trillion (US$ 132.84 billion) by 2023. India’s unorganized primary healthcare system is presently worth $30 billion and is growing at least 25 percent a year.
Apart from the size of the market, another striking fact is the hunger for innovation by entrepreneurs and patients alike. This is why multi-specialty chains and diagnostic laboratories are turning out to be game changers in this domain.
Also, unlike many restrictive Indian industries, from insurance to real estate and telecoms, there are no limits on foreign ownership in healthcare.
Healthcare Is The Most Lucrative Destination For Moneybags In India
The healthcare sector in India is all set to be the next boom area in the economy. With a growing population interested in personal health and hygiene, government efforts that prioritize health policy and spending and a significant, if underutilized, population of medical professionals, the health economy in the country is proving to be a magnet for private equity and venture capital investments. Goldman Sachs, Warburg Pincus, Sequoia Capital and the Government of Singapore Investment Corp are among investors that pumped $520 million into India’s basic healthcare industry this year, compared with $137 million in 2011, according to Thomson Reuters data.
In my previous blog posts, I’d explained how the Indian Government has emerged as a key market force, with funds focused specifically on healthcare. The national budget for the year 2018-19 has allocated funds specially for healthcare entrepreneurship and innovation. Add to this, limited grant funding, philanthropic & other public-sector funding agencies, investors of all types (high-net-worth individuals and angel investors, venture capital funds, commercial private equity funds, impact investors), initiatives like tax rebates for new businesses, incentives for investors who support early-stage organizations and a growing spate of public-private partnerships and academic institutions, it is easy to see why the medical sector in India is poised for significant bolstering.
Why Is It So Hard For Organised Healthcare Providers And Start-Ups Alike To Succeed In India, Inspite Of Obvious Market Potential Here?
You are a leader of your own healthcare organization in India. Or, you are looking at the numbers and deciding to foray into India’s dynamic and growing healthcare market. As part of your market scan, you understand only too well the pressures that rising health care costs place on individuals, employers, and the government, as you are of the unacceptable shortfalls in the quality and efficiency of healthcare in the country.
Through your personal experiences in your own institution and through communication and collaboration with colleagues in others, you may have learned that better health outcomes at lower costs can be achieved through care transformation initiatives. These measures yield improved results, more satisfied patients, and organizational cultures of continuous learning.
In this last of the three part blogpost series, I have created a set of questions that you can use in the form of A Checklist for High-Value Health Care In India. My attempt is to describe, in as generic a way as possible, the foundational lessons that will be relevant to every Medical Director, CEO and Board member, and to the healthcare delivery organizations they lead.
These are central not only to your work, to date, in Indian healthcare, but also impact your ability to sustain and reinforce the system-wide transformation necessary for continuous improvement in the face of rapidly increasing pressures, demands, and market changes.
This Checklist is intended to be a living and dynamic document, and I invite both suggestions to improve its utility and reach, and inquiries from decision-makers of healthcare organizations who wish to incorporate these transformation strategies for effective, efficient, and continuously improving health care for all Indians.
- What is our strategy for continuous improvement in the effectiveness and efficiency of care, and are we reinforcing it with every member of our organization?
- What else can our Board and its members do to emphasize and help drive our continuous improvement efforts?
- In what ways are our employees at every level supported and empowered to improve effectiveness, efficiency, and outcomes in their daily work?
- What tools have we built into our processes for continuous feedback and action to improve care delivery?
- How well is our I.T. system used to help providers streamline administrative tasks and improve the care experience and patient outcomes?
- How well is our Electronic Health Records (EHR) aligned with Meaningful Use requirements?
- For which of our most common and highest-cost conditions and procedures do we not yet have evidence-based care protocols? What is our strategy for filling these gaps and keeping others current?
- Which of our care protocols are not yet integrated into provider workflows via our EHR and what is our plan to fully integrate them?
- What procedures have we put in place for continuous monitoring of patient flow, occupancy, and staffing levels for each major service line?
- What indices do we use to identify and eliminate unnecessary and wasteful fluctuations, variation, and inefficiencies in each element?
- What procedures ensure optimal care transitions, both within units of the hospital and between the hospital and the community?
- How do we assess which care setting is most cost-effective and appropriate to the patient experience and outcome?
- How do we define the patient’s care team and ensure that each care step is delivered by the most appropriate team member?
- What tools are being provided to our clinicians to aid in the communication of complex medical information to patients and their families?
- How do we require and facilitate the routine engagement of patients and their families as fully-informed, active decision makers in the planning and execution of their care?
- What is our procedure for identifying, engaging, and tailoring the management of high-risk, resource-intensive patients?
- What resources are we dedicating to the targeting and intensive management of the health of these patients, here and in the community?
- For which of the most common injuries and errors have we developed or adapted specific protocols to reduce their incidence, and what are the priorities ahead?
- How are these protocols fully integrated into existing workflows, such as through prompts in our EHR?
- How do we measure and benchmark adherence to evidence protocols, service utilization rates, and performance on quality, costs, and outcomes?
- What are our procedures for using performance data to improve outcomes and reduce variability, costs, and waste?
- How do we communicate clinician specific performance data back to clinicians, and how can we improve that communication?
The Checklist addresses the systems-level issues central in transitioning to a high-value healthcare system in India, one that improves outcomes while reducing costs. The Checklist’s 22 items reflect the strategies that, in my experience, have proven effective and essential to improving quality and reducing costs.
They describe the foundational, infrastructure, care delivery, and feedback components of a system oriented around value, and represent basic opportunities – indeed obligations – for hospital and healthcare delivery system CEOs and Boards to improve the value of health care in their institutions.
Taken together, this Checklist needs to be woven into the organizational strategy for improving quality and reducing cost amid a changing landscape, one that is marked by growing demand for cost-effective, quality healthcare services in India, the rapid proliferation of telemedicine, the penetration of health insurance companies, mergers and acquisitions leading to rising corporatisation in the medical industry and government schemes that are fast changing the competitive landscape.
Featured Image Source:
Forget what you learned in B-School about marketing and selling. Demand = Sales is an equation that doesn’t work in India. Sure, to succeed in India, you certainly require a sustainable business model, great execution, and something in reserve to avoid being derailed by bad luck or a shift in business environment.
But is this all that is needed to succeed in India? I think not. Just ask Hyperlocal grocery delivery start up PepperTap, which raised over US$50 million, including a US$36 million series B round led by ecommerce player Snapdeal in September, 2015, LocalBanya, which raised US$5 million, or GrocShop, founded by IIT Bombay alumni and selected by Google for mentoring. All of them floundered and bit the dust in spite of hedge funds and VCs falling over themselves to back these internet businesses in India. Same is the case with edtech start-ups like iProf & Purple Squirrel, used car marketplace Zoomo (earlier called GoZoomo), Getit Infoservices, the parent company of ecommerce marketplace AskMe, on-demand laundry start up Doormint, FranklyMe and Murmur, well funded food delivery startups like TinyOwl, ZuperMeal, BiteClub, Zeppery, iTiffin, fashion ecommerce start ups like Fashionara & Ladyblush, fashion rental companies like Flyrobe, Liberent, Elanic, SwishList, Klozee & The Clothing Rental, logistics-transportation-delivery start ups like Parcelled and TruckMandi, the marketplace for building materials in Delhi NCR – Buildzar, the mobile app to enable an entrepreneur to send a pitch to an investor with a single click-Shotpitch, mobile auto-hailing app Autoncab, and finally, the heartbreak of India’s first Tinder, Cogxio, shutting down.
To understand how to win in the Treacherous Indian Market which is littered with folded-up companies, business owners can learn from Prime Minister Narendra Modi’s Marketing Manual. This is a man who wins election after election, each more convincingly than the previous one by using a simple Marketing Mantra – E.S.C.R.O.W.
To know what this is, read my blog post at http://wp.me/p6tQjj-3o
Using Modi’s Marketing Mantra, you can also succeed in Indian markets.
I will tell you something you don’t hear in B-Schools or read of in scholarly course material. To sell to Indians, what is needed the most on the part of the business firm is Empathy & Compassion for the customer. This has to come through first, above all else. Its time to unlearn your Marketing knowledge, folks. In India, we are like this only!
Any company wanting to engage consumers in India with their market offering must be seen as Empathetic and Compassionate. Indians describe Empathy as the capacity to ‘see from another’s point of view’ and Compassion is the capacity to ‘feel with the disadvantaged and less fortunate members of society’. These twin qualities are at the heart of what makes us Indian. This is our DNA. These are the two strands that wind around each other like a twisted ladder, giving us Indians a unique and distinct identity. Think of Empathy as the red coloured oxygen atoms and compassion as the blue coloured nitrogen atoms in our DNA helix.
In India, power is vested with the Prime Minister. Since 1947, when the modern Indian nation state came into being, till date, Indians view their Prime Minister as the ‘Ruler of the Land – A Karma Yogi’. The main reason why PM Modi is able to hold on to and improve his popularity ratings among Indians at home and abroad is that he is able to embody this most crucial aspect of Ruler of the Land. He is perceived to be a Karma Yogi – one who lives out the tenets of Karma Yoga. In Indian philosophy (which is a living, breathing, everyday construct in the life of the average Indian), Karma Yoga is a technique of performing actions as a duty without any expectation of rewards. The concept of duty arises in relation to others and an absence of desire for rewards implies an altruistic motive. Thus, the actions of a Karma-Yogi are necessarily altruistic.
To illustrate this point, one has to only see the recent exercise of Demonetization that PM Modi unveiled on November 8th last year. Demonetisation is unlike other policies, it has benefits but also pain built into it. Black money in India is like a cancer. It has spread all over the country, almost like a parallel circulatory system for our economy. The use of currency notes is a big part of it. Black money stalls growth, kills efficiency and keeps the economy sub-optimal. To that extent, to cure black money, the government justified demonetization as a treatment that resembles chemotherapy. The Demonetization step is, therefore, welcome. However, what is not acceptable to Indians is the government (or its fanboys) gloating over the brilliance of their idea to do a chemo, and being unwilling to look at or address the ugly side effects that come with it. No doctor gloats after giving a patient a chemo. They work to lessen the pain of the patient and limit the impact on good, weak cells. This is what PM Modi was perceived to have done. He understood that for India’s poor, all it takes to make them descend in a negative spiral of abject poverty is one brutal blow – daily wages lost for a few months, savings wiped out because no bank took them, a job loss as their employer shut down, an industry downturn or a hospital turning them away – and they can never get back on their feet again. The chemo of Demonetization could do that. To ignore that would have been both insensitive and irresponsible.
No matter how brilliant the solution, the execution here was vital. PM Modi was roundly criticized by the media, the pundits and the Opposition parties for his government’s execution of the Demonetization exercise. They said he hadn’t done it as well as he could have. That we still don’t have enough notes, banks have queues and people are being inked for taking out their own money. Policies are changing on a daily basis. That the finance guys sat at the meeting hailing this plan, and nobody invited or heard logistics professionals, who were needed to make this happen.
Cutting through the noise, Indians saw empathy and compassion in this act. They saw Demonetization as PM Modi’s generalized disposition to engage in altruistic helping. Here was a man who came from humble beginnings; he knew first hand, the compromises that ordinary Indians make every day just to put food on the family thaali (plate) and out came the empathy and compassion of ordinary Indians, mirroring their ruler’s attitude. They patiently stood in long bank queues, surrendered their small savings in old currency at bank counters, put up with a daily and weekly ceiling on their cash withdrawals, tolerated ATM’s running dry and watched on with wry humour, as people who had no stake in their welfare blathered on about how ‘ordinary Indians were being inconvenienced’. Using social media, digital platforms and electronic & print media, PM Modi convinced ordinary Indians that Demonetization was necessary chemotherapy administered by the government to root out the cancer of black money. That managing the side effects and showing empathy to the patient was top priority for him now. After that, he would take steps to ensure there’s no relapse. Indians bought into this premise. They saw Demonetization as necessary and laudable. The painful treatment was worth it. PM Modi would do his best to ensure the carcinogens, the stuff that caused the cancer of black money in the first place, were eliminated too.
The recent assembly elections in five Indian states were seen as a referendum on the government’s Demonetization move. PM Modi won in four out of the five states.
Question: Why did PM Modi succeed so spectacularly in the recent assembly elections?
Answer: He is seen to be Empathetic & Compassionate. Sure he has definite motives to accomplish. He is not completely altruistic. But by his actions and his public engagement strategies, he is able to mould public perception in his favour. He comes across as Empathetic & Compassionate.
In the eyes of most Indians, only when an individual has genuine empathetic concern for others can he/she be sensitive and be aware of his/her duty. Empathetic concern and role-taking with respect to individuals affected by one’s actions constitutes moral sensitivity, which is the first step towards moral development. This is what makes a person a Karma Yogi and a ‘ruler of hearts’.
So what can you learn from PM Modi as a business owner? First, engage your customer, don’t start selling straightaway. Use content to drive dialogue and automation to enhance your reach. Second, spend time, effort & money creating a strong connection between your customers and your brand. You can do this by creating programs that serve their needs and address their biggest pain points. Third, demonstrate compassion for your customers by creating marketing programs that are informed and driven with empathy.
In my previous post, I had triggered thought in the minds of business owners by posing a set of questions. Answering these questions honestly will trigger an empathetic & compassionate mindset among business owners that will serve them well in the Indian market. Empathy is reflected through a company’s ethics, leadership, internal culture, brand perception, and public messaging via social media. A company’s singular quality to be accepted by Indians is to be perceived by them as being high on empathetic concern for their customers and low on personal distress in their marketing effort. Such businesses are thought to be more likely to take actions for the benefit of their consumers rather than for their own benefit.
To be a market leader, your company (i.e. YOU – the owner) must be perceived by consumers to be a Karma Yogi. To give you a small exercise, rate yourself of the following Empathy-Compassion scale. This will tell you how much of a Karma Yogi you are.
Scale for Karma-Yoga: Sense of duty or obligation towards others
- I hesitate to do what is expected of me∗ (negative).
- I willingly do whatever task is assigned to me, even if I do not enjoy it.
- I am aware of my obligations to society.
- I willingly perform all duties, which are expected of me.
- I feel it is my duty to contribute to society.
Scale for Karma-Yoga: Absence of desire for rewards
- I work only in order to get some personal benefits∗ (negative).
- While working, I keep thinking about success or failure∗ (negative).
- I expect to be rewarded for good work done∗ (negative).
- I often dream of becoming very successful∗ (negative).
- I am disappointed when the outcomes of my efforts do not yield the results I expected∗ (negative).
- I strive to be selfless in whatever activity I undertake.
Are you a Karma Yogi? How can your company be seen to be Empathetic and Compassionate? Write in and let me know.
If you require professional assistance in doing this, please contact me on my website at http://cobblestonesconsulting.com
Like Daniel H. Pink said, “Empathy is about standing in someone else’s shoes, feeling with his or her heart, seeing with his or her eyes. Not only is empathy hard to outsource and automate, but it makes the world a better place.” To this, may I add that in India, this can make all the difference between market longevity and market disappearance!
In tomorrow’s post, we will discuss the second Mantra in Modi’s Marketing Manual – Segmentation.
Prime Minister Narendra Modi has been ranked among the 10 most powerful people in the world in a list by Forbes magazine. This comes as no surprise to his fellow 1.3 billion Indians among whom he remains hugely popular, well into the middle of his first term as Prime Minister. Deflecting any anti-incumbency sentiment that besets every politician across the world, PM Modi is often touted by young Indians under the age of 35 years (who form 60% of India’s humongous population) as their best Prime Minister till date!
In India, Modi is the mood of the nation.
Source: Press Trust of India
Describing Modi’s actions in 2016, Forbes took note of the demonetisation drive announced by the PM and wrote, “In November 2016, he unexpectedly announced plans to eliminate India’s two largest bank notes in a bid to reduce black money laundering and corruption, creating nationwide frenzy to swap out the bills.” In spite of the inconvenience this move caused to the general public and being reviled for it by the intelligentsia, both at home & abroad, PM Modi registered widespread support for the government’s demonetisation initiative and surgical strikes in Pakistan occupied Kashmir.
The recent assembly elections in five states, especially in India’s heartland of Uttar Pradesh, bear testimony to the Prime Minister’s popularity surge.
A recent Pew Research Center report has found that 87% of Indians have a favourable view of Modi, including a strong majority (68%) who see the prime minister very favourably. And among all respondents – men and women, the young and old, the urban and rural populations and members of the three national political parties – a majority holds very favourable views of the prime minister. So strong is the Modi magic in India that it has swept the Indian National Congress party, the principal opposition party, to India’s political fringe.
Every business owner dreams of doing a Modi in his chosen field of work. Like PM Modi, being a competent business person is not enough to win in India’s markets. What is needed is dominance. A quality Modi has.
To do this, you need to employ his marketing mantra of E.S.C.R.O.W. (read more about this at http://wp.me/p6tQjj-3o)
The first letter E stands for EMPATHY. In today’s blog post, I will explain how a business person can employ Empathy like Modi does, to telling effect.
Empathize means to understand and share the feelings of another.
Modi sees voters not just as poll constituents who are to be sermonized & then be taken for granted later. He is able to create a strong connection between his audience and his personal brand. He does this by creating programs that serve the audience needs and addresses their biggest pain points. And he creates these types of programs by informing & driving them with empathy.
Case in Point:
Pradhan Mantri Ujjwala Yojana (PMUY) is among the most successful social-sector projects of the Narendra Modi-led government. The program has achieved its target to give cooking gas connections to 15 million families in 2016-17. The scheme is followed by the success of ‘Give it Up’ campaign launched by the petroleum ministry through which 10.5 million people gave up their LPG subsidy.
Gathering impetus from PMUY scheme, the government has added 20.5 million LPG customers this year. In the past two-and-a-half years, the government has been successful in adding 60 million LPG connections, while in the 60 years before that, only 130 million connections were added.
Numbers apart, this program is a latent exercise in social engineering in a country notorious for its social inertia. By freeing up women from back breaking kitchen chores and dependence on firewood as cooking fuel, the Prime Minister has not just emancipated the female gender in rural India, he has given Indian women what they most yearn for. Dignity in the kitchen and time of their own! How could PM Modi do this? He empathizes with women. As a young man, he would often help his mother in the kitchen and he knew the difficult time women endured in there, for better part of the day. By providing poor rural women FREE cooking gas in their own homes (many of whom could not even dream of such a ‘luxury’), he has earned a place in their hearts. Like many women in India say, “Humein Modiji se lagaav nahin hai. Hume unpar shraddha hai (We are not ‘fond’ of Prime Minister Modi. We repose our ‘faith’ in him)”. Who do you think will win the women’s vote in the polls? Duh!! With half the voting population rooting for him, this is stupendous market coverage! And remember, women are past masters at Word of Mouth marketing.
Source : Pinterest
To replicate this success in business, entrepreneurs have to be relentlessly consumer focussed. How many times have you heard this before? How often do you do this?
Modi-fied questions businesses need to ask themselves:
- Do you understand your audience? Can you create a profile of your typical customer?
- Can you connect with them on a deep, intuitive level? Can you translate that connection in terms of money?
- Do you really know what your customers want? Do you really know what your customers need? Do you know why?
- Do your marketing efforts strongly project an innate understanding of your customer? How do you measure such marketing successes?
- Will your perfect client/customer come to your website and say, ‘Hey this guy is talking to me?’ Will your mobile business app be adopted by her?
Write out your answers to these questions. Be brutally honest with yourself. Or else, your customers will be! Revisit these questions every quarter. And learn from your customers, like PM Modi does.
If your answers are not convincing enough or if you aren’t sure the answers are correct, do not hesitate to undertake Market Research. It can make all the difference between your market credibility and market disappearance!
For any Market Research activity in India, and consequent strategic marketing advice, please do not hesitate to contact me. Visit my website http://cobblestonesconsulting.com for more details.
There was a time when strong, sexy ad campaigns would move Indians to buy from their ego place. But today, most Indian consumers have to be careful with their spending and only a strongly demonstrated understanding of their feelings and life/business circumstances will inspire them to pull out the wallet. As businesses learn to embrace these right-brained, empathy-driven marketing tactics, consumers in India are also learning; they keep their eyes open for the brand that understands them the best.
This is why Modi wins the ballot even before the votes are cast!