Can design thinking help formulate a sustainable model which enables affordable access to quality healthcare for the masses?

Aug 01, 2014 | Posted by admin in Campus Corner   No Comments »

Dr Nomal Chandra Borah ,the Renaissance health person in the North East,shares his story at WeSchool

“I was very unhappy and restless…” was how he started his adress to a packed audience of young students,faculty and guests assembled in the Brainstorm room at WeSchool . Dr Nomal Chandra Borah ,son of the mighty Brahmaputra was indeed an unhappy man looking at the conditions prevailing in the Indian healthcare industry nearly 45 years ago .While the  healthcare services offered to the vast population by  the government and charitable hospitals were inadequate and pathetic in quality  the private service providers  offered better healthcare but  it was affordable to  only 20 % of the population .The intense competition between the Doctors and medical organizations was bringing a paradigm shift in the patient -doctor relationship,so while the treatments offered were getting better,the  trust on the medical profession was deteriorating .And looking at this scenario Dr Borah was indeed an unhappy man   !!

How to take the much needed affordable  healthcare to the multitudes of needy,poor patients in far -flung places ,that would not only take care of their  bodily ailments but also of their minds and  spirit ? was the million dollar question…

As he grappled with the problem ,his determination to find a solution kept becoming stronger. ” Hence despite getting job offers from within and outside the country, I decided to set up my own healthcare facility. During that time, Assam was passing through a phase of tremendous social unrest, but I took it as a challenge and decided to struggle to work towards my dream,” he stated.

What started as  a small clinic in Guwahati initially contributed  the promoter’s contribution which was substantiated by an investment subsidy from Government of India and a SEED capital assistance from IDBI. A term loan of Rs 88 lakh was sanctioned by AIDC. After various expansions, today the hospital stands tall with 165 beds and has 1,000 employees  working for more than half a million customers. “We have been able to maintain our  position in healthcare in the North East for more than two decades” he added with a sense of pride.

But the journey wasn’t  an an easy one !!

“We realized the 75% medial problems can be solved at the patient’s doorstep,only a few needed to actually go to the diagnostic center.When I studied the population of Assam,I tried to understand what kind of treatments would they need,the kind of doctors and hospitals were required to cater to their needs.With the stakeholders’  feedback we went to the engineers,architects for designing the hospital,used locally available technology and materials and engaged local labor.There was one factor we  never compromised on, and that was  safety while building the first Eco-friendly hospital in the country.The response of the community was so spontaneous and sense of ownership so strong  that we were able to complete the hospital nine months in advance.And that ,in turn resulted in saving  the costs !! ” said the Doctor with a twinkle in his eye.He also asked local contractors to tailor-make hospital beds instead of ordering them from pricier multinational manufacturers. The result: beds have no frills but meet the needs of the patients.

To limit expenses, bamboo cladding was used extensively in the building’s exterior. That acts as a natural insulator and allows the hospital to do away with air conditioning in common areas such as lobbies and reception. This resulted in saving electricity and reducing maintenance cost. The hospital is built under green building norms and is expected to receive a so-called gold certification later this year as an environmentally-friendly building.

Dr. Nomal Chandra Borah who currently serves as the Chairman and Managing Director at GNRC Community Hospitals Limited and GNRC Hospitals Ltd, began dispatching “Hospitals on Wheels,” buses re-purposed as mobile hospitals equipped with X-ray machines, sonogram equipment, and a patient exam room in 2013. These buses, along with a group of doctors, visit several remote parts of Assam to screen and treat patients free of charge. In addition to the  hospitals on wheels,he also uses hospitals in boats that navigate the banks of  Brahmaputra,offering solace to villagers living along the length of the mighty river.

” Even for  the patients that come to the hospital ,the services offered in the first 24 hours are completely free.Here,the patients who can afford to pay and those who can’t, get the same quality of treatment and it is free for the first 24 hrs .As we dont want the patients to be fleeced by the  taxi and auto rickshaw drivers,we have started bus services from a few strategic spots that ferry them to and fro, free of cost.The tribal or villager  hailing from some little pocket in remote Assam can not afford to loose his daily earnings needed for survival,so we  have set up a schedule  to complete  his tests ,deliver the results by evening so that he is able to consult the respective specialist if needed  and  goes home with the prescribed medicines” he said. As the soft spoken ,gentle Dr Borah ,went of unfolding the story of his quiet medical revolution in Assam ,there was no uneasy shuffle of feet or chairs in the Brainstorm Room as the faculty and students listened to his every word  in rapt attention.
The hospital charges Rs2,500  for an MRI. In most private hospitals, that can go up to double or treble the figure . A blood sugar test will cost Rs21  while a CT scan , Rs900 . Around 150-200 patients visit the hospital daily.On being questioned about the profitability of his his venture considering the free treatments and  extremely reasonable fees being charged  for various operations ,he had a ready answer.”Having a business model is important .But Healthcare is about quality and to me, healthcare  is defined by Quality ,Cost and overall experience.If one takes  care of these factors,the healthcare venture will be successful “.
The GNRC is a 165-bed multi-speciality ISO-9002 certified hospital at Guwahati, promoted by the renowned neurosurgeon is one of the two well known private health care facilities of the region. It houses state-of-the-art equipment, intensive care units and seven operation theaters, apart from providing 24-hours emergency services. The health unit also features histopathology, immunology, biochemistry, microbiology, and non-invasive cardiac labs. The GNRC has opened 30 retails shops all over Guwahati city. 

The World Bank has  awarded GNRC a grant worth $150,000 earlier this month to help scale up operations. He plans to set up 10 similarly low-cost hospitals in the next five years across northeast India. And just like the bus-cum-hospital, GNRC plans a helicopter service to transport doctors to the even more rural parts of the northeast.“The helicopter service,  to be inaugurated on the 15th August,  will  ferry doctors from GNRC to difficult-to-access locations across the region and provide medical support at the doorstep for people of  the north-eastern states”He added.

“Never spend more before you earn more in business, never be afraid of change, the person is not bigger than the organisation, you patient is the most important person ,value that relationship because that is what defines you  and never compromise on quality,” was his message to to young MBAs while concluding  his speech .

Needless to mention that he got a standing ovation !!



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