The
MANAGEREAL
APRIL’2019 Volume-1 : Issue-I
SPECIAL ARTICLE:
India's Energy Diplomacy in Liquefied Natural Gas
Need for strong Diplomatic relationship to secure
LNG supply (Page:09)
Department of Management Studies Rajiv Gandhi Institute of Petroleum Technology
The discipline
to overcome
the threats of business
disruption
Rohit Dudi
Page: 04
Entrepreneurs
hip: A Roller Coaster Ride
Sanjeev Kumar
Page : 07
Human resource and
technology in
today’s fast changing
times
Chinmay Sahu
Page: 13
Building A
Smart
Healthcare Ecosystem
Sneha Maheshwari
Page: 15
2
Dear Readers,
It gives us immense pleasure to present before you
the very first edition of our distinguished the
Managereal. We have put together a wide range of
interesting articles that would help us to fulfill the
primary agenda of the Think Tank Team (working
under Department of Management Studies, Rajiv
Gandhi Institute of Petroleum Technology’s
umbrella). To offer a conjoint platform to the
Industry people and academicians to express and to
contribute a holistic understanding of the various
diverse topics from both the perspectives.
We have, in this issue topics covering the Energy
diplomacy concerning LNG supply, an apt
combination of Human Resource and Technology
that the world needs in today’s scenario, some valid
insights on Business Disruption and a proposed way
out through discipline. And to compliment these
subjects, this issue will be dealing with
Entrepreneurship a way to live life with a difference
and the need of Smart Healthcare sector in present
society as a whole.
Editor’s Desk
Associate Editor(s)
Dr. Kavita Srivastava
Associate Professor (Marketing) DoMS, RGIPT-
Jais campus
M. Chandra Shekar
ICSSR Teacher Research Fellow, Asst.
Professor, Finance & Accounting, IPE, Hyderabad.
Vijay Tiwari
Senior Manager-HR, HAL, Korba
Shafqat Mobarak
YP-Energy, Public Policy
NITI Aayog, New Delhi
Student Editor(s)
Sayandeep Chandra Subhankar Mazumdar Akash Gupta
Urja Suman Natasha Rastogi Soumya Mishra
3
The Ministry of Petroleum & Natural Gas (MoP&NG), Government of India set up RGIPT at Jais, dist.
Amethi, Uttar Pradesh through an Act of Parliament (“Rajiv Gandhi Institute of Petroleum Technology
act 2007"). RGIPT has been accorded the eminence of being an “Institute of National Importance” along
the lines of the Indian Institutes of Technology (IITs). The institute is empowered to award degrees in its
own right. RGIPT is co-promoted as an energy domain specific institute by six leading oil public sector
units (ONGC, IOCL, OIL, GAIL, BPCL and HPCL) in association with the Oil Industry Development
Board (OIDB).
The Institute has been associated with leading International Universities/ Institutions specializing in the
realm of Petroleum and Energy sector with an extensive area of focus in the domain of Marketing, Finance,
Operations and Human Resources. The prime objective of the institute is to provide world-class education,
training and research to roll out efficient human resources to meet the growing requirements of the
Petroleum & Energy and allied sectors.
RGIPT, Sivasagar offers diploma courses to address the skill gap in the industry. RGIPT, Bangalore centre
is being developed to take up advanced research in the energy domain. Currently RGIPT, Jais offers
B.Tech and M.Tech in Petroleum and Chemical Engineering.RGIPT offers Master of Business
Administration (MBA) and PhD in management. Besides PhD programs in science and engineering are
successfully running from RGIPT, Jais campus.
About us
Rajiv Gandhi Institute of Petroleum Technology
4
“Strategy is not the consequence of planning, but the opposite: its starting point.” –Henry Mintzberg
It is possible to start a business from the
grassroots and catapult it to the height of
achievement by crafting proper strategies,
detecting the discontinuities that may pose a real
challenge for the business in future.
In business, when we speak of disruption, it
actually means “Disruptive Innovation”. This
term was coined for the first time by Clayton
Christensen of Harvard Business School in his
magnum opus “The Innovator’s Dilemma” in
1997.
Disruption is not as scary as it sounds. It actually
means advancement in the age of globalization
and industrialization. Disruption aka “disruptive
innovation” depicts the creation of new markets,
which earlier no one had thought of. It means
understanding not only the present demands of
the people but also having knowledge and
insights about their future needs and
requirements.
The theory of Clayton Christensen also throws
light on the way small enterprises or firms with
minimal resources entered the market, created
new customers, attracted old customers, and
finally disrupted the established market system.
Some well-known Disruptions of the existing
business that we use in our day-to-day life.
What Disruption poses for the business
owners of today?
Disruption has become jargon in the
entrepreneurial world. With the rapid emergence
of disruptive business models, the existing
scenario of business functioning and engaging
the customers is undergoing a transformation.
However, the concept, unlike innovative
businesses is not new. With the advancement of
technology, and rapid evolution in knowledge;
wants and demands of people are changing. This
is driving the business models to change in to
keep up with the pace of change. In this
competition, the firms that could not match up
the speed of evolution failed like “Lonely Planet”
but at the same time, start-ups like “Trip
Advisors” snatched all the followers.
In the 21st century what we think of little
disruption, are actually catastrophic changes that
are revolutionizing the way firms engage with
their customers, creates seamless and memorable
experiences for them by understanding their
wants.
The discipline to overcome the threats of
business disruption
Rohit Dudi | PGP 2017-2019 | IIM LUCKNOW | [email protected]
5
For example- the 3600 video launch by YouTube
gives the experience of virtual reality that was
once only a dream. The official VR channel of
YouTube has many attractive offers for the
viewers including music performances, news
events, sports, racing and films. This is not only
a disruption but a remarkable shift in business
plans to engage the customers.
Abilities to overcome the disruptions in
business
For any business owner, it is perilous to
underestimate the power and magnitude of
disruptive models of business. No business wants
to suffer the phase suffered by Kodak, once a
market leader and now an almost extinct brand.
So let us look at some of strategies and changes
to cope up with disruption in the business
competition.
✓ To ensure a business is ready for
digitization – it is vital to understand and
accept that the current period is of digital
disruption. So, for companies it better to stay
focused, innovate and collaborate instead of
fearing or rejecting the new change. This will
boost the effectiveness of the business;
provide an exciting path for customers, offer
them better, real-time communication, and
finally opening
up some new market segments.
✓ To ensure collaboration in different
business teams– in the age of disruptive
innovation, a partnership will act as the key
to success. The team leaders of the business
need to encourage communication and
collaboration of inter-departments like heads
of marketing, and information technology
need to work hand in hand to embrace the
changes. The firm should also pair up with
the right consultants and technology provider
to embark upon a seamless journey of
disruption.
✓ Taking advantage of the internet speed
and rejuvenating the subscription model –
gone are the days of DVDs and cassettes,
even saving music in external hard disks or
pen-drives. As the massive internet speed and
mobile tech-advancement helped in
streaming of high-quality videos and music
contents for a monthly payment of fees.
Ganna.com, Wynk Music etc. are two of the
many that supply millions of song listeners.
Nowadays daily use materials for vital
medicines can be obtained by an online
subscription and shipped directly to
customers. Examples of Grofers, Lenskart,
and even home services like UrbanClap are
new disruptive models working in different
cities. Thus, existing business firms need to
extend their arms in the new markets to
prevent from being endangered.
✓ To cope up with changing the definition of
consumer convenience – as the definition of
comfort is changing for customers with the
changing era, businesses are fighting hard to
come up with seamless services to satisfy
them. For instance, the long waiting hours at
airports or railway stations have been
reduced with applications (like IRCTC app,
Goibibo, Paytm) in our smartphones. We can
now book tickets with preferred seats
anytime, anywhere. Similarly, for hotel or
movie show bookings, etc. Companies need
to come up with even better solutions to give
utmost convenience to customers.
✓ Introducing gamification – this technique
involves the use of different elements of a
gaming strategy by individual companies on
their brand interfaces/platforms. This
includes points, rewards, stars to engage and
attract customers to buy more products or
services from them. For instance, Big Bazaar
has its own card where points get added on
each purchase and customers can redeem it
on their next purchase. Starbucks has its own
reward system where customers on specific
products can earn points for the future
purchase. All these are to increase the number
of visitors to the stores.
6
✓ Self-disruption – till now, the best business
strategy to live up to the expectation of
consumers is self-disruption. All the big
players in the market like Apple, Amazon,
etc. follow it. The steps are to find new ways
to adapt, evolve, and then recapture the
market to stay relevant. Companies should
follow this model where they should
understand the unsaid need of customers and
come up with a solution.
✓ Thus, for any business or company, whether
small medium or large, new or existing,
require focusing on the customers and their
experiences to thrive in the competitive
market. This includes spending more
resources and capital on research and
development to think and solve problems
anticipated for future; or else the business
themselves will become the victim of
disruption.
Reference(s):
• Harvard Business Review. (2018). What
Is Disruptive Innovation?. Available at:
https://hbr.org/2015/12/what-is-
disruptive-innovation [Accessed 3 Nov.
2018].
• tonyrobbins.com. (2018). What
disruption really means for your business.
Available at:
https://www.tonyrobbins.com/career-
business/what-disruption-really-means/
• Money 101. (2018). What is Business
Disruption and how does it work?
Available at:
https://money101.co.za/business-
disruption-work/
• En.wikipedia.org. (2018). Disruptive
innovation. [online] Available at:
https://en.wikipedia.org/wiki/Disruptive
_innovation
• Shortpress.com.au. (2018). What
disruption really means and how to
handle it. Available at:
http://www.shortpress.com.au/what-
disruption-really-means-and-how-to-
handle-it
• Startupgrind.com. (2018). What Is
Disruption, Really? 8 Examples and
What to Learn From Them. Available at:
https://www.startupgrind.com/blog/what
-is-disruption-really-8-examples-and-
what-to-learn-from-them/ [Accessed 3
Nov. 2018].
• Keys, L. (2018). 5 Ways Disruption Has
Changed the World -- And How
Businesses Can Adapt to the Future.
Entrepreneur. Available at:
https://www.entrepreneur.com/article/29
6345
• Meltzer, D. (2018). Disruption vs.
Innovation: Defining Success.
Entrepreneur. Available at:
https://www.entrepreneur.com/article/31
1246
• Harvard Business Review. (2018). How
Likely Is Your Industry to Be Disrupted?
This 2×2 Matrix Will Tell You. Available
at: https://hbr.org/2018/01/how-likely-is-
your-industry-to-be-disrupted-this-2x2-
matrix-will-tell-you
7
A Roller Coaster Ride
Entrepreneurship is a buzzing word that excites
most of us today, and Mr MBA is no exception. He
too did not know initially that it’s a roller coaster
ride, which thrilled him in the beginning and scared
him en-route. But he lives in highlight and believes
that ‘the end will be the beginning of a beautiful
life filled with choices.’ Everyone he knows,
beyond the finish line, shares the same thought –
it’s incredible & worth riding.
Opportunity v/s Challenges
Most people ask this question, and most are not
sure about venturing into. Although it seems to be
a journey embarked on by chance, hearts of hearts
he knows it came to him because he had asked for
it. When the opportunity knocked at his door, his
financial situation wasn’t conducive, and the mere
thought of betting his life-long savings caused him
sleepless nights. Even before embarking on the
journey, he thought of quitting a lot of times. He
knew, as he had read many times, failure is the
stepping stone to success; but the unanticipated
roadblocks this time were his own family
members/ close friends & well-wishers. And to
add to their rationale, he had already closed his first
e-retail venture before its anniversary. As he often
says - What it takes is ‘to get up again’ after every
fall. Today, he believes entrepreneurship is for
anyone who is ready to replace ‘I wish’ with ‘I
will.’
Few things he did right:
1. Decision (Right or wrong?)
He knew, even after all the R&D, the decision to
venture into the domain of your choice is just a
decision - neither right nor wrong. After firing his
boss within a year of starting this venture, he
proved his decision right; but again, firing his boss
was just a decision. A dream came true and many
more to come with time.
2. Commitment (does 87.3% commitment
works?)
Soon he realized that the journey isn’t an easy
one. There is no balanced life for an entrepreneur.
Our Mr MBA chose to live an imbalanced life for
4 to 5 years (only work and no life) because he
knows the end result of this journey is a fantastic
imbalance for rest of the life. He is not alone in
paying the price, his family is equally involved.
Nevertheless, he is 100% committed towards his
dream.
3. Got a Coach (I know it all!)
Today, it isn’t necessary to re-invent the wheel to
be successful. It’s a no brainer for him to work
together with more than one brain in sync. There is
nothing better than leveraging someone else’s real-
life learnings. He feels lucky to have a coach like
Mr Vibes, a game changer throughout his career, a
certified trainer and above all a serial entrepreneur.
Few things he avoided:
1. Will everybody buys into my philosophy
(Yes/No?)
He believes that there is no exception to the 80:20
rule and knows that if he wants to achieve success,
he must be strong enough to survive through 80%.
Entrepreneurship: A Roller Coaster Ride
Sanjeev Kumar | Apna Haat Retail Private Limited
(Co-Founder and COO) | [email protected]
8
There is no substitute for hard work, no elevator to
success and hence we must climb the staircase. He
believes whatever he does, it is the most important
attribute to his success. The only person who can
make him successful is , himself.
2. I am the king (or Kingmaker?)
One thing he learned though hard-way is the value
of time over money. He knows if he wants to enjoy
the life to the fullest, he must have freedom (24x7).
The successful 3% decentralize control - the secret
of living a life of choices. It’s always better to
leverage on other’s resources than trading own. A
goal is more critical than a role. And He became
the kingmaker by choice.
3. I can’t do it (How can I do it?)
Challenges are an integral part of our life, and an
entrepreneurial life is no exception. Many think
that challenges come to break them, but he believes
that problems come as an opportunity to introspect
& rediscover the true self. When someone says, I
can’t do it; the person has already quit on himself.
The right question to ask is – How can I do it?
Toughest time of his journey:
Take off was great, though as part-time with a job,
soon came the point where he had to take the
toughest decisions of his life. He had to choose
between the employment and entrepreneurship; the
security (oxymoron) or the freedom. It was a battle
within, a risk, where his decision could be right or
wrong. It was a tough choice for him as he hails
from the middle class where the only legacy we get
is to study for decades to secure a means of survival
- the job. Nobody was supporting his decision,
neither family nor best friends; it scared him even
more. After swaying between two minds, he finally
chose to take a leap of faith and decided to let go
of security.
Advice to the Aspirants:
Before asking what to do and how ask actively
WHY to do it? Do the needful, think through and
decide. But once decided, keep doing till it
happens. There are only two ways of not being
successful in any business - one is not to start; the
other is to quit. Remember, there are three kinds of
people in this world; 1. People who ‘Make things
happen’ 2. People who ‘Watch things happen’ and
3. People, who wonder ‘What happened’?
Who Are You A Warrior or a Wimp?
I Create! I Take Risks! I Live My Passion! I Am
An Entrepreneur!
9
India is the second largest country by population
with 1.21 billion people (Census, 2011) and third
largest economy in the world. Indian economy is
proliferating with an average growth rate of
approximately 7% in the last two decades.
Energy is the critical input for economic
activities, and to achieve sustainable growth we
need a greater share of green/clean energy in the
energy mix. India’s energy mix (shown in
Figure-1) is dominated by polluting coal
(56.26%) & Oil (29.47%) whereas; natural gas
contributes only 6.12%. Natural gas is cleanest
fossil fuel and is being considered as a transition
fuel between coal/oil & renewable. Hence,
Government of India has set the target for making
India a Gas Based Economy by increasing the
share of natural gas in India’s energy mix from
the current 6.12% to 15% by 2025.
Figure-1: India's Energy Mix (Source: BP
Statistics, June 2018)
As per "PNGRB's Vision 2030" document,
demand supply gap (shown in Figure-2) for the
natural gas market in India necessitate import of
natural gas from the international market.
"Energy diplomacy of India is playing a
significant role to ensure sustainable, affordable
and continuous import of natural gas from
exporting countries". There are two options to
import natural gas, firstly, in the form of LNG
through LNG import terminals and secondly,
through trans-national natural gas pipelines.
Considering current geopolitical challenges in
trans-national pipeline projects, the only feasible
option available is importing through LNG
terminals in India.
Figure-2: India's Demand-Supply gap of
Natural Gas (Source: PNGRB, 2015)
Trend in Natural Gas supply & consumption
in India:
The production of domestic natural gas in India
has decreased from 113.42 MMSCMD during
2009-010 to 69.42 MMSCMD during 2016-17
(PPAC, 2017) due to a drastic decrease in
production level of KG basin. Total supply and
consumption are being supported by imported
India's Energy Diplomacy in Liquefied Natural
Gas (LNG) Sambhaji Kadam | PhD scholar | Rajiv Gandhi Institute of Petroleum Technology.
Kavita Srivastava | Associate Professor (Marketing) | Rajiv Gandhi Institute of Petroleum
Technology.
10
LNG. Authors have tabulated the historical trend
of consumption/supply of natural gas in the
country as shown in Figure-3.
Figure-3: Trend in consumption/supply of
natural gas (Source: PPAC)
The trend in consumption and supply of natural
gas in India has shown that LNG is playing a
significant role in total consumption and meeting
demand-supply gap. Percentage contribution of
LNG in India's total natural gas consumption is
shown in Figure-4.
The increasing role of LNG in India's natural gas
consumption has shown that India's dependence
on LNG is crucial. Hence, to ensure the
sustainable, affordable and long-term
relationships with LNG exporting countries
India's energy diplomacy need to play a
significant role.
Energy Diplomacy in re-negotiating long term
LNG contracts:
The import of LNG in India had started in the
year 2004 when the first Phase of Petronet LNG
Ltd.’s (PLL) Dahej terminal commenced its
operation with 5 MMTPA capacity. PLL is
promoted by four Indian PSUs, GAIL, ONGC,
IOCL & BPCL. It is the first company started
LNG business in India by signing long term
Master Sales & Purchase Agreement (MSPA)
with RasGas, Qatar. India's Major long-term
contracts (20 Years) for importing LNG are as
follows:
1. PLL with RasGas, Qatar for 7.5
MMTPA.
2. PLL with Exxon Mobil's Gorgon Venture
in Australia for 1.44 MMTPA.
3. GAIL with Gazprom, Russia for 2.5
MMTPA.
Figure-4: Role of LNG in India's Gas
Consumption (Source: PPAC)
Recently, Energy Diplomacy of India through
representation from the Ministry of Petroleum
and Natural Gas to Qatar, Australia and Russia
have helped to re-negotiate the commercial terms
and pricing formula of the above long-term
contracts. This energy diplomacy has helped
India to save billions of dollars and played a
crucial role in securing sustainable energy
relation with LNG exporting countries. The
details of contracts & savings under re-
negotiation are as follows,
A. PLL with RasGas, Qatar for 7.5
MMTPA:
Long term LNG price formula was, LNG
Price=12.66 %* JCCt
Where,
JCC: Price of Japan's Japan Customs-cleared
Crude. JCCt: Last 60 months’ average price of
JCC.
11
Under diplomatic success, re-negotiation of
above formula has been done in 2016 as follows,
Revised LNG Price=12.66 %* Brent+0.6
Whereas,
Brent is 3 months’ average Price of Brent Crude.
Due to this revised formula & re-negotiated
commercial terms India would save billions of
dollars as follow,
▪ Saving of around Rs. 4000 Corers
per year for remaining contracts
period.
▪ Payable Take or Pay (ToP)
obligation of Rs 12000 Corers
were waived off
Extracts of Interview of CEO, PLL with Business
Line on 5th January 2016 is as follows,
“From January 1, 2016 we are getting daily
advantage of $5 per mmBtu,” from January 1,
2014, we started hitting the floor price. The
advantage of low gas price was not available to
us and we were always paying more than what
was the prevailing rate.
For example, if crude was at $80 per barrel, the
floor was at $110 per barrel. The $12.5 per
mmBtu price that we were paying till December
31, 2015, was based on the crude price at $96 per
barrel, while it had fallen to $40 per barrel. But,
now we have removed such things and linked it
as close as possible to the market pricing. Yes,
there is always a premium in the long- term
contract, while spot can keep fluctuating. Due to
commercial reasons I cannot share the details of
the formula with you"
B. PLL with Exxon Mobil's Gorgon
Venture in Australia for 1.44
MMTPA:
Original formula as per 2009 contract is LNG
Price=14.5 %* JCC (FOB basis) Revised
formula is LNG Price=13.9 %* JCC (DES basis)
PLL has an agreement for purchase of 1.44
MMTPA of LNG from Mobil Australia
Resources (part of ExxonMobil) for 20 years
from Gorgon project in 2009. PLL began
receiving supplies in January 2017 at a rate much
higher than the spot, prompting the company to
re-negotiate the deal. In 2017, price formula and
commercial terms has been revised. As per
revised commercial terms, PLL will take
additional 1 MMTPA LNG at 12.5 % of the Brent
crude price whereas the original supplies will
come at a price 13.9 % of Brent, lower from
14.5 % earlier, and the transportation cost would
shift to Exxon from PLL under Delivered Ex-
Ship (DES) instead of Free on Board (FOB) trade
terms.
Due to this revised formula & re-negotiated
commercial terms India would save around Rs.
10,000 Corers for contract period.
C. GAIL with Gazprom, Russia for 2.5
MMTPA:
India received its first LNG cargo from Gazprom
on June 4, 2018 under a long-term deal of
2.5 MMTPA with Gazprom at PLL's Dahej
terminal in Gujarat.
GAIL will buy 2.5mn mt/yr of LNG under a 20-
year contract. The contracted volume has been
lowered from 2.5mn mt to 0.5mn mt in the first
year 2018-19, 0.75mn mt in 2019-20, 1.5mn mt
in the third year 2020-21. GAIL will start
importing the full 2.5mn/yr by the fourth year
and make up for the initial volume reduction over
the remaining length of the contract.
Original Formula, LNG Price=JCC (JCC were 9
months average)
Revised Formula, LNG Price=JCC (JCC is 3
months average)
In return of re-negotiated formula, the full term
of the contracts has been extended by two years.
The revised price and commercial terms would
save around Rs. 9500 Cr (at crude oil at $ 70/b)
over the contract period (2018-2040).
12
D. LNG Infrastructure Development in
Neighboring Countries:
India's expertise in setting up LNG import
terminals is going to help neighboring countries
to develop LNG infrastructure. It may boost
India’s role in creating a new energy security
architecture for its neighbors. PLL is planning to
set up LNG terminals in Myanmar, Bangladesh,
Sri Lanka and Mauritius. Also, PLL is exploring
a similar opportunity in the Maldives. Prime
Minister Jagnauth PM of Mauritius visited India
in January 2017, and had energy-related talk with
Hon'ble Minister, MoPNG for India to set up
LNG terminal in Mauritius. PLL has also begun
preliminary studies to construct 2-3 (MMTPA)
floating LNG unit in collaboration with Sojitz,
Mitsubishi and a Sri Lankan state-owned
company in the South- western part of Colombo,
Sri Lanka with an approximate investment of
$250-$300 million.
E. Conclusion:
It would be crucial for India to maintain its
energy diplomacy to secure LNG supply from
international market and take-up our expertise to
build proposed LNG terminals in Myanmar,
Bangladesh, Sri Lanka and Mauritius.
Reference(s):
• https://www.thehindubusinessline.com/c
ompanies/renegotiated-qatar-gas-deal-
giving-daily- gain-of-
5mmbtu/article8069384.ece
• https://www.naturalgasworld.com/india-
to-save-over-1bn-on-gazprom-lng-deal-
62889
• https://energy.economictimes.indiatimes.
com/news/oil-and-gas/renegotiation-of-
gorgon-lng- contract-could-pave-the-
way-for-other-deals-icra/60913940
• https://www.firstpost.com/business/india
-plans-to-set-up-lng-import-terminal-in-
myanmar- to-expand-energy-diplomacy-
in-neighbourhood-says-dharmendra-
pradhan-4885701.html
• http://web.isanet.org/Web/Conferences/
AP%20Hong%20Kong%202016/Archiv
e/d724cccf- d926-4880-a1f8-
1b4b2825c563.pdf
• https://www.thenational.ae/business/indi
a-aims-to-boost-energy-ties-1.71178
• https://energy.economictimes.indiatimes.
com/news/oil-and-gas/petronet-to-
invest-rs-400- crore-next-fiscal-kochi-
utilization-seen-dipping-in-q4/63537496
• https://www.livemint.com/Industry/GzB
JIonvBR5UYE2vNT9H5I/LNG-
diplomacy-India- plans-to-build-
terminals-in-4-nations.html
13
The present era has been a turnaround in every
aspect involved in human life vis-a-vis the fast-
changing technology. The breakthroughs in
technology aspects have hit the human being all
around the planet, in a big way. It merely has
opened up a whole new arena enabling each one
to connect to every other person on the earth in
more than a single way and at the same time has
made each individual susceptible to a multitude
of externalities. Moreover, the times where
knowledge and wisdom were limited to a few
intelligent is over and long gone. Presently, with
those small devices in the palm, every little
thing of knowledge can be accessed from any
corner of the world. What industry needs to tap
today, is no more the person with vast
knowledge but is the right individual with a
positive intent, who could decipher the
knowledge in the best, intelligent and most
profitable manner. This aspect of ready access
has given rise to a threat of dilution in firewalls
and restrictions as well, giving rise to a sense of
breach in trust between the employees and
employers.
The very aspect of ethics has become the most
sought-after attribute in an individual. If we track
the transition, it was at the beginning of a skill-
based community framework, which got
transformed to the industrial framework,
marking the beginning of the industrial
revolution. Gradually, the man-force that
involved human muscle-power besides the power
of tamed animals at the start of industrial
revolution, got transformed into human
resources. As the application of human brain
apart from the muscle power started to become
more relevant in tackling the day to day
activities, and finally the modern day has arrived
where technology that is the outcome of human
mind is the very base for each aspect of day to
day life. (Para need rephrasing). Taking of India,
the market that India involves is very different
from the rest of the world, due to many reasons,
the primary of them are:
1. The market size in India is of vast size, but
with a different attribute that is purchasing power
as well as the requirements of them is varied to
the utmost extent. Moreover, majority in India is
still dependant on agriculture for livelihood, also
a vast population still delves with poverty and
inadequacy.
2. India is endowed with the gift called
demographic dividend, but the very stage to reap
the benefits is not yet fully ready, the youths are
not however adequately trained for the modern-
day technological parlance.
3. Apart from the above two, the biggest hurdle
being faced is the pace with which the country
has advanced in the service sector. It has been
phenomenal, and has outrun the manufacturing
sector by a significant margin (the present share
of each sector in the country’s GVA is: Service
sector contributes nearly 54%, Industry 29% and
Agriculture & allied activities contribute around
17%; the growth rate for the three areas for the
current year is 8.3, 4.4 and 2.1 respectively)
(source?); thereby indulging the country in a
skewed sort of growth.
Human resource and technology in today’s fast-
changing times Chinmay Sahu | Manager (Operations) | National Thermal Power Corporation
14
There are many more reasons that aid in taking
on the Indian market with a different view than
the rest of the world and accordingly act to
mitigate the various aspects of the market,
including Human resource and the fast-changing
technology-generated implications.
Further, the energy sector in the country is
feeling the stress from every possible angle,
thereby opening up the opportunities in multiple
dimensions, also presenting threats in the equal
number of aspects. In this changing time, there
happens to be a small breathing zone and find
profit for the industries, related to energy. The
ever-expanding need for energy and ever-
tightening environment protection norms, both
are acting antagonistically are squeezing that
little zone rapidly. Adding difficulties to the
situation is the fast-changing technology, the
rapid advancements in technology is making the
instruments obsolete faster than anticipated.
Apart from that, a threat is also being projected
from the renewables in case of the power sector
and biofuels in case of fuel sector. The more the
penetration is happening for renewables
especially solar, the bigger the market it is
capturing and hence the lower the cost of
generation is happening owing to the concept of
the mass scale of production applied to the solar
panel manufacturing.
Further the concepts of micro-grid, net metering
etc. are creating turbulence in the power market.
The environmental compliances and even the
lower costs for the renewable energy are making
them more sought after than some traditional
thermal based power generations. This results in
many of the power plants laying stranded without
any schedule. Moreover, the precarious situation
of the distribution sector is forcing them to look
for cheaper options. The whole cycle has resulted
in making India a power surplus country
although there many homes where even a single
bulb does not glow for even a single minute. (not
sure about the hypothesis).
Energy is at the core of every little modern day
development, the turmoil in the energy sector is
getting pinched into all the allied sectors. Be it
the agricultural sector where the solar powered
pump set is bringing revolutions in the life of
farmers, also to the enhancement in crop
production through increased crop intensity, be it
the usage of bad lands for creating mega solar
parks, be it the automobile sector where there has
been a revelation through R&D for the efficient
electric vehicles and so many stories.
Talking of technology, the up gradation is
happening like flipping the pages of a book. For
example, the size of the storage devices has been
a real inspiration, now gigabytes of data can be
stored in a minute flash drive. For mobile phones,
every single day they are getting enhanced with
some or other attribute. Even data is on-the-go
with the free wi-fi systems available in most of
the places or even tiny OTG supported storage
devices enable a person to access an
unfathomable amount of data. The driverless cars
are no more a myth and so are many more.
Thus, the present era where human resource and
changing technology have come up posing a big
challenge for every industry, they need to be
appropriately mitigated to make the industry
flourish and make the human race reap-in the
benefits.
Reference(s):
• Economic Survey 2017-18; Vol: 01: Government
of India; Ministry of Finance; Department of
Economic Affairs; Economic Division- January,
2018
• Energy Statistics 2018(Twenty-fifth Issue):
Central Statistics Office; Ministry of Statistics
and Programme Implementation; Government of
India, New Delhi
• Monthly Executive Summary- Power sector
(March 2018): Government of India; Ministry of
Power; Central Electricity Authority, New Delhi
• http://www.energynext.in/2017/07/renewable-
energy-is-a-dynamic-and-a-fast-changing-sector/
• https://www.geographyandyou.com/economy/de
velopment/concept-demographic-dividend-india/
15
TARGET:
Target hospitals would include Tier 1 and Tier 2 hospitals as well as government hospitals in Tier 1 cities.
As the category of patients visiting such hospitals is much acquainted with the proposed technology.
The targets are categorized into a budget healthcare unit and a premium segment healthcare unit.
RESEARCH METHODOLOGY
Hospital Visits at varied locations were conducted, and conversed with the staff and the patients along
with their representatives focusing on the various operational procedures with an aim to identify the pain
points in the “Patient Journey” and recommendations for improvements.
Pain points of the patient:
• Admission Process
• Navigation around the hospital
• Estimation of patient care expenses
• Patient Refunds
• Long Queues at the Cash Counter
• Difficulty in Supply of Drugs and Return of Medicines
Pain points for the healthcare unit:
• Compliance to regulatory norms as applicable
• High cost of holding Inventory
• Helpdesk Operations
Changes have been proposed to address the above-stated pain points and to improve the patient’s journey.
Thereby improving levels of patient’s satisfaction and bringing about operational efficiency within the
healthcare unit.
STRATEGY:
Building A Smart Healthcare Ecosystem
Sneha Maheshwari | PGDM 2017-2019
K.J. Somaiya Institute of Management Studies and Research
Bricks and Mortar
Healthcare
Transition Digital Health &
Healthcare
16
PATIENT JOURNEY
The patient journey explores the pathway of interaction
between the patient and the healthcare providers at all
stages of a disease including coping up with the treatment
and dealing with expectations. It also encapsulates the
interaction with and between different stakeholders.
Patient Journey Mapping outlines all the patient
touchpoints within each stage of the care journey. It aids
in creation of strategic outreach that improves both patient
engagement as well as patient satisfaction.
The "triple aim" of healthcare — better care, lower cost and a healthier population — is driving much
of this effort to coordinate care across the continuum. To achieve this, healthcare providers need to learn
to work together to coordinate treatment, prevent unnecessary testing, manage chronic conditions and
provide cost-effective care in the appropriate setting.
VALUE-CHAIN ANALYSIS: A HEALTHCARE UNIT
SUPPORT ACTIVITIES
PRIMARY ACTIVITIES
Hospital Administration [Board of Directors, Medical Director, Chief of Nursing]
Hospital Support Services [SCM Department, Housekeeping, Maintenance and Security Services]
Information Services [Patient Registration, Billing & Collection, Customer Service, Medical Records, IS, Health
Education, HR]
Diagnostic & Therapeutic Services [Lab, Diagnostic Imaging Center, Emergency Medicine, Therapy Centres,
Psychiatric Centre, Pharmacy, Medical Staff & Nursing] Margin
Margin
Administration
• Emergency Room • In-Patient
Department • Out-Patient
Department
Care
• Clinical Evaluation
• Diagnostic Tests • Treatment
Discharge
• Routine Discharge
• Discharge Against Medical Advice
• Referred to Other Healthcare Facilities
Marketing &
Sales
• Service Pricing • Customer Service • Patient
Experience Assessments
• Financial Aid • Insurance: HMO
Service
• Ambulatory Services • Patient Monitoring • Referral to
Wellness Centre • Health
Education • Follow-up
17
PROPOSED CHANGES IN THE PATIENT JOURNEY
Though bed availability and system capacity can determine the number of patients flowing in and out of
the hospital, delays often are caused due to process inefficiencies due to delays in diagnosis, discharge of
in-patients, refunds, etc.
VIRTUAL CARE & AT-HOME CARE - MEDIUM TERM
Virtual Care Diagnosis shall work on an outsourced model wherein the healthcare unit shall have partnered
with virtual diagnosis unit to extend the service to its patients and based on revenue sharing model.
Empaneled Doctors including Physicians and Specialists shall be available for On-Call for diagnosis
enabling 24*7 care for the patient at his ease.
In both the point of care, the patients can use the provided checklist of symptoms and describe their
situation in detail, make note of health history, and upload any relevant files or images.
Subsequently, the doctor and patient shall interact either via HD video conferencing (Virtual Care) or via
visit (At Home Care) and perform diagnosis and drug prescription. In addition, sensory devices such for
measurement of body vitals shall also be provided on request.
The process shall be wrapped up by a Consultation Summary and stored as part of the Electronic Health
Record of the Patient (EHRs)
MINI-HEALTH ATM
Introduction of a fully automated healthcare Kiosk that allows instant access to medication and nutrition
and enables to track of body vital statistics.
Features include:
◙ Over the counter Medication and Wellness Products including Allopathic medicines (Crocin,
Saridon, Gelusil etc.) and Ayurvedic medicines from brands like Himalaya and Dabur
◙ Prescription Management and Online Management
◙ Body Vitals such as BMI, BP, and Hemoglobin can be monitored and tracked.
The Kiosk towards logging out shall redirect towards Healthcare Unit Website and App asking for basic
registration details and generating UHID.
Target locations: Schools, Corporate Institutional Towers, etc.
Benefits: Better Patient Care before hospital, Target Marketing, Increase in Patient Conversion Rate
18
PATIENT PORTAL: Mobile App and
Website for E-Health
Propose to introduce patient portal operative via
an application and website by using the
Cognitive Solutions and Business Intelligence to
cater to patient needs and digitalizing the patient
experience at various stages.
It shall include the customer data based on the
unique health id (UHID) generated and the
various other databases which include price
master (examinations, medicine prices, room rent), drug dosage record, doctor prescription, doctor
consultation fees, etc. among all the backend data required for cost estimations of the patient care.
In addition to patient registration at the time of sign-up (creating UHID), it shall provide following
features:
• Doctor availability and appointment scheduling/rescheduling (including Virtual Care and At-
Home Care)
• Request for ambulatory care via emergency services
• Access to the patient’s EHRs (Secured Download option available)
• Expense Estimator
• Bill Payment and Refunds
• Drugs and Consumables Management
• Patient Assessment
• Personal Health Manager (via Query Chatbot)
• Request for post-hospitalization care at home
• Externally embedded provider search that helps in nearby hospital and other point of care location.
Expense Estimator – Short Term
Insurance funded patients: Patients get access to the extent of coverage of treatment borne by the
Insurance Firm as per SLAs. In case of absence of hospital tie-up with the Insurance Firm, patient details
along with copy of insurance document shall be sent to the Insurance Company and confirmation with
advance shall be obtained by hospital on behalf of patient.
Drugs and Consumables Management – Short Term
Include an option for medicines return for the patients so that the attendants would save out on their time
as the nurse would collect it from them and return it back to the pharmacy.
We also would have a feature of showing the medicines availability and whether the prescribed
medicines are ready to be delivered or not. This would reduce the waiting time for the patients and their
attendants and also reduce queues at the pharmacy counter.
19
Patient Assessment – Short Term
A real-time patient feedback system that includes both qualitative as well as quantitative factors to
understand the patient expectations. Automated Reports highlighting priority improvement areas can be
derived.
Patient estimates basis their diagnosis and health examinations enable better patient financing. It shall
include a detailed report on the actual expenses being incurred under various heads such as medicines,
room rent, nurse fees, doctor fees, meals etc.
This shall be accessible within the hospital via 1-2 tablet per floor with designated nurse on each floor to
enable the less affluent people also have access.
E-Bill Payment and Refund Counter - Medium Term
Online transaction facility would enable patients to make payments and receive refunds at the click of a
button.
Personal Health Manager – Short –Medium Term
Provide clinical alerts and reminders with respect to routine or follow-up appointments, drug dosage, drug
purchase requirements and requests for purchase of medical equipment’s. It shall also provide consumer
driven personalized healthcare plans and Query Chatbot. Benefits: Better Patient Financing; Reduction
in Financial Write-offs; Availability of Virtual and At home Care; Reduced TAT in Patient Journey, Better
Patient Relationship Management
New Patients register on the portal and generate their UHID.
Existing Patients login the portal with their registered UHID
Login In will be password and OTP protected to prevent any malpractices
Online portal will include Menu Options enabling patient access the services
Expense Estimator would incorporate data from the price master, drug dosage record, doctor prescription, doctor consultation fees etc. enabling patient to get an
estimate and compare the same with actual bill amount
Periodic expense updates would be provided to the patient and his family in order to help
them in arranging fund
Add-on features include Drugs return facility for the patients in
case of incorrect or change in medication prescribed
The nurse would come and collect the medicine from the ward and return it to the pharmacy. This
would lead to higher operational efficiency and better time management in the return process
Medicines availability status and the estimated time to delivery would be available on the online portal which
would lead to reduction in the waiting time at pharmacy counters
20
INSTALLATION OF SELF-SERVICE KIOSKS – MEDIUM TERM
To address the long queues and waiting time, propose to install Self Service Kiosks at the reception area.
Initially the kiosks would be manned for short term to assist patient or patient representative.
Kiosks can be basic which would include just a screen for feeding in the details and a provision for fee
payments through cards. Advanced Kiosks would also have a feature of payment through cash and cash
refunds. The choice of kiosk would be based on the healthcare unit’s budget.
Kiosks would include patient registration (Unique Health ID, Symptoms & Diagnosis), Doctor
availability, Doctor Appointment scheduling/rescheduling, Payment through payment gateways with an
option for Auto Credit in case of any refunds and total estimate for OPD (MRI, X-Ray etc.) patient care
if required by the patient. The interface of the Kiosk Machine will be in 3 languages – English, Hindi and
Local Regional Language.
Benefits: Reduced patient waiting time; Patient Database; Reduced cost per patient; Ease of payment &
refunds
Advanced Kiosks Basic Check-In Kiosks
21
ELECTRONIC HEALTH RECORDS– SHORT-MEDIUM TERM
Manual records storage result in increased cost of storage due to warehouse requirements, insurance costs,
personnel cost for management, etc.
These can be reduced via transitioning from paper-based records to digitalized records in the following
ways:
• Digitalized Doctor Prescription and Drug Administration: Doctors would be provided with a
digital writing pad and a stylus which would help reduce the paperwork and also the doctor
prescription will be mapped against the patient id and would be visible on the online portal.
• Enhanced Patient File Management: As per regulatory norms, specific patient files such as
Transplant Records, PNDT Records, MLC File etc. follow certain coding and security locations.
These files can be easily secured via restricted access. Furthermore, it will result in ease of access
of records.
• Automated ICD Coding: As per regulations ICD coding of diseases in mandatory for hospitals.
The servers would be pre-installed with ICD Coding mapped for each diagnosis and shall be
automatically updated and statutory reporting performed.
• Risk Management: EHRs can detect patterns of potentially related adverse events and enable at-
risk patients to be notified quickly thereby enabling Preventive Diagnosis. Improving aggregation,
analysis, and communication of patient information, it is easier to consider all aspects of a patient’s
condition with easy access. Hence enabling evidence-based decisions at point of care.
Benefits: Automated regulatory reporting and compliance; Cost Savings from reduced Insurance &
Warehouse Costs; Improved Risk Management via preventive diagnosis, clinical reminders, etc.; Enhance
Research & Monitoring thereby improving Clinical Quality
Incoming Patients to Kiosk Machine*
Literate Patients
Illiterate Patients
Admin Consultant for Kiosk guidance
Patient Registration Details entered for Unique Health ID (UHID) generation
- Personal Information (Name,Email id, Emergency Contact number, Patient Representative, Card Details)
-Selection of the affected body area from a drop down list
- Severity of pain and few symptoms being experienced via Menu Options available
List of Doctors along with their avaibility and consultancy fee is displayed for appointment scheduling by patient
Confirmation of appointment with the selected doctor detailing cabin number and it's navigation
Payment made by card or by cash at the Kiosk Machine
Receipt of the consultancy fee can be printed and mailed to patient as per the patient requirement
22
NAVIGATION SCREENS – SHORT TERM
Navigation Screens shall enable addresses the difficulty in maneuvering around the hospital for the
patients and their representatives.
Based on the type of hospital and the budget constraints, the type of navigation screens (interactive or
photo navigation) would be installed. Helper assistance inform of Red Press Button on the navigation
screen would also be provided for people who are unable to access the navigation screens.
Benefits: Reduced patient search time; Increased patient satisfaction
WORKFLOW AUTOMATION – SHORT-MEDIUM TERM
To overcome operational inefficiencies, we propose the following
Benefits: Collaborative Relationship Management; Better Drug Administration; Reduced Costs in terms
of Inventory Management
Vendor Managed Inventory
• We propose that the hospitals should go for Vendor Managed Inventory rather than actually purchasing inventory andhaving it on. This would lead to a decrease in the inventory costs and working capital requirements
• For high value & critical items such as Stents etc. the vendor's inventory can be stored & managed by the hospitalswhich would lead to a decrease in the warehousing costs for the vendor and also an assurance of the consumption of hisparts
Medicine
Barcoding
• Automation in the barcode scanning process would lead to a real time mapping of the prescribed dosage with the onebeing provided and any errors would immediately show up on the online portal
• This would lead to a reduction in the risk of incorrect medication and would also help in curbing the financial lossesthat the hospitals would have to bear
• This would lead to increased satisfaction to the customer and financial benefits to the hospital as well
Inventory Level Updations
• Predictive Data Analytics via Cognitive Solutions shall enable real-time updation of inventory levels such as maximuminventory, minimum inventory, re-order levels and other such critical metrics.
• Based on the patient data analytics with regards to the consumption and growth.
• However, as these inventory levels shall be subject to approval to ensure that no extraordinar situation impacting dataresuts in higher inventory carrying costs
23
POST CARE: DIGITAL HEALTH INTEGRATION
Reference(s):
• Andrew Blythe, “The Patient Journey – Patient-Oriented Approaches to Care”, AUSMED, Nov.
2016
• Evariant, “What is Patient Journey Mapping?”
• “Building the healthcare system of the future”, World Economic Forum
• Departments of Health and Family Welfare,“ e-Health & Telemedicine”,June 2018
• Liquid State, “Digitising Healthcare: The Patient-Driven Journey”, Sept. 2017
• Source: Deloitte, “The evolution of smart health care”, Global health care outlook, 2018
• Christensen, Clay, The Innovator’s Prescription: A Disruptive Solution for Health Care, McGraw-
Hill, 2008
• SVARK, The Health AT
Clinician sets health goals and targets for patients
Data is recorded and analysed by the app
Patients visit the clinician
for follow-up or first-time
consultations based on the
App alerts
Option 1: Connected app or Sensor for condition
management
Option 2: Recommends Full Digital Health Disease
Management Program
PATIENT DOWNLOADS THE APP AND
OBTAINS SENSOR DEVICE
• Patient starts collecting data via active (eg.
Measuring blood pressure) and/or passive (using
an actigraph) method
• For patients who are not required to purchase any
sensor for condition management, they would
update their condition manually in the app
ALERTS TRIGGERED BY THE APP
• Regular alerts regarding drug dosage, drug
refilling, follow-up consultations etc. would be
sent to the patient as a part of after care service
• Alerts would also be sent by the app to the
clinician and the patient when the health values are
in a concerning range
PATIENT LOGIN VIA PATIENT PORTAL
• Patient who don’t own a sensor device opt for the Virtual Diagnosis
through the patient portal
• Patient keys in the current condition through video call with the doctor
24
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