Dr Giridhar Gyani, founder Director General of Association of Healthcare providers of India (AHPI), is sorted and well combed. He is widely known for his penchant for quality in every aspect of human activities, healthcare being uppermost on his mind. Anything sub standard is anathema to him. It is not for nothing that he has earned the moniker of ‘Quality Man of India’
In a candid interview with Medicare News, Dr Gyani opened up about different aspects of healthcare in India i.e. Ayushman Bharat, CAHO (Consortium of Accredited healthcare Organizations) as a quality aggregator across hospitals, class of care in private hospitals, Private Hospitals being unfairly treated by people and media, NABH ( National Accreditation Board for Hospitals and Healthcare Providers), et al.
Being champion of Universal Health Coverage, he is optimistic about Ayushman Bharat, central government funded health insurance scheme. He looks at it as game changer provided implemented in right earnest. Dr Gyani says, ‘It is a complete package for patients all and sundry. No party in future elections in India would dare to ignore healthcare as PM Modi has firmed it up as core of electoral politics. The government has made this so far fringe issue a permanent fixture in politics of the land.’
Looking forward to early and judicious resolution of package rates issue with private hospitals regarding Ayushman Bharat, Dr Gyani says, ‘PM Modi aims India as a welfare state. He is planning that majority of underprivileged population gets free medical care. He is also focusing on preventive healthcare. He has already put in place PMJAY under which 40% of population gets free care up to 5 lakh per year for family. For rest of population he aims to have affordable care for which he has introduced price control for medicine and consumables. He will work in this tenure to establish 1.5 lakh health and wellness centres. He will also try to add about 2500 new hospitals by private sector in tier-3 cities. We will urge government to equally focus on quality and patient safety measures.’
As for healthcare scenario in India, Dr Gyani, is particularly upbeat about one development called CAHO (Consortium of Accredited Healthcare Organizations). Dr Gyani, former Secretary General of Quality Council of India, said, ‘CAHO has emerged as a potent tool to make quality care a continuum and culture across accredited hospitals. Its fame is catching up fast and may in time take a life of its own and morph as an independent rating agency. Even in a short span of five years, it has heralded an era of motivation for patient safety and quality care among accredited hospitals. It was more than evident in just concluded CAHOCON in Mumbai. The conference was marked by the presence of 3 representatives of JCI (Joint Commission International), the gold standard for international accreditation, which amply underlined CAHO’s growing clout and relevance.’
Dr Gyani further said, ‘CAHO is now a movement which NABH should earnestly take note of. It is high time NABH recognizes CAHO’s important role as its own force multiplier in creating ecosystem of quality care across hospitals in India. CAHO is a phenomenon that is all set to make quality culture in Indian Hospitals. It can become customer’s body, a watch dog for quality care. CAHO’s feedback can be a great help for NABH in promoting quality all across hospitals. In terms of training for quality, CAHO is aegis of excellence. If NABH takes CAHO along, more and more hospitals will weave around NABH. NABH will immensely benefit from CAHO. If CAHO gets support from Quality Council of India, it can do wonders. There are around 50 thousand hospitals in India, out of which only 1000 hospitals are accredited, hardly 2 % of the total. This needs to increase.’
Dr Gyani was all praise for Dr Vijai Agarwal, the President of CAHO. He added, ‘Dr Vijai Aggarwal is a self motivated leader and is highly passionate about quality in healthcare. The likes of him are few and far between and can be counted on fingers.’
As former CEO of NABH, Dr Gyani wants domestic accreditation body to emerge as a brand like JCI. He said, ‘NABH is still equivalent to JCI and other International quality standards. Its standards have been accredited by ISQUA (International Society for Quality in Health Care). It makes it at par with JCI. But the lack of optics around NABH is what makes it short of a brand. It being low key is its biggest weakness. It should learn from JCI which chose CAHO conference as a platform to promote itself. JCI gives its ad every 3 months.’ Dr Gyani is the first Indian to have served as elected Director on Board of International Society for Quality and Healthcare (ISQUA), Quality accreditation infrastructures in India owe a world to Dr Gyani. Down the memory lane, he also spoke about time when he designed NABH at the behest of then Health Secretary Mr Hota and how he got inspirational support from legendry Dr Mashelkar.
As for claim that Accredited Indian hospitals are world class, Mr Gyani did not mince words. He said, ‘In all aspects of treatments except Cancer, the claim is well founded. Robotically, we are yet to measure up to western standards. That is why our leaders and luminaries rush to foreign countries for cancer care. In cardiology, kidney and liver transplants our hospitals are global grade. In terms of oncology, we are yet to be world class.
Dr Gyani further added, ‘As a health tourism hub, India is bound to excel other hubs. We are giving 1st class health services at third world cost. More and more hospitals need to get accredited to augment health tourism to India. CAHO like organizations will certainly bolster the health tourism prospects.’
As for tendency in hospitals to hide medical errors, he said, ‘hospitals should be encouraged to come clean about medical errors. This will improve transparency and inculcate a culture to learn from errors.’ He advised that patient safety protocols need to be formulated to stop medical errors. A study by the Harvard University last year showed that 5,000,000 deaths occur in India annually, thanks to medical errors. He said, ‘this is a worrying fact. That must stop. It will happen only when medical errors are shared. Besides death, medical errors also result in longer stay of patients in hospitals.
Dr Gyani expressed his angst over unfair treatment meted out to private hospitals by media and society. Media disproportionately whip up random cases of mishap here and there to make villain of all hospitals but they become blind to the fact that the same hospitals save lives of dozen of patients every day. Hospitals have earned notoriety thanks to media’s unfair treatment.’
‘The ever widening chasm between doctors and community is a matter of great concern. The trust deficit needs to be plugged immediately. It is in the interest of both doctors and patients. Good doctors should formulate preventive guidelines which would prove that doctors worries about society. Those guidelines should be published in newspapers from time to time’ He added.