Anubhav Sukhwani, Vice President, CK Birla Hospitals, in an exclusive interview with CIOTech Outlook, shares his views on how hospitals restructure doctor engagement strategies to foster interdepartmental collaboration, measured adopted to improve job satisfaction and reduce stress, role of AI and telemedicine reshaping doctor engagement and retention strategies and more. He has over 21 years of experience in the healthcare industry, spanning various sectors such as F&B, Cinema, and Retail.

Given the current emphasis on collaborative care models in India, how are hospitals restructuring doctor engagement strategies to foster interdepartmental collaboration and ensure a seamless clinical environment?

Over the past 12 years, there have been a lot of changes in how care delivery in hospitals has evolved. Earlier, there was fixed remuneration for doctors, and that's how they used to function. Now, doctors are partnering in various ways, which means that an established doctor who would have a practice may already be based in the town or the city where they collaborate. There are two ways to perform it. One is that they would shift to the hospital full-time and work for the hospital. The other way would be that there are very few procedures and surgeries.

So what they do is then they get those cases as a referral from us, a referral in the sense that we have already diagnosed the patient at the first level. Also, the patient is aware that he requires extra care or another level of intervention. So, the team would come in and do that procedure. Their team would take care of that patient, and then once the patient is nearing discharge, the patient would be handed over back to the hospital. Hence, this happens within the hospital. However, the care changes as we are sure the patient is getting the correct type of treatment with the proper skill set. Besides, the doctor's team is already trained in those interventions.

For instance, there would be a liver or heart transplant, which is very rare and not the daily routine hospital work. However, the team would be specialized in liver transplants, and they might be attached to five hospitals. So that is one way to collaborate and change how things move.

Moreover, there are other models like partial outsourcing wherein the hospital will give you the space, the doctor comes with the team, the capital in the expenditure in the medical side is done from the doctor's end, and the hospital gives the infra. So these are a mix and match of various ways and means. Now, doctors are getting engaged and attached to the hospitals. The next model would be one with no fixed remuneration. It will be based on the business or the revenue stated. The good part about the overall story is that we are getting the best of the care for your patients as a hospital provider. But at the same time, you also have that ownership of the doctor, which is a hand-in-hand story. It is not only the hospital that is responsible for the care, but the doctors also have equal or more shares.

With the rise of digital health tools and AI in clinical settings, what impact are these technologies having on doctors' work engagement and their ability to maintain high performance?

There are proven facts that digital tools now keep doctors more connected and informed about the patient's journey in the hospital. The key performance indicator that gets the correct indication is the average length of stay in the hospital. It would be the expense of the patient and better diagnostics. So, fewer investigations and medications would be needed, and the patient would return to normal life faster.

For instance, AI could be in diagnostics or radiology with the hospital's data, which is already being captured, or the software is creating the AI, which will prompt at various points in a USG, a CT, or an MRI. It will give you those touchpoints. Also, you have done a spine MRI or a USG for the stomach or abdomen. In that case, it will prompt the key, the critical report indicators so that the performance, the efficiency and speed and the accuracy increases, which leads to faster diagnosis, processing and transferring of the images to the OT.

So when they are doing those surgeries or treating patients, the information is already available, which creates all the impact. So when in an OT, if we're already seeing that digital image in front of us, we would always be in a better place to treat the patient faster, in an accurate way, with less bleeding, pain, and in and out quicker. So, it makes a lot of difference, and AI technology will also help later once it has enough data points.

Amid increasing rates of doctor burnout in India, particularly following the pandemic, what targeted measures are hospitals adopting to improve job satisfaction and reduce stress among clinical professionals?

It is a four-pronged approach that generally every good hospital should follow. One is engagement, which is meant not only for clinical but also for social. So, regular specialty meetings to hear them out, listen to their concerns, address them with a timeline, ensuring that they have enough workforce to perform their clinical practice in the shortest possible time, in the sense that having a good work-life balance is something which the hospital is responsible for.

Also, at the same time, creating ease of use for the tools being provided should not become more difficult for them. So it could be in the form of an electrical medical record, and all the records of the patient coming into the OPD get consolidated at one place.

For instance, Over the last 100 years, we have seen that a patient would generally carry a file containing 100 pages. The doctor will have to go back to see everything, assess, analyze, diagnose, ask for the present problem and give the proper treatment. However, by putting everything electronically at the click of a button, he can see trends, a lot of information that has been flown, and what kind of pharmacy he has utilized over the years. Hence, for patients with heart problems, diabetes, and prolonged diseases, these kinds of trends help a lot.

Looking to the future, how do you see the evolving role of AI and telemedicine reshaping doctor engagement and retention strategies in India’s healthcare sector over the next decade?

Artificial intelligence (AI) will always support clinical treatment and can never be replaced. AI gives us responses and indications, but it will never be able to provide us with the treatment. Doctor retention strategies would always work better. Nowadays, doctors have to travel to cities in a month to do camps that require more time, whereas if there is a way the doctor can treat the patient through telemedicine or videoconferencing, it will save time. Besides, the number of patients that the doctor would be able to see would be higher, and it would always be beneficial for the doctor to have data at hand. For instance, we witnessed a COVID outbreak happening across the nation where every doctor was doing telemedicine. However, the doctor only treated the patient based on the symptoms.

 With AI, if the right data sets are given to the doctors and the information is accessible, it will be faster, more accurate and more scientific. Moreover, it will give the doctor a lot of confidence when diagnosing and treating. The trends coming in the country have to be consolidated and collaborated across through technology. So, artificial intelligence is a reproduction of something we have already done. It gives you the relevant answers at the right point in time. However, it is also learning from all the data points happening, and that analysis will help in clinical treatment across the country. Furthermore, there have to be more platforms wherein this information is available, for example, the Oncor Registry or other government initiatives, which have been taken and consolidated and have to be presented in a manner wherein it can be used for the right kind of treatment at the right time.