This presentation was presented at Regional Scrum Gathering South Asia 2015.

1. Transform Indian Health Care
through Agile Scrum
- By
Krishnamurty VG Pammi
CSP, CSM, PMI-ACP, PMP, ITIL, MCTS

2. Family doctor in ancient India was treated
equivalent to “God”
Service to mankind .. True Examples

3. Family doctor in ancient India was treated equivalent to “God”
Service to mankind was service to God….True Examples

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5. Indian Health Care Sector- Current State of Affairs5

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9. Patients' Challenges
 Doctors try their best to convert short term treatments into Long Term treatment
scenarios
 Doctors do not disclose the disease details in their exact form and shape
 Doctors are not approachable
 Doctors do not provide sufficient time to counsel patients
 High Cost Factor – Sometimes Hospitals create scenarios to charge more
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10. Patients' Challenges continued…
 For the patients with insurance coverage, hospitals try to squeeze entire insured high
slab rate amount for the prescribed disease that patient is covered with
 Doctors prescribe wide list of medicines. They are ignorant of the side-affects
 Paying money does not guarantee good healthcare. The private healthcare system
largely treats patients as revenue generators, without rationality or medical logic
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11. Doctor’s Challenges
 Patient does not trust Doctor prescription and does not show up on the
prescribed follow up dates
 Pharma companies are giving foreign tours and junkets to doctors. It happens
under the pretext of medical study. Unfortunately, some doctors eagerly wait for
the pharma company invitation for foreign tours
 Corporate hospitals only want doctors who can help them earn more money
 Frequent irrational procedures and surgeries, the distorting influence of corporate
and multi-speciality hospitals on ethics of the medical profession, and the growing
grip of pharmaceutical companies on private medical practice.
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12. Doctor’s Challenges Continued…
 Lack of adequate regulations on Fee and quality of medical service in
private sector
 Wealthy patients are admitted directly into intensive care and several
thousand rupees are pocketed by the doctors
 Corruption, kickbacks and the nexus between Hospitals and
pharmaceutical firms
 High work load avoid doctors to counsel patients to the best of their ability
 Half Knowledge Patients - With advent of Internet, patients browse the
internet and comes to doctors to test their skill and ability
 Complete lack of regulation of the private medical sector
 Usage of unsafe injections and medicines
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13. Indian Health Care Sector- Current State of Affairs
 Voices of Conscience from the Medical
Profession: Revealing testimonies by rational
doctors about the reality of private medical
practice in India http://www.sathicehat.org/
 Published by SATHI (Support for Advocacy and
Training to Health Initiatives).
 The sensitive “Trust Layer” between Doctor and
“Patient” communities has been consistently
tested in the past 15 years on the negative side.
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15. Root Causes For This Disconnect…
 The distorting influence of corporate and multi-specialty hospitals on “ethics”
of the medical profession
 The growing grip of pharmaceutical companies on private medical practice
 Government’s Successive health policies and resource allocation exercise has
allowed degeneration of public health infrastructure and actively
encouraging private sector
 Frequent irrational procedures and unnecessary surgeries
 More focus is given on “Following the set plan” over “responding to change”
 More focus is given on “Fixed and non-cooperative attitude” over “Flexible,
accommodating and stakeholder collaboration”
 More Focus is given to compliance with documentary admitting procedures
over talking to patients and counselling them
 Success is measured on motivated Documented facts over healthy patient
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16. 16
Communication

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18. Restore the Trust – For God Sake!....
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19. Proposed model hospital “Trust Re-invented”
a non profit Hospital where “care”, “counselling” and “value” are our motto.
Service Mindset – Management
 Rational and Ethical doctor community
Care Value Counseling
Government Policies
 Regulated pharmaceutical Companies
Distorting influence of corporate and
multi-specialty hospitals
Growing grip of pharmaceutical companies
Monitory Aspects
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20. Hospital “Trust Re-invented” Addresses Cost Factor through
 Money Pooled up from Volunteers /Charitable volunteers/sources
 Fee charges as per regulatory norms
 Transparency on the balance sheet every quarter.
 Pass on the profit gained (after keeping minimum reserve for future sustenance)
to the patients through decreasing fee rates for major diseases
 Fall back support from government in-case of no/less reserve funds

21. Hospital “Trust Re-invented” – 5 Scrum teams
 Development Team - Each team consists of 6 Doctors.
 Scrum Master - “Hospital Customer Service Contact”
 Area Product Owner –Senior Doctor who can mentor / help prioritize
 Chief Product Owner – Resolve dependencies among Area Product Owners.
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22. Scrum Artefacts
Patient Backlog
Release Backlog
Sprint Backlog
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23. Nurture Trust and Accountability through…23

24. Scaling…
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25. Scrum Implementation – Key Insights
 Value Driven Planning using techniques
 Value Stream Mapping
 Patient Value Prioritization
 Inspect & Adapt after every iteration
 Information Radiators
 Patient Recovery Burn Down
 Value Points / Patient Satisfaction Index Delivered
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26. Proposed Benefits
 A thrust for India’s much needed national movement begins for “building
more number of rational and ethical doctors” for better health care
 Restore the trust, communication between Doctor and Patient Community
 Monitory factor removed from Patient and Doctor communities
 Influence of corporate and multi-specialty hospitals nullified
 Influence of Pharmaceutical companies nullified
 India starts experiencing the art of pure “health care”
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27. Thank You
 Krishnamurty VG Pammi
 Facebook: Krishnamurty Pammi
 Linked In: Krishnamurty Pammi
 Twitter: @krishnamtypammi
 +91 9848456687
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