2. Glocal Healthcare System
Glocal Healthcare is different because it delivers healthcare in the most rational,results-based method possible.Glocal relies
on three pillars in devising its healthcare platform.These are:
Evidence Based Medicine: Glocal uses evidence judiciously to
decide the best course of treatment and is not guided merely by
market practices. It delivers healthcare that is medically, not
commercially, necessary. Thus, when patients come to a Glocal
hospital,our employees are focused not on how much they can pay,
but on what they actually need.
Protocolized Healthcare:
Outcome Based Healthcare:
Glocal continuously defines protocols for Diagnosis, Management & Administration.This not only
allows results to be measured but ensures economy and efficiency. 95% of the disease load in the community is comprised of
42 diseases ranging from Ischaemic Heart Disease to Malaria. At Glocal, we
have protocolized these diseases to ensure the best treatments at
the lowest costs.
Every patient who comes to
a Glocal Hospital is assured of outcomes.Our feedback is
primarily for checking how well the patient recovered and
not merely focused on comfort. At Glocal,we believe that
hospitals are meant to ensure health and are not for just
delivering healthcare interventions. Our yardstick of
success is, therefore, not how many surgeries we did, but
how many patients got well.
Glocal Healthcare Model
DEFINING GLOCAL HEALTHCARE
“Rather than India's first Formula 1 car racing team, we
at Express Healthcare are sure that it is the likes of Dr.
Devi Shetty and Dr. Sabahat Azim who are the true
'Force India', who will make a real difference in the days
to come.”
-Viveka Roychowdhury, Express Healthcare; November 2011
(http://www.expresshealthcare.in/201111/editorial01.shtml)
Evidence Based
Medicine
Feedback from
studying outcomes
of patients
Defining
Outcomes
Standardized
Treatment
Protocols
Standardized
Diagnostic
Protocols
Glocal - a Social Enterprise - is driven by the desire to bring real healthcare to everybody by leveraging Knowledge &
Technology for every locality - hence We at Glocal are aware about the asymmetry that exists between patients &
doctors, between doctors & industry, between capital investment & execution and between dreams & implementation.We
believe that it is only by creating winning linkages for everyone,can the problem of health access be sustainably met.By creating
an ecosystem where everyone, including patients, clinicians, industry, real estate owners, investors and government benefit,
Glocal believes it can help create a very large scale intervention in healthcare.Thus making healthcare universally affordable,
accessible and equitable.
To make the dream of universal healthcare possible, Glocal believes in not working for its own success alone.We create
ecosystems where we can leverage the best of every player and ensure that we are facilitators of success for everyone.Thus,
land comes from local real estate investors,capital comes from GlobalTier I Capital Funds,Clinicians already present come first,
supplemented by those whose skills are needed, Technology & Systems come from Glocal itself, skills support from the
National Skills Development Corporation & the world’s best medical schools,Social Health Insurance (RSBY,ESI,CGHS) from
the Government - and all these are put to work for the patient.
Global
Glocal.
CreatingWin-Win Ecosystems around the Patient
What drives Glocal
It is about Change.
The Sustainable Way.
The Glocal Way.
COMMITTED TO QUALITY
CARE AND TREATMENT
3. One of the ways that Glocal has been
able to improve the efficiency of
buildings has been the removal of
clutter and smoothening of traffic
flows - it takes about 6 hours in most
hospitals for an OPD patient to get his
check ups, tests & reports done
whereas Glocal has brought it down
to about 1.5 hours by process
improvements. This means that less
waiting spaces are required.
“Mint reported on 19 August 2010 that the company (Glocal) is spending less than
half the investment of Rs 16-20 lakh per bed that corporate groups have been
projecting as the cost of opening speciality hospitals in urban and semi-urban areas.”
Namrata Nandakumar, LiveMint, January 17, 2012
(http://www.livemint.com/Politics/jChCCzXxdcWmMAavyaWibO/Primary-healthcare-gets-a-
corporate-lift.html)
Glocal Hospitals are among the best
designed hospitals in terms of efficiency
and economy.
World class infrastructure is set up at
costs that the patients can afford while
bringing many-fold improvements in the
way healthcare functions.
INFRASTRUCTURE FOR HEALTHCARE
Paresh Singhal, Chief Planning & Supply Chain,
designs hospitals and constructs them
besides coding logic in the ERP, checking
financial statements, correcting Chartered
Accountants & electrical consultants and
teaching them something about their own
domains.
Infrastructure for Efficiency
Hospital Infrastructure
Each Glocal hospital is a smart hospital, designed in
house with a Zero Based Framework where all
assumptions were questioned. Energy efficiency,
eco-friendliness and durability were areas of focus.
Construction has been protocolized so that each
hospital gets constructed within 8 months, right
from scratch.The result is a breathtaking 28,000 sq ft,
100-bed hospital that is great to look at and heavenly
to work inside. Technologically superior designs
ensure effective containment of infections.
Glocal’s World-Class Infrastructure
4. What differentiates Glocal Hospitals
from others is its in-house Technology
Division. Glocal has pioneered the use of
technology to integrate all aspects of a
hospital. Systems such as tele-radiology,
around which many companies build their
entire business models,are routinely used
at Glocal hospitals.
We have integrated clinical intelligence
with process flows and pioneering
applications for which patents have been
filed.
Glocal Hospitals support their clinicians
with an Artificial Intelligence system that
not only helps in diagnosis, but also helps
in choosing medications, preventing drug
interactions, contra-indications and
adverse drug reactions.
The Secret Sauce
TECHNOLOGY FOR HEALTHCARE
“ The level of technology integration that Glocal has achieved in a small time is
amazing. Even in our hospital we have systems that don't talk to each other.”
Dr. Sharmila Anandasabapathy, MD
Director of GI Endoscopy, Mt Sinai Hospital, NewYork
Soura Bhattacharyya, Chief, MedTech, believes in
technology that can change people’s lives. After
spending years at the cutting edge of tertiary-
quarternary medical devices, Glocal gives him the
opportunity to create technology that can help
millions of people .
Technology
Screenshots of Glocal’s Integrated IT System
Digital Hospital—100% Paperless & WiFi Enabled
Electronic Health Records
Artificial Intelligence based Diagnosis Support & Management (MDMS)
Electronic Pharmacy
Tele-Consultation
Tele-Radiology
Tele-Pathology
Tele-Sonology
Tele-Endoscopy
Each hospital linked over a 2 Mbps link to a data center
Telemedicine systems deployed at Glocal
facilities allow our clinical experts to offer
their expertise to patients in remote
locations/other hospitals from the
comfort of their offices.
5. Glocal Hospitals are about giving the best
treatment known to science at the most
affordable prices.These are probably the
only hospitals in India that measure health
outcomes. We at Glocal believe that
hospitals are meant to deliver health;and
healthcare interventions, like medicines,
investigations and surgeries are only
important if they can restore the health of
a patient. Therefore, we measure our
outcomes and ensure that we are always
focused not on the number of
interventions delivered but on the
number of patients treated and cured.
That is Glocal.
Patient-centric Care
“For the sake of India, we need ventures like Glocal to work to attract more such
entrepreneurs to solve rural India’s problems – not only within the healthcare space,
but also across the education, financial services and affordable housing sectors.”
- S. Prem Kumar,The Smart CEO; 15th June 2011
(http://www.thesmartceo.in/Functions/strategy/a-cure-for-rural-healthcare.html)
Ashutosh Shrivastava, COO, is available
literally 24 hours a day for all team members.
Between 4 AM & 8 AM he would prefer to
sleep if possible. He feels bored if there is less
than overwhelming work.
SERVICES FOR HEALTHCARE
Shri Pranab Mukherjee, Hon’ble
President & then Union Minister of
Finance, inaugurating KKMISAP
Glocal Hospital, Khargram
Services
General Medicine
Pediatrics & Neonatology
24 Hour Laboratory
24 Hour Emergency &
Critical Care (ICU & NCU)
24 Hour Radiology
24 Hour Pharmacy
General Surgery
Orthopedics & Trauma
ENT
USG, Color Doppler,
Echocardiography
ECG & TMT
Endoscopy
Gynecology &
Obstetrics
Ophthalmology
Dental
Dialysis
EEG
Laparascopy
Photos of current hospitals
6. “Providers are waking up to the need of investing in healthcare facilities that are
asset-light, low on investment and manpower requirements, and easy to scale up and
replicate. Corporate players which have so far concentrated mainly on achieving high
occupancies in large multi-specialty hospitals are venturing into formats that involve
lower in-patient hospital stay, higher bed turnover and lower operational costs.
Some of these encouraging initiatives include Narayana Hrudayalaya,Vaatsalya,
Glocal Healthcare,Viva Sehat to name a few.”
Saloni Nangia, Business Standard, Dec 12,
(http://www.businessstandard.com/india/news/improvingpictureindia%5Cs-healthcare/477590/)
At the end of the day,each hospital needs
money.Glocal’s unique strength is that its
hospitals break even in 8 months on
average, compared to the industry
standard of 24 months, while reducing
costs to patients.This seems impossible
but happens due to focus on lean
operations and ability to create a market
quickly.
Sustainability
HEALTHCARE REVENUES
Glocal is able to make the investment in hospitals attractive by strong focus on the following:
Glocal teams start working much before a hospital is commissioned.This communication involves
group meetings,creating resource persons,CMEs, AudioVisual,Print Media etc.Our teams of highly trained experts customize
standardized communication strategies to quickly cover everyone.
Glocal Hospitals are empaneled with a range of insurance schemes, from all private health
insurance to Government Health Insurance Schemes,such as RSBY,CGHS,ESI & SHS.Glocal actively promotes the selling and
adoption of health insurance by people, since we believe that out-of-pocket expenditure causes great stress and strain on a
person’s economic livelihood.
COMMUNICATION :
MARKET DEVELOPMENT :
REVENUE CYCLE MANAGEMENT :
DATA ANALYTICS :
COST REDUCTION :
From Billing Management to Debt Collection, Debt Management, Cash
Management System - all of these have been standardized to ensure painless collections. ERP systems allow each hospital to
keep track of the financial health of the hospital.
Continuous and life cycle measurement along the lines of Pareto, ABC analysis and outcome
management through the ICT platform enables the hospitals to ensure the well being of the patient and the hospital.
Regular Audits, Protocolization & Supply Chain Systems ensure that wastage is removed and
leakages stopped.All orders are filled electronically, thus reducing chances of pilferage. Similarly Telemedicine systems allow
using one highly skilled resource in multiple locations.
Experts in creating markets & achieving sustainability
7. RISK MANAGEMENT
Running a hospital today is a risky
business and complying with all
regulations and laws is not very easy.Non
compliance with loss leads to
unquantified risks. Carrying such risks
make all efforts hostage to unwanted
events.Therefore it is not a very easy task
to run a hospital.
Glocal brings with it a very well
developed and systematic risk
management expertise. We at Glocal
believe in identifying and covering all risks.
When it comes to compliance,Glocal has
a professional team that ensures
complete compliance and hence
minimizes regulatory risks.
Risk Management &
Regulatory Compliance
“ Of all the companies that we have invested in, Glocal has probably the best
Risk Management Systems. In fact, we are asking other investee companies of
ours to follow their model”
- GV Ravishankar, MD, Sequoia Capital.
Identify Risks
Share/ Insure
Mitigate Risk
Alternate Strategies
ENTERPRISE
SECURITY
Risk Management Strategies
Enterprise Security
HAZARD RISKS
FINANCIALRISKS
OPERATIONALRISKS
STRATEGIC RISKS
Criminal
Proceedings
Macroeconomics
Natural
Disasters
Reputational
Risk
Civil
Litigation
Regulatory
Risk
Property
Damage
Competition
Revenue
Risks
Patient
Satisfaction
Price Risks
Data/
IT Security
Capital
Availability
Supply
Chain Risks
Leakage RisksManpower
Availability
Protocolization
Quality Processes
Insurance
Full Regulatory Compliance
Full Disclosure & Information
Complete Documentation
D & O Insurance
24 Hour Legal Team
Internal Audits
ERP
Competition Analysis
Financial & Treasury Management
8. SKILLS FOR HEALTH
There is nothing more important in the
healthcare industry than ensuring a
continuous supply of skilled manpower
and continuously upgrading the skills of
our teams.To this end,Glocal has set up a
huge engine to ensure the best skills for
our people.Glocal has acquired Indigram
Skills & Knowledge Initiatives, a company
focused on Skill Development.Through it,
Glocal has already trained paramedical
staff. Glocal is supported in this initiative
by the National Skills Development
Corporation, set up by the Government
of India to ensure broad-based skill
enhancement. Glocals iSkill Portal
delivers e-learning content seamlessly to
its trainees.
Skill Development
Gautam Chowdhury, CEO, Indigram
S&K IPL, looks forward to training
7000 people by March 2013, and
about 20,000 every year thereafter
to ensure a continuous supply of
skilled manpower.
On December 7,2012,Glocal signed an MoU with Mt.Sinai School of Medicine,NewYork,NY. The 5-year MoU comes into
effect on January 1,2013,and spans multiple facets of collaboration in Gastroenterology,GI Endoscopy,and Internal Medicine.
This will ensure cross fertilization of ideas and training to Glocal by one of the best in the world.This will give Glocal the edge in
terms of training and skilling of its teams.
The Mount Sinai Medical Center encompasses bothThe Mount Sinai Hospital and Mount Sinai School of Medicine.Established
in 1968,Mount Sinai School of Medicine is one of the leading medical schools in the United States.The Medical School is noted
for innovation in education,biomedical research,clinical care delivery,and local and global community service.It has more than
3,400 faculty in 32 departments and 14 research institutes, and ranks among the top 20 medical schools both in National
Institutes of Health (NIH) funding and by U.S.News &World Report.
The Mount Sinai Hospital,founded in 1852,is a 1,171-bed tertiary- and quaternary-care teaching facility and one of the nation's
oldest, largest and most-respected voluntary hospitals. In 2012, U.S. News &World Report rankedThe Mount Sinai Hospital
14th on its elite Honor Roll of the nation's top hospitals based on reputation, safety, and other patient-care factors. Nearly
60,000 people were treated at Mount Sinai as inpatients last year,and approximately 560,000 outpatient visits took place.
Glocal – Mt. Sinai Partnership
The iSkill Program
9. Major (Ret’d) Ashutosh Kumar Shrivastava (MBA, XLRI) : Ashutosh
has been associated with companies like SubhikshaTrading Services Ltd.as the
Project Head - North,and Sahaj e – village Ltd.as Head of Operations & Chief
Marketing Officer. He has participated in the famed Operations Vijay and
Parakram, and has a distinction of serving in Indian Air Force as well as in the
Indian Army. A true professional in nature and with outstanding Marketing,
Contingency Planning & Operations skills, Mr. Shrivastava has always been a
team player and the main driving force behind the company’s marketing
operations.
Paresh Singhal (MBA,XLRI) : Paresh heads Strategy & Projects in Glocal.
An ex major of the Indian army, he is a leader in Supply Chain Management &
Logistics.He has been associated with companies like Subhiksha Retail & Essar
Steel. A highly versatile planner & implementer, his interests span from ERP
implementation to Building Design to Medicine Procurement &Testing. He is
the strategic backbone of the company.
Gautam Chowdhury (Serial Entrepreneur & Process Specialist) :
Gautam heads the Skill Development Division of Glocal and is independently
CEO of Indigram Skill & Knowledge Initiatives Pvt Ltd, which in partnership
with NSDC is spearheading skilling of people across India.He has earlier run his
business in microfilming & archiving of National Manuscripts and later set up &
managed WB Operations for Sahaj eVillage Ltd, where he promoted 4800
Telecenters in rural West Bengal.
Soura Bhattacharyya (MBA, Harvard Business School; B.Tech, IIT
Kharagpur) : Soura heads the MedTech division, developing appropriate
medical devices and also the technology backbone of Glocal. Soura spent 5
years in OmniGuide Inc., a laser microsurgery enterprise from MIT, where he
helped grow the company to $25Mn revenues. Earlier, he worked at ITC
Limited in Operations and Engineering Project Management.
Glocal is led by people whose credibility
and long years of institution building give
them both the ability to conceive big and
also implement them on the ground.
Together, the top team has a massive
experience in Healthcare, Government,
Law, Development, Industry, Finance,
Retail, Supply Chain, Technology, Project
Implementation, Marketing & Sales, along
with a deep understanding of under-
served India . It is a dream team that lives
not in ivory towers but has created
successful institutions before.
The Chairman, M. Damodaran has been
billed as one of the seven people who
created modern India (In Search of
Change Maestros,Dr.Pritam Singh and Dr.
Asha Bhandarker, Sage,2011)
Leadership
MANAGEMENT TEAM
The People behind Glocal
Meleveetil Damodaran (Chairman) :
Dr Syed SabahatAzim,(MD)
GV Ravishankar (Director, Glocal & MD, Sequoia Capital) :
(www.sequoiacap.com).
A thought leader, business executive and former government official. He is presently
Advisor and Chief Representative in India for the ING Group of Netherlands.He served as the Chairman of the Securities and
Exchange Board of India(SEBI),India's financial markets regulator,from February,2005 to February,2008.Prior to this,he served
as Head of IDBI,a development finance institution which he converted to a bank.He was also Chairman of UnitTrust of India,
then India's largest mutual fund from July, 2001 to December, 2004. He served UTI from an impending collapse and turned it
around.He belongs to the IndianAdministrative Service.Damodaran also served as Chief Secretary, Tripura and Joint Secretary
of the Banking Division of the Indian Ministry of Finance for five years.
Sabahat is a medical doctor, IAS officer,Private Sector CEO & an entrepreneur. He is an alumnus
of JNMC, AMU; LBSNAA, Mussourie & IIM,Ahmedabad. He is currently the Chief Executive Officer & Founder of Glocal
Healthcare Systems Pvt Ltd.Till 2006, he was Secretary to Chief Minister ofTripura. He also worked in various capacities like
Joint Secretary, Cabinet & Confidential department; JS, Personnel & Training; Director, IT ; Director, Vigilance; ADM &
Collector, WestTripura District,Subdivisional Magistrate,Sonamura &Ambassa.He was also the founder of Sahaj eVillage Ltd, a
18000 plus telecenter network in PPP with Govt of India and 6 state Governments.
Ravi Shankar is Managing Director with Sequoia Capital India
Prior to joining Sequoia Capital, Ravi Shankar worked at McKinsey & Company in Mumbai, where he
advised senior management of top Indian companies on a variety of issues including business building,channel management and
leadership development.Prior to McKinsey,Ravi Shankar worked atWiproTechnologies in their Embedded and InternetAccess
:
division.AtWipro,Ravi Shankar helped several venture-backed networking start-up clients design and build customer premise
equipment for next generation applications likeVoDSL and Internet over Cable.Ravi Shankar is an MBA (PGDBM) from Indian
Institute of Management,Ahmedabad where he was awarded the President’s Gold Medal. He also holds a BE in Computer
Science and Engineering from REC, Trichy.
is Managing Director of Elevar Equity , a thesis
based investor focused on backing entrepreneurs who deliver essential services to disconnected communities underserved by
global networks. Sandeep founded the India operations of Unitus (a global microfinance accelerator) in 2004 and was Chief
Innovation Officer of Unitus in 2007. Sandeep came to the impact space from Nishith Desai Associates (NDA), one of India’s
leading law firms where he founded the firm’s development sector practice,incubated new practice areas and led its corporate
law practice.He also established the firm’s offices in PaloAlto,California and Bangalore,India.Sandeep also serves as a Director
of Vistaar Finance, Aarusha Homes,Shubham Housing Finance and Madura Microfinance and has served as a Director of Ujjivan.
Sandeep has an integrated Law &Arts Honors Degree from the National Law School,Bangalore.
Sunil has worked in the agribusiness and development
sector in India for more than 18 years. He is a B.Tech in Agriculture Engineering and a Management Post Graduate from IIM
Ahmedabad. He conceptualised and co-founded Indian Agribusiness Systems Pvt Ltd. which runs Agriwatch
Subsequently he has been involved in promoting three social enterprises
and spanning agriculture development,vocational skill development and rural healthcare.
AnAshoka Fellow,Sunil helps Glocal in creating local ecosystems that can work in synergy.
As President and COO,Mt.
Sinai Medical Center, NewYork , Mr. Keathley oversees all executive and operational functions of
the hospital,including ambulatory care,emergency services,surgical,nursing,and support services. As ExecutiveVice President
for Business Development, Mr. Keathley guides Mount Sinai’s efforts to build and strengthen relationships with community-
based physicians and other institutional providers of care.With over 30 years of experience in healthcare,Wayne is a thought
leader in Hospital Operations. He is helping Glocal see the future of Operations in an increasingly cost conscious world.
Sandeep Farias (Director, Glocal & MD, Elevar Equity) (www.elevarequity.com)
Sunil Khairnar (Director, Glocal Advisory Board & MD,Agriwatch) :
(www.agriwatch.com). (www.isapindia.org,
www.indigram.net www.ishpindia.org)
Wayne Keathley (Director,GlocalAdvisory Board & President & COO of Mt.Sinai Medical Center) :
(http://www.mountsinai.org)
10. WHY GLOCAL HOSPITALS
Why Glocal Hospitals
SIDBI, Glocal Healthcare to set up hospitals
“We plan to partner with Glocal in taking this model across all states in the country,” said Mr.
Sushil Muhnot, Chairman and Managing Director, SIDBI.“The partnership aims to build 50 such
hospitals within the next 18-months.”
The Hindu Business Line, 11th June 2012
(http://www.thehindubusinessline.com/industry-and-economy/economy/article3531830.ece)
Healthcare investing is the sunrise sector
of India’s growth story. With structural
changes coming, this space is among the
most attractive avenues for investment.
As schemes like RSBY diffuse and bring
cashless coverage to an ever-growing
share of the population, a functional
network of affordable healthcare
providers will be ideally positioned to
fully utilize this growth opportunity.
Tertiary & quarternary hospitals will be
stressed for margins as more caregivers
enter the market. However, for
technologically advanced affordable
hospitals, costs reduce & operational
efficiencies increase as a larger patient
base is served. With a network of
hospitals, Glocal brings a large pool of
clinicians and resources that can be
shared to provide superior returns to
everyone, including patients, employees,
the local economy,and our co-investors.Healthcare is a universal need
With rising prosperity, people
now demand better services
Healthcare as an industry
faces no slumps
Section 35AD IT Act provides for
tax exemption for income up to
1.5 times of capex
With increasing penetration of
cashless services, demand will
phenomenally increase
Lifestyle diseases have created the
need for regular health services
Fund flow like NREGS has directly
elevated demand even from BoP
With increasing stress, need for
healthcare actually increases
Section 80 IB IT Act provides for a
5-year tax exemption
Increasing regulations make it difficult
for individual players
to provide services
Perpetual Demand
Rising Incomes
Recession Free
Income Tax Benefits
Structural Changes
Sequoia Capital: Sequoia Capital is an American
venture capital firm in Menlo Park, California, United
States. Sequoia's diverse portfolio includes companies
in energy, financial services, health care, mobile and
technology sectors.The firm is known for the success
of companies it has funded,such as Google,YouTube, Apple,PayPal,Cisco Systems,Oracle,Yahoo!,NVIDIA,LinkedIn, Airbnb,
Aruba Networks,Instagram,ElectronicArts,Navigenics,Cotendo,Atari,Ameritox,Kayak,Meebo,Admob,Zappos,Green Dot.
Its broad range of highly successful investments proves its ability to create wealth.19% of the NASDAQ’s value is made up of
firms that Sequoia has invested in.
Elevar Equity: Elevar Equity is a thesis based investor focused on generating
outstanding investment returns by delivering essential services to disconnected
communities underserved by global networks. Since 2006, Elevar has managed
two private equity funds totaling $94 million and has backed 16 companies at
various stages of their growth.Elevar’s portfolio companies have served close to
11 million households and have mobilized over $4 billion in equity and debt capital
for targeted communities. Elevar is among the select few in the impact investing
market who have been highly successful.
Investors
Why are some of the world’s best funds so strongly committed to Glocal Healthcare?
Benchmarking Glocal against the Industry
Industry Average Glocal
Capex/bed,
Rs. Lakhs
0
10
20
30
Build time/
hosp.,
months
Breakeven
time/hosp.,
months
Investment
Payback,
years
Each hospital is put up by Glocal @ Rs. 8
Lakhs/Bed when the market cost of
infrastructure alone is Rs.15 - 20 Lakhs/bed for a
similar set up.
Shortest time to market - typically each hospital
gets commissioned within 8 months from land
possession. This is the shortest time by any
standard. This means that investments start
earning earlier.
Each hospital starts earning profits within a year,
typically from 6 months.In general,IRR of 20% at
the base are easily achieved from year 2 onwards
(Profit Returns)
The real estate is always a hard asset that keeps
appreciating @ 20% annually.
