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While urban healthcare infrastructure competes for competitive advantages, rural India lacks sufficient health infrastructure. This creates an imbalance of supply and demand, leading to a healthcare resource crisis
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The pandemic situation has exposed the hidden critical resourcing problems in the Indian healthcare system. On one hand, as of 2021, the doctor to population ratio stands at 1:1500  in India—against the WHO prescribed standard of 1:1000. On the other hand, the unavailability of medical devices in several parts of the country led to chaos and hospitals’ inability to attend to the increasing demand. Yet, according to a GE Healthcare study, hospitals use any given machine only about 42 percent of the time.

While the lack of affordability of advanced medical devices creates a scarcity of equipment in a few parts of the country, the purchase of expensive and advanced medical equipment by affordable hospitals does not reap full economies of scale. This variation in healthcare resource utilisation is more prominent in public health due to the urban-rural divide. Because 75 percent of the healthcare infrastructure is concentrated in urban areas where only 27 percent of the total Indian population lives. According to a recent KPMG study, 80 percent of the available doctors and nurses are located in urban areas. While urban healthcare infrastructure competes for competitive advantages, rural India lacks sufficient health infrastructure. This creates an imbalance of supply and demand, leading to a healthcare resource crisis.

One way to overcome this problem is to share resources across healthcare players rather than owning them—just like how Zomato, Uber, and OYO rooms enable sharing of resources for their consumers. Imagine a pool of doctors and medical equipment shared across healthcare providers to solve the imbalance of resource utilisation problem.

The rise of telehealth-based business models presents a new sharing economy frontier. Cloud and the Internet of Things (IoT) have facilitated medical device sharing. For example, GE’s @Asset—an asset performance management system—helped Sir Run Run Shaw Hospital in China create a swap centre to mobilise the hospital’s idle assets and significantly increase resource utilisation while enhancing clinical satisfaction. Another example is Cohealo—a Boston-based technology startup—enabling hospitals to share medical equipment across facilities to optimise spending, accelerate cash flow, and improve access to care.

Alongside physical equipment, human resources like physicians are also sharable. For example, India-based Cloudphysician and Springer Healthcare offer centralised command centres comprising physicians and medical equipment to offer 24×7 critical care remotely.

With the growing number of mobile app developers, sharing economy-based care could help providers and consumers engage in constructive information sharing of various health resources. In contrast to traditional, office-based services, patients may access medical services ‘on demand’.  Pager.com, for example, provides a virtual care platform that brings together concierge services to help patients navigate, coordinate, and access whole-person healthcare using mobile phones. Another example is PatientsLikeMe.com, headquartered in Massachusetts which fosters a peer coaching culture that allows patients to share stories of symptoms, treatment, and care outcomes.

Group practices by doctors are now offering services to hospitals that are improving access and quality of care. Department-wise services like emergency room maintenance, providing consultants for critical care services, or anaesthesia service in operation theatres that are considered backend services are being outsourced to group practices to improve 24×7 service availability with greater accountability. Typically, patients select established doctors for treatment, particularly when surgery is involved. Diabetes and Obesity Surgical Solutions, a general and laparoscopic surgical group in Pune, is taking over surgery departments of 50-100 bed hospitals with an assurance of care quality and access to specialised surgeons.  

The sharing economy in healthcare provides new opportunities to physicians, care-providing organisations, and consumers of such care (patients). Physicians could truly experience a professional services career by not associating themselves with any single hospital but acting as an available resource across supply centres. For care-providing firms (hospitals), it improves resource utilisation. For patients, the sharing economy in healthcare offers a natural solution to accessibility problems.

With the rise of health technologies, enabling sharing economy within the healthcare sector could be seamless. However, what is difficult is to create an ecosystem that could make healthcare providers come together willfully to make this happen. Hospitals should see a need to complement their resources for the formation of physician-patient sharing networks. It is time for them to realise competitive advantages through strategic alliances and sharing of resources, rather than restricting their view of other local hospitals as their competitors.

Entrepreneurs and investors should see sharing economy in healthcare as an opportunity for opening new-age healthcare systems to solve healthcare resourcing problems in the country. The government should see an opportunity to disrupt the public health systems under the sharing economy frameworks. Policymakers should support the sharing economy in healthcare with governance and regulations, with no compromise on the quality of care.
 

Vijaya Sunder M is an Assistant Professor (Practice) in the Operations Management Department at the Indian School of Business (ISB) and affiliate faculty with Max Institute of Healthcare Management at ISB.

Sowmya Shashidhara is an Associate Director with Max Institute of Healthcare Management at ISB.

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[This article has been reproduced with permission from ISBInsight, the research publication of the Indian School of Business, India]