The

MANAGEREAL

APRIL’2019 Volume-1 : Issue-I

SPECIAL ARTICLE:

India's Energy Diplomacy in Liquefied Natural Gas

Need for strong Diplomatic relationship to secure

LNG supply (Page:09)

Department of Management Studies Rajiv Gandhi Institute of Petroleum Technology

The discipline

to overcome

the threats of business

disruption

Rohit Dudi

Page: 04

Entrepreneurs

hip: A Roller Coaster Ride

Sanjeev Kumar

Page : 07

Human resource and

technology in

today’s fast changing

times

Chinmay Sahu

Page: 13

Building A

Smart

Healthcare Ecosystem

Sneha Maheshwari

Page: 15

2

Dear Readers,

It gives us immense pleasure to present before you

the very first edition of our distinguished the

Managereal. We have put together a wide range of

interesting articles that would help us to fulfill the

primary agenda of the Think Tank Team (working

under Department of Management Studies, Rajiv

Gandhi Institute of Petroleum Technology’s

umbrella). To offer a conjoint platform to the

Industry people and academicians to express and to

contribute a holistic understanding of the various

diverse topics from both the perspectives.

We have, in this issue topics covering the Energy

diplomacy concerning LNG supply, an apt

combination of Human Resource and Technology

that the world needs in today’s scenario, some valid

insights on Business Disruption and a proposed way

out through discipline. And to compliment these

subjects, this issue will be dealing with

Entrepreneurship a way to live life with a difference

and the need of Smart Healthcare sector in present

society as a whole.

Editor’s Desk

Associate Editor(s)

Dr. Kavita Srivastava

Associate Professor (Marketing) DoMS, RGIPT-

Jais campus

M. Chandra Shekar

ICSSR Teacher Research Fellow, Asst.

Professor, Finance & Accounting, IPE, Hyderabad.

Vijay Tiwari

Senior Manager-HR, HAL, Korba

Shafqat Mobarak

YP-Energy, Public Policy

NITI Aayog, New Delhi

Student Editor(s)

Sayandeep Chandra Subhankar Mazumdar Akash Gupta

Urja Suman Natasha Rastogi Soumya Mishra

3

The Ministry of Petroleum & Natural Gas (MoP&NG), Government of India set up RGIPT at Jais, dist.

Amethi, Uttar Pradesh through an Act of Parliament (“Rajiv Gandhi Institute of Petroleum Technology

act 2007"). RGIPT has been accorded the eminence of being an “Institute of National Importance” along

the lines of the Indian Institutes of Technology (IITs). The institute is empowered to award degrees in its

own right. RGIPT is co-promoted as an energy domain specific institute by six leading oil public sector

units (ONGC, IOCL, OIL, GAIL, BPCL and HPCL) in association with the Oil Industry Development

Board (OIDB).

The Institute has been associated with leading International Universities/ Institutions specializing in the

realm of Petroleum and Energy sector with an extensive area of focus in the domain of Marketing, Finance,

Operations and Human Resources. The prime objective of the institute is to provide world-class education,

training and research to roll out efficient human resources to meet the growing requirements of the

Petroleum & Energy and allied sectors.

RGIPT, Sivasagar offers diploma courses to address the skill gap in the industry. RGIPT, Bangalore centre

is being developed to take up advanced research in the energy domain. Currently RGIPT, Jais offers

B.Tech and M.Tech in Petroleum and Chemical Engineering.RGIPT offers Master of Business

Administration (MBA) and PhD in management. Besides PhD programs in science and engineering are

successfully running from RGIPT, Jais campus.

About us

Rajiv Gandhi Institute of Petroleum Technology

4

“Strategy is not the consequence of planning, but the opposite: its starting point.” –Henry Mintzberg

It is possible to start a business from the

grassroots and catapult it to the height of

achievement by crafting proper strategies,

detecting the discontinuities that may pose a real

challenge for the business in future.

In business, when we speak of disruption, it

actually means “Disruptive Innovation”. This

term was coined for the first time by Clayton

Christensen of Harvard Business School in his

magnum opus “The Innovator’s Dilemma” in

1997.

Disruption is not as scary as it sounds. It actually

means advancement in the age of globalization

and industrialization. Disruption aka “disruptive

innovation” depicts the creation of new markets,

which earlier no one had thought of. It means

understanding not only the present demands of

the people but also having knowledge and

insights about their future needs and

requirements.

The theory of Clayton Christensen also throws

light on the way small enterprises or firms with

minimal resources entered the market, created

new customers, attracted old customers, and

finally disrupted the established market system.

Some well-known Disruptions of the existing

business that we use in our day-to-day life.

What Disruption poses for the business

owners of today?

Disruption has become jargon in the

entrepreneurial world. With the rapid emergence

of disruptive business models, the existing

scenario of business functioning and engaging

the customers is undergoing a transformation.

However, the concept, unlike innovative

businesses is not new. With the advancement of

technology, and rapid evolution in knowledge;

wants and demands of people are changing. This

is driving the business models to change in to

keep up with the pace of change. In this

competition, the firms that could not match up

the speed of evolution failed like “Lonely Planet”

but at the same time, start-ups like “Trip

Advisors” snatched all the followers.

In the 21st century what we think of little

disruption, are actually catastrophic changes that

are revolutionizing the way firms engage with

their customers, creates seamless and memorable

experiences for them by understanding their

wants.

The discipline to overcome the threats of

business disruption

Rohit Dudi | PGP 2017-2019 | IIM LUCKNOW | pgp33286@iiml.ac.in

5

For example- the 3600 video launch by YouTube

gives the experience of virtual reality that was

once only a dream. The official VR channel of

YouTube has many attractive offers for the

viewers including music performances, news

events, sports, racing and films. This is not only

a disruption but a remarkable shift in business

plans to engage the customers.

Abilities to overcome the disruptions in

business

For any business owner, it is perilous to

underestimate the power and magnitude of

disruptive models of business. No business wants

to suffer the phase suffered by Kodak, once a

market leader and now an almost extinct brand.

So let us look at some of strategies and changes

to cope up with disruption in the business

competition.

✓ To ensure a business is ready for

digitization – it is vital to understand and

accept that the current period is of digital

disruption. So, for companies it better to stay

focused, innovate and collaborate instead of

fearing or rejecting the new change. This will

boost the effectiveness of the business;

provide an exciting path for customers, offer

them better, real-time communication, and

finally opening

up some new market segments.

✓ To ensure collaboration in different

business teams– in the age of disruptive

innovation, a partnership will act as the key

to success. The team leaders of the business

need to encourage communication and

collaboration of inter-departments like heads

of marketing, and information technology

need to work hand in hand to embrace the

changes. The firm should also pair up with

the right consultants and technology provider

to embark upon a seamless journey of

disruption.

✓ Taking advantage of the internet speed

and rejuvenating the subscription model –

gone are the days of DVDs and cassettes,

even saving music in external hard disks or

pen-drives. As the massive internet speed and

mobile tech-advancement helped in

streaming of high-quality videos and music

contents for a monthly payment of fees.

Ganna.com, Wynk Music etc. are two of the

many that supply millions of song listeners.

Nowadays daily use materials for vital

medicines can be obtained by an online

subscription and shipped directly to

customers. Examples of Grofers, Lenskart,

and even home services like UrbanClap are

new disruptive models working in different

cities. Thus, existing business firms need to

extend their arms in the new markets to

prevent from being endangered.

✓ To cope up with changing the definition of

consumer convenience – as the definition of

comfort is changing for customers with the

changing era, businesses are fighting hard to

come up with seamless services to satisfy

them. For instance, the long waiting hours at

airports or railway stations have been

reduced with applications (like IRCTC app,

Goibibo, Paytm) in our smartphones. We can

now book tickets with preferred seats

anytime, anywhere. Similarly, for hotel or

movie show bookings, etc. Companies need

to come up with even better solutions to give

utmost convenience to customers.

✓ Introducing gamification – this technique

involves the use of different elements of a

gaming strategy by individual companies on

their brand interfaces/platforms. This

includes points, rewards, stars to engage and

attract customers to buy more products or

services from them. For instance, Big Bazaar

has its own card where points get added on

each purchase and customers can redeem it

on their next purchase. Starbucks has its own

reward system where customers on specific

products can earn points for the future

purchase. All these are to increase the number

of visitors to the stores.

6

✓ Self-disruption – till now, the best business

strategy to live up to the expectation of

consumers is self-disruption. All the big

players in the market like Apple, Amazon,

etc. follow it. The steps are to find new ways

to adapt, evolve, and then recapture the

market to stay relevant. Companies should

follow this model where they should

understand the unsaid need of customers and

come up with a solution.

✓ Thus, for any business or company, whether

small medium or large, new or existing,

require focusing on the customers and their

experiences to thrive in the competitive

market. This includes spending more

resources and capital on research and

development to think and solve problems

anticipated for future; or else the business

themselves will become the victim of

disruption.

Reference(s):

• Harvard Business Review. (2018). What

Is Disruptive Innovation?. Available at:

https://hbr.org/2015/12/what-is-

disruptive-innovation [Accessed 3 Nov.

2018].

• tonyrobbins.com. (2018). What

disruption really means for your business.

Available at:

https://www.tonyrobbins.com/career-

business/what-disruption-really-means/

• Money 101. (2018). What is Business

Disruption and how does it work?

Available at:

https://money101.co.za/business-

disruption-work/

• En.wikipedia.org. (2018). Disruptive

innovation. [online] Available at:

https://en.wikipedia.org/wiki/Disruptive

_innovation

• Shortpress.com.au. (2018). What

disruption really means and how to

handle it. Available at:

http://www.shortpress.com.au/what-

disruption-really-means-and-how-to-

handle-it

• Startupgrind.com. (2018). What Is

Disruption, Really? 8 Examples and

What to Learn From Them. Available at:

https://www.startupgrind.com/blog/what

-is-disruption-really-8-examples-and-

what-to-learn-from-them/ [Accessed 3

Nov. 2018].

• Keys, L. (2018). 5 Ways Disruption Has

Changed the World -- And How

Businesses Can Adapt to the Future.

Entrepreneur. Available at:

https://www.entrepreneur.com/article/29

6345

• Meltzer, D. (2018). Disruption vs.

Innovation: Defining Success.

Entrepreneur. Available at:

https://www.entrepreneur.com/article/31

1246

• Harvard Business Review. (2018). How

Likely Is Your Industry to Be Disrupted?

This 2×2 Matrix Will Tell You. Available

at: https://hbr.org/2018/01/how-likely-is-

your-industry-to-be-disrupted-this-2x2-

matrix-will-tell-you

7

A Roller Coaster Ride

Entrepreneurship is a buzzing word that excites

most of us today, and Mr MBA is no exception. He

too did not know initially that it’s a roller coaster

ride, which thrilled him in the beginning and scared

him en-route. But he lives in highlight and believes

that ‘the end will be the beginning of a beautiful

life filled with choices.’ Everyone he knows,

beyond the finish line, shares the same thought –

it’s incredible & worth riding.

Opportunity v/s Challenges

Most people ask this question, and most are not

sure about venturing into. Although it seems to be

a journey embarked on by chance, hearts of hearts

he knows it came to him because he had asked for

it. When the opportunity knocked at his door, his

financial situation wasn’t conducive, and the mere

thought of betting his life-long savings caused him

sleepless nights. Even before embarking on the

journey, he thought of quitting a lot of times. He

knew, as he had read many times, failure is the

stepping stone to success; but the unanticipated

roadblocks this time were his own family

members/ close friends & well-wishers. And to

add to their rationale, he had already closed his first

e-retail venture before its anniversary. As he often

says - What it takes is ‘to get up again’ after every

fall. Today, he believes entrepreneurship is for

anyone who is ready to replace ‘I wish’ with ‘I

will.’

Few things he did right:

1. Decision (Right or wrong?)

He knew, even after all the R&D, the decision to

venture into the domain of your choice is just a

decision - neither right nor wrong. After firing his

boss within a year of starting this venture, he

proved his decision right; but again, firing his boss

was just a decision. A dream came true and many

more to come with time.

2. Commitment (does 87.3% commitment

works?)

Soon he realized that the journey isn’t an easy

one. There is no balanced life for an entrepreneur.

Our Mr MBA chose to live an imbalanced life for

4 to 5 years (only work and no life) because he

knows the end result of this journey is a fantastic

imbalance for rest of the life. He is not alone in

paying the price, his family is equally involved.

Nevertheless, he is 100% committed towards his

dream.

3. Got a Coach (I know it all!)

Today, it isn’t necessary to re-invent the wheel to

be successful. It’s a no brainer for him to work

together with more than one brain in sync. There is

nothing better than leveraging someone else’s real-

life learnings. He feels lucky to have a coach like

Mr Vibes, a game changer throughout his career, a

certified trainer and above all a serial entrepreneur.

Few things he avoided:

1. Will everybody buys into my philosophy

(Yes/No?)

He believes that there is no exception to the 80:20

rule and knows that if he wants to achieve success,

he must be strong enough to survive through 80%.

Entrepreneurship: A Roller Coaster Ride

Sanjeev Kumar | Apna Haat Retail Private Limited

(Co-Founder and COO) | smile.sanjeev@gmail.com

8

There is no substitute for hard work, no elevator to

success and hence we must climb the staircase. He

believes whatever he does, it is the most important

attribute to his success. The only person who can

make him successful is , himself.

2. I am the king (or Kingmaker?)

One thing he learned though hard-way is the value

of time over money. He knows if he wants to enjoy

the life to the fullest, he must have freedom (24x7).

The successful 3% decentralize control - the secret

of living a life of choices. It’s always better to

leverage on other’s resources than trading own. A

goal is more critical than a role. And He became

the kingmaker by choice.

3. I can’t do it (How can I do it?)

Challenges are an integral part of our life, and an

entrepreneurial life is no exception. Many think

that challenges come to break them, but he believes

that problems come as an opportunity to introspect

& rediscover the true self. When someone says, I

can’t do it; the person has already quit on himself.

The right question to ask is – How can I do it?

Toughest time of his journey:

Take off was great, though as part-time with a job,

soon came the point where he had to take the

toughest decisions of his life. He had to choose

between the employment and entrepreneurship; the

security (oxymoron) or the freedom. It was a battle

within, a risk, where his decision could be right or

wrong. It was a tough choice for him as he hails

from the middle class where the only legacy we get

is to study for decades to secure a means of survival

- the job. Nobody was supporting his decision,

neither family nor best friends; it scared him even

more. After swaying between two minds, he finally

chose to take a leap of faith and decided to let go

of security.

Advice to the Aspirants:

Before asking what to do and how ask actively

WHY to do it? Do the needful, think through and

decide. But once decided, keep doing till it

happens. There are only two ways of not being

successful in any business - one is not to start; the

other is to quit. Remember, there are three kinds of

people in this world; 1. People who ‘Make things

happen’ 2. People who ‘Watch things happen’ and

3. People, who wonder ‘What happened’?

Who Are You A Warrior or a Wimp?

I Create! I Take Risks! I Live My Passion! I Am

An Entrepreneur!

9

India is the second largest country by population

with 1.21 billion people (Census, 2011) and third

largest economy in the world. Indian economy is

proliferating with an average growth rate of

approximately 7% in the last two decades.

Energy is the critical input for economic

activities, and to achieve sustainable growth we

need a greater share of green/clean energy in the

energy mix. India’s energy mix (shown in

Figure-1) is dominated by polluting coal

(56.26%) & Oil (29.47%) whereas; natural gas

contributes only 6.12%. Natural gas is cleanest

fossil fuel and is being considered as a transition

fuel between coal/oil & renewable. Hence,

Government of India has set the target for making

India a Gas Based Economy by increasing the

share of natural gas in India’s energy mix from

the current 6.12% to 15% by 2025.

Figure-1: India's Energy Mix (Source: BP

Statistics, June 2018)

As per "PNGRB's Vision 2030" document,

demand supply gap (shown in Figure-2) for the

natural gas market in India necessitate import of

natural gas from the international market.

"Energy diplomacy of India is playing a

significant role to ensure sustainable, affordable

and continuous import of natural gas from

exporting countries". There are two options to

import natural gas, firstly, in the form of LNG

through LNG import terminals and secondly,

through trans-national natural gas pipelines.

Considering current geopolitical challenges in

trans-national pipeline projects, the only feasible

option available is importing through LNG

terminals in India.

Figure-2: India's Demand-Supply gap of

Natural Gas (Source: PNGRB, 2015)

Trend in Natural Gas supply & consumption

in India:

The production of domestic natural gas in India

has decreased from 113.42 MMSCMD during

2009-010 to 69.42 MMSCMD during 2016-17

(PPAC, 2017) due to a drastic decrease in

production level of KG basin. Total supply and

consumption are being supported by imported

India's Energy Diplomacy in Liquefied Natural

Gas (LNG) Sambhaji Kadam | PhD scholar | Rajiv Gandhi Institute of Petroleum Technology.

Kavita Srivastava | Associate Professor (Marketing) | Rajiv Gandhi Institute of Petroleum

Technology.

10

LNG. Authors have tabulated the historical trend

of consumption/supply of natural gas in the

country as shown in Figure-3.

Figure-3: Trend in consumption/supply of

natural gas (Source: PPAC)

The trend in consumption and supply of natural

gas in India has shown that LNG is playing a

significant role in total consumption and meeting

demand-supply gap. Percentage contribution of

LNG in India's total natural gas consumption is

shown in Figure-4.

The increasing role of LNG in India's natural gas

consumption has shown that India's dependence

on LNG is crucial. Hence, to ensure the

sustainable, affordable and long-term

relationships with LNG exporting countries

India's energy diplomacy need to play a

significant role.

Energy Diplomacy in re-negotiating long term

LNG contracts:

The import of LNG in India had started in the

year 2004 when the first Phase of Petronet LNG

Ltd.’s (PLL) Dahej terminal commenced its

operation with 5 MMTPA capacity. PLL is

promoted by four Indian PSUs, GAIL, ONGC,

IOCL & BPCL. It is the first company started

LNG business in India by signing long term

Master Sales & Purchase Agreement (MSPA)

with RasGas, Qatar. India's Major long-term

contracts (20 Years) for importing LNG are as

follows:

1. PLL with RasGas, Qatar for 7.5

MMTPA.

2. PLL with Exxon Mobil's Gorgon Venture

in Australia for 1.44 MMTPA.

3. GAIL with Gazprom, Russia for 2.5

MMTPA.

Figure-4: Role of LNG in India's Gas

Consumption (Source: PPAC)

Recently, Energy Diplomacy of India through

representation from the Ministry of Petroleum

and Natural Gas to Qatar, Australia and Russia

have helped to re-negotiate the commercial terms

and pricing formula of the above long-term

contracts. This energy diplomacy has helped

India to save billions of dollars and played a

crucial role in securing sustainable energy

relation with LNG exporting countries. The

details of contracts & savings under re-

negotiation are as follows,

A. PLL with RasGas, Qatar for 7.5

MMTPA:

Long term LNG price formula was, LNG

Price=12.66 %* JCCt

Where,

JCC: Price of Japan's Japan Customs-cleared

Crude. JCCt: Last 60 months’ average price of

JCC.

11

Under diplomatic success, re-negotiation of

above formula has been done in 2016 as follows,

Revised LNG Price=12.66 %* Brent+0.6

Whereas,

Brent is 3 months’ average Price of Brent Crude.

Due to this revised formula & re-negotiated

commercial terms India would save billions of

dollars as follow,

▪ Saving of around Rs. 4000 Corers

per year for remaining contracts

period.

▪ Payable Take or Pay (ToP)

obligation of Rs 12000 Corers

were waived off

Extracts of Interview of CEO, PLL with Business

Line on 5th January 2016 is as follows,

“From January 1, 2016 we are getting daily

advantage of $5 per mmBtu,” from January 1,

2014, we started hitting the floor price. The

advantage of low gas price was not available to

us and we were always paying more than what

was the prevailing rate.

For example, if crude was at $80 per barrel, the

floor was at $110 per barrel. The $12.5 per

mmBtu price that we were paying till December

31, 2015, was based on the crude price at $96 per

barrel, while it had fallen to $40 per barrel. But,

now we have removed such things and linked it

as close as possible to the market pricing. Yes,

there is always a premium in the long- term

contract, while spot can keep fluctuating. Due to

commercial reasons I cannot share the details of

the formula with you"

B. PLL with Exxon Mobil's Gorgon

Venture in Australia for 1.44

MMTPA:

Original formula as per 2009 contract is LNG

Price=14.5 %* JCC (FOB basis) Revised

formula is LNG Price=13.9 %* JCC (DES basis)

PLL has an agreement for purchase of 1.44

MMTPA of LNG from Mobil Australia

Resources (part of ExxonMobil) for 20 years

from Gorgon project in 2009. PLL began

receiving supplies in January 2017 at a rate much

higher than the spot, prompting the company to

re-negotiate the deal. In 2017, price formula and

commercial terms has been revised. As per

revised commercial terms, PLL will take

additional 1 MMTPA LNG at 12.5 % of the Brent

crude price whereas the original supplies will

come at a price 13.9 % of Brent, lower from

14.5 % earlier, and the transportation cost would

shift to Exxon from PLL under Delivered Ex-

Ship (DES) instead of Free on Board (FOB) trade

terms.

Due to this revised formula & re-negotiated

commercial terms India would save around Rs.

10,000 Corers for contract period.

C. GAIL with Gazprom, Russia for 2.5

MMTPA:

India received its first LNG cargo from Gazprom

on June 4, 2018 under a long-term deal of

2.5 MMTPA with Gazprom at PLL's Dahej

terminal in Gujarat.

GAIL will buy 2.5mn mt/yr of LNG under a 20-

year contract. The contracted volume has been

lowered from 2.5mn mt to 0.5mn mt in the first

year 2018-19, 0.75mn mt in 2019-20, 1.5mn mt

in the third year 2020-21. GAIL will start

importing the full 2.5mn/yr by the fourth year

and make up for the initial volume reduction over

the remaining length of the contract.

Original Formula, LNG Price=JCC (JCC were 9

months average)

Revised Formula, LNG Price=JCC (JCC is 3

months average)

In return of re-negotiated formula, the full term

of the contracts has been extended by two years.

The revised price and commercial terms would

save around Rs. 9500 Cr (at crude oil at $ 70/b)

over the contract period (2018-2040).

12

D. LNG Infrastructure Development in

Neighboring Countries:

India's expertise in setting up LNG import

terminals is going to help neighboring countries

to develop LNG infrastructure. It may boost

India’s role in creating a new energy security

architecture for its neighbors. PLL is planning to

set up LNG terminals in Myanmar, Bangladesh,

Sri Lanka and Mauritius. Also, PLL is exploring

a similar opportunity in the Maldives. Prime

Minister Jagnauth PM of Mauritius visited India

in January 2017, and had energy-related talk with

Hon'ble Minister, MoPNG for India to set up

LNG terminal in Mauritius. PLL has also begun

preliminary studies to construct 2-3 (MMTPA)

floating LNG unit in collaboration with Sojitz,

Mitsubishi and a Sri Lankan state-owned

company in the South- western part of Colombo,

Sri Lanka with an approximate investment of

$250-$300 million.

E. Conclusion:

It would be crucial for India to maintain its

energy diplomacy to secure LNG supply from

international market and take-up our expertise to

build proposed LNG terminals in Myanmar,

Bangladesh, Sri Lanka and Mauritius.

Reference(s):

• https://www.thehindubusinessline.com/c

ompanies/renegotiated-qatar-gas-deal-

giving-daily- gain-of-

5mmbtu/article8069384.ece

• https://www.naturalgasworld.com/india-

to-save-over-1bn-on-gazprom-lng-deal-

62889

• https://energy.economictimes.indiatimes.

com/news/oil-and-gas/renegotiation-of-

gorgon-lng- contract-could-pave-the-

way-for-other-deals-icra/60913940

• https://www.firstpost.com/business/india

-plans-to-set-up-lng-import-terminal-in-

myanmar- to-expand-energy-diplomacy-

in-neighbourhood-says-dharmendra-

pradhan-4885701.html

• http://web.isanet.org/Web/Conferences/

AP%20Hong%20Kong%202016/Archiv

e/d724cccf- d926-4880-a1f8-

1b4b2825c563.pdf

• https://www.thenational.ae/business/indi

a-aims-to-boost-energy-ties-1.71178

• https://energy.economictimes.indiatimes.

com/news/oil-and-gas/petronet-to-

invest-rs-400- crore-next-fiscal-kochi-

utilization-seen-dipping-in-q4/63537496

• https://www.livemint.com/Industry/GzB

JIonvBR5UYE2vNT9H5I/LNG-

diplomacy-India- plans-to-build-

terminals-in-4-nations.html

13

The present era has been a turnaround in every

aspect involved in human life vis-a-vis the fast-

changing technology. The breakthroughs in

technology aspects have hit the human being all

around the planet, in a big way. It merely has

opened up a whole new arena enabling each one

to connect to every other person on the earth in

more than a single way and at the same time has

made each individual susceptible to a multitude

of externalities. Moreover, the times where

knowledge and wisdom were limited to a few

intelligent is over and long gone. Presently, with

those small devices in the palm, every little

thing of knowledge can be accessed from any

corner of the world. What industry needs to tap

today, is no more the person with vast

knowledge but is the right individual with a

positive intent, who could decipher the

knowledge in the best, intelligent and most

profitable manner. This aspect of ready access

has given rise to a threat of dilution in firewalls

and restrictions as well, giving rise to a sense of

breach in trust between the employees and

employers.

The very aspect of ethics has become the most

sought-after attribute in an individual. If we track

the transition, it was at the beginning of a skill-

based community framework, which got

transformed to the industrial framework,

marking the beginning of the industrial

revolution. Gradually, the man-force that

involved human muscle-power besides the power

of tamed animals at the start of industrial

revolution, got transformed into human

resources. As the application of human brain

apart from the muscle power started to become

more relevant in tackling the day to day

activities, and finally the modern day has arrived

where technology that is the outcome of human

mind is the very base for each aspect of day to

day life. (Para need rephrasing). Taking of India,

the market that India involves is very different

from the rest of the world, due to many reasons,

the primary of them are:

1. The market size in India is of vast size, but

with a different attribute that is purchasing power

as well as the requirements of them is varied to

the utmost extent. Moreover, majority in India is

still dependant on agriculture for livelihood, also

a vast population still delves with poverty and

inadequacy.

2. India is endowed with the gift called

demographic dividend, but the very stage to reap

the benefits is not yet fully ready, the youths are

not however adequately trained for the modern-

day technological parlance.

3. Apart from the above two, the biggest hurdle

being faced is the pace with which the country

has advanced in the service sector. It has been

phenomenal, and has outrun the manufacturing

sector by a significant margin (the present share

of each sector in the country’s GVA is: Service

sector contributes nearly 54%, Industry 29% and

Agriculture & allied activities contribute around

17%; the growth rate for the three areas for the

current year is 8.3, 4.4 and 2.1 respectively)

(source?); thereby indulging the country in a

skewed sort of growth.

Human resource and technology in today’s fast-

changing times Chinmay Sahu | Manager (Operations) | National Thermal Power Corporation

chinmay.always4u@gmail.com

14

There are many more reasons that aid in taking

on the Indian market with a different view than

the rest of the world and accordingly act to

mitigate the various aspects of the market,

including Human resource and the fast-changing

technology-generated implications.

Further, the energy sector in the country is

feeling the stress from every possible angle,

thereby opening up the opportunities in multiple

dimensions, also presenting threats in the equal

number of aspects. In this changing time, there

happens to be a small breathing zone and find

profit for the industries, related to energy. The

ever-expanding need for energy and ever-

tightening environment protection norms, both

are acting antagonistically are squeezing that

little zone rapidly. Adding difficulties to the

situation is the fast-changing technology, the

rapid advancements in technology is making the

instruments obsolete faster than anticipated.

Apart from that, a threat is also being projected

from the renewables in case of the power sector

and biofuels in case of fuel sector. The more the

penetration is happening for renewables

especially solar, the bigger the market it is

capturing and hence the lower the cost of

generation is happening owing to the concept of

the mass scale of production applied to the solar

panel manufacturing.

Further the concepts of micro-grid, net metering

etc. are creating turbulence in the power market.

The environmental compliances and even the

lower costs for the renewable energy are making

them more sought after than some traditional

thermal based power generations. This results in

many of the power plants laying stranded without

any schedule. Moreover, the precarious situation

of the distribution sector is forcing them to look

for cheaper options. The whole cycle has resulted

in making India a power surplus country

although there many homes where even a single

bulb does not glow for even a single minute. (not

sure about the hypothesis).

Energy is at the core of every little modern day

development, the turmoil in the energy sector is

getting pinched into all the allied sectors. Be it

the agricultural sector where the solar powered

pump set is bringing revolutions in the life of

farmers, also to the enhancement in crop

production through increased crop intensity, be it

the usage of bad lands for creating mega solar

parks, be it the automobile sector where there has

been a revelation through R&D for the efficient

electric vehicles and so many stories.

Talking of technology, the up gradation is

happening like flipping the pages of a book. For

example, the size of the storage devices has been

a real inspiration, now gigabytes of data can be

stored in a minute flash drive. For mobile phones,

every single day they are getting enhanced with

some or other attribute. Even data is on-the-go

with the free wi-fi systems available in most of

the places or even tiny OTG supported storage

devices enable a person to access an

unfathomable amount of data. The driverless cars

are no more a myth and so are many more.

Thus, the present era where human resource and

changing technology have come up posing a big

challenge for every industry, they need to be

appropriately mitigated to make the industry

flourish and make the human race reap-in the

benefits.

Reference(s):

• Economic Survey 2017-18; Vol: 01: Government

of India; Ministry of Finance; Department of

Economic Affairs; Economic Division- January,

2018

• Energy Statistics 2018(Twenty-fifth Issue):

Central Statistics Office; Ministry of Statistics

and Programme Implementation; Government of

India, New Delhi

• Monthly Executive Summary- Power sector

(March 2018): Government of India; Ministry of

Power; Central Electricity Authority, New Delhi

• http://www.energynext.in/2017/07/renewable-

energy-is-a-dynamic-and-a-fast-changing-sector/

• https://www.geographyandyou.com/economy/de

velopment/concept-demographic-dividend-india/

15

TARGET:

Target hospitals would include Tier 1 and Tier 2 hospitals as well as government hospitals in Tier 1 cities.

As the category of patients visiting such hospitals is much acquainted with the proposed technology.

The targets are categorized into a budget healthcare unit and a premium segment healthcare unit.

RESEARCH METHODOLOGY

Hospital Visits at varied locations were conducted, and conversed with the staff and the patients along

with their representatives focusing on the various operational procedures with an aim to identify the pain

points in the “Patient Journey” and recommendations for improvements.

Pain points of the patient:

• Admission Process

• Navigation around the hospital

• Estimation of patient care expenses

• Patient Refunds

• Long Queues at the Cash Counter

• Difficulty in Supply of Drugs and Return of Medicines

Pain points for the healthcare unit:

• Compliance to regulatory norms as applicable

• High cost of holding Inventory

• Helpdesk Operations

Changes have been proposed to address the above-stated pain points and to improve the patient’s journey.

Thereby improving levels of patient’s satisfaction and bringing about operational efficiency within the

healthcare unit.

STRATEGY:

Building A Smart Healthcare Ecosystem

Sneha Maheshwari | PGDM 2017-2019

K.J. Somaiya Institute of Management Studies and Research

sneha.maheshwari@somaiya.edu

Bricks and Mortar

Healthcare

Transition Digital Health &

Healthcare

16

PATIENT JOURNEY

The patient journey explores the pathway of interaction

between the patient and the healthcare providers at all

stages of a disease including coping up with the treatment

and dealing with expectations. It also encapsulates the

interaction with and between different stakeholders.

Patient Journey Mapping outlines all the patient

touchpoints within each stage of the care journey. It aids

in creation of strategic outreach that improves both patient

engagement as well as patient satisfaction.

The "triple aim" of healthcare — better care, lower cost and a healthier population — is driving much

of this effort to coordinate care across the continuum. To achieve this, healthcare providers need to learn

to work together to coordinate treatment, prevent unnecessary testing, manage chronic conditions and

provide cost-effective care in the appropriate setting.

VALUE-CHAIN ANALYSIS: A HEALTHCARE UNIT

SUPPORT ACTIVITIES

PRIMARY ACTIVITIES

Hospital Administration [Board of Directors, Medical Director, Chief of Nursing]

Hospital Support Services [SCM Department, Housekeeping, Maintenance and Security Services]

Information Services [Patient Registration, Billing & Collection, Customer Service, Medical Records, IS, Health

Education, HR]

Diagnostic & Therapeutic Services [Lab, Diagnostic Imaging Center, Emergency Medicine, Therapy Centres,

Psychiatric Centre, Pharmacy, Medical Staff & Nursing] Margin

Margin

Administration

• Emergency Room • In-Patient

Department • Out-Patient

Department

Care

• Clinical Evaluation

• Diagnostic Tests • Treatment

Discharge

• Routine Discharge

• Discharge Against Medical Advice

• Referred to Other Healthcare Facilities

Marketing &

Sales

• Service Pricing • Customer Service • Patient

Experience Assessments

• Financial Aid • Insurance: HMO

Service

• Ambulatory Services • Patient Monitoring • Referral to

Wellness Centre • Health

Education • Follow-up

17

PROPOSED CHANGES IN THE PATIENT JOURNEY

Though bed availability and system capacity can determine the number of patients flowing in and out of

the hospital, delays often are caused due to process inefficiencies due to delays in diagnosis, discharge of

in-patients, refunds, etc.

VIRTUAL CARE & AT-HOME CARE - MEDIUM TERM

Virtual Care Diagnosis shall work on an outsourced model wherein the healthcare unit shall have partnered

with virtual diagnosis unit to extend the service to its patients and based on revenue sharing model.

Empaneled Doctors including Physicians and Specialists shall be available for On-Call for diagnosis

enabling 24*7 care for the patient at his ease.

In both the point of care, the patients can use the provided checklist of symptoms and describe their

situation in detail, make note of health history, and upload any relevant files or images.

Subsequently, the doctor and patient shall interact either via HD video conferencing (Virtual Care) or via

visit (At Home Care) and perform diagnosis and drug prescription. In addition, sensory devices such for

measurement of body vitals shall also be provided on request.

The process shall be wrapped up by a Consultation Summary and stored as part of the Electronic Health

Record of the Patient (EHRs)

MINI-HEALTH ATM

Introduction of a fully automated healthcare Kiosk that allows instant access to medication and nutrition

and enables to track of body vital statistics.

Features include:

◙ Over the counter Medication and Wellness Products including Allopathic medicines (Crocin,

Saridon, Gelusil etc.) and Ayurvedic medicines from brands like Himalaya and Dabur

◙ Prescription Management and Online Management

◙ Body Vitals such as BMI, BP, and Hemoglobin can be monitored and tracked.

The Kiosk towards logging out shall redirect towards Healthcare Unit Website and App asking for basic

registration details and generating UHID.

Target locations: Schools, Corporate Institutional Towers, etc.

Benefits: Better Patient Care before hospital, Target Marketing, Increase in Patient Conversion Rate

18

PATIENT PORTAL: Mobile App and

Website for E-Health

Propose to introduce patient portal operative via

an application and website by using the

Cognitive Solutions and Business Intelligence to

cater to patient needs and digitalizing the patient

experience at various stages.

It shall include the customer data based on the

unique health id (UHID) generated and the

various other databases which include price

master (examinations, medicine prices, room rent), drug dosage record, doctor prescription, doctor

consultation fees, etc. among all the backend data required for cost estimations of the patient care.

In addition to patient registration at the time of sign-up (creating UHID), it shall provide following

features:

• Doctor availability and appointment scheduling/rescheduling (including Virtual Care and At-

Home Care)

• Request for ambulatory care via emergency services

• Access to the patient’s EHRs (Secured Download option available)

• Expense Estimator

• Bill Payment and Refunds

• Drugs and Consumables Management

• Patient Assessment

• Personal Health Manager (via Query Chatbot)

• Request for post-hospitalization care at home

• Externally embedded provider search that helps in nearby hospital and other point of care location.

Expense Estimator – Short Term

Insurance funded patients: Patients get access to the extent of coverage of treatment borne by the

Insurance Firm as per SLAs. In case of absence of hospital tie-up with the Insurance Firm, patient details

along with copy of insurance document shall be sent to the Insurance Company and confirmation with

advance shall be obtained by hospital on behalf of patient.

Drugs and Consumables Management – Short Term

Include an option for medicines return for the patients so that the attendants would save out on their time

as the nurse would collect it from them and return it back to the pharmacy.

We also would have a feature of showing the medicines availability and whether the prescribed

medicines are ready to be delivered or not. This would reduce the waiting time for the patients and their

attendants and also reduce queues at the pharmacy counter.

19

Patient Assessment – Short Term

A real-time patient feedback system that includes both qualitative as well as quantitative factors to

understand the patient expectations. Automated Reports highlighting priority improvement areas can be

derived.

Patient estimates basis their diagnosis and health examinations enable better patient financing. It shall

include a detailed report on the actual expenses being incurred under various heads such as medicines,

room rent, nurse fees, doctor fees, meals etc.

This shall be accessible within the hospital via 1-2 tablet per floor with designated nurse on each floor to

enable the less affluent people also have access.

E-Bill Payment and Refund Counter - Medium Term

Online transaction facility would enable patients to make payments and receive refunds at the click of a

button.

Personal Health Manager – Short –Medium Term

Provide clinical alerts and reminders with respect to routine or follow-up appointments, drug dosage, drug

purchase requirements and requests for purchase of medical equipment’s. It shall also provide consumer

driven personalized healthcare plans and Query Chatbot. Benefits: Better Patient Financing; Reduction

in Financial Write-offs; Availability of Virtual and At home Care; Reduced TAT in Patient Journey, Better

Patient Relationship Management

New Patients register on the portal and generate their UHID.

Existing Patients login the portal with their registered UHID

Login In will be password and OTP protected to prevent any malpractices

Online portal will include Menu Options enabling patient access the services

Expense Estimator would incorporate data from the price master, drug dosage record, doctor prescription, doctor consultation fees etc. enabling patient to get an

estimate and compare the same with actual bill amount

Periodic expense updates would be provided to the patient and his family in order to help

them in arranging fund

Add-on features include Drugs return facility for the patients in

case of incorrect or change in medication prescribed

The nurse would come and collect the medicine from the ward and return it to the pharmacy. This

would lead to higher operational efficiency and better time management in the return process

Medicines availability status and the estimated time to delivery would be available on the online portal which

would lead to reduction in the waiting time at pharmacy counters

20

INSTALLATION OF SELF-SERVICE KIOSKS – MEDIUM TERM

To address the long queues and waiting time, propose to install Self Service Kiosks at the reception area.

Initially the kiosks would be manned for short term to assist patient or patient representative.

Kiosks can be basic which would include just a screen for feeding in the details and a provision for fee

payments through cards. Advanced Kiosks would also have a feature of payment through cash and cash

refunds. The choice of kiosk would be based on the healthcare unit’s budget.

Kiosks would include patient registration (Unique Health ID, Symptoms & Diagnosis), Doctor

availability, Doctor Appointment scheduling/rescheduling, Payment through payment gateways with an

option for Auto Credit in case of any refunds and total estimate for OPD (MRI, X-Ray etc.) patient care

if required by the patient. The interface of the Kiosk Machine will be in 3 languages – English, Hindi and

Local Regional Language.

Benefits: Reduced patient waiting time; Patient Database; Reduced cost per patient; Ease of payment &

refunds

Advanced Kiosks Basic Check-In Kiosks

21

ELECTRONIC HEALTH RECORDS– SHORT-MEDIUM TERM

Manual records storage result in increased cost of storage due to warehouse requirements, insurance costs,

personnel cost for management, etc.

These can be reduced via transitioning from paper-based records to digitalized records in the following

ways:

• Digitalized Doctor Prescription and Drug Administration: Doctors would be provided with a

digital writing pad and a stylus which would help reduce the paperwork and also the doctor

prescription will be mapped against the patient id and would be visible on the online portal.

• Enhanced Patient File Management: As per regulatory norms, specific patient files such as

Transplant Records, PNDT Records, MLC File etc. follow certain coding and security locations.

These files can be easily secured via restricted access. Furthermore, it will result in ease of access

of records.

• Automated ICD Coding: As per regulations ICD coding of diseases in mandatory for hospitals.

The servers would be pre-installed with ICD Coding mapped for each diagnosis and shall be

automatically updated and statutory reporting performed.

• Risk Management: EHRs can detect patterns of potentially related adverse events and enable at-

risk patients to be notified quickly thereby enabling Preventive Diagnosis. Improving aggregation,

analysis, and communication of patient information, it is easier to consider all aspects of a patient’s

condition with easy access. Hence enabling evidence-based decisions at point of care.

Benefits: Automated regulatory reporting and compliance; Cost Savings from reduced Insurance &

Warehouse Costs; Improved Risk Management via preventive diagnosis, clinical reminders, etc.; Enhance

Research & Monitoring thereby improving Clinical Quality

Incoming Patients to Kiosk Machine*

Literate Patients

Illiterate Patients

Admin Consultant for Kiosk guidance

Patient Registration Details entered for Unique Health ID (UHID) generation

- Personal Information (Name,Email id, Emergency Contact number, Patient Representative, Card Details)

-Selection of the affected body area from a drop down list

- Severity of pain and few symptoms being experienced via Menu Options available

List of Doctors along with their avaibility and consultancy fee is displayed for appointment scheduling by patient

Confirmation of appointment with the selected doctor detailing cabin number and it's navigation

Payment made by card or by cash at the Kiosk Machine

Receipt of the consultancy fee can be printed and mailed to patient as per the patient requirement

22

NAVIGATION SCREENS – SHORT TERM

Navigation Screens shall enable addresses the difficulty in maneuvering around the hospital for the

patients and their representatives.

Based on the type of hospital and the budget constraints, the type of navigation screens (interactive or

photo navigation) would be installed. Helper assistance inform of Red Press Button on the navigation

screen would also be provided for people who are unable to access the navigation screens.

Benefits: Reduced patient search time; Increased patient satisfaction

WORKFLOW AUTOMATION – SHORT-MEDIUM TERM

To overcome operational inefficiencies, we propose the following

Benefits: Collaborative Relationship Management; Better Drug Administration; Reduced Costs in terms

of Inventory Management

Vendor Managed Inventory

• We propose that the hospitals should go for Vendor Managed Inventory rather than actually purchasing inventory andhaving it on. This would lead to a decrease in the inventory costs and working capital requirements

• For high value & critical items such as Stents etc. the vendor's inventory can be stored & managed by the hospitalswhich would lead to a decrease in the warehousing costs for the vendor and also an assurance of the consumption of hisparts

Medicine

Barcoding

• Automation in the barcode scanning process would lead to a real time mapping of the prescribed dosage with the onebeing provided and any errors would immediately show up on the online portal

• This would lead to a reduction in the risk of incorrect medication and would also help in curbing the financial lossesthat the hospitals would have to bear

• This would lead to increased satisfaction to the customer and financial benefits to the hospital as well

Inventory Level Updations

• Predictive Data Analytics via Cognitive Solutions shall enable real-time updation of inventory levels such as maximuminventory, minimum inventory, re-order levels and other such critical metrics.

• Based on the patient data analytics with regards to the consumption and growth.

• However, as these inventory levels shall be subject to approval to ensure that no extraordinar situation impacting dataresuts in higher inventory carrying costs

23

POST CARE: DIGITAL HEALTH INTEGRATION

Reference(s):

• Andrew Blythe, “The Patient Journey – Patient-Oriented Approaches to Care”, AUSMED, Nov.

2016

• Evariant, “What is Patient Journey Mapping?”

• “Building the healthcare system of the future”, World Economic Forum

• Departments of Health and Family Welfare,“ e-Health & Telemedicine”,June 2018

• Liquid State, “Digitising Healthcare: The Patient-Driven Journey”, Sept. 2017

• Source: Deloitte, “The evolution of smart health care”, Global health care outlook, 2018

• Christensen, Clay, The Innovator’s Prescription: A Disruptive Solution for Health Care, McGraw-

Hill, 2008

• SVARK, The Health AT

Clinician sets health goals and targets for patients

Data is recorded and analysed by the app

Patients visit the clinician

for follow-up or first-time

consultations based on the

App alerts

Option 1: Connected app or Sensor for condition

management

Option 2: Recommends Full Digital Health Disease

Management Program

PATIENT DOWNLOADS THE APP AND

OBTAINS SENSOR DEVICE

• Patient starts collecting data via active (eg.

Measuring blood pressure) and/or passive (using

an actigraph) method

• For patients who are not required to purchase any

sensor for condition management, they would

update their condition manually in the app

ALERTS TRIGGERED BY THE APP

• Regular alerts regarding drug dosage, drug

refilling, follow-up consultations etc. would be

sent to the patient as a part of after care service

• Alerts would also be sent by the app to the

clinician and the patient when the health values are

in a concerning range

PATIENT LOGIN VIA PATIENT PORTAL

• Patient who don’t own a sensor device opt for the Virtual Diagnosis

through the patient portal

• Patient keys in the current condition through video call with the doctor

24

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