The interview presented below has been edited and abridged for clarity.
Kelvin, thank you so much for joining us today. It’s a pleasure to have you here. What is the road to recovery starting to look like for you, in the absence of things like medical tourism and a regular flow of patients that you were seeing in Singapore and South East Asia? How is this going to impact your business model for tomorrow?
Thanks, Anu; that’s a really important question. IHH is an acute care hospital business, so we are remaining resilient during this time. We continue to see patients, we have a strong balance sheet, and we do expect recovery.
There are three types of medical conditions: the urgent, the semi-elective and the elective. During this time, we continue to see the urgent cases. Of course, we do so by implementing the highest standards of safety at our facilities, which we have used before, during the SARS and H1N1 outbreaks.
The semi-elective and elective cases get deferred out but, even so, they come back. An example of a semi-elective case would be a gentleman who needs an angioplasty to address a heart vessel blockage that is increasing. These tend to bounce back quite quickly; say, after one or two months of lockdown. Then there are the elective cases that also come back, it just takes a bit more time as patients get used to the new normal.
In the long term, we expect the demand for our hospital services to continue and grow strongly because the main drivers, such as the rise of non-communicable diseases and aging population, are mega-trends and remain unchanged.
Indeed, there is a new normal, and we can expect that even for healthcare in the post-COVID era. To me, there are three trends that will be accelerated. The first is to provide healthcare where possible by digital means, the second is that healthcare consumers will demand greater transparency, and the third is the need for better public-private partnership and collaboration.
On the first point, we had already started the journey to provide more healthcare digitally even prior to COVID-19. COVID-19 is an accelerator simply because there is a need for patients to get information quicker and, if possible, not visit the hospitals. For instance, in May 2020, we launched telemedicine services globally. It’s not a replacement for our acute hospital care services and it’s not a replacement for our bricks-and-mortar business because, after all, appendectomies and heart surgeries still need to be done in hospitals. However, it’s important that we stay connected with our patients so we can continue to provide advice and make care more convenient for them. Whenever information can be provided online, it should be.
The second trend in the new normal is that there will be a greater need for transparency. Patients are consumers, and they want to know what outcomes they will receive and what price they will pay prior to buying the service. The healthcare industry, as a whole, has been lagging in this but at IHH we are taking the lead on change. For instance, in Singapore, we have used artificial intelligence to improve the accuracy of the pre-hospitalization bill estimates. Right now, we are able to reach 80 percent bill estimate accuracy, up from 50 percent previously, so these patients have greater peace of mind and greater transparency. In a post-COVID era, this demand for transparency of information will be greater than ever before.
Finally, COVID-19 has demonstrated the importance of public and private sectors coming together to deal with pandemics. For instance, we have worked with governments in different countries that we serve to support their fight against the virus by taking COVID-19 patients, operating community care facilities, supporting laboratory testing, and so on. It would be a loss if we don’t continue these public-private collaborations in the future, as they have been very important and useful.
Kelvin, it’s so impressive to hear that you made the strategic choices to capitalize on these trends to better serve your customers and, as you explained, COVID-19 has really been an accelerator. I would be interested in hearing what sort of leadership challenges you’ve encountered as you’ve pivoted to this strategy and, in particular, dealing with this acceleration. Can you talk a little bit about either the leadership qualities that you are looking for in people or developing in people to adjust to this new normal?
Thanks, Dana. COVID-19 certainly has created new leadership challenges. The most important overall challenge to me is the ability to continue building trust in these times where we see much higher uncertainty and change with our customers and employees. Even in the pre-COVID world, trust was really the bedrock in healthcare. Why would patients come to seek care with us? Because they believe in the safety, the clinical quality and appropriateness of care that our hospitals provide.
In the post-COVID world, the ability to connect with people – with patients, employees, and the community – to build trust is more important than ever. Employees in particular want to know that leadership remains able to navigate the uncertain environment and do the right things for our community. Early this year, IHH launched our new vision to be the world’s most trusted healthcare services network. There may be a new normal, a new low-touch economy going forward, but for us in healthcare, we will always be high touch and high empathy.
So that’s the challenge. There are three main adjustments we are making in healthcare to make it easier to build trust going forward. The first is to lead in a more agile fashion, the second is to communicate more than ever, and the third is to get feedback quickly.
Let me explain those. First, on leading in a more agile fashion, there’s a need to keep the overall strategy goals of the organization intact but allow the entire leadership network to act and respond in a more agile fashion, even as we operate in different geographies and in different regulatory environments. How would we do this? It means leaning towards a less-centralized decision-making model, where we’re staying true to longer term objectives but empowering leadership at various levels to respond to short-term issues in their own ways, even if it means they have to change their KPIs for that period. It also means allowing quick experimentation so that we can shorten learning cycles, and then spread these lessons quickly across the global network.
The second important adjustment is the need to communicate honestly, quickly and more frequently than ever before. Leadership must find new means to do so in this new low-touch economy, such as through regular short memos and webinars, since in uncertain times, lack of communication will erode trust faster than in stable times. To communicate more, it also requires leaders to be frank with difficult news and then explain to them concisely but precisely how leadership will overcome each of these challenges – this will reduce uncertainty and engender trust.
Thirdly, getting feedback from employees quickly is really important. In our case, we have a large majority of our workforce who have not experienced the impact of a pandemic of such a magnitude, so we are pulling many levers to hear from them to address the issues. One is by using pulse surveys. In healthcare services, there are two categories of employees with different needs. The first group are our staff in corporate, support functions who work remotely and, second, our frontline healthcare staff. We have found that we need to help those in the first category remain engaged and feel good about working from home. For the second category, we have found that we need to focus on keeping them safe, making sure that they have all the equipment they need to be safe, so that they can continue to care for our patients.
Thank you, Kelvin; that’s very helpful. Keeping that entire innovation agenda in mind, are you expecting a shift in responsibilities for existing roles? Are you seeing current roles look very different in the new normal? Share a little bit about that with us, please.
As I mentioned earlier, using digital as a means of delivering healthcare will be more important in the new normal than before. In our context, it doesn’t mean that everything will go digital; that’s simply not possible. But it’s an opportunity for us to use a digital connection with our patients in a much better way. In fact, we’ve seen the provision of healthcare digitally and provision of healthcare in our actual facilities merging into one seamless continuum, so that patients can get care in the most convenient way, but also in the most logical locations. If they can get it at home, we should use a digital technology to deliver it at home. If they need to come to hospital, we can then advise them of that.
The leadership challenge is the ability to recognize that healthcare is neither a digital service nor a bricks and mortar service, but it is both. Leaders will need to recognize that the provision of healthcare via the entire continuum crosses the different possible digital means into the bricks and mortar space. The job, therefore, is to merge this together as seamlessly as possible for our patients.
Can I just ask you a little more on that? You also have some extremely qualified doctors who are part of this entire network and they have obviously been doing things in a particular way. How are you changing the needle on how they are dealing with their patient communities and the way they impart care?
Doctors, too, have to be part of this change. They are a critical component of our healthcare provision; we need to bring them along on a journey. We’ll find the earlier adopters as there always are in any group, and in our group there are many, especially because doctors are people who do want to try new ways of doing things. We are also seeing that, as time passes, because of these earlier adopters, then those practices could be spread throughout the rest. COVID-19 has proven to be a time which has accelerated that diffusion of innovation, so we are pretty happy to see that. The mindset that’s needed, even for the doctors, is to make sure they can see that the digital world and the physical world is really merging into one, so that we can provide the entire continuum of care as seamlessly as possible.
Kelvin, thank you so much for your insights and also for your leadership and IHH’s leadership in helping bring more innovative care to the world. We wish you all success and look forward to further developments.