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This case study is designed to enable students to analyze the competitive landscape of a business impacted by technological disruption; evaluate the viability of an organic growth strategy using stakeholder analysis; evaluate the revenue and cost structure of Apollo 24/7 and decide on the future investment strategy; and analyze funding strategies of traditional hospitals versus pure digital players.

To extend its reach, Apollo Hospitals Enterprise (Apollo Hospitals), a leading private sector brick-and-mortar hospital chain in India known for using state-of-the-art technology, launched a unified virtual mobile platform Apollo 24/7 in February 2020, 45 days into the COVID-19 pandemic. The management believed that the digital platform had a unique ecosystem that could not be replicated. The analysts were optimistic about the impact of the decision on the future performance of Apollo Hospitals, as it was expected to lead to higher penetration and increased revenue. They also anticipated the unlocking of value, as and when the venture capitalist (VC) would invest in Apollo Hospitals. However, with increasing operating expenses on account of burgeoning technological and marketing expenses, things did not seem to go going as planned. Three years later, in February 2022 after the Q3 of financial year 2023 results. Suneeta Reddy, the company’s managing director found herself pondering whether the digital platform could boost Apollo Hospitals’ profitability in addition to expanding its reach and increasing affordability when the company missed the analyst estimates. In India, which was then the second most populous country, “incremental access” and “affordability” were what mattered to the patients, However, for the investors and analysts, it was quarter-on-quarter performance. The change in the macroeconomic environment stalled the company’s plan of raising money from VCs.

Furthermore, the financing dilemma also plagued Reddy. She knew there was a difference between financing for conventional businesses that for digital businesses. She also had to take decide between short-term profitability with which investors were obsessed versus long-term sustainability, which involved taking care of stakeholders’ interests.

This case study is basically aimed at postgraduate courses and executive management courses.

Teaching notes are available for educators only.

CSS11: Strategy.

The purpose of this paper is to ascertain the performance of Indian hospitals in recent past and derive meaningful insights for policy makers and practicing managers in this area.

This paper analyses the technical efficiency of select Indian private hospitals using three related methodologies: data envelopment analysis (DEA), Malmquist Productivity Index (MPI) and Tobit regression. Two output variables (i.e. total income and profit after tax) and four input variables (i.e. cost of labour, net fixed assets, current assets and other operating expenses) were selected for the purpose of the study.

DEA analysis has shown that 14 out of 37 hospitals are found to be efficient under the Cooper and Rhodes model of DEA and 20 out of 37 hospitals are efficient under the Banker, Charles and Cooper model of DEA. The empirical results pertaining to MPI indicate an overall productivity progress in the private Indian hospital industry during the study period, which is largely due to technological advancement in the industry. Tobit regression demonstrates that chain affiliated, specialized and multi-city located hospitals exhibit a higher technical efficiency.

This study has a limitation with reference to the unavailability of data on the input and output parameters of the model. The data related to the number of beds, number of doctors, number of nurses, etc., were not available for the period under consideration.

This study seems to be one of the few studies applying productivity and performance analysis using DEA, MPI and Tobit regression for the Indian private hospital industry.

The purpose of this conceptual paper is to present the scope of telemedicine, current state of telemedicine in India, challenges in its diffusion and suggest the way forward for implementation of such initiatives.

This is a viewpoint paper that is prepared based on authors’ exposure and knowledge about research topic and the context. A number of appropriate and current citations have been utilised to illustrate current state on the topic as well as to support authors arguments presented in this paper.

The discussion presented in this paper suggests that optimal utilisation of technology in healthcare delivery system requires overcoming barriers at multiple levels including policy, resources and socio-cultural levels. Successful implementation of telemedicine entails involvement of all the stakeholders, namely, the specialists, general duty doctors, paramedical personnel, technical staff, coordination staff, policymakers and, most importantly, the target community, from the design stage itself.

The primary value of this paper lies in providing an overview of current state of telemedicine development in India. It is believed that this article will act as a precursor to future articles on this topic.

Is humanity heading to immortal living? If so, what areas of society are playing an active role in achieving this? In order to understand this, the study explores the relationship between immortality and the wellness and medical tourism industry to seek potential relationships between them and ultimately, asks difficult questions about the growth of these tourism sectors and the potential need for greater regulation of them.

Taking a pragmatic philosophical approach and through the examination of refined information from secondary sources and published material and reports, the study presents original theoretical knowledge and a model exploring tourism and human immortality.

This paper argues that continued growth in the wellness and medical markets today could lead to a world where transhumanists and cyborgs are present in our world, even taking over from Homo sapiens. The study presents a model highlighting the potential role of wellness and medical tourism markets, illustrating the potential for future consumer services that could further fuel the search for immortality. Thus, how such markets and consumer desires are (in)directly supporting humanities desire for (non-human) immortal existence.

Today, individuals are driven by wellness practices and medical and cosmetic desires and are willing to travel the globe in search of companies who are either capable of carrying out the desired procedures or seeking prices more affordable to them. This research offers novel insights into these complex relationships and maps the affiliation between wellness and medical practices and the concept of immortality.

Human resource (HR) disclosures are voluntary in nature in most countries including India. The voluntary nature of HR disclosures results in discrepancy in the HR disclosure practices across companies and industries. The purpose of this paper is to examine the extent of HR disclosures in annual reports of Indian listed companies and to identify their determinants in a three stage analysis.

In the first stage a 16 item human resource disclosure index (HRDI) has been constructed for the set of CNX 200 companies listed on National Stock Exchange. Thereafter the effect of various independent variables on HRDI is analysed descriptively. Finally in the third stage HRDI has been regressed against the independent variables using regression analysis technique to identify key determinants of HRDI.

The research reveals that there is high variation among sample companies as regard HRDI. The results of descriptive analysis, correlation analysis and multivariate regression analysis establish that government’s participation in ownership and market capitalisation has positive significant effect on HRDI at 1 per cent, presence of separate HR directors committee, presence of more independent directors on board at 5 per cent and cross-list America and profit after tax at 10 per cent level. Implicitly HRDI is positively affected by size of company as measured by market capitalisation. Though contrary to expectations, other variables leverage, number of employees, assets, ownership concentration, type of auditor, age, complexity of business structure, employee expense to total operating expense ratio, industry affiliation, foreign investment and proportion of non-executive directors on board are found to have moderate though insignificant influence on HRDI.

Cross-sectional design, dependence on annual reports as a primary document for disclosure and subjectivity in HRDI construction are the main limitations of the research. A longitudinal study may be carried to study the pattern of HR disclosures in future. Weighted ranking of different items of disclosures may be studied to improve the understanding of extent of disclosures.

The HRDI as constructed in the research may be used as a benchmark by companies to improve their HR disclosures. It can also be used by accounting bodies and company regulators while deciding about standards regarding HR disclosures. Investors can also use HR disclosures made by a company as a basis to understand its financial standing and future potentials.

The study adds to the existing literature by developing 16 item HRDI to measure the extent of disclosures by listed companies in India and thereafter by including some new propositions in the determinants of HRDI have never been tested in the existing studies. These propositions are government’s participation in ownership, separate HR committee of directors, board composition and foreign activity. These propositions have been empirically validated in this research except for foreign activity.

Robotic systems for laparoscopic minimally invasive surgery (MIS) always end up with highly sophisticated mechanisms and control schemes – making it a long and hard development process with a steep price. This paper aims to propose and realize a new, efficient and convenient strategy for building effective control systems for surgical and even other complex robotic systems.

A novel method that takes advantage of the modularization concept by integrating two middleware technologies (robot operating system and robotic technology middleware) into a common architecture based on the strengths of both was designed and developed.

Tests of the developed control system showed very low time-delay between the master and slave sides; good movement representation on the slave manipulator; and high positional and operational accuracy. Moreover, the new development strategy trial came with much higher efficiency and lower costs.

This method results in a modularized and distributed control system that is amenable to collaboratively develop; convenient to modify and update; componentized and easy to extend; mutually independent among subsystems; and practicable to be running and communicating across multiple operating systems. However, experiments show that surgical training and updates of the robotic system are still required to achieve better proficiency for completing complex minimally invasive surgical operations with the proposed and developed system.

This research proposed and developed a novel modularization design method and a novel architecture for building a distributed teleoperation control system for laparoscopic MIS.

Corporate social responsibility (CSR) in India includes education, environment, healthcare and rural development. In post-liberalized India, the healthcare sector (services and facilities) has grown in leaps and bounds over last two decades. The purpose of this paper is to reveal and explain the CSR profile of select healthcare companies of India and reveal gaps and scope of healthcare activities with a special consideration towards maternal health.

Primary data are collected from seven listed companies of Goa state which were willing to participate in the study. In total, 67 companies constituting the Healthcare Sector Index of Standard & Poor of the Bombay Stock Exchange are considered as secondary source. Data of 59 companies that come within the threshold of Companies Act, 2013, are studied. CSR guidelines (with a turnover of Rs 10bn or a market capitalization of Rs 5bn or a net profit of Rs 50m) are taken as an initial frame of reference.

In total, 89.83 per cent of these companies have initiatives related to health care. Structured companies (contribute to the company’s overall mission and goals) with CSR policy have committee size varying from three to five directors with an independent director. During 2016–2017, they were mandated to spend Rs 4.2613bn out of which only 74.59 per cent was spent. Geographical spread of CSR initiatives is skewed, with majority of companies focussing on the states of Maharashtra and Gujarat, whereas the states of Odisha and North-Eastern being neglected. The focus areas of CSR are education, healthcare and rural development. The variation of MMR in different states of India is an indicator for corporate as to which state needs more attention. The corporate sector in India needs to focus on SDG3 target of MMR and move towards a newer dimension and direction.

The originality of this paper lies in the recognition of the initiative of Government of India of weaning out CSR activities outside the purview of business sense and towards instilling a social sense in company behaviour. This is a dimensional and directional change in the evolution of CSR practices in companies and countries. To this end, 59 healthcare sector companies under the threshold of Companies Act 2013 were studied and results were outlined.

The Abdur Razzaque Ansari Memorial Weavers Hospital (ARAM) came into effect on 7 April 1996, and is dedicated to the people of Jharkhand and weavers. To deal with the issues of inequity in healthcare services, ARAM was founded for the extension of affordable healthcare services to the needy in and around the area of Jharkhand. Visualised by a great social worker and legend Abdur Razzaque Ansari, it has been successfully run by his eldest son Mr Sayeed Ahmad Ansari for 28 years. This research uses mainly a case-study approach through secondary data from the hospital website and other websites citing ARAM and its functions. Consent to use data for the study was obtained from Mr. Sayeed Ahmad Ansari. Primary information was collected through the patients who availed facilities from the hospital. They were interviewed through a semi-structured questionnaire each taking 30-40 minutes. Taken over by Medanta Group on 8 July 2015 (earlier being managed by Apollo Hospitals Group for 20 years), it is the first super speciality community hospital in Eastern India. Treating over 50,000 patients yearly with state-of-the-art medical equipment and providing discounts to lower-income groups, people from the weaver’s community, freedom fighters and members of ICSI have intrigued people from these sections for affordable treatment and facilities in and near Jharkhand. With a 200 bed-capacity, nine different disciplines and 12 departments spread across the city of Ranchi, the hospital caters to a massive population at a much-subsidised rate. Reaching out to rural villages through free medical camps and awareness campaigns, the hospital showcases how a successful model of healthcare cooperative can be replicated accordingly in similar developing and underdeveloped regions.

To underscore the significance of international health care management, we focus on three themes: the problem of global blindness; global health care challenges and opportunities; and learning from international health care management. The problem of global blindness highlights how health care managers’ inattentional blindness to competitors’ operational performance and market strategies lead to avoidable and expensive failures. To address global challenges and opportunities, health care organizations are employing two different strategies: (1) building and marketing a world-class health care facility internationally, and (2) organizing and integrating multinational health care operations. The first strategy exploits the medical-tourism market. The second strategy requires either multinational health care networks or transnational health care organizations. One of the lessons to be learned from international health care management is that an organization can create a meta-national competitive advantage. Another lesson is that by examining best practices from around the world, health care organizations can obtain new insights and become more innovative within their home markets. A corollary and third lesson is that while health care organizations can learn a great deal from examining international best clinical practices, sometimes the most important management lessons are lost in clinical translations. The fourth and last lesson is that worst cases – serious international management failures – offer perhaps the most valuable insights into the role of culture, complexity, and leadership for health care organizations.