In Conversation with Prisila, correspondent, Asia Business Outlook Magazine. Zoya shares her views on how to stay up to date with the latest advancements in the diagnostic industry, and how to determine which technologies are worth investing in.
How do you incorporate innovation into the diagnostic processes and services offered by your laboratory? Could you share some examples of a specific innovative approach or technology that your laboratory has implemented successfully?
The inception of my startup was based on a simple observation: while the “delivery system” of healthcare services had caught up with the western standards, clinical diagnostics had lagged behind the developed markets by almost a decade. There are a handful of large players and local small labs. Neither of them had either the skills or the incentives to move away from “routine diagnostics.” We saw a ‘white space’: high-end diagnostics. We created to bridge this gap by making the advanced diagnostics procedures available, affordable and accessible in India.
We have only one unique strategy: perpetual innovation – in everything we do.
Let’s take the example of how we conduct customer satisfaction surveys. We ask only ONE question: will you recommend us to a family member? Think about how powerful that statement is – as an indicator of customer delight. And we score in the high 90’s in percent Net Promoter Score.
Have you seen our booth at any of the Oncology or Pathology or ObGyn conferences? You could tell it is our booth even if we had no signage at all.
Knowing what to invest in and ensuring that new methodologies are launched accurately and quickly, comes down to three things – what you have, what you know, and who you know
Additionally, a non-hierarchical culture and one of radical transparency was a key leadership innovation. This permeates the organization at every “level” (the double quotes only to reinforce that we don’t have a hierarchy in the organization).
The disruptive nature of our work also comes from the fact that our innovation and quality doesn’t imply high cost. And our low cost doesn’t imply a compromise on quality and innovation.
How do you ensure the accuracy and reliability of test results in your laboratory, particularly when implementing new diagnostic methodologies? How do you stay up to date with the latest advancements in the diagnostic industry, and how do you determine which technologies are worth investing in?
At the most macro level, knowing what to invest in and ensuring that new methodologies are launched accurately and quickly, comes down to three things – what you have, what you know, and who you know.
In “what you have,” it is the capital. From the very beginning, we have ensured that the company is well funded so that capital never becomes the rate limiting factor for innovation. We have invested heavily in innovation and in cutting edge technology.
In “what you know,” the talents and skills of our workforce come in. We have managed to hire some of the finest professionals in diagnostics – from India and from the US – and have created a culture of transparency and performance around them. This motivates them to build their own teams, often made of fresh recruits from universities, with the same value framework.
Finally, “who you know.” This refers to our network, starting with Silicon Valley, Boston, London and Mumbai based investors and the most diverse set of strategic alliances across the world.
What is your perspective on the increasing illegal diagnostic labs and pathology shortages in the country? What steps can be taken to mitigate this?
Back in 2012, I spent nearly six months interviewing clinicians and fellow diagnosticians to understand the pain points of our industry. Even then it was clear to me that the chasm between those that were providing reliable results and everyone else was extremely wide. Today, not much has changed. Good news though is that we are talking about it more transparently. Unfortunately, the sheer number of diagnostic labs far outnumber the number of certified pathologists in the country. As a direct result of this skill gap, most laboratories are functioning illegally and their results are often questionable.
Another data point is that less than 5 percent laboratories are authorized by the National Accreditation Board for Testing & Calibration Laboratories (NABL). Self-regulation works well in the domain of pricing, but when it comes to quality, the lack of a mandatory and enforced system has brought us to the point we are at today. Consequently, it is evident that there are very few quality labs in India.
"In healthcare, we don’t compete for patients. We compete for talent"
Broadly speaking the government must help create a regulatory environment that ensures that organizations get incentivized to focus on providing the right quality. There should also be a severe penalty for those that are not following the principles laid down in the Clinical Establishments Act.
Finally, those that are in a position to influence the ecosystem, (people at well-functioning diagnostic labs), should shoulder the responsibility of creating awareness and education on the need for high quality and the impact of allowing such illegal labs to survive.
What should be done to improve quality in the diagnostic industry while not minimizing speed or innovation?
As I mentioned above, there is a need for the government to create policies to incentivize high quality. While there is a relevance of penalizing those that don’t follow the law, there is a place for encouraging those that do. Both levers need to be deployed by the government in equal measure.
To fully solve this problem, we essentially need to reshape the industry. Reshaping an industry is never a sprint; it is a marathon. And in the re-sculpted healthcare industry I envision, diagnostics will be center-stage.
While diagnostics makes up for only 3% of the Healthcare expense, it impacts 70% of the cost downstream, and 100% of the outcome. So, setting up a high end testing facility not only bridges this important lacuna, it also places the apt responsibility and accountability on diagnostics as a segment. Once we achieve this, the improvement of clinical outcome, and reduction of the downstream cost is simply a corollary. It is bound to happen.
For the sake of completeness, I must point out that education will have to be an important component. The end-goal is to rebuild the ecosystem. I believe that the entire ecosystem of healthcare - from the patient to physician to payer to diagnosticians - needs to understand this.
What strategies do you employ to attract and retain top talent in the field of diagnostic innovation and laboratory science?
In healthcare, we don’t compete for patients. We compete for talent. We are constantly looking to create a cadre of entrepreneurs. While finding and retaining great employees is already a challenge, getting them to think and behave like entrepreneurs is even harder. Our mantra is - like in medical training – see one, do one, teach one.
Our industry-low attrition rate of less than 5% for over a decade speaks volumes to our one core strength: a culture like none other in India, and I mean this very literally. I truly believe it is the first successful experiment, at least in healthcare, in defining a new generation work culture – transparent, flat, candid and dialog-driven.