Narayana Hrudayalaya Ltd

Welcome to the 25th Annual General Meeting of your Company. Welcome to the VUCA world — a world that is volatile, uncertain, complex, and ambiguous. Amid all the uncertainties, one clear picture has emerged: we have truly moved from the analogue to the digital world. We are even watching nations at war without a soldier touching or even spotting the enemy soldiers from a distance.

ChatGPT has virtually turned our world upside down. The potential of any breakthrough technology is always grossly overestimated in the short run and grossly underestimated in the long run. There is no doubt that artificial intelligence is going to transform our industry dramatically over a period of time. About the fear of AI replacing doctors, I want to quote Dr. Curtis Langlotz, Professor of Radiology at Stanford University: "AI will not replace the radiologist, but the radiologist who will use AI will replace the radiologist who will not use AI." It will dramatically improve doctors' productivity and prevent them from making mistakes. For your information, medical error is the third leading cause of death in the USA. AI tools can potentially eliminate medical error.

Based on our experience, I can confidently say that EMR and AI will transform the patient experience from a painful ritual to an enjoyable consumer experience — like most other services. Post ChatGPT, media is filled with articles about the power of AI tools in transforming global healthcare and dramatically improving longevity. Unfortunately, many are not aware that the majority of global hospitals do not use electronic medical records, and even if they do, EMR adoption is poor with unstructured data. AI tools cannot work when the data is on paper or in unstructured digital form in the cloud. In a hospital without smart electronic medical records, AI tools cannot be used, and that's why I want to congratulate our team for their foresight in starting the digital journey way ahead of many hospital groups — over two decades ago.

Twenty-four years ago, when we started our digital journey with a locally made electronic medical record, we never dreamt that we would be building one of in building AI tools on a digital platform was to treat patients as consumers and dramatically change the consumer experience of healthcare — apart from making healthcare safer, accessible, and affordable.

A patient's journey in healthcare starts with doctors taking the history. For the doctor, this is a time-consuming routine requiring immense patience; for the patient, it is the most boring and repetitive job. To convert this into a happy experience for both doctors and patients, we are now using medhaX Bot to collect the most advanced digital platforms for delivering healthcare. We never thought that our digital platform Athma and AI platform Medha would be used by many hospitals in India and even outside India. As investors, I am sure you are curious to know the impact of our home-grown digital platform and AI tools on the performance of our hospitals. Our aim the patient history from home so that the patient spends less time in the clinic and doctors have detailed knowledge well before the patient arrives.

Today, when you enter our hospitals, you will see there is no queue for registration, since registrations are done online or through kiosks at the reception counter.

The reception counter has very few receptionists who assist occasional patients who need help with self-registration. When you undergo tests like echocardiogram or ultrasound, doctors will politely inform you that they are beginning to speak to the BOT during the examination and request you not to interrupt during dictation. As soon as the test is done, the BOT will convert the entire report into the prescribed format and signed off by the doctor, and then print the report for the patient. This entire exercise in a busy hospital could take 2 to 4 hours. Generally, it takes 4 to 6 hours for blood test reports to reach the patient in a hospital. With Athma Lab Information System supported by AI, most of the blood test reports appear on the patient's phone in less than 45 minutes. This is nothing short of magic, and this and present it. Then the doctor reviews the report, corrects any mistakes, and taps enter. In less than a second, the entire report appears in the patient's mobile phone in the NH Care app.

Without medhaX AI, there was a need for a trained medical transcriptionist to write and type the report, get it checked is the power of AI running on a smart digital platform.

In the last 5 years, the number of tests done in our lab increased by about 50% without adding a single additional technical person. Lab automation dramatically improves the productivity of laboratories. Most nurses in wards are busy checking the pulse rate, blood pressure, temperature, and respiratory rate of patients and entering the data into a chart — a boring, repetitive, low-skilled job that wastes skilled nurses' precious time. We are evaluating reusable sensor- based patches that can continuously monitor vital parameters and display them on a TV in front of the nurses' station along with a cardiac arrest risk score.

Data from this system will allow nurses to identify high-risk patients and, if required, shift them to intensive care — thereby virtually eliminating so-called "sudden cardiac arrests" in the ward. Once nurses are relieved from the job of data collection, they can spend their time caring for sick patients.

Today, patients or their family members can interact 24/7 via a BOT on WhatsApp linked with Athma. It is an amazing experience to watch the entire discharge summary completed by AI tools, requiring only a few minutes of the doctor's time for correction and sign-off. The patient discharge process, which used to take over 4 to 5 hours with a large team of medical transcribers, is now reduced to less than an hour, done entirely by AI on the digital platform.

A few months ago, we launched Narayana Aarogyam at a tech park in Bangalore for preventive checkups with diagnostics like echocardiography, abdominal ultrasound, bone densitometry, mammogram, PAP smear, and even CT scans of the chest and abdomen. This centre is paperless and smart and can perform health screening for nearly 100 people with just 12 employees — only nurses and technicians with 2 doctors. There are no receptionists, typists, or secretaries.

As you are aware, we are building several large hospitals across the country. I can confidently say that in these hospitals, only doctors, nurses, and technicians who touch the patients will be working. All the important non-clinical support staff will be working from centrally, supporting multiple hospitals at the same time —dramatically improving productivity.

The largest growth segment in healthcare is going to be ICU beds. Unfortunately, India is desperately short of trained senior intensivists to manage intensive care. Interestingly, the foundation of critical care management is based only on data. Athma EMR connects doctors, nurses, technicians, patients, and medical equipment like cardiac monitors seamlessly.

Six months ago, our senior paediatric intensivist shifted to London for family reasons. Because of the time difference, he manages the entire paediatric ICU in Bangalore from London at night —since he has access on his phone to our EMR, which covers every patient in the ICU. He can even see the child online and talk to the nurses caring for the child. If a doctor sitting in London at night can manage our ICU in Bangalore because of the Athma digital platform, it is only a matter of time before our intensivists working in Bangalore manage ICU patients in England at night when they have a shortage of intensivists.

I am pleased to inform you that the white paper on the 10-year plan of the NHS of England quoted Athma and Medha digital health platforms as examples for British health experts to study.

Tenwek Hospital, one of the largest charitable hospitals in Kenya, is using the Athma digital platform. We gave the Athma digital platform free of cost to Sai Baba's Hospitals and Scudder Memorial Charitable Hospital in Tamil Nadu. A few months ago, when I met the CEO of Scudder Hospital, he asked me a very interesting question about why we gave them the EMR for free. I politely told him that it was too expensive for them to afford. Then I told him that by giving our EMR free of cost to them, I have not become poorer — and if I didn't give them our EMR, that would not make us richer. This is the beauty of converting atoms into bytes.

Nearly 80% of global hospitals do not have smart digital platforms and AI tools. We want them to use our digital platform at a price they can afford. Once doctors, nurses, and technicians stop using pen and paper and embrace smart digital tools, healthcare will become safer, affordable, and accessible to everyone — and this is our dream: to make this world a better place to live.

Thank you so much for giving us the opportunity to build an organization to transform society.