'Patients should come to AIIMS only for complex diseases': Director M. Srinivas

Dr M. Srinivas, who joined AIIMS New Delhi in 1994, took over as the director of the institute in September 2022. He has more than three decades of experience in academics, administration and research. Srinivas, who hails from Karnataka’s Yadgir district, was serving on deputation as dean at the Employees’ State Insurance Corporation Medical College in Hyderabad when he took up the director’s post at AIIMS. In an exclusive interview with THE WEEK, Srinivas spoke about opportunities before the new AIIMS hospitals, the role of AI in patient care and the importance of making health care equitable. Edited excerpts:

Q New AIIMS are coming up across the country. What should their priorities be in their journey to become like AIIMS New Delhi?

A Each and every AIIMS operational today is doing a great service to the nation. Many of them have made advanced health care accessible to the masses like never before. Great institutes like AIIMS are destined to be leaders and are the perfect breeding grounds for pathbreaking innovations. New AIIMS shall have their own growth pangs and challenges. These shall evolve with the changing times, and it will be very important for them to embrace change without the burden of the past limiting their growth.

While the new ones can learn a lot from the journey of AIIMS New Delhi, it is not necessary that they become an exact replica. All of them need to focus on becoming AIIMS+ to establish new global paradigms and to establish Bharat as a Vishwaguru in health care. They should develop their services in a manner wherein accountability and transparency are at the heart of their growth journey. Adopting good governance practices from day one is important to imbibe these values in the institutional DNA. Further, the focus on Atmanirbharta―patient-centric care, applied academics, digital health, innovation and entrepreneurship―must be evident in letter and spirit.

Q How do you envisage the impact of AI on the care you provide?

A AI, like any new technology, shall prove its worth as it matures. It has the potential to make health care safer and error-free by assisting doctors in diagnosis and treatment. AI can also help increase the efficiency of diagnostic services by automating reporting in those cases wherein the scope of error is much lower than a possible human error. It has the potential to help doctors, nursing professionals, allied health care workers and field workers in remote areas. However, the most visible impact of AI is expected to be in promoting wellness and early diagnosis by deeper integration with personal wearable devices and predictive analytics.

Q You must have had your list of things to do when you took over as director. What worked and what needed tweaking?

A AIIMS New Delhi is an institute with a vast legacy, which also means that it comes with its own baggage. Our faculty, residents and staff are among the best in the country and, hence, perform the best when empowered. One of the major factors bearing on hospital performance is good governance in patient care, teaching and research. In line with this, my single focus has been on enabling good governance practices and transparency. We have been an early adopter of the ABHA (Ayushman Bharat Health Account)-linked ‘Scan and Share’ facility, which has, in the past one year, helped over 10 lakh patients avoid queues and has also brought in transparency in their waiting times for OPD consultations. We have rolled out eICU and eCasualty to enable centralised and remote monitoring (for example, from nursing stations and doctors’ mobile phones) of patient care parameters and to enable auditing the quality of the care being provided.

Embracing transparency, AIIMS New Delhi has deployed a dashboard to share real time bed status, admission and waiting status, OT utilisation, statistics of radiodiagnostics, nuclear medicine, radiotherapy and laboratories. We have thrown open our gates to evaluation by external agencies by embracing NABH (National Accreditation Board for Hospitals & Health Care Providers) and NABL (National Accreditation Board for Testing and Calibration Laboratories) accreditation for various facilities. We have also embraced facial recognition-based biometric attendance and access control systems. Our Centre for Medical Innovation and Entrepreneurship has started to contribute significantly to Atmanirbhar Bharat.

Q Do you think health care has become more inequitable in terms of access and quality?

A I strongly believe that the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has made quality health care more accessible. The statistics speak for themselves: Of the approximately 50 crore beneficiaries of this scheme, almost six crore poor patients have successfully availed hospitalisation services with zero out-of-pocket expenditure. Moreover, with an impressive number of both public (15,000+) and private (12,000+) facilities empanelled under its umbrella, AB-PMJAY has enabled patients to seek services at the nearest health facility.

Q Our disease burden is changing from communicable to non-communicable and lifestyle-related diseases. What unique challenges do that pose?

A The shift in disease burden is an opportune time for greater focus on promoting wellness, as most of these diseases are preventable. The expanded range of services made available under the Ayushman Bharat Health and Wellness Centres defines the biggest strategic shift in screening, prevention, control and management of non-communicable diseases. Simultaneously, tertiary care facilities like AIIMS, too, need to gear up to new challenges by augmenting their curative services in these areas and research on prevention/mitigation of these diseases. The Centre for Integrative Medicine and Research (CIMR) is a pioneering initiative by AIIMS New Delhi in the quest to converge contemporary medicine with India’s traditional medical practices. Research studies at CIMR have proven the power of yoga in the prevention and mitigation of many lifestyle diseases.

Q What is it about AIIMS that people must know?

A Because of the hard work of our faculty, residents and staff, AIIMS New Delhi is a name that resonates with trust. This is also one of the main reasons of overcrowding as a lot of patients come here even for minor illnesses like cough and cold, which could be easily treated at primary/secondary level facilities. I strongly feel that patients should respect AIIMS New Delhi as a tertiary care facility and should come to us only for complex diseases. Further, I would like to highlight our state-of-the-art research labs and facilities where hundreds of faculty and scientists work behind the scenes to publish pathbreaking research.