Modern times have seen major developments in different industries ranging from education, transport, manufacturing, healthcare and so on. The healthcare industry has also made numerous progressions in terms of technology and innovative treatment methods. Many leaders in the healthcare industry have paved the path to excellence, while making a massive impact on the medical sector.
These leaders are passionate about the field of medical science and treat every patient with compassion and dedication. They are optimistic and are always open towards adopting new ideas and treatment methods. These are the forerunners, who embrace change and uphold healthcare, while ridding every patient of their ailments.
One such transformational leader in healthcare is none other than Dr. R. Kishore Kumar, the Chairman of Cloudnine Hospitals. He founded Cloudnine in 2007 to revolutionise maternity and newborn care in India, on par with international standards.
He saw a lot of deaths during his training in India, but hardly saw any deaths during his 16-year tenure in the western world. There, he also saw what the ‘intact’ survival of a premature baby means to the parents. Hence, he had this dream of providing similar care in India and is committed to his passion for scaling new heights in maternity care and neonatology. He pioneered this concept in India with Cloudnine dedicated to providing exclusive and comprehensive services in maternal and childcare.
Focused on Delivering the Best Healthcare Services
Dr. R. Kishore Kumar always wanted to become a doctor to make a difference in the world. While he was pursuing his medical degree, he realized that the field he could make a huge difference in – was paediatrics. However, after qualifying as a paediatrician in 1989, he realized that there is still a lot of learning to do. He intended to specialize in neonatology (babies under 28 days of life including premature babies).
Dr. Kishore’s intention was to get the answer of “Why were we losing 130 children per thousand live births” – being babies under 1 year of age when the developed world was losing only less than 10 per thousand live births? He wanted to study their way. Hence, he decided to head west with his qualifications to specialize in neonatology.
Eventually, after working for a while in the USA he returned to Australia and established a “hub and spoke neonatal intensive care unit” in Tasmania. “I took up that challenge, completed the task and then moved to Perth, Australia where I was instrumental in establishing the FIRST private neonatal unit in Australia with the late Prof. Alfred Grauaug, the first professor of Neonatology in Australia,” he expressed. Dr. Kishore then decided to fulfil his dreams. Accordingly, he returned to India in 2005/06 after having been felicitated by the former president of USA, Bill Clinton for his achievements in neonatology.
The Inception of a Leader
After spending more than 16 years abroad, with experience in various leadership positions and different healthcare systems across the world, Dr Kishore felt the need to return to India, where focused maternal and neonatal care were not a priority. Seeing the untapped potential and the need for change, he returned in 2006. Building upon his experiences, he turned them into an opportunity and founded Cloudnine – a hospital that reimagined maternal care, birthing and neonatal care. It soon became India’s largest chain of specialised maternity and neonatal care hospitals.
With Dr Kishore at the helm, Cloudnine continues to be a pioneer and he serves as an inspirational role model to patients, doctors, and health professionals all over the country, pushing Cloudnine to new heights of innovation. This resulted in Cloudnine being the recipient of many awards for both medical and entrepreneurial successes.
True to Dr. Kishore’s belief and his concentrated efforts, Cloudnine became very popular and is now a household name.
Dr. Kishore is a perfectionist; hence, he has always wondered, whether he could have done better, or if he could do anything in the public sector. He also asked himself the question, “which way we should do things in public sector – is it better to do by NGO way or PPP way or in your own way?”. Finally, this led Dr. Kishore to pursue his executive MBA in Harvard Business School on Healthcare Delivery, after 34 years since becoming a doctor.
About Cloudnine Hospital
Cloudnine Hospital upholds the belief that a child is life’s greatest gift and pregnancy is one of the most magical experiences nature can offer. This gift deserves to be nurtured and cared for, not just at birth, but for the entire duration of one’s pregnancy. Hence, to ensure a healthy and happy pregnancy, Cloudnine provides world-class medical expertise, state-of-the-art facilities, a space filled with love and laughter and staff dedicated to the holistic well-being of the mother and the baby.
Having celebrated over 1 lakh births across regions, with a 3000+ strong team, Cloudnine has expanded its reach to multiple facilities across India with nearly 20 centres all across India and growing while continuing to maintain and excel international standards of care. It is still going strong with plans to reach every woman and child in India.
The Success Saga
Under Dr. Kishore’s astute leadership, Cloudnine Hospital has achieved many prominent landmarks throughout its illustrious journey. It was recently awarded the Great Places to Work (GPW) certificate – it is one of the very few hospitals in India for having achieved this feat. Cloudnine received this recognition owing to the fact that it provides the best working atmosphere for nurses – be it working conditions, working hours, accommodation facilities, and their mental wellbeing.
Success for the doctors – Ensuring Overall Development of the Doctors
Dr. Kishore opines that any doctor who joined Cloudnine has improved in four areas – financial, academic, social, and QoL. This is because they work in one place rather than providing their services across different locations. Also, any doctor who has worked in a multi-speciality hospital knows too well, the priority they get when faced with an emergency slot for an operation theatre and so on.
This has improved their quality of life with minimal stress. Their number of patients increased as they are accessible all the time in 1 place, their social life improved with more time for interaction among peers of the same speciality, and their financial state also improved.
Finally, their academicism also improved as the hospital provided them with regular academic meetings, CMEs (Continuing Medical Education), and access to journals through membership to the staff. “We are one of the few hospitals which assisted the doctors to obtain ASOPs within the purview of the law and made them feel part of the growing company,” expresses Dr. Kishore
Success for the customers – Saving premature babies, low maternal mortality and morbidity
We conceived “the concept of Cloudnine” – It’s an English idiom meaning a state of perfect happiness, a feeling of well-being or elation – as we believed in the concept of pregnancy being a WELLNESS and not an ILLNESS4. But what we realised is that parents were going through a lot of stress – because of the uncertainty of the finances involved for the labour and delivery.
Hence, among other things we did, we also felt the joyous moment should not be spoilt with the unnecessary financial issues. We created delivery packages – for both normal delivery and caesarean sections – considering all possible charges – doctors (obstetrician, paediatrician, and if required, anaesthetist in case of epidural pain relief for normal deliveries and for caesarean sections), consumables used, drugs commonly used and the hospital charges.
This was a comprehensive charge with no need of the husband or the family dashing down to the pharmacy or other places every time something was required, to get the medicines or other consumables to be ‘bought’ and given to the doctor or the nurse concerned, as used to happen in all the hospitals.
This changed the way the prospective parents enjoyed their birthing process – as even before they got admitted, they knew what they were in for. They were left in peace to enjoy their newborn with no worries of dashing down here and there. They didn’t have to have the unknowns – how they can arrange the finances, whether they can afford this hospital or the doctor or not – were able to make a judicious decision. This led to many other hospitals following suit – the result is that it is not stressful anymore for most families as they could choose the hospital according to their needs and finances.
Success for the staff – a happy place to work, safe place to work, Great place to work from day 1 we have treated the nurses and allied staff in Cloudnine on par with doctors – unlike most hospitals in India. This boosted their confidence and, we have regular training programmes for them which makes them more focussed in their job. Why would you work in any other hospital when Cloudnine is such a happy place?
Success for the industry – maternity and newborn care started being recognised as an important part of healthcare & set the standards that can be achieved in India.
Emphasis on Research
As per Dr. Kishore, research has been the top-most priority at Cloudnine – be it clinical or otherwise. The hospital has also established an ICMR recognised and industry approved IEC (Independent Ethical Committee) which oversees the research undertaken and have managed to publish just over 50 articles in national and international medical journals, which focuses on improving medical care. All staff – both medical and non-medical are encouraged to take part in research – which could be as simple as quality indicators to see how we can improve on the existing situation to make things better. In a sense, we are our own competitors as we keep improving day by day.
Achievements Galore
Dr. Kishore has led Cloudnine towards winning numerous laurels. Under his ardent leadership, the hospital has carried out transformational initiatives in the field of maternal healthcare.
Following are the major achievements which Cloudnine proudly boasts of:
- It is the largest chain of maternal and neonatal hospitals with level 3 NICUs in all hospitals employing close to 150 neonatologists and over 200 Obstetricians.
- It has achieved near zero percent maternal mortality (when the country’s maternal mortality is 113 per 1,00,000 live births) – and 99.34% neonatal survival. Moreover, Cloudnine is one of the few hospitals in India catering for babies less than 28 weeks – called extreme premature babies – when the country’s survival is much less than that even without taking into account babies less than 28 weeks.
- Cloudnine is one of the very few hospitals with constant physiotherapy support – helping to reduce the post birth pelvic floor damages – accounting for nearly 15 to 20% complications in any other place as opposed to less than 2% in its hospitals and also non-surgical treatment of breast abscess.
- Cloudnine provides 24/7 lactation support to the mothers – accounting for 96% success rate in breastfeeding – compared to the national average of 46 to 52%.
- It has one of the lowest infection rates of less than 1% when the acceptable infection rates are about 2%. This means there are less expenses and morbidity for families involved.
- It is one of the most academic institutions in the world – with fellowship training in neonatology, advanced fertility training, and advanced high risk pregnancy training to the eligible doctors.
- The hospital has an active research department – with an Independent Ethics Committee (IEC) overseeing its functioning and involving multicentric multinational research to improve the quality of the care it is providing.
- It is one of the Great Places to Work (GPW) with employee satisfaction of over 97%.
- Cloudnine is a part of Vermont Oxford Network (VON) – one of the very few Asian groups of hospitals and the only one in India – to compare its standards to the western standards and matching in most areas and probably better in some areas.
- Also, we introduced Newborn Screening from day 1 in Cloudnine despite resistance from medical personnel – we took lot of trouble explaining to every parent that this was a standard test everywhere in the world for the last 5 decades – in India the awareness is not there. When you examine a baby – physically we can examine but biochemically and enzymatically one cannot – hence newborn screening is essential to identify babies with biochemical or enzymatic problems arising either out of mutations or because of genetics or environmental issues – and any baby identified soon after birth – can be treated to ensure they remain normal. Now after 15 years it is getting to be a standard test in most hospitals at least in the southern part of India – if not everywhere.
Owing to the dedicated endeavours of Dr. Kishore, case studies on Cloudnine Hospital was conducted by Indian Institute of Management, Bangalore (IIM-B) and Cleveland University, Cleveland, Ohio, USA. The study discussed about the hospital’s success in such a short span of time and the ways and means the management achieved, which itself is a feather in the cap of the hospital.
But more than that, within 4 years of Cloudnine’s success and causing ripples in the medical fraternity, many other institutions started emulating their operations. For Dr. Kishore, this itself is a pat on the back. “But we have remained the ‘innovators’ and moving ahead with improved services every day,” he shares.
Taking Steady Steps Ahead
“We went from family run set up to a professionally run company with marquee PE investors, like Matrix, Sequoia, and True north. In the process, we have created 5 entrepreneurs, returned good returns to the angel investors and private equity players, created more than 10 healthcare leaders, 15 nursing leaders, a dozen medical leaders (would/could be medical directors), numerous lactation consultants, numerous NICU nursing leaders, and so on.”
Through the unwavering dedication of Dr. Kishore, Cloudnine has achieved almost negligible maternal mortality, improved survival for babies despite resuscitating extreme premature babies with very minimal morbidity and infections – these were thought to be unachievable, impossible to dream of in India. Now that the hospital has shown that this is possible, it is expanding across all geographies to offer such services in metropolitan areas – the hospital also plans to extend these services to rural areas and government sectors. “We have a lot of knowledge, experience, expertise in maternal and neonatal care which we can offer to the governmental sectors,” opines Dr. Kishore. He further added that if the opportunity arises Cloudnine is also open for public private partnerships (PPP) to improve the maternal and neonatal services in India
Speaking about the future, Dr. Kishore states that after reaching the pinnacle, Cloudnine has redefined its vision of the future. The hospital plans to extend its expertise in maternal and neonatal care to the rest of the country. It aims to make India a developed country with respect to the healthcare standards, especially the public sector and the parts of the country where the MMR (Maternal Mortality Rate), Infant Mortality Rate (IMR), and Neonatal Mortality Rate (NMR) is unacceptably high using technology and AI (Artificial Intelligence).
Dr. Kishore is of the opinion that Cloudnine has already commenced AI in maternal and neonatal care to this effect by piloting to identify the high-risk mothers and high-risk babies. This ensures that the babies are transferred to the tertiary centres well in time rather than in the last minute.
Dr. Kishore says they have empowered and employed tele-NICU across all the Cloudnine Centres. This has made them have ‘command centres’ in their 15 Cloudnines, so that these centres can provide NICU care for any part of India through technology and expertise available in all the 20 centres, 24/7 and also making them the largest chain of Tele-NICU centres.
Under Dr. Kishore’s fervent leadership, Cloudnine has developed robust research team and research capacity – by creating Institutional Ethics Committee under the aegis of ICMR (Indian Council of Medical Research) and as per GOI (Government of India) regulations. The hospital has also started quality research projects in maternal and neonatal care to improve the services in India. It has collaborated with multiple countries/universities such as Notre Dame University, Perth, Australia; University of Sydney, Australia; Cincinnati University, Cincinnati, USA; Harvard Medical School, Boston, USA; Newcastle-upon-Tyne, UK; and so on.
Dr. Kishore’s team has created working from home (WFH) modules for both doctors and nurses – which means irrespective of the location – they can provide quality care to people across India. “With tele-triage, tele-consultation and tele-NICU, integrated with AI – this is going to revolutionise the maternal and neonatal care in India,” he states.
Dr. Kishore states that being one of the first hospitals in India to do mandatory new-born screening for various disorders, Cloudnine has saved more than 1200 babies and has reduced the potential morbidity in about 2800 babies. Under his stewardship, the hospital plan to ensure that this happens soon across all over India.
One of the main issues that the hospital wants to focus on is to educate and inform people about the various myths leading to lot of issues that affect the health of people. Dr. Kishore, along with his team, aims to actively provide health education to bust the myths and in the process remove the quackery that exists in many parts of the country.
He also is of the opinion that healthcare delivery is a complex issue that too for India as the country is huge, with a young population and only 3.7% of the population paying taxes but the budget allotted is not enough to cater for the whole country. The healthcare delivery in the private sector vs public needs to be balanced. It is fair to say that no country has mastered the topic yet. Some countries have come closer to mastering the issue, but we still have a long way to go.
