A turnaround story in healthcare- how CTSI is leading the 'fight against Cancer' in 'South Asia'

CTSI- is a holding company of 4 businesses- (i) AOI, American Oncology Institute is a chain of 15 Cancer Hospitals, (ii) Citizens Specialty Hospital is a premier multispecialty hospital brand with 300 beds under operation, (iii) Ampath- a diagnostic chain focused on specialty pathology, (iv) CTSI Oncology Solutions- with a focus on providing host of Oncology Services including Radiation treatment Planning, Dosimetry etc. CTSI is a subsidiary of the NYSE Listed company Varian Medical Systems (NYSE: VAR).

Dr. Jagprag Singh Gujral, the Group CEO- South Asia of CTSI has steered CTSI to become the largest and most reputed Cancer Care provider of South Asia, to learn of the journey.

How was CTSI started and how has the journey been thus far?

CTSI was started by a group of clinicians and entrepreneurs for the University of Pittsburgh Medical Center (UPMC) who came together to bridge the gap in Cancer specialty care between the Western developed hospitals and the Specialty hospitals in emerging markets. The key objective was to develop a comprehensive cancer care setup across the emerging markets. Along the journey, AHH (Asia Healthcare Holdings), a Single specialty investing arm of TPG Growth took an active investing and operating role and bought on a management team to realize this vision. Backed by the phenomenal growth displayed by the team, CTSI was bought by Varian in mid-2019. With >100 Mn USD of revenue from its 4 businesses and a y-o-y Growth rate of >65% CTSI today is setting new benchmarks in Cancer Care delivery through its Cancer Hospitals under the brand “American Oncology Institute” and diagnostic chain called “Ampath”.

How do you live up to your reputation of being the best oncology providers?

To succeed in a scientifically driven, services centric business, it is important to have a benchmarked strategy, flawless execution and a continually innovating model. Three of the major distinguishing factors of CTSI or AOI have been- Clinical excellence, Service differentiation and Capital efficiency. The single most important determinant for healthcare delivery is “outcome”. Benchmarked outcomes have to go hand-in-hand with superior service quality, as more often than not, the softer aspects in service delivery take a driving seat in satisfaction scores. The above two have to be delivered in a way that they provide better-than-peer and market returns in a capital intensive, talent reliant and high fixed cost financial structure.

To maintain clinical excellence, AOI benchmarks its clinical processes with UPMC and other reputed Western hospitals, through its roots. AOI’s Central treatment planning model, International Tumor boards, US qualified dosimetry checks, Central quality forums and comprehensive NCCN adopted formulary ensure advancements and best practices are adopted very quickly across the AOI hospitals. The constant feedback mechanism and a customer centric approach in a patient's journey through Cancer is key to a differentiated services model that AOI adopts.

Could you provide us with a few details about the technology you follow?

Oncology is a dynamic science with advancements being achieved almost on a daily basis. One just needs to look at the number of clinical trials in Oncology globally to understand the amount of work going on to better patient lives. Adopting the proven protocols early is key to keeping pace with the advancements. CTSI today is an established benchmark for most of these technology adaptations- Product Technology, Information Technology (IT),  and Clinical Technology. It is well established that these three are synergistic to each other and ultimately- how well you translate the technology for the end consumer or doctor or patient is the value that can be derived from these adaptations.

We are the first cancer provider to provide benchmarked technology solutions on an out-sourced basis. From our hospitals in India, we have provided cancer treatment plans through our technology to some of the most reputed healthcare institutions globally.

How safe are the clinical protocols that you follow in general and specifically in the Covid era?

The Oncology clinical protocols followed at AOI are benchmarked with the National Comprehensive Cancer Network (NCCN) Guidelines of the United States. Covid has been especially challenging for Cancer patients due to their added vulnerability as a result of the Cancer so it was important to not only ensure continued treatment of the Cancer but also create an environment of comfort for the same. AOI has been able to treat in excess of 25,000 Cancer patients over the last 9 months in a safe and covid restricted environment in its hospitals.

What approach do you adapt to fatal diseases like cancer?

The approach of AOI to cancer treatment has always been to provide Comprehensive Holistic Cancer Care. That is, we're not only treating cancer, but also helping the patient and family cope with the emotionally draining journey.

Diagnosing early is an important determinant in our approach hence we undertake exhaustive screening camps and preventive checks. Once diagnosed, staging and preparing the most optimal and comprehensive treatment plans. An important facet of our approach also lies in ensuring compliance so that AOI lives up to its statement of providing ‘precision cancer care’.

Which new technology did you implement recently in your hospitals to provide precision cancer therapy?

We are a 100% subsidiary of high-quality products. All 15 hospitals that fall under this group have access to the latest radiation equipment and protocols. Another significant thing is the utilization of available technology for patients.

The technologies are all based on NCCN protocols and information technology networks, with the help of which we deliver benefits of advanced technology to the patients.

How do you see CTSI (AOI) grow in the next five years?

CTSI has been registering a compound annual growth rate of around 65% over the last few years. Considering that we are a very young company and are around 100 Mn USD in revenue with a very robust growth pipeline, I see us sustaining this growth rate. We have launched on an average 5 Cancer hospitals annually and would continue the trajectory.

AOI has become the most awarded Cancer Specialty Hospital of 2020. Adding to this Dr. Jagprag Singh Gujral said ,”It’s an honor to be recognized as the most awarded Cancer Specialty Hospital of 2020 and it speaks of the commitment, dedication and competence of AOI’s Clinical and Operational teams. I truly believe that in the field of healthcare delivery, players don’t compete with each other. We all strive to deliver what's best for our patients and through access to improve the lives of the patients we serve.”

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