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INTEGRATED HEALTH SERVICES (IHS

)
We have heard millions of people saying I want to be an employer, rather than be employed, probably a gazillion times but those who have truly excelled while following the formula are the ones that are quite few in numbers. Dr. Asim Mahmood Khan is one of those few people who not only said it but with his conviction and perseverance, achieved it in the form of Integrated Health Services (IHS Pakistan) which is Pakistan's leading health organization involved in health service delivery through establishing clinics, hospitals, labs and home & emergency medical response systems besides school, occupational & corporate health services, health research, consultancies and health infrastructure development. It specially focuses on the neglected areas of the healthcare spectrum in Pakistan with emphasis on prevention and early detection of diseases & disabilities. IHS has grown from a small establishment into a conglomerate of health services with no parallel in Pakistan having seven divisions. Each division focuses on specific aspects of the health spectrum but also complement each other thus enabling us to provide complete healthcare solutions for everyone.

MISSION STATEMENT
“Provide quality healthcare through integrating professional services, focusing on immediate attention, prevention, detection, and early correction, in a manner affordable for everyone” IHS has the distinguished honor of being the pioneers in school health, home medical care, corporate health services and occupational health consultancy in Pakistan. We proudly claim that at the moment IHS is operating:     The largest school health network in Pakistan. The most organized, effective and efficient home medical care services in the country. A comprehensive corporate health system in Pakistan. Occupational health trainings & consultancies for national and multinational

organizations with client base spread across the country.

THE PATHFINDER’S TALE
Dr. Asim Mehmood Khan is the first doctor in his family. He did his MBBS in 1992 from Rawalpindi Medical College. He did not go abroad for practice or service even though he could, like all other doctors. Instead, he wanted to serve in the area of primary health care because he thought it was the neglected area in Pakistan. He did his MCPS in family health care in 1994 after his graduation. People think that just getting a degree for General Physician is of no use and hence, it is usually the last one in priority list but Dr. Asim was of the view that a General Physician can contribute a lot in the primary levels to ensure prevention as they are the first point of contact of the patients, after which they are referred to appropriate specialists. Love and respect for human beings and respect for life are the most important attributes of a general Physician. This shows that Dr. Asim likes to work with people, love serving people and mankind in general. In 1996 he threw himself in the market, applied for various jobs but unfortunately did not get any. However, he needed a stable income stream to support his family. He started off with a small clinic near airport named Airport Medical Centre, in Rawalpindi. His selection of this particular area was based on the thought that he would be in access of many when he would grow and he wanted to differentiate himself from those serving in local colonies that have as such no visions to expand and grow. Another interesting thought that he carried along was that he wanted to serve in an area where no one else has entered yet. For establishing a clinic there he rented a place for Rs. 1500 per month. At the first day in Airport Medical Centre he planned to charge Rs. 50 from each patient but when he treated his first patient he thought his services were too good to charge Rs. 50 only. So, he decided to charge Rs. 80 instead. On his first day he almost earned Rs. 200. The number of patients gradually after he gained some goodwill and experience, he was offered with three jobs out of which he opted for a government job. In March 1996 he joined a government health institute in G-8 sector. He opted for this job because of his family pressure due to the privileges in government jobs but never liked it and he stated in the interview that “I would much rather be a cobbler and be self-employed, then being a well paid employee”

He received a salary of Rs. 4700 per month. Yet, he was unhappy and always argued with his family for resigning but when he was transferred to pathology department in which he had no interest he just found out the reason to bail out and ultimately resigned. However on the other hand the clinic was performing really well and the number of patients increased to almost 150 per day in the time between 5 PM through midnight. Laboratory equipments were added to the clinic and new space was rented by him through which he transformed the clinic into Airport Family hospital.

THE BIRTH OF IHS PAKISTAN
Although the Airport hospital was going nice and smooth and most of the doctors would be happy just at this stage but Dr. Asim was different and wanted to expand his services thus his next area of target was home medical services where he thought to deliver the medical services to patients at the houses to serve the local community. In order to fulfill the purpose he established “Integrated Health Services (IHS)”. Dr. Asim remarked, “My dream was never to buy flashy cars and property; rather I wanted to do something for the society”.

HOME MEDICAL CARE
IHS Home Medical Care is a comprehensive, highly personalized program to meet the needs of people who choose to get medical treatment in the comfort of their home. IHS provides a highly skilled, cost effective alternative to hospital stays. IHS is a pioneer of “Home Medical Care” in Pakistan and is currently operating the largest and the most efficient and reliable home care team in the country with services available in Islamabad, Rawalpindi, Peshawar, Karachi and Lahore. Residing in f-8, Islamabad, Dr. Asim made his first office in his house. He started this IHS by creating awareness among the people for vaccination of hepatitis B. For this 1000 flyers were printed which totaled around 4000 rupees, and were thrown in, at random, in the residential area of Sectors F-8 and F-7 of the Capital City. Dr. Asim received the magic call (so to say) on the third day after distribution of flyers. The caller requested vaccination of Hepatitis B at a house located in Sector F-8of Islamabad. Fortunately, there were two patients who wanted complete

diagnosis. They were both prominent political leaders of the country. Dr. Asim’s business broke even the very same day and the cost of the flyers was recovered. For his first two patients he took their blood samples to the Excel Lab for testing and discovered that he will be given 25% discount. He then thought over it and decided that he could provide these services on his own. As a result, he adopted the backward integration strategy and began to offer all services of checkup, lab test, vaccinations, and treatment from under a single roof, boosting the level of revenues. He used the best vaccines and never compromised on quality, not caring about the fact that the margin was quite less as compared to other poor quality local vaccines. With the passage of time, the revenues stream started building up and the word spread that home care services are available at the doorstep. The intensity of calls and the number of clients increased day by day. He hired nurses and doctors who could visit the clients to their houses on demand and offer their services at their door step. They started receiving calls for checking blood pressure, blood sugar, and vaccinations etc. Today, IHS makes available team of specially trained doctors and paramedics in the art of personalized home care. IHS provides services like House-Call doctors / specialists / paramedics, collection of lab samples, vaccinations, infusions and medical procedures, in the comfort of home or office through a call on IHS 24 hr. Medical Help line numbers. IHS also provides home nursing facilities for prolonged periods for chronically and terminally sick patients. This includes provision of doctors, nurses and paramedics for extended periods even months, at home. Besides the clinical services IHS arranges for home medical equipment such as nebulizers, wheel chairs, oxygen cylinders, hospital beds, suction units, cardiac monitors, etc. on nominal rent. All these services are just a phone call away.

SCHOOL HEALTH CARE
Home medical care, being a new concept, was going good but patient base was rather not very large. The team was only able to serve 4 to 5 patients per day. Therefore, alongside the efforts to deepen the home care services, Dr. Asim started touring different schools for introducing the idea of School Health Services, which has ever since become a prime area of activity of IHS.

Initially, due to lack of awareness in Pakistan about the concept, it was difficult to make the school administrators appreciate the need to adopt a school health system, let alone persuading them to sign up. They had to work hard to make the educationists understand the importance of school health services in the overall mental & physical development of a child. With his persistence, Dr. Asim was able to convince the principal of the Convent School, Islamabad. It was a reputable school that IHS served and instigated its School Health Services with, in 1998. Although in Pakistan school health has been a part of the government health infrastructure since 1952 but practically on ground it is still non-existent. IHS took the initiative to make an investment in our nation’s future by providing school health solutions to both the private and public schools. It not only strives to prevent illness but also provides the opportunity for students to enhance their ability to learn by promoting physical and mental health and social well-being. Now, in school health IHS is a market leader in provision of various types of health services to the educational institutions in Pakistan. Due to their commitment and non commercial and professional approach IHS is the largest operator of school health in the country with over 0.8 million students enrolled so far and 223,180 registrations (till June 2007), mostly from Karachi and Islamabad.

CORPORATE HEALTH SERVICES
Healthy employees are the key to the future and success of a company. The corporate world of the 21st century is much different from what it was a few years back from now. The speed of work has increased tremendously. Economies are moving faster, communication has reached new heights, and standard of living has gone up. The pressures of the fast paced system start taking its toll. Health gets affected. The physical drive that we demand in order to lead a successful life diminishes. This is where Dr. Asim spotted an opportunity and IHS intervened. By the end of year 1998 and start of 1999, he made proposals for different organizations like leading multinationals in oil industry and tobacco industry for providing vaccination services. He hired qualified professionals and developed a team that visited corporations and vaccinated their employees. At the end of year 1999, IHS made contact with the Islamabad Traffic Police for vaccination of Hepatitis-B. A meeting was held with the Superintendant Islamabad Police where

they successfully sold him the idea. This opportunity created worth and credibility for Dr. Asim and his company. Ever since then, IHS has been ensuring that the health of the employee, their dependants and the company as a whole. Establishing work site wellness programs in corporations has been able to drastically reduce health care costs while employee productivity and morale are also increased. The IHS Corporate Health System covers the full spectrum from hiring an employee, to meeting his/her day-to-day needs, to protecting his/her health through health education and timely vaccinations, and health and safety measures to shield the employee from occupational hazards. A brief outline of IHS Corporate Health Services is as follows: o 24 hr. Round the clock a team of competent IHS Physicians is available for medical advice or consultation. o 24-hr On-Call Services of doctors, paramedics, nurses and state of the art ambulances for any medical emergency at your home or office. Our normal response time within Islamabad city is 15 minutes. o Pre-Employment & Annual Medical Examinations of employees either at our centers or at your sites anywhere in Pakistan, as desired. o Vaccination Services especially for expatriate employees against all vaccine preventable diseases as per international standards set by World Health Organization (WHO). o Health Related Trainings of employees in First Aid, Occupational Health, Ergonomics and HSE by our experienced and well trained Public & Occupational Health consultants of international repute.

OCCUPATIONAL HEALTH AND TRAINING
To raise the business volume, in the year 2002, Dr. Asim considered providing trainings of first aid at corporate and school level. The IHS Occupational Health & Training Division (OH & T) was, thus, initiated. Dr. Asim and his dedicated team launched a program known as “FATS” which is an abbreviation for “First Aid Training for Schools”. The duration of the training was six hours. Dr. Asim himself was the master trainer who trained his staff and developed a team of technical experts who could provide trainings at different schools. A contract was duly signed

between IHS and Pakistan Red Crescent Society, which was the sponsoring agency. It was decided that Rs. 2000 per training will be given to Pakistan Red Crescent Society. However, after two to three months the contract was ended and the first aid trainings were provided solely by IHS. Since margins were low in schools and colleges, IHS turned towards the corporate sector where it already had a presence. Initially, they received a very lukewarm response; the decision makers were not interested in spending any money on it considering it an extravagance. Gradually due to their consistent efforts many multinationals in Pakistan started adopting health friendly systems and investing in employees’ health, thus, promoting the development of a culture in which health & safety of the employee is of prime importance. IHS specializes in health & safety related trainings for the corporate and industrial sector, offering the following trainings conducted by experts of the field: o Work Place Safety o Injury & Disease Prevention o Defensive Driving Practice o Fire Fighting (Basic to Advanced levels) o Manual Handling Procedures o Accident Reporting & Investigation o Hazard Identification & Risk Analysis o Ergonomics o First Aid (Basic to Advanced levels)

CHILDREN HOSPITAL
Dr. Asim and his team members estimated that roughly out of every hundred patients 45%-50% comprised of children who were less than 15 years of age. For catering the health needs of children, government hospitals are there but, there are a limited number of beds for children and quality health services are also not provided to them. Therefore, working in accordance with their aim of helping the society and creating health awareness in the masses, Integrated Health Services (IHS) opened Islamabad’s first specialized child health center in F-10 (in 2007), to not just preserve but to promote health of children. IHS Children Hospital offers a complete healthcare solution to children of ages 0 – 18 years. Free of cost health services are also

provided to the poor and the needy children at this service unit. A charity profile is made for such type of needy children. The health of a child is never compromised in any way, whether or not the needy child’s parents had paid for the service taken. Another unique thing about this centre is that it provides 24-hours health services to the patients. There are two shifts of doctors whose contributions are the reason behind the success of this hospital. Dr. Asim’s idea for hospitals was quite different from the traditional one where people rent buildings, adjust reputable doctors and start operating on their goodwill. He actually did the opposite and hired highly qualified new graduates who did not have goodwill of their own. Rather, their good performance helped create goodwill for the Integrated Health Services (HIS), which had become their identification.

CONSULTANCIES AND HEALTH INFRASTRUCTURE DEVELOPMENT
IHS has an experienced pool of consultants including Physicians, Occupational Health Specialists, Public Health Scientists, Clinical Psychologists and Anthropologists. Some are working on permanent basis while others are on panel and work with IHS on project to project basis. Due to IHS involvement in many health related areas like Emergency & Home Care, School Health, Occupational Health & Safety and diagnostic services over the years; it now has diverse resources at its disposal that can be diverted towards research studies and consultancies at any level or location in Pakistan. IHS also specializes in infrastructure development for hospitals and diagnostic centers. On their panel are architects who have designed major hospitals in USA, Canada, Russia & India.

CLINICAL CARE
Through a network of centers IHS provides standardized quality clinical care ranging from GP and specialist consultation to diagnostics and inpatient facilities. Besides having their own clinical setups in Karachi, Islamabad, Balakot and Rawalpindi, IHS has integrated many existing health providers of the country to develop a system through which none of their patients have to worry about their health needs. They take care of everything ranging from arranging appointments, doctor visits, medicine delivery to sample collection and provision of preventive medical services all through one system, anywhere in Pakistan.

TACKLING OPERATIONAL DIFFICULTIES
The entrepreneur came up with an idea that was mind blowing but the team couldn’t perform well and eventually the project failed to achieve the desired goals, sounds familiar? This is what happens in the practical reality to those who fail to accommodate the team members spirit in for the projects because making yourself work for own will is okay but making others follow the path is rather challenging. IHS would’ve also failed if it hadn’t shown its quality of work and if the founder had failed to incorporate the workers spirit. Dr. Asim quoted that his staff is emotionally attached to their work because at the time of need IHS would always be there to help their employees considering their significance because they are the ones who make the system. Above all the basic motivation for a person to work is the money that he is being paid for his services thus Dr. Asim says that they always keep the salary level above the market price of the employee to retain them in the system and pay on average 20% surplus to them, which has led them to experience a very minute employee turnover rate.

NETWORK OF MONITORING SYSTEMS
For those who miss these qualities of life there are other systems designed at IHS which monitors them off and on to make sure they work such as o Networked Monitoring system, that via security cameras keeps a check on the IHS group to ensure people are performing their tasks efficiently and not just wasting time. o Designated VFones, in remote areas where the monitoring network is unable to reach. At any random time the operations managers have to call their respective areas and based on the response it makes them aware whether the employees are present or not.

LESSONS LEARNT
The life of Dr. Asim and the tale of IHS have answered many questions in life one of which is that before entering the market one can never predict what sort of opportunities can be encountered. The most valuable lessons we’ve learnt is that opportunities exist in every corner of the world but to achieve them one needs to show persistency and have faith in one’s own self as from the case with the School health care division. And quality of work is of supreme importance it would never pay off early but eventually the focus on quality distinguishes one from others and becomes the core competency of the organization.