Narayana Hrudayalaya Limited

Transcript of proceedings of 23rd Annual General Meeting

Held through Video Conference / Other Audio-Visual Means

August 4, 2023

MANAGEMENT:

DR. DEVI PRASAD SHETTY - CHAIRMAN

DR. EMMANUEL RUPERT - MANAGING DIRECTOR AND GROUP CHIEF EXECUTIVE

OFFICER

MR. VIREN PRASAD SHETTY, EXECUTIVE VICE CHAIRMAN

MS. SANDHYA J - GROUP CHIEF FINANCIAL OFFICER

MR. S. SRIDHAR - COMPANY SECRETARY

DIRECTORS:

MR. SHANKAR A - INDEPENDENT DIRECTOR AND CHAIRMAN - AUDIT, RISK &

COMPLIANCE COMMITTEE

MR. NAVEEN TEWARI - INDEPENDENT DIRECTOR AND CHAIRMAN - STAKEHOLDERS

RELATIONSHIP COMMITTEE

MS. TERRI SMITH BRESENHAM - INDEPENDENT DIRECTOR AND CHAIRPERSON

NOMINATION AND REMUNERATION COMMITTEE

DR. NACHIKET MOR - INDEPENDENT DIRECTOR AND CHAIRMAN, CSR COMMITTEE

DR. KIRAN MAZUMDAR SHAW - NON-EXECUTIVEDIRECTOR

MR. ARUN SETH - INDEPENDENT DIRECTOR

MR. DINESH KRISHNASWAMY - INDEPENDENT DIRECTOR

MR. B. N. SUBRAMANYA - INDEPENDENT DIRECTOR

MR. MUTHURAMAN BALASUBRAMANIAN - INDEPENDENT DIRECTOR

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Narayana Hrudayalaya Limited

Transcript of proceedings of 23rd Annual General Meeting

Moderator:

Dear shareholders, good morning and a warm welcome to you all to the 23rd Annual General

Meeting of Narayana Hrudayalaya Limited through video conference. As a reminder for the

smooth conduct of the meeting, the members will be in mute mode. The audio and video will be

switched on when they are invited to speak, as per the preregistration. Please note that as per the

requirement, the proceedings of the Annual General Meeting will be recorded and available on

the website of the company. I now hand over to Dr. Devi Prasad Shetty, Chairman.

Dr. Devi Prasad Shetty:

Dear shareholders, I'm happy to meet you again and welcome you all to the 23rd Annual General

Meeting of your company held through video conference facility. Pursuant to the Articles of

Association of the company, as the Chairman of the Board of Directors I am entitled to chair the

general meeting of shareholders. Accordingly, I am chairing this 23rd Annual General Meeting.

We have requisite quorum to commence the meeting and accordingly call this meeting to order.

I would now like to introduce your Board members who have joined this meeting from a

common venue in Bangalore.

 Mr. B.N. Subramanya, Independent Director

 Mr. Arun Seth, Independent Director

 Ms. Terri Bresenham, Independent Director

 Mr. Muthuraman, Independent Director

 Mr. Viren Prasad Shetty, Executive Vice Chairman

 Dr. Kiran Mazumdar Shaw, Non-Executive Director

 Dr. Emmanuel Rupert, Managing Director & Group CEO

 Mr. Dinesh, Independent Director

 Mr. Shankar, Independent Director

 Dr. Nachiket Mor, Independent Director, is joining virtually from Kolkata.

 Mr. Naveen Tewari, Independent Director, is joining us virtually from Bangalore.

 We also have Managing Director of Health City Cayman Island Limited, our subsidiary at

Cayman, Dr. Anesh Shetty.

 We have our CFO- Ms. Sandhya and Company Secretary - Sridhar.

I would like to acknowledge the participation of the Partner, our authorized representative of

our statutory auditors, Deloitte Huskins & Sons and the secretarial auditors Ganapathi & Mohan

Company Secretaries.

I take this opportunity to inform you that four of our Independent Directors, Mr. Arun Seth, Mr.

Muthuraman, Mr. Subramanya and Mr. Dinesh are retiring on the 7th August 2023, on

completion of their second term as Independent Directors. I profusely thank them on behalf of

myself, the Board and the shareholders for the immense contribution made by them to the

growth of the company through the board process and their continuous guidance, strategic

advice and governance oversight during their tenure.

I also take this opportunity to introduce our recently appointed Independent Directors, Mr. A.

Shankar, Dr. Nachiket Mor and Mr. Naveen Tewari. The new Board members come from

diverse industry backgrounds, skills and expertise. While Mr. Shankar is a designated senior

advocate and a chartered accountant with nearly four decades of experience in finance, legal

and taxation field, Dr. Nachiket Mor is an economist and management postgraduate with wide

experience and expertise in financial and healthcare sector. Mr. Naveen Tewari, on the other

hand, is the founder of InMobi -mobile advertising technology company, comes with vast

experience in technology and digital marketing area. Your Board will utilize the diverse and

vast experience and expertise of the new Directors for further growth and good governance of

your company.

Shareholders kindly note that those shareholders participating in this meeting and have not cast

vote through remote E-voting facility can now cast the vote through the E-voting facility

provided in this meeting VC screen.

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Transcript of proceedings of 23rd Annual General Meeting

I now request Mr. Sridhar, Company Secretary, to provide the general information about the

meeting for the benefit of the shareholders participating in this meeting. Thank you.

Mr. Sridhar S:

Thank you, Chairman Sir.

Dear shareholders, in compliance with the provisions of the Companies Act, 2013, SEBI

regulations, circulars issued by the Ministry of Corporate Affairs and SEBI, this meeting is held

through video conference facility. I would like to state that all efforts feasible have been made

by the company to enable members to participate and vote on the items being considered in this

meeting. The company has made available the facility for the shareholders to join the meeting

through video conference on first come first serve basis. LIVE web streaming of this meeting is

also being done through the video conference facility provided by NSDL.

Pursuant to the directions of the Ministry of Corporate Affairs, the notice along with the audited

financial statements, Auditor's report, Director's report and other information required to be sent

to the shareholders has been sent through email to the registered email ID of the shareholders

and physical copy of Annual Report has been dispatched to those shareholders who made

specific request for the same.

Since the meeting is conducted through virtual means, the option of appointing proxy is not

allowed as per the circular of the Ministry of Corporate Affairs. Only the shareholders can

attend the meeting. However, authorized representatives of corporate shareholders and

institutional shareholders who have submitted the authorization resolution can attend and vote at

the meeting.

Shareholders who have registered themselves to speak in the meeting would be enabled to speak

after the Chairman announces the opening of the floor for the shareholders to speak.

Shareholders can also pose questions through the 'Communicate' tab provided in the video

conference screen anytime up to 12:15 p.m.

The registers and documents that are required to be made available during the meeting for

inspection to the shareholders under Companies Act, 2013 are available for electronic

inspection. Shareholders who want to inspect can send email to the designated email ID given in

the notice.

We shall now have a message from our Chairman followed by presentation on the performance

of the company by the Managing Director and Group CEO.

Dr. Devi Prasad Shetty:

Dear shareholders, in '2011 Mark Anderson, the co-founder of Netscape, famously stated that

software is eating the world. His prediction was proven correct as companies like Amazon,

Google and Facebook changed the way we live our lives. However, not many people are aware

that these companies were able to change the world because they are standing on the shoulders

of giant platform ecosystems like Windows, Android, iOS and ALWAYS. Being built on a

stable platform allowed these companies to share information rapidly and innovate and build

software that is so intuitive even children can download an app for the first time they pick up a

phone. Unfortunately, the healthcare industry doesn't benefit from a platform that allows

multiple programs to interact with one another. We are rigidly isolated from the progress made

in the consumer technology industry due to the complexity of the existing systems. Contrary to

popular perception, hospitals are not the safest places for the patients. Despite having

worldclass hospitals and intense regulation it's estimated that if 200 patients just spend one

night in an American hospital, one of them will die due to medical error. Medical error is

widely acknowledged to be the third commonest cause of death in the U.S. hospitals after heart

disease and cancer. According to the Joint Commission of the U.S., medical error usually

happens due to communication failure. The foundation of patient care is built on the ability of

the doctors, nurses and paramedics to communicate with each other in real time and take critical

decisions. However, the existing electronic medical record systems don't do a very good job of

addressing the communication gap in healthcare. Despite costing tens of millions of dollars, the

dominant EMR system in the West don't have a happy end users and is cited as one of the

commonest cause for the physician burnout in the United States of America. There needs to be a

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Transcript of proceedings of 23rd Annual General Meeting

new platform that allows multiple sources of information and multiple methods of communicating patient data among doctors, nurses and technicians.

As a senior doctor, I believe that technology will make healthcare safer, more affordable and restore the joy of taking care of patients. However, I also believe that if a technology company builds software far away from the patient's bedside, it won't be acceptable to the doctors. This inspired us to start our digital journey, which eventually gave birth to the 'Athma' platform for healthcare delivery and made our platform for healthcare analytics and AI. Today Athma includes AADI app for the inpatient care, NAMAH app for the nursing care, Athma Laboratory Information System for managing laboratory, Athma Radiology Information System for radiology and reporting and NH Care app for the patients. True to our mission, we can seamlessly integrate with third party applications to unlock the full potential of our data. Athma enables mobile first; seamless communication between all our doctors, nurses, paramedics, administrators, patients and medical equipment. About 1.5 million messages flow every day between doctors, nurses, technicians and even the patients. This has dramatically improved the quality of patient care and patient satisfaction across all our group hospitals.

Here is an example of how our doctors have vastly improved our patient care routine because of the new tools available to us. Before I go to bed at 11 p.m., I conduct my ICU rounds sitting in the comfort of my home. I'm able to do this through AADI app on my iPhone which allows all the relevant patient information from Athma. My day begins at 4.30 in the morning with a fresh cup of coffee and checking up on all my patients virtually. Today, I can be anywhere in the world and I still see my ICU patients, interact with my colleagues, see the cardiac monitor or a particular patient or even talk to the patient, check the latest X-ray, change the medication or even speak to the patient's family from my phone. For the first time in my professional life as a heart surgeon, I can see everything about my patients from anywhere I choose and at any time I want to see it. We are among the few hospitals in the world that can remotely treat critically ill patients with all the medical reports at our fingertips. For someone like me who used to spend many nights in the hospital as a young surgeon, this is nothing short of magic. Young students join the medical profession because they are inspired to heal the sick and reduce suffering in this world but modern healthcare system have a lot of mindless and rote tasks that kills the spark. We designed Athma to restore the joy of patient care by eliminating pointless task while improving clinical outcomes and administrative efficiency. Our study on nurses routine revealed that over 50% of their time is spent simply copying information from the machines and entering into another system or writing on a paper. After deploying NAMAH Nursing App, we were able to reduce the time spent on this kind of monotonous work from 50% to less than 5%. This means that the nurses are now able to spend more time performing their clinical task and caring for their patients with empathy.

These innovations dramatically enhance patient satisfaction and improve the quality of care. Our Medha Analytics team has gathered mountains of clinical data to build the normal heart score, a risk scoring algorithm, which can predict an adverse cardiac event in post-op period well before the incidents can happen. In a recently published peer reviewed study NH score outperformed both the existing benchmarks, STS and EuroSCORE II, for all outcomes in an Indian population. The Medha team is currently working on predicting cardiac function from a simple ECG with better accuracy than the existing models.

Building Athma and our technology platform is the most complex project we have ever undertaken. It is my belief that worldclass software for our industry can be built by brilliant engineers coding at the bedside, interacting with the doctors in the halls of the ICU and experiencing the joys of healing patients and relieving suffering. We are truly blessed to have the opportunity to run an institution that attracts both talented clinicians and worldclass software engineers with magic in their fingers. The end result is truly special.

I would like to thank the Ministry of Health, Government of India, for encouraging hospitals and diagnostic centers to adopt electronic medical records and bring about EMR as the next UPI moment for India. In a world where vast majority of hospitals don't use an electronic medical record or a modern software, there is an immense opportunity to improve the quality and affordability of healthcare through these digital tools. We want Athma to be embraced by hospitals around the world at a price they can afford. This will save millions of lives and will be

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Transcript of proceedings of 23rd Annual General Meeting

a fitting tribute to the brilliant software developers who worked tirelessly for years to create this masterpiece.

We are extremely grateful for your trust in us and for giving us an opportunity to make this world a better place to live. Thank you so much.

Dr. Emmanuel Rupert: Ladies and gentlemen, esteemed shareholders and honored guests, I welcome you to the Annual General Meeting of Narayana Hrudayalaya Limited. As we reflect upon the milestones achieved in the past year, we strive to make a difference and shape a healthier tomorrow. We thank you all for being a crucial part of our shared vision and mission. We are extremely delighted and honored to have received the coveted Joint Commission Enterprise Accreditation. This achievement reflects our unwavering commitment to excellence, continuous improvement and delivering outstanding services to our stakeholders. The Joint Commission International based in the United States is a 70 year old nonprofit organization that provides accreditation and certification services to healthcare organizations worldwide. Joint Commission mission is to improve the quality and safety of patients across the globe by helping healthcare organization meet rigorous international standards. The surveyors who are experienced healthcare administrators and professionals assess compliance with standards covering various aspects of governance, alignment of the governance to all the units, oversight on the direction and administration of each facility, integrated and operational processes between the enterprise and each facility, common set of policies and procedures, shared resource allocation, strategic planning and oversight on quality, patient safety, clinical outcomes and infection prevention processes.

This, we are the first healthcare organization in India to be accredited with the Joint Commission Enterprise and we are the first hospital chain to be accredited in Asia- Pacific and we are the largest cross continent groups to be accredited. We have units in India as well as the Caribbean.

The accreditation is not merely a certificate or a recognition. It symbolizes our dedication to providing exceptional value to our customers and communities. It reaffirms our commitment to uphold the highest standards of integrity, ethics and social responsibility in all that we do. This is just a steppingstone towards even greater heights. Together we shall continue to raise the bar and set new benchmarks of excellence in our industry, always striving to make a positive impact and leave a lasting legacy.

The individual units, there will be 8 units of us which will also go for individual unit wise accreditation and the Joint Commission accreditation will be completed by early October in all the 8 units.

A quick snapshot of the units of Narayana Hrudayalaya. At a glance, we have 20 units in India and 1 unit in the Cayman Islands and we have 3 Heart Centres and 21 Primary Care Centres and key focus areas has been Cardiac Sciences, Oncology, Gastro Sciences, Nephron-Urology practice, the Orthopedic units and the Neurosciences and the new emerging work in the Image Guided Therapies as well. We are transitioning hospitals from being just a hospital to Centres of Excellence. Excellence is not just on the paper but truly a Centre of Excellence is when we combine multiple things. Due to aging population and increase in noncommunicable disease, healthcare needs of patients are becoming more complex leading to complex clinical work. This enhanced complexities of clinical work is increasing day by day and there's a new recognition that ambulatory options have been available, shifting care from the inpatient to short stay or care in the outpatient settings because early discharge following surgery can be achieved without increasing the risk of complications. This when it is combined with high quality care and concentrated into a specialized high volume Centre of Excellence, combined with patient experience and service excellence and the clinical team giving outstanding clinical outcomes, this all leads to an outstanding healthcare practice and this is what we aim to convert all our hospitals into Centres of Excellence in all the respective fields. All this leads to increasing costs which puts pressure on the hospitals and there's a challenge to deliver all this high quality care in a more affordable manner.

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Narayana Hrudayalaya Ltd. published this content on 10 August 2023 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 10 August 2023 07:30:03 UTC.