In 2004, you already had three development centres in the US. Why the fourth one in India? And why a BOT model instead of starting your own?

We looked at India, primarily to secure access to the great intellectual capital here. None of our competitors had an India operation at that point. We were a young company then, and for us to work out of the Silicon Valley of India (Bangalore) made sense. Now we are able to develop products faster than our competitors.

What is your plan for the India development centre. What is the growth roadmap?

India is the largest centre for us outside of our global headquarters in Mountain View. We have over 70 people in India focussed on three major areas.

This includes working on the next generation of our software products, software quality testing and proactive remote monitoring of our customers’ systems. Our headcount in India will grow at the same rate as our annual growth which is 20-30 per cent.

Unlike BFSI and telecom, healthcare traditionally is not considered to have a great appetite for technology.

True. Healthcare is not like the traditional technology sector. They are a little technology averse. It takes five to seven years for a hospital to implement the same system that a business can do in one year.

Because, it is not about software or technology. It is about user modification. User modification in a hospital is very difficult, and requires a lot of training. Hospitals are really focussed on clinical activities, not technology.

So, simple things like monitoring back-ups are difficult things for hospital. To move away from paper to electronic is very difficult to implement even if you have the money. Because, it is about behaviour modification. Because you will have the people tuned to what the customers are concerned about, and what they want is change without disruption, which is almost a contradiction.

Is it also similar in the US, where over 90 per cent of your customers are located?

Every hospital that I go into today, has three or four big strategic objectives for the next two-three years. To improve patient safety significantly is the first or second among these. In the US, the fastest-growing expense in the hospital is in the areas of drugs. Most of our solutions and services are centered around patient safety in the hospitals by reducing medication errors.

The world of pharmacy is extremely complex. The more the number of drugs created or deployed, it becomes more difficult for the doctor concerned, the nurse and even the patient, to understands all those drugs.

A system like ours can solve a lot of errors or problems in hospitals revolving around the wrong drugs or even may be the right drugs, but in the wrong time or even may be the right drug but the wrong dose (amount).

Last year, for instance, some small children in a very well-known hospital in the US died due to wrong and look-alike drugs. They did not have a system at that time. This is a big opportunity for us.

But hospitals may prefer different vendors...

Hospitals typically claim to have the ‘best of the breed’ solutions. While oncologists need a system that is best required for cancer patients, the emergency department needs a different system. There is a lot of standardisation within the configuration of electronic medical records (EMRs).

This allows you to address such issues. The EMR is still in its infancy, and it is not user-specific. You might create an electronic record, but that is just a record and it is not stored somewhere for retrieval in future.

And if you go to a different doctor, he does not have access to that since this is stored in a different system in a different hospital. But we have countries that now mandate a single system for the storage of medical records.