The transplant journey as a digital product
A transplant enquiry is not a lead. It is the opening of a case that will run for four to nine months, touch three or four cities, involve a patient, a donor, several relatives, a referring haematologist or nephrologist, a financial counsellor, a coordinator, a visa office and a landlord, and end — if it ends well — in an admission the unit’s capacity plan needed to know about two months earlier. Nothing in a standard hospital funnel is built for that, and the enquiry gets treated like a request for a cardiology appointment until somebody senior notices it has gone quiet.
I came to transplant the way most growth people do: through the demand numbers. The programme was the group’s most visible promise and its highest-value line, and the pipeline reporting was a spreadsheet kept by one coordinator who was, in effect, the product. When she went on leave, the pipeline went on leave. That was the moment it became obvious that the journey needed a product owner, not a better coordinator.
What follows is the journey as digital, product and brand see it — from the first message to the admission and the follow-up in the home city — and where it breaks when nobody owns the whole thing. It is not about clinical protocol. The clinicians own that and I have never pretended otherwise. It is about everything around it that decides whether the family arrives.
The journey, stage by stage, as the family experiences it
The first contact is rarely the patient. It is a relative, or a doctor in a Tier 2 city who has run out of options locally, and it usually arrives through a channel the hospital does not control: a forwarded phone number, a message to a doctor’s personal handle, an aggregator, a search for the programme’s name plus the word “cost”. Then reports travel, a second opinion happens — often on a video call — and a decision is made in principle. Then the work begins: donor identification and testing, financial counselling and fund-raising, travel and accommodation, pre-admission workup that may take weeks, and finally the admission itself. Afterwards, months of follow-up, much of it back in the home city with the referring doctor.
Each stage has a different owner inside the hospital, a different system, a different channel to the family and a different point of failure. The family experiences it as one relationship. The hospital runs it as six. The gap between those two is the product.
Designing the CRM for cases, not leads
The first design decision is the unit of record. It is the case, not the person and not the enquiry. A case holds the patient, the donor or donors, every family contact with their language and city, the referring doctor, the assigned coordinator, the financial counsellor, the stage the case is in, the date it entered that stage, and the next action with a due date and an owner.
Stages should reflect the family’s decision points, not the hospital’s departments: enquiry received, reports reviewed, second opinion given, decision in principle, donor identified, donor cleared, estimate issued, funds confirmed, travel booked, admitted, discharged, in follow-up. Each stage has a service-level expectation. The reason for defining them this tightly is not process for its own sake. It is that a transplant case can sit silent for three weeks at any stage for a legitimate reason — a donor being tested in another state, a fund-raising appeal running — and the only way to tell the legitimate silence from the case you have lost is a stage with a date and an owner.
Multi-touch here means something specific. The family will contact the hospital through the contact centre, through the coordinator’s mobile, through the doctor’s secretary, through a messaging channel, and through the international desk if they are abroad. Every one of those touches has to land on the same case. In practice that means the coordinator’s messaging thread is either integrated or logged, and the doctor’s secretary has a way to attach a message to a case in thirty seconds. If it takes longer, it does not happen, and the thread becomes the real system, which is where we started.
The donor and the family are separate workflows
A bone marrow transplant can involve a sibling in another city, or a search of an unrelated donor registry with its own timeline. A living-donor organ transplant involves a relative whose evaluation and consent are, legally and ethically, separate from the patient’s. The digital product has to hold that separation. The donor is a person with their own record, their own consent, their own contact details and their own privacy, related to the case but not subsumed by it.
This matters for the data-protection obligations under the DPDP framework — the donor’s health data is being collected for a purpose that has to be stated to the donor, not just the patient — and it matters for the family dynamics that the coordinator manages daily. A sibling who is being tested may not want the patient to know a result yet. A donor who withdraws needs to be able to do so without the CRM sending the patient an automated update. Getting this wrong is not a data incident. It is a family incident, and the hospital will be blamed for it.
The family workflow is the practical layer: who is travelling, who is staying, who is paying, who needs the estimate in Bengali, who speaks for the patient when the patient cannot. Record it once, early, and let every subsequent touchpoint read from it. The number of times a family is asked the same question by different desks is the metric they judge you on, and nobody measures it.
The inter-city and international component
For a large group, a meaningful share of transplant cases come from other states and a visible share from abroad — Bangladesh, parts of Africa, the Middle East, Central Asia. That brings a set of steps that are not clinical and not marketing, and that decide whether the admission happens at all.
The medical visa invitation letter, with the correct details and issued quickly. Airport pickup. Accommodation near the hospital for a stay that may run to three months, with a kitchen, because families cook. A local mobile number. An interpreter for languages the contact centre does not cover. Currency and payment arrangements. The return-trip planning and the follow-up protocol with a doctor in the home country. The same list applies, with less paperwork, to a family coming from a district town six hundred kilometres away.
Then there is the facilitator channel. International patients, and many domestic ones, reach large hospitals through agents who take a commission. The ethics are contested, the practice is widespread, and pretending it does not exist means the channel runs unmanaged. My position is that the group needs a written policy on who it works with, what is paid, and what is disclosed to the family, and that the CRM records the source honestly so the P&L can see what the channel costs and what it brings. Unmanaged, the channel corrupts the case data and eventually the brand.
Financial counselling is a conversion step
The single most common place a transplant journey stalls is between the decision in principle and the confirmation of funds. Transplant is expensive, insurance coverage is partial, and most Indian families assemble the money from savings, relatives, employer schemes, state relief funds, central schemes where they apply, and increasingly crowdfunding. This is a months-long project in itself, and the hospital either helps or watches the case drift.
Helping means the financial counsellor is part of the product. The estimate is a document with a version number, issued within a stated time, in the family’s language, itemised enough to be used in a scheme application or a crowdfunding page, and updated when the plan changes. The counsellor knows the state and central schemes, the paperwork each needs, and which TPAs cover which packages. The CRM tracks the funds stage separately from the clinical stages, because a case can be clinically ready and financially stuck for two months, and the capacity planner needs to know which of those it is.
I have argued for financial counselling headcount in a budget review on growth grounds, not service grounds, and won. The case was simple: the cost of a counsellor is small against a single transplant admission, and the number of clinically eligible cases lost at the funds stage was visible once we tracked it. The visibility was the argument. Before the stage existed in the CRM, the losses were invisible and therefore free.
The brand promise and what proves it
A transplant programme is the most public promise a hospital group makes. It says: for the hardest things, come here. That promise is heard by referring doctors in smaller cities first, and they judge it on whether their patients come back with a written summary, whether the hospital called them at discharge, and whether follow-up can happen locally. The referral network is the brand, and the digital product that serves it — a referring-doctor portal or even a disciplined messaging protocol with a case summary at each stage — does more for demand than any campaign.
Patient stories are powerful in this category and constrained by the same advertising norms as everywhere else in Indian healthcare: no outcome claims, no implied typicality, documented consent, and a preference for narratives about the journey over narratives about the result. The volume of transplants performed, stated plainly, is permitted and persuasive. The programme’s process — how a donor is found, how a family is supported, how long things take — is the content families actually read, and it is honest.
Where the journey breaks without a product owner
It breaks at every handoff, and the handoffs are numerous. The contact centre passes to the coordinator by email. The coordinator passes reports to the doctor by messaging thread. The doctor’s opinion comes back verbally. The financial counsellor is told about the case a week later. The international desk is not told at all. The reports are lost, re-requested, and the family concludes the hospital is disorganised — which it is, at exactly the points where no one owns the whole path.
It also breaks when the coordinator resigns. In most groups the transplant coordinator holds the pipeline in her head and her phone, and her departure resets the programme’s demand to zero for a quarter. That is not a people problem. It is the absence of a product.
And it breaks at capacity. A transplant unit has a fixed number of isolation beds and a fixed team, and admissions have to be sequenced. Without a case-stage pipeline the unit finds out about ready cases when the family arrives, and either delays them or turns away a case that was months in the making. The pipeline view — how many cases are at each stage, how many are expected to be ready in each of the next eight weeks — is the artefact the unit head and the medical director need from growth, and it is what earns growth the seat in the transplant programme’s review.
The order of operations
- Find the current pipeline. It is a spreadsheet or a phone. Read it and count the cases nobody has touched in three weeks.
- Define the case as the unit of record, with patient, donors, family contacts, referring doctor, coordinator, counsellor and stage. Build it in the CRM you have before buying anything.
- Define the stages around family decision points, each with an owner, a service expectation and a date. Make silence visible.
- Separate the donor record and its consent from the patient record. Review this with legal against the data-protection obligations.
- Give the coordinator and the doctor’s secretary a thirty-second way to log a touch to a case. If it takes longer, they will not.
- Make financial counselling a tracked stage with a versioned estimate document. Track cases lost at the funds stage and take the number to the budget review.
- Write the facilitator policy and record the source honestly.
- Build the eight-week readiness view and put it in front of the unit head and the medical director monthly.
- Name a product owner for the journey who is not the coordinator and not the clinician.
The family will remember the surgeon. They will judge you on everything else.
Questions people ask
It means someone owns the whole path from first message to home-city follow-up — the CRM, the stages, the handoffs, the family’s channels, the financial counselling, the international logistics — the way a product owner owns an app. The clinicians own the protocol. The product owns everything around it that decides whether the family arrives. In most groups that path lives in one coordinator’s spreadsheet and phone, and when she goes on leave the pipeline goes with her.
Because it opens a case that runs four to nine months, touches three or four cities, and involves a patient, a donor, several relatives, a referring haematologist or nephrologist, a financial counsellor, a coordinator, a visa office and a landlord. It ends in an admission the unit’s capacity plan needed to know about two months earlier. A standard funnel treats it like a cardiology appointment request until somebody senior notices it has gone quiet.
Make the case the unit of record, not the person or the enquiry. It holds the patient, donors, every family contact with language and city, the referring doctor, coordinator, counsellor, current stage, the date it entered that stage, and the next action with an owner and due date. Stages follow the family’s decision points, not hospital departments. A case can legitimately sit silent for three weeks; a stage with a date and owner is the only way to tell that from a case you have lost.
Because the donor is a person with their own consent, contact details and privacy, related to the case but not subsumed by it. Under the DPDP framework the donor’s health data is collected for a purpose that has to be stated to the donor, not just the patient. A sibling being tested may not want the patient to know a result yet; a donor who withdraws must not trigger an automated update to the patient. Getting this wrong is a family incident before it is a data incident.
The most common place a transplant case stalls is between decision in principle and confirmation of funds. Families assemble the money from savings, relatives, employer schemes, state relief funds, central schemes and crowdfunding, which is a months-long project. The counsellor is part of the product: a versioned estimate in the family’s language, itemised enough for a scheme application, updated when the plan changes. Track the funds stage separately, because a case can be clinically ready and financially stuck for two months.
Four to nine months is typical, and the family experiences it as one relationship while the hospital runs it as six. First contact, reports travelling, a second opinion often by video, decision in principle, donor identification and testing, financial counselling, travel and accommodation, pre-admission workup, then admission and months of follow-up back home. Each stage has a different owner and point of failure. The silence between them is where cases are lost.
A named product owner who is not the coordinator and not the clinician. The coordinator runs cases; the clinicians run protocol; the product owner runs the system — stages, service expectations, integrations, the readiness view, the facilitator policy. This person usually sits in growth or digital, because that is where the demand numbers first exposed the problem. Without them, every handoff is an email, and the programme’s pipeline resets to zero when the coordinator resigns.
In most groups the coordinator holds the pipeline in her head and her phone, and her departure resets demand to zero for a quarter. Reports get re-requested, families conclude the hospital is disorganised, and ready cases arrive without the unit knowing. That is not a people problem; it is the absence of a product. The fix is a case-based CRM where every touch is logged in thirty seconds, so the pipeline survives any individual.
With a written policy, not by pretending the channel does not exist. International patients and many domestic ones reach large hospitals through agents who take a commission; the ethics are contested and the practice is widespread. The group needs to decide who it works with, what is paid and what is disclosed to the family, and the CRM must record the source honestly so the P&L sees what the channel costs and brings. Unmanaged, it corrupts the case data and eventually the brand.
The eight-week readiness view: how many cases are at each stage and how many are expected to be ready in each of the next eight weeks. A transplant unit has a fixed number of isolation beds and a fixed team, and admissions have to be sequenced. Without the pipeline view the unit finds out about ready cases when the family arrives. That artefact, in front of the unit head and medical director monthly, is what earns growth a seat in the programme’s review.
The volume of transplants performed, stated plainly, is permitted and persuasive. The process — how a donor is found, how a family is supported, how long things take — is what families actually read. Patient stories are constrained by the same norms as everywhere in Indian healthcare: no outcome claims, no implied typicality, documented consent, and journey narratives over result narratives. The referral network judges the promise on written summaries and discharge calls, not on campaigns.
A medical visa invitation letter with correct details, issued fast. Airport pickup. Accommodation near the hospital for up to three months, with a kitchen, because families cook. A local mobile number, an interpreter for languages the contact centre does not cover, currency and payment arrangements, and a follow-up protocol with a doctor in the home country. The same list, with less paperwork, applies to a family from a district town six hundred kilometres away.
Less than one admission, which is the argument. Build the case structure in the CRM you already have before buying anything. The real costs are a product owner, a financial counsellor and the integration or logging that lets a coordinator attach a message to a case in thirty seconds. I have argued for counselling headcount on growth grounds and won, because once the funds stage existed in the CRM the eligible cases lost there became visible. Before that they were invisible and therefore free.
Yes. Most of the journey — the case as unit of record, donor separation, financial counselling, the readiness view, the referring-doctor loop — is the same whether the family comes from abroad or from a district town six hundred kilometres away. Drop the visa and interpreter steps and keep everything else. A single-site programme is if anything more exposed to the coordinator-resigns problem, because there is no second unit to absorb the cases.
