# Healthcare services: Value chain, from upstream to the customer

Hospitals, clinics, laboratories and pharmacies that diagnose, treat and care for patients

Source page: https://www.materialinsights.org/industries/healthcare/value-chain/

#### Value chain, from upstream to the customer
**Criticality to the chain:** 5 · Chokepoint 4 · Critical 3 · Important 2 · Supporting 1 · Commodity service Stage 1 **Medical supplies and equipmentPharmaceutical and consumables distributors**3 · Important

Buy medicines, vaccines and disposables from manufacturers and deliver them, often under cold chain, to hospitals, clinics and pharmacies on short credit cycles.
**Why important:** Several national and regional distributors serve each market, but a switch means re-contracting thousands of SKUs and credit lines, which takes months. Technologies Temperature-controlled warehousing Serialisation and track-and-trace Demand forecasting software Route-optimised delivery fleets Depends on Chemicals [API Small-molecule APIs](https://www.materialinsights.org/chemicals/apis/)[Exc Pharmaceutical excipients](https://www.materialinsights.org/chemicals/excipients/) Energy [PCM Latent heat and cold storage](https://www.materialinsights.org/energy/e_latent_heat/)[ICV Combustion road vehicles](https://www.materialinsights.org/energy/e_road_ice/) Industries [Pharmaceuticals](https://www.materialinsights.org/industries/pharmaceuticals/)[Paper and packaging](https://www.materialinsights.org/industries/paper_packaging/)**Examples:** McKesson, Cencora, Cardinal Health, Entero Healthcare Solutions

**Medical equipment and imaging suppliers**4 · Critical

Sell and service imaging scanners, monitors, ventilators, surgical tools and single-use devices to hospitals and diagnostic centres, usually with multi-year maintenance contracts.
**Why critical:** High-end MRI and CT come from a handful of global makers, most imported into India, and a failed scanner can wait weeks for parts and engineers. Technologies MRI with superconducting magnets CT and digital X-ray Patient monitoring and ventilators Minimally invasive and robotic surgery systems Single-use moulded devices Depends on Commodities [He Helium](https://www.materialinsights.org/commodities/helium/)[Nb Niobium](https://www.materialinsights.org/commodities/niobium/)[Cu Copper](https://www.materialinsights.org/commodities/copper/)[St Steel](https://www.materialinsights.org/commodities/steel/)[REE Rare earths](https://www.materialinsights.org/commodities/rare_earths/) Chemicals [PC Polycarbonate](https://www.materialinsights.org/chemicals/polycarbonate/)[PP Polypropylene](https://www.materialinsights.org/chemicals/polypropylene/)[PVC PVC](https://www.materialinsights.org/chemicals/pvc/) Energy [Dist Distribution grids, mini-grids and interconnectors](https://www.materialinsights.org/energy/e_distribution/) Industries [Medical devices](https://www.materialinsights.org/industries/medical_devices/)[Semiconductors](https://www.materialinsights.org/industries/semiconductors/)**Examples:** Siemens Healthineers, GE HealthCare, Philips, Trivitron Healthcare  Stage 2 **Workforce, facilities and systemsMedical colleges, nursing schools and teaching hospitals**5 · Chokepoint

Train and license-ready doctors, nurses and technicians, run residency programmes and produce the clinical research that shapes treatment protocols.
**Why chokepoint:** No substitute exists for trained clinicians, and a new doctor or specialist takes roughly 5 to 10 years to produce (estimate), so shortages cannot be fixed quickly. Technologies Clinical simulation labs Competency-based curricula Clinical trial and research infrastructure Online continuing education Depends on Chemicals [Rgt Reagents and high-purity lab chemicals](https://www.materialinsights.org/chemicals/lab_reagents/) Energy [Bld Energy in buildings](https://www.materialinsights.org/energy/e_buildings/) Industries [Education and research](https://www.materialinsights.org/industries/education_research/)**Examples:** AIIMS New Delhi, Christian Medical College Vellore, Manipal Academy of Higher Education, Johns Hopkins University

**Healthcare real estate developers and lessors**2 · Supporting

Build, own and lease hospital buildings, clinics and medical office space to operators, often through long sale-and-leaseback arrangements.
**Why supporting:** Many developers and landlords compete, although a new hospital building takes two to four years to plan and build (estimate). Technologies Hospital design for infection control Medical gas pipeline systems HVAC with clean-room filtration Backup power and water storage Depends on Commodities [Cem Cement](https://www.materialinsights.org/commodities/cement/)[St Steel](https://www.materialinsights.org/commodities/steel/)[Cu Copper](https://www.materialinsights.org/commodities/copper/) Chemicals [Pnt Paints and coatings](https://www.materialinsights.org/chemicals/paints_coatings/) Energy [HP Heat pumps, air conditioning and refrigeration](https://www.materialinsights.org/energy/e_heat_pumps/)[ICE Internal combustion engines and gensets](https://www.materialinsights.org/energy/e_engines/) Industries [Real estate](https://www.materialinsights.org/industries/real_estate/)[Construction and infrastructure](https://www.materialinsights.org/industries/construction/)**Examples:** Welltower, Ventas, Medical Properties Trust

**Health IT and electronic records vendors**3 · Important

Supply hospital information systems, electronic health records, lab and imaging software, and telemedicine platforms that link clinicians, payers and patients.
**Why important:** Several vendors exist, but replacing a hospital's records system is a multi-year project that disrupts clinical work. Technologies Electronic health records Picture archiving (PACS) Interoperability standards (HL7 FHIR, ABDM) Telemedicine Clinical decision support and AI triage Depends on Energy [DC Data centres](https://www.materialinsights.org/energy/e_data_centres/) Industries [Software and IT services](https://www.materialinsights.org/industries/software_it/)[Data centres and cloud](https://www.materialinsights.org/industries/data_centres/)**Examples:** Epic Systems, Oracle Health, InterSystems, Practo  Stage 3 **Support servicesHospital catering, linen and facility contractors**1 · Commodity service

Run patient kitchens, laundry, housekeeping and sterile linen supply under outsourcing contracts with hospitals.
**Why commodity service:** Many local and national contractors compete and hospitals can take services in-house within weeks. Technologies Therapeutic diet planning Industrial laundries with thermal disinfection Hospital-grade cleaning protocols Barcode linen tracking Depends on Commodities [Ri Rice](https://www.materialinsights.org/commodities/rice/)[Wh Wheat](https://www.materialinsights.org/commodities/wheat/)[Mk Milk & dairy](https://www.materialinsights.org/commodities/dairy/)[Ct Cotton](https://www.materialinsights.org/commodities/cotton/)[H₂O Water](https://www.materialinsights.org/commodities/water/) Chemicals [Srf Surfactants](https://www.materialinsights.org/chemicals/surfactants/)[Cl2 Chlorine](https://www.materialinsights.org/chemicals/chlorine/)[H2O2 Hydrogen peroxide](https://www.materialinsights.org/chemicals/hydrogen_peroxide/) Energy [LPG CNG, LPG and biogas distribution](https://www.materialinsights.org/energy/e_cng_lpg/)[Blr Boilers, furnaces and stoves](https://www.materialinsights.org/energy/e_combustion_heat/) Industries [Food and beverage processing](https://www.materialinsights.org/industries/food_beverage/)[Textiles and leather](https://www.materialinsights.org/industries/textiles/)[Household and personal care](https://www.materialinsights.org/industries/household_care/)**Examples:** Sodexo, ISS, Aramark, BVG India

**Biomedical waste treatment operators**2 · Supporting

Collect segregated clinical waste from hospitals and labs and treat it by incineration, autoclaving or shredding under pollution-board licences.
**Why supporting:** Treatment plants are licensed per district, so local supply is limited, but operators are widespread and service can be shifted to a neighbouring plant. Technologies Common biomedical waste treatment facilities Incinerators with flue-gas cleaning Autoclaves and microwave sterilisers Barcoded bag tracking Depends on Chemicals [Cl2 Chlorine](https://www.materialinsights.org/chemicals/chlorine/) Energy [Blr Boilers, furnaces and stoves](https://www.materialinsights.org/energy/e_combustion_heat/)[WtE Waste-to-energy](https://www.materialinsights.org/energy/e_waste_to_energy/) Industries [Waste and recycling](https://www.materialinsights.org/industries/waste_recycling/)[Transport and logistics](https://www.materialinsights.org/industries/transport_logistics/)**Examples:** Stericycle, Veolia, Re Sustainability  Stage 4 **Payment and oversightHealth insurers, TPAs and public health schemes**4 · Critical

Pool premiums and taxes, set tariffs, approve treatment and pay hospitals, often through third-party administrators that process claims.^[4](https://www.digitalhealthnews.com/ab-pmjay-marks-8-years-with-13-25-cr-hospital-admissions-worth-inr-2-03-lakh-cr)
**Why critical:** In India one public scheme, AB-PMJAY, has funded 13.25 crore admissions, so its tariffs and payment delays shape the finances of thousands of hospitals. Technologies Claims adjudication engines Cashless pre-authorisation Fraud analytics National health ID and claims exchange (ABDM, NHCX) Depends on Energy [DC Data centres](https://www.materialinsights.org/energy/e_data_centres/) Industries [Finance: banking, insurance, markets](https://www.materialinsights.org/industries/finance/)[Software and IT services](https://www.materialinsights.org/industries/software_it/)**Examples:** UnitedHealth Group, National Health Authority (AB-PMJAY), Star Health and Allied Insurance, Medi Assist

**Health regulators and accreditation bodies**3 · Important

License clinicians and facilities, set standards for quality and safety, and accredit hospitals and laboratories that insurers and patients rely on.
**Why important:** Each country has one licensing body per profession, but accreditation is voluntary in many markets and delays slow rather than stop care. Technologies Accreditation standards (NABH, NABL, JCI) Digital professional registries Inspection and audit frameworks Depends on Energy [Bld Energy in buildings](https://www.materialinsights.org/energy/e_buildings/) Industries [Public administration, defence and security](https://www.materialinsights.org/industries/public_admin/)[Software and IT services](https://www.materialinsights.org/industries/software_it/)**Examples:** National Medical Commission, NABH, Joint Commission International  Stage 5 **DiagnosticsDiagnostic laboratories and imaging centres**3 · Important

Run pathology tests and scans for doctors and patients, through networks of collection centres feeding central automated labs.
**Why important:** Many chains and independent labs compete in cities, but analysers and reagents are locked to a few global makers, so switching platforms takes months. Technologies Automated clinical chemistry and immunoassay analysers Molecular diagnostics (PCR, sequencing) Digital pathology Home sample collection logistics Depends on Commodities [He Helium](https://www.materialinsights.org/commodities/helium/) Chemicals [Rgt Reagents and high-purity lab chemicals](https://www.materialinsights.org/chemicals/lab_reagents/)[Enz Industrial enzymes](https://www.materialinsights.org/chemicals/enzymes/)[PP Polypropylene](https://www.materialinsights.org/chemicals/polypropylene/) Energy [Dist Distribution grids, mini-grids and interconnectors](https://www.materialinsights.org/energy/e_distribution/)[PCM Latent heat and cold storage](https://www.materialinsights.org/energy/e_latent_heat/) Industries [Medical devices](https://www.materialinsights.org/industries/medical_devices/)[Transport and logistics](https://www.materialinsights.org/industries/transport_logistics/)**Examples:** Quest Diagnostics, Labcorp, Dr Lal PathLabs, Metropolis Healthcare  Stage 6 **Care deliveryHospitals and specialty hospital chains**4 · Critical

Provide inpatient, surgical, emergency and intensive care, combining clinicians, beds, equipment and medicines into treatment billed to patients or payers.
**Why critical:** Hospital capacity is local and slow to add, so a closed or full hospital pushes patients to distant alternatives. Technologies Operating theatres and ICUs Medical gas systems Hospital information systems Robotic and minimally invasive surgery Infection control Depends on Commodities [H₂O Water](https://www.materialinsights.org/commodities/water/) Chemicals [O2 Oxygen](https://www.materialinsights.org/chemicals/oxygen/)[IPA Isopropanol](https://www.materialinsights.org/chemicals/isopropanol/)[N2 Nitrogen gas](https://www.materialinsights.org/chemicals/nitrogen_gas/)[API Small-molecule APIs](https://www.materialinsights.org/chemicals/apis/) Energy [Dist Distribution grids, mini-grids and interconnectors](https://www.materialinsights.org/energy/e_distribution/)[ICE Internal combustion engines and gensets](https://www.materialinsights.org/energy/e_engines/)[HP Heat pumps, air conditioning and refrigeration](https://www.materialinsights.org/energy/e_heat_pumps/)[Blr Boilers, furnaces and stoves](https://www.materialinsights.org/energy/e_combustion_heat/) Industries [Pharmaceuticals](https://www.materialinsights.org/industries/pharmaceuticals/)[Medical devices](https://www.materialinsights.org/industries/medical_devices/)[Real estate](https://www.materialinsights.org/industries/real_estate/)[Water and sanitation](https://www.materialinsights.org/industries/water_sanitation/)**Examples:** HCA Healthcare, Apollo Hospitals, Narayana Health, Max Healthcare

**Primary care clinics and doctors' practices**2 · Supporting

Offer first-contact consultations, chronic disease management, vaccinations and referrals, in person or by teleconsultation.
**Why supporting:** Clinics are numerous and fragmented, so patients can switch doctors within days, though rural coverage is thin. Technologies Practice management software Teleconsultation Point-of-care tests E-prescriptions Depends on Chemicals [API Small-molecule APIs](https://www.materialinsights.org/chemicals/apis/)[IPA Isopropanol](https://www.materialinsights.org/chemicals/isopropanol/) Energy [Bld Energy in buildings](https://www.materialinsights.org/energy/e_buildings/) Industries [Pharmaceuticals](https://www.materialinsights.org/industries/pharmaceuticals/)[Software and IT services](https://www.materialinsights.org/industries/software_it/)**Examples:** Apollo Clinic, One Medical, Ayushman Arogya Mandir (public health and wellness centres)

**Retail and online pharmacies**2 · Supporting

Dispense prescription and over-the-counter medicines to patients through chains, independent chemists and e-pharmacy apps.
**Why supporting:** India has a very large number of chemist shops and several e-pharmacies, so patients can switch within days. Technologies Pharmacy management and inventory systems E-prescription verification Last-mile delivery apps Cold storage for insulin and vaccines Depends on Chemicals [API Small-molecule APIs](https://www.materialinsights.org/chemicals/apis/)[Exc Pharmaceutical excipients](https://www.materialinsights.org/chemicals/excipients/) Energy [PCM Latent heat and cold storage](https://www.materialinsights.org/energy/e_latent_heat/) Industries [Pharmaceuticals](https://www.materialinsights.org/industries/pharmaceuticals/)[Wholesale and retail trade](https://www.materialinsights.org/industries/wholesale_retail/)[Paper and packaging](https://www.materialinsights.org/industries/paper_packaging/)**Examples:** CVS Health, Walgreens, Apollo Pharmacy, MedPlus Health Services, Tata 1mg

## Other sections

- [Overview](https://www.materialinsights.org/industries/healthcare/index.md)
- [Where ₹100 goes](https://www.materialinsights.org/industries/healthcare/cost-mix/index.md)
- [Price links with suppliers](https://www.materialinsights.org/industries/healthcare/price-links/index.md)
- [Example story](https://www.materialinsights.org/industries/healthcare/story/index.md)
- [Linked industries](https://www.materialinsights.org/industries/healthcare/linked-industries/index.md)
- [Materials drawn on](https://www.materialinsights.org/industries/healthcare/materials/index.md)
- [Chokepoints and risks](https://www.materialinsights.org/industries/healthcare/risks/index.md)
- [Sources](https://www.materialinsights.org/industries/healthcare/sources/index.md)