By Arunima Rajan

India is racing to build population-scale digital healthcare. Inside most hospitals, the signal cannot keep up. Ram Sellaratnam, Group CEO and Managing Director of iBUS Networks, argues that in-building connectivity must now be treated as clinical infrastructure, not an IT line item.

You’ve spent over 15 years building connectivity inside complex environments. When did hospitals stop feeling like just another building type to you?

For much of my career, connectivity was a matter of convenience or commerce. In airports, it was about helping a traveler find their gate; in office towers, it was about boosting a team’s productivity. The stakes were operational, but they weren't existential.

Hospitals shifted my entire worldview. The turning point arrived during the peak of the COVID-19 vaccination drives when digital verification systems became the primary method of confirming patient identity. I remember watching hospital teams struggle when the network slowed. It wasn't because the systems were poorly designed, but because identity itself had become dependent on the network. If the authentication failed, the entire treatment workflow paused.

That was the moment I realized healthcare networks are fundamentally different. In a mall, a dead zone is an annoyance. In a hospital, a dead zone is a clinical risk. The network has moved from the background of the building to the very forefront of patient safety. It is no longer just infrastructure; it has become a vital sign.

You’ve described patient safety as a network issue. Can you paint a picture of what actually happens inside a hospital when connectivity drops?

**Ram Sellaratnam, Group CEO and Managing Director, iBUS Networks**

The hospital network functions like a nervous system, carrying identity, diagnostics, monitoring signals, and communication simultaneously. When it fails, clinical workflows don’t slow; they stop. Imagine a nurse administering medication using a handheld device. Before giving the dose, the system verifies the patient through digital authentication, often involving secure credentials or SMS. If connectivity drops, that verification cannot happen, and the nurse is forced to wait. In critical care, those minutes carry real consequences.

In one deployment, clinicians temporarily lost access to imaging results during a connectivity disruption. The scans existed, and the doctors were ready, but the data simply could not reach them in real time. Decisions slowed not because expertise was missing, but because the information flow had stopped.

We see this in ICU monitoring as well. During complex procedures, specialists often observe patient data simultaneously from different rooms. Even brief interruptions create clinical uncertainty, and medicine works very hard to eliminate uncertainty.

Indian hospitals vary enormously. Is there a minimum digital dignity every facility should provide?

The diversity of India’s healthcare landscape is extraordinary, from large public medical colleges serving thousands daily to smaller private hospitals operating under tight budgets. Regardless of the scale or the price point, every patient deserves a baseline level of digital dignity.

At a minimum, every hospital should provide reliable indoor mobile connectivity, secure patient authentication, and immediate access to clinical records exactly where the care happens. Today, basic telecom coverage reaches most of India outdoors, yet care delivery happens indoors—inside wards, basements, and operating rooms where signals are often weakest.

Advanced AI systems or IoT devices can come later, but no doctor should have to walk toward a window or a specific corridor just to retrieve a patient’s lab results. Reliable connectivity should be treated as fundamentally as the supply of electricity or oxygen.

India’s digital health ambitions are enormous. Are we moving faster than our physical infrastructure?

India is attempting something very few countries have ever tried: building population-scale digital healthcare for over a billion people simultaneously. The ambition is remarkable. However, we are seeing applications and platforms evolve much faster than the indoor infrastructure required to run them.

We have built strong digital frameworks on paper, but many hospitals—even in major cities—still struggle with consistent connectivity inside their own walls. I wouldn't say we’re building on sand, but the foundation is certainly incomplete. Telemedicine, digital health IDs, and AI diagnostics depend on continuous, high-speed data exchange. Without reliable in-building networks, these systems work perfectly in a controlled demonstration but struggle in the messy reality of everyday clinical environments. Infrastructure must evolve alongside digital health policy, not as an afterthought.

Why do neutral-host, carrier-agnostic systems matter so much in a hospital environment?

From my experience, neutral host carrier agnostic systems are vital in hospitals because communication must work for everyone, regardless of the mobile network they use. Doctors, nurses, and emergency responders often rely on different carriers, which can lead to uneven coverage inside complex hospital buildings.

I have seen communication improve almost immediately after deploying neutral host infrastructure because signals from all operators became available throughout the building. This made emergency coordination much smoother. It also adds resilience. If one network fails, others still work. In healthcare, even a single communication failure during an emergency is one too many.

What pushback do hospitals typically give when infrastructure investments are proposed?

The first concern is always cost, which is understandable. My first response is usually: you won’t be the one writing the cheque. Under our partnership model, we invest the capital and work with telecom operators to monetize the infrastructure; the hospital carries none of the core deployment costs. That changes the conversation immediately. Healthcare administrators operate under constant financial pressure, balancing clinical investments with operational sustainability. Initially, connectivity is often viewed as an IT upgrade rather than a core clinical infrastructure.

Once leaders understand that improved connectivity reduces workflow delays, enhances digital services, and prepares them for future healthcare models, the discussion shifts. It stops being about spending money and becomes about reducing operational risk and improving patient outcomes.

From an engineering standpoint, what makes hospitals the hardest buildings to wire?

Hospitals combine engineering challenges that you rarely see together anywhere else. First, MRI rooms and operating theaters are hermetically sealed and shielded to contain radiation, which also blocks wireless signals entirely. Second, medical equipment generates significant electromagnetic interference that changes how signals behave.

Finally, unlike offices or malls, hospitals never shut down. Upgrades must happen without ever disrupting patient care. You also have to manage immense device density; hundreds of connected monitors, handheld tools, and imaging systems operate simultaneously. Designing networks that remain stable under those conditions requires precision engineering rather than traditional "one size fits all" deployment methods. Hospitals are not just buildings; they are living, continuously operating systems.

Looking ahead three to five years, what keeps you up at night as AI and connected devices enter hospitals?

The technology itself doesn’t worry me; it’s the pace of adoption and readiness that does. We are entering an era where AI will become foundational infrastructure, comparable to electricity. Clinical decision support, diagnostics, and hospital operations will increasingly rely on continuous streams of reliable data.

What concerns me is a two-tier outcome: hospitals with strong infrastructure will see AI amplify care quality dramatically, while hospitals with patchy connectivity will get the same tools and experience frustration instead of transformation. That gap will be measured in patient outcomes, not just user experience scores. The good news is the solution is straightforward: treat in-building connectivity as public-health infrastructure today, and everything that follows- AI, IoT, remote specialist care will scale without friction. We have a narrow window to get the foundation right before the next wave of clinical AI arrives. I’d rather we sprint now than retrofit later.

Got a story that Healthcare Executive should dig into? Shoot it over to arunima.rajan@hosmac.com—no PR fluff, just solid leads.

When the Network Fails, the Ward Stops