eHealth February

eHealth Magazine

Asia’s first Monthly Magazine on the enterprise of healthcare Volume 11

Issue 02

February 2016

EDITOR-IN-CHIEF: Dr Ravi Gupta MANAGING EDITOR: Raghav Mittal EDITORIAL TEAM

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Contents

february 2016 | VOLUME - 11 | ISSUE - 02

10 Cover Story

31 Focus

Tethering Medical Education to Technology While shortage of doctors and paramedical staff is perennial, the need to inculcate adequate skills in the faculties of medical colleges and the field doctors is acute. The current estimated doctor-population ratio in India is 1:1700 as compared to a world average of 1.5:1000. The MCI has set a target of 1:1000 by the year 2031. For achieving this target and considering the number of existing medical colleges in the country, the present intake by medical colleges in India and the critical mass of doctors have to be rationally enhanced

44 Health Insurance

Preventive Healthcare Push â&#x20AC;&#x201C; Need of the Hour The efforts of the government is on and private health insurance providers also are rollingout new user-friendly policy plans to bridge the gap and make preventive healthcare a benefit for every Indian, because only a healthy India will be the engine of a progressive India

February / 2016 ehealth.eletsonline.com

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Exclusive Interviews

22 Connecting Doctors & Patients, Virtually

Varun Anand, Co-Founder, MphRx

Roadmap for Healthier Kerala

State Scan

36 Baddi Shines as the Pharma Capital of India

Dr K Ellangovan, Secretary-Health & Family Welfare Department, Government of Kerala

Affordable No-frills Health Services Dr Dharminder Nagar, MD & CEO, Paras Hospital

Punjab: De-Addiction Centres Raise Hope

Startups

Kerala to be a Global Destination for Ayush

Bridging Doctor-Patient Gap

Dr M Beena, Secretary (Ayush), Govt. of Kerela

Industry Speak Smart Records in Pocket 24 Abhimanyu Bhosale, Co-Founder, Livehealth

26 Healthcare Cashing in on Innovations

Ananda Sen Gupta, CEO, TrackMyBeat

Seamless Interfaces for Smooth Services

Jyoti Sahai, CoFounder, Kavaii Business Analytics India Pvt Ltd

30 Lender

With A Difference Jose Peter, CoFounder & CEO, Arogya Finance

February / 2016 ehealth.eletsonline.com

Genuine Drugs at Your Fingertips

news

38 50 52 54 56

Government Desk International News Hospital News Company News Pharma Buzz

editorial

Startups on a Roll In a country like India, where almost 70 per cent of the healthcare expenses are out-of-the-pocket, finding ways for affordable medical facilities could be a huge relief for the needy. And, in this age of digitisation and information technology, healthcare startups are making that happen, slowly but surely. Necessity is the mother of invention, they say, and the healthcare startups are making no mistakes in deciphering the underlying idea – to their advantage and to the advantage of those seeking cheaper, better medical care. Be it finding the right doctor for a particular ailment, getting an expert medical advice sitting at a far off place, buying medicines from the comfort of one’s home, or getting healthcare services delivered at one’s doorstep – the startups are doing it all. With technological advancements happening at an unimaginable pace, these newbies have come up with mobile apps that can bring together various healthcare providers like doctors, hospitals, clinics, diagnostic centres and pharmacists, on a single platform, to provide home and preventive care services, resulting in easier access to healthcare at affordable costs. Not stopping just at that, the medical startups are also providing solutions to healthcare facilities like hospitals and clinics for better management of various in-house records, patient data, availability of doctors and paramedical staff, and connecting patients with the desired medical professionals at pre-decided times. What keeps this startup momentum going is India’s huge market potential for healthcare services, which is believed to be a US $100billion opportunity. Moreover, an industry prediction of the number of mobile internet users in India crossing 300-million mark by 2017 from 159 million users now gives the startups even more reason for jubilation, as their primary focus is mobility-based healthcare solutions. This issue of eHealth magazine tracks the rise and rise of healthcare startups in India and talks to a number of entrepreneurs hogging the limelight for translating their innovative ideas into reality. The interactions will provide the readers a sneak peek into the future shape of the continuously evolving startup story. This issue also unravels the latest trend of digitally-aided medical education through a special feature that goes beyond the obvious to bring you a realistic account from the classrooms of educational institutions across India. Besides, the magazine also has lavish sprinkles of views of various stakeholders in the health domain. Hope you like the packaging and keep us posted with your valuable inputs.

Dr Ravi Gupta ravi.gupta@elets.in february / 2016 ehealth.eletsonline.com

Cover Story

Startup Twist in Healthcare Tale The startup movement has given new dimension to the way healthcare is delivered, with more and more IT-led innovations emerging on the horizon. But going hasnâ&#x20AC;&#x2122;t been all that easy for the startups, who have to fend for funding, followed by numerous regulatory challenges. Romiya Das of Elets News Network (ENN) takes a look on how the healthcare startups are gaining momentum amid various roadblocks on the way

february / 2016 ehealth.eletsonline.com

Cover Story

Nipun Goyal Co-founder, Curofy

ith technology consolidating its presence in the healthcare industry, it has opened a new market for the healthcare startups, with innovative ideas floating around. Over the years, the

“It is without any doubt that despite ample opportunities, there are a lot of hurdles in this sector due to lack of clarity in the regulations. If we look at startups into online pharmacies, there is no transparency of laws and regulations for them. According to some, they are allowed to sell drugs online, others say they are not. Due to this lack of clarity, innovators are skeptical in venturing into this sector. If there is more clarity for these startups, there will a clear path for them to grow at a faster pace, which in turn will help the Indian economy and ecosystem grow. In fact, the government should ease the laws and regulations for the startups making India stand out globally.”

industry has seen many healthcare IT innovations making their way in the form of wearables to applications to solutions. But now, the industry

has entered an altogether new phase, with healthcare records moving online, doctors and patients looking forward to mobile solutions, diagnosis from doctors sitting hundreds of miles away, tracking medicine regime, 3D printing and much more. However, with startup movement gaining pace in India, new innovations in IT healthcare is order of the day, with more and more devices and systems making their entry into the healthcare ecosystem at fastest-ever pace with broader diversity. Startups penetrating into the healthcare industry are eyeing the horizon that doesn’t seem too far away, with medical breakthroughs in the segments, such as computing, writing algorithms and analytics. They try targeting respective audiences—doctors and patients—by bridging the gap in the prevailing unorganised healthcare system, and bridging the supply-demand gap with innovative solutions in an ecosystem where healthcare market and digital health had been poles apart for long. These startups are leveraging advanced technology with high analytics to grab the untapped potential of the market. Although the healthcare industry in our country is complex in nature, especially at the grassroots level, it also presents a huge opportunity. The sector is well on its way to touch the magical figure of US$300 billion by 2020.

Hurdles on the way Even as the healthcare sector makes its way to the digital world, the startup as newbies in the domain are facing various hurdles in implementing their innovative ideas. These companies face their share of obstacles. Nipun Goyal, Co-founder, Curofy, told Elets News Network, “It is without any doubt that despite ample opportunities, there are a lot of hurdles in this sector due to lack of clarity in the regulations. If we look at startups into online pharmacies, there is no transparency of laws and regulations

february / 2016 ehealth.eletsonline.com

Cover Story

Shivam Bhagat Founder and CEO, Pockdoc

Easy availability of well-trained medical staff and booming investments in the sector are India’s advantage. But startups continue to face a variety of roadblocks in functioning, as the sector remains largely unorganised. Increase in insurance coverage as well as simplifying the procedure would bring in liquidity to the business. There is also need for a streamlined regulatory framework. The absence of a strong mentorship programme, essential for the growth and scaling of any startup, further adds to the problem. The challenge of cash flows is one of the distresses faced by most of the entrepreneurs. for them. According to some, they are allowed to sell drugs online, others say they are not. Due to this lack of clarity, innovators are skeptical in venturing into this sector. If there is more clarity for these startups, there will a clear path for them to grow at a faster pace, which in turn will help the Indian economy and ecosystem grow. In fact, the government should ease the laws and regulations for the startups making India stand out globally.” The easy availability of welltrained medical staff and booming investments in the sector are India’s advantage. Startups continue to face a variety of roadblocks in functioning and implementation, as the sector remains largely unorganised. Low insurance coverage is one such hurdle that hampers growth. Increase in insurance coverage as well as simplifying the procedure would bring in liquidity to the business. There is also a need for a streamlined regulatory framework to give an overview of the operations of healthcare startups. The absence of a strong mentorship programme, essential for the growth and scaling of any startup, further adds to the problem. The challenge of cash flows is one of the distresses faced by most of the entrepreneurs in the healthcare space said Shivam Bhagat, Founder and CEO, Pockdoc to Elets News Network. The growth in the healthcare sec-

february / 2016 ehealth.eletsonline.com

Challenges faced by healthcare startups emerge from many quarters, though regulation is perhaps a dominant one. Very often, regulations simply fail to play a proactive or a supporting role they can and are required to play...they are inhibitors to innovation... tor is slow; therefore, it is essential for the startups to tackle the roller coaster ride with patience. Innova-

tive ideas do not receive immediate funding and those who receive have to walk down a long path for recognition. There might not be tough competition, but only a few can survive the sluggish pace of the sector. M N Rao, Chairman, MediSys Edutech said, “The challenges faced by healthcare startups emerge from many quarters, though regulation is perhaps a dominant one. Often, regulations simply fail to play a proactive or a supporting role they can and are required to play. In that sense, they are usually inhibitors to innovation, and not necessarily roadblocks except in a few areas. From drug launches to medical education to health insurance to health informatics, the ambit of regulation is very wide. Regulatory convictions run deep in some areas, while oversight and ineptitude hurt in other areas. The industry awaits innovations in operating models, not merely is drugs and devices. The manner, in which regulation actually impacts healthcare startups and model innovations, is perhaps not very obvious to the casual observer. But, there are many contexts that are illustrative. Healthcare has witnessed a progressive investment activity over the last few decades, though it has been more in the secondary and tertiary healthcare delivery. As an evolutionary mode, this investment has moved

Varun Gera CEO, HealthAssure

“All startups are challenged by regulatory, compliance and other elements in the early few years distracting their focus from their objective and being successful. Healthcare startups are no different and have to face a few more regulatory challenges in the form of licenses and other tedious regulatory requirements, especially for setting up a primary care centre. Other regulatory challenges faced by healthcare sector include increased cost due to service tax on essential products like insurance and other health service businesses providing healthcare to the public. Also, there is a requirement of licences for health service providers associated with insurers even though insurers themselves are already regulated.”

Cover Story

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Cover Story

towards segments like primary care, medical devices and health services, and we have seen a lot of startups in these areas recently. Clearly, primary care is the need of the hour as India moves from treatment to prevention and day-to-day healthcare. Also, with the advent of technology and mobile engagement, health services industry across the world including India has witnessed a spurt of activity. “All startups are challenged by regulatory, compliance and other elements in the early few years distracting their focus from their objective and being successful. Healthcare startups are no different and have to face a few more regulatory challenges in the form of licenses and other tedious regulatory requirements, especially for setting up a primary care centre. Other regulatory challenges faced by healthcare sector include increased cost due to service tax on essential products like insurance and other health service businesses providing healthcare to the public. Also, there is a requirement of licences for health service providers associated with insurers even though insurers themselves are already regulated,” said Varun Gera, CEO, HealthAssure. Healthcare being a very sensitive issue to consumers and the government, health tech startups have to face many regulatory roadblocks to reach their customers. Various associations of healthcare industries lay down a lot of rule and regulations,

which mostly lack clarity that creates a lot of confusion in the workspace. Aditya Kandoi, Co-founder, CareOnGo told Elets News Network that in India, laws related to pharmacies were written prior to the arrival of computers, let alone the Internet. Drug and Cosmetics Act 1940, Drugs and Cosmetic Rules 1945, Pharmacy Act 1948 and Indian Medical Act 1956 were written way before the e-commerce era. Therefore, there is no clarity on the regulations for online pharmacies. Information Technology Act 2000 still lies in the grey zone, when it comes to healthcare technology. As per the regulations, the prescribed drugs cannot be dispensed without a valid prescription. “But on our platform, the prescription is verified by a qualified pharmacist before the order can be processed for delivery within the same day. The original copy of the prescription is checked and stamped

M N Rao Chairman, MediSys Edutech

“The challenges faced by healthcare startups emerge from many quarters, though regulation is perhaps a dominant one. Often, regulations simply fail to play a proactive or a supporting role they can and are required to play. In that sense, they are usually inhibitors to innovation, and not necessarily roadblocks except in a few areas. From drug launches to medical education to health insurance to health informatics, the ambit of regulation is very wide. Regulatory convictions run deep in some areas, while oversight and ineptitude hurt in other areas. The industry awaits innovations in operating models, not merely is drugs and devices.”

Anurav Rane CEO, PlanMyMedicalTrip.com

“The PM’s speech was like an icing on the cake. While the entire summit was aimed at promoting startups, our expectations were limited to motivating the youngsters in taking initiatives for doing something they believe in. However, we truly feel that this summit has been worthwhile after listening to the announcements made by the PM. Policies like no capital gain, no taxes for three years, and most importantly, the Startup Fest will allow us to build a healthy collaborative environment with an aim to grow in this competitive world.”

february / 2016 ehealth.eletsonline.com

to avoid the drug-abuse cases. Also, there are stricter regulations on the sale of Schedule X drugs and we do not sell the same at our platform.”

Online Pharmacies’ woes He maintained that the present healthcare issues cannot be resolved without technology and the government needs to play the role of

Cover Story

Dr Adarsh Somashekar Director and Consultant Pediatrician, Ovum Hospital, Bangalore, told ENN

“Healthcare companies face regulatory roadblocks at different points throughout establishment. Starting with the registration formalities, a typical new hospital requires clearances from at least 30 different agencies. This includes both local and central government agencies. Diverse procedural requirements, like X-rays, lab machines, pharmaceuticals, etc., call for unique approvals. The narcotics licence for controlled usage of drugs and pollution control mechanism certification, among many others, require separate clearances. In short, these take anywhere between three to six months for completion.” a facilitator to encourage technology disruption in healthcare. However, the government laws are not yet clear on using digital prescriptions for dispensing medicines. Online payment of medicines still lies in the grey zone as there is no clear stance taken by the government, he further said. For entrepreneurs making healthcare a part of the digital era has been a challenge. The consumers seem to be comfortable in purchasing apparels or home appliances online, but when it comes to health, trust and authenticity plays a major role. The adoption of technology is a big hurdle to cross with minimal efforts from the government to promote technological innovation in this domain.

Nilesh Aggarwal and Amit Sharma, Co-founders, eMediNexus, told Elets News Network (ENN), “Healthcare startups face a variety of roadblocks, apart from registration and maintenance of corporate status. Internet-based startups have to deal with low insurance coverage, a massive shortage of data and confusion around permissibility of the virtual delivery of services. Brick and mortar startups have to deal with the fit out and construction cycle, heavy permitting and expensive term, and working capital financing. The devices segment lacks a clear regulatory framework clarifying even basic distinctions between devices and drugs. Still, there is significant activity in

these segments with regard to establishment and growth of startups.” The overwhelming growth of insurance would build capacity and liquidity throughout the segment, and the government is singularly placed to accelerate its pace, they further said, adding, “A disease repository for matching the supply of healthcare capacity optimally with demand is also sorely missing, although significant public health efforts have been undertaken across the country. Further, viability gap in funding and operational financing would be helpful to startups across the board. Challenges in medical education lead to major bottlenecks in the availability of skilled workforce, which leads to expensive services, or its lack of availability. There is a lack of a formalised framework for continuous medical education, in addition to the slow pace of creation of new medical colleges. Finally, increased public health expenditure is not just a desire of startups but required for the benefit of the nation and its productivity. To

Aditya Kandoi Co-founder, CareOnGo

“laws related to pharmacies were written prior to the arrival of computers, let alone the Internet. Drug and Cosmetics Act 1940, Drugs and Cosmetic Rules 1945, Pharmacy Act 1948 and Indian Medical Act 1956 were written way before the e-commerce era. Therefore, there is no clarity on the regulations for online pharmacies. Information Technology Act 2000 still lies in the grey zone, when it comes to healthcare technology. As per the regulations, the prescribed drugs cannot be dispensed without a valid prescription.”

february / 2016 ehealth.eletsonline.com

Cover Story

the extent possible, the private sector would collaborate and fill the void, but the overall quantum of contribution is in a fledgling stage.” Even with the hype of ‘Make in India’ campaign, the lack of regulations in the market is making it easier for the foreign players to dominate the market. Sandeep Napa, Co-founder and CEO, HealSpace, talking to Elets News Network said, “70 per cent of the medical devices sold in India are imported, but a structured regulatory mechanism in India is lacking, putting patients at risk. The recent amendment to the Drugs and Cosmetics Act and the government’s decision to allow 100 per cent FDI in the device sector are steps in the right direction, but device manufacturers and hospitals can be proactive in ensuring patient safety. Competing for priorities should not impede our common goal of making healthcare affordable and outcome-driven.” The startups in the online pharmacy domain in the country are chasing nearly US$1 billion market struggling to convert orders into sales. The Director of online pharmaceutical company BigChemist.com, Puneet Kapoor, told Elets News Network that the absence of clear laws and regulation for the online healthcare and pharmacy under the prevailing acts is the biggest challenge for the e-healthcare startups to operate.

This is a major roadblock as it does not help strategise the expansion and operating activities. The lack of implementation of GST is also a major roadblock. For e-healthcare, the need for central regulatory framework rather than state framework is very important and need of the hour to ensure that the e-healthcare can serve pan India to provide affordable, quality and primary healthcare to all segments of the society at large. For

Nilesh Aggarwal and Amit Sharma Co-founders, eMediNexus

“Healthcare startups face a variety of roadblocks, apart from registration and maintenance of corporate status. Internet-based startups have to deal with low insurance coverage, a massive shortage of data and confusion around permissibility of the virtual delivery of services. Brick and mortar startups have to deal with the fit out and construction cycle, heavy permitting and expensive term, and working capital financing. The devices segment lacks a clear regulatory framework clarifying even basic distinctions between devices and drugs. Still, there is significant activity in these segments with regard to establishment and growth of startups.”

february / 2016 ehealth.eletsonline.com

instance, the law does not identify delivery vis-à-vis dispensing. The online pharmacy startups are already facing opposition from the offline chemists, and adding to that is the scrutiny of the regulators. They are spending their large chunks of investments to improve patient awareness of proper prescriptions.

Regulatory Challenges Healthcare companies face regulatory roadblocks at different points throughout establishment. Starting with the registration formalities, a typical new hospital requires clearances from at least 30 different agencies. This includes both local and central government agencies. Diverse procedural requirements, like X-rays, lab machines, pharmaceuticals, etc., call for unique approvals. The narcotics licence for controlled usage of drugs and pollution control mechanism certification, among many others, require separate clearances. In short, these take anywhere between three to six months for completion, Dr Adarsh Somashekar,

Cover Story

Suvro Ghosh Founder, Lazoi

“As there is lack of proper knowledge about online healthcare domain, the government can take this issue and start educating our people to book through online portals for greater convenience of the patients and with least hassle. A thorough campaign is needed to make more people aware and especially in rural areas, so that more and more people go the registered practitioner rather than to quacks, which will ultimately lead to more traffic to online healthcare portals. The government can also make it mandatory for all medical practitioners to register themselves with their respective organisations online, along with all their details, and update it regularly for general people to know and choose their doctors.”

Director and Consultant Pediatrician, Ovum Hospital, Bangalore, told ENN. He further added that sourcing investment capital is another challenge. Hospitals need to acquire land and equipment as per the standard government norms and procedure. Procuring loans are a hassle, as there is no subsidised rate of interest and repayment window is limited to three to four years. Loans are not disbursed without collateral this makes access to funds a major concern. Albeit the healthcare entities are levied service tax for the services they avail, charging the customers any service tax is not allowed, thereby causing financial duress to the healthcare providers. Besides, no incentives are provided in the form of tax breaks or the likes for the initial period of operations, despite the fact that employment is generated for more than 130 persons. Vipul Jain, CEO and Founder, Advancells, said, “Regulations are important in this industry as we are dealing with the health and lives of people and unless the government regulates the proceedings well, it will be difficult to offer safe and well researched treatment to the general public. However, unfortunately healthcare is over regulated in India. Regulations here present a major roadblock in research and innovation as most regulators have a closed mind towards innovations. It is almost impossible to get new trials registered in

our field and even if you do, hardly any trials in the recent history have been approved by the regulatory bodies.

Sandeep Napa Co-founder and CEO, HealSpace

“70 per cent of the medical devices sold in India are imported, but a structured regulatory mechanism in India is lacking, putting patients at risk. The recent amendment to the Drugs and Cosmetics Act and the government’s decision to allow 100 per cent FDI in the device sector are steps in the right direction, but device manufacturers and hospitals can be proactive in ensuring patient safety. Competing for priorities should not impede our common goal of making healthcare affordable and outcome-driven.”

“There is almost no incentive towards innovations. The government does have a lot of schemes towards extending financial aid, but it is very difficult to even complete the paperwork to apply for these grants. Healthcare research requires heavy capital investments and there are no subsidies available for startups to make that kind of investment. Healthcare incubators are unheard of and general outlook of regulators towards innovation and research is always negative. With a renewed focus on innovation in the startup India plan, we hope the things to change and regulatory approvals for research and innovation to get easier.” The healthcare startup companies wish to closely work with the government making a cohesive partnership to put in efforts to make healthcare accessible to every citizen of the country. Prime Minister Narendra Modi’s ‘Startup India, Stand Up India’ initiative can offer a much needed motivation to the local entrepreneurs but, bureaucratic and regulatory red tape slows down the process. It is required that the government address this issue making it easier for the small businessmen to set up their ventures. Bank funding is still a challenge for startups in general and tech organisations in particular, as the collateral requirement is difficult to comply with in the nascent stage. The entrepreneurs sometimes find themselves wired in the maze of laws and compliances across states. Anurav Rane, CEO, PlanMyMedicalTrip.com, commenting on the Startup India initiative by the government told Elets News Network, “The PM’s speech was like an icing on the cake. While the entire summit was aimed at promoting startups, our expectations were limited to motivating the youngsters in taking initiatives for doing something they believe in. However, we truly feel that this summit has been worthwhile after listening to the announcements made by the PM. Policies like no capital gain, no taxes for three

february / 2016 ehealth.eletsonline.com

Cover Story

years, and most importantly, the Startup Fest will allow us to build a healthy collaborative environment with an aim to grow in this competitive world.” The Prime Minister’s initiative is a good beginning but simultaneously needs to build up the momentum, he added. The roadblocks that Indian startups are facing today are manifold whether in terms of reach or speed of Internet or in terms of technology, because in the long term, reach as well as technology advancement will be very important for startups to grow and flourish in India. Elaborating on the flexibility that a healthcare startup company expects from the government, Suvro Ghosh, Founder, Lazoi, said, “As there is lack of proper knowledge about online healthcare domain, the government can take this issue and start educating our people to book through online portals for greater convenience of the patients and with least hassle. A thorough campaign is needed to make more people aware and especially in rural areas, so that more and more people go the registered practitioner rather than to quacks, which will ultimately lead to more traffic to online healthcare portals. The government can also make it mandatory for all medical practitioners to register themselves with their respective organisations online, along with all their details, and update it regularly for general people to know and choose their doctors. Full tax benefits should be given till one starts making profit. There is a requirement of one-window system for all regulatory sanctions. There is a need to allocate a corpus of funds to be given to startups after due diligence as a loan for them to grow and expand.” To foster innovation, delivery of healthcare should be exempt from service tax if it is a health services company involved in various aspects of care, including home care, discounted

february / 2016 ehealth.eletsonline.com

Puneet Kapoor BigChemist.com

“The absence of clear laws and regulation for the online healthcare and pharmacy under the prevailing acts is the biggest challenge for the e-healthcare startups to operate. This is a major roadblock as it does not help strategise the expansion and operating activities. The lack of implementation of GST is also a major roadblock. For e-healthcare, the need for central regulatory framework rather than state framework is very important and need of the hour to ensure that the e-healthcare can serve pan India to provide affordable, quality and primary healthcare to all segments of the society at large. For instance, the law does not identify delivery vis-à-vis dispensing.” access to care, insurance, etc. IRDA should regulate the insurers and not other parties related to them, such as brokers, TPAs, assistance companies, etc. This will allow these industries to evolve and create new products for Indian market. Insurer agents should be allowed to distribute insurance products of more than just one life, one non-

Vipul Jain CEO and Founder, Advancells

“Regulations are important in this industry as we are dealing with the health and lives of people and unless the government regulates the proceedings well, it will be difficult to offer safe and well researched treatment to the general public. However, unfortunately healthcare is over regulated in India. Regulations here present a major roadblock in research and innovation as most regulators have a closed mind towards innovations. It is almost impossible to get new trials registered in our field and even if you do, hardly any trials in the recent history have been approved by the regulatory bodies.”

life and one health insurer. This will lead to deeper penetration of insurance, which ultimately is very essential for the Indian public, adds Varun. India faces an immense challenge as far as competent workforce is concerned in healthcare domain and where technology can play a crucial role.

Funding the Ideas The venture capitalists (VC) or private equity firms look for startups beyond just aggregation and price discovery. They look for companies offering effective care delivery, along with good data play. However, sadly though, there are not many startups coming up with the ideas in the preventive healthcare domain leveraging technology. While funding, the VCs do not opt for pure molecule-based research, but about the ideas that can improve access in healthcare domain. In the October-December quarter of fiscal 2015-2016, 17 Indian Healthcare IT companies received VC funding — the highest ever in a single quarter, according to a report by Mercom Capital Group released last month. There were also two M&A transactions involving Indian companies, the report said. Talking about healthcare IT startups, the report said investment worth USD4.6 billion were made in 2015 through various venture capital and private equity investors.

Entrepreneurs Transforming Healthcare The country saw a large pool of healthcare startups in 2015 who are driven by technological innovations, and sizeable funding. Out of 4,200-odd startup companies around 300 startups focused on health domain

Portea Medical

Founders - Manjusha Anumolu, Ganesh Krishnan & Meena Ganesh Portea provides hospital-quality healthcare in the comfort of your home by providing doctors, nurses, and physiotherapists. They also facilitate lab tests at home and medical equipment rentals, making health care more accessible for the patients.

Practo

Praxify

Founders Abhinav Lal & Shashank ND The platform features over 200,000 medical professionals and handles upwards of 10 million searches each month.

Founder – Ram Sahasranam, Mohan Rao An EMR platform providing so many services that it is quite literally healthcare in your hands.

Lybrate

Founders - Saurabh Arora A mobile healthcare communication platform that brings patients and doctors closer, bridging the yawning gap between them. The platform offers patients the opportunity to seek multiple opinions from doctors for free and initiate a one-on-one dialogue with any healthcare expert on payment of professional fees online, it’s Health Feed having tips from doctor’s aims to encourage preventive mindset among the Indian population and make them live healthy and fit. It is available on on iOS, Android and web.

SmartRx

Foundation date: 2012 Anil Kumar, Founder & CEO; Vijayakumar Kannan, Co-Founder & VP; Mathivanan Selvaraj, Chief Operating Officer SmartRx provides a mobile engagement platform offering healthcare solutions to hospitals, doctors and corporate. It provides solutions for chronic care management, post-discharge care and online consultation (e-consult).

Health Corniche

Foundation date: February 2015 Dr Archana B.M, Founder & Principal Consultant Health Corniche provides technology based solutions in the field of information technology, delivering adoptable solutions serving the healthcare providers and other sectors.

COD Medi Alert

Foundation date: August 2014 Mahesh Bansal: Co-founder; Kidar Nath Bansal : Co-founder; Yashu Kapoor : CEO; Pitambar Jha : CTO Portea provides hospital-quality healthcare in the comfort of your home by providing doctors, nurses, and physiotherapists. They also facilitate lab tests at home and medical equipment rentals, making health care more accessible for the patients.

HealthCare at Home (HCAH)

Foundation date: April 2013 Founders - Dr Anand Burman, Chairman, Dabur Group; Vivek Srivastava, Co-Founder &Chief Executive Officer With the coming years, the home will be the hub for all healthcare equipped with all the technology being used in the industry. The company provides the service that complements the work done by the doctors in hospitals or clinics at home with sophisticated technology at an affordable price.

Curofy

Foundation date: February 2015 Co-Founders: Mudit Vijayvergiya, Nipul Goyal, Pawan Gupta Curofy is a medical networking app that powers a spam-free and secure communication between doctors pan India. It comprises registration of more than 20,000 verified doctors on the app. The application connects doctors with each other to discuss difficult cases, stay updated with latest medical advancements and to browse premium jobs.

HealthEminds

Foundation date: February 2015 Ankita puri, Co-Founder & CEO; Dr Sunita Maheshwari, Co-Founder & Strategic Adviser HealthEminds believes in holistic approach and provide various types of Online Psychiatry and Counseling services which are integrated with a secure and confidential video technology platform. Their panel comprises of renowned psychiatrists, psychologists, counselors, life coaches and nutritionists. It also has an offline program customized for corporate and educational institutions.

Health Konnect

Foundation date: 2012 Hemant Jatav, CEO & Founder HealthKonnect provides the patient an option to get the opinion, treatment plan and cost from multiple providers.

iKure

Foundation date: November 2012 Sujay Santra, Founder & CEO iKure is a rural healthcare service provider dedicated to providing affordable and accessible primary care leveraging technology as a differentiator. Our mission is to improve quality of health for Indiaâ&#x20AC;&#x2122;s poor through value-driven comprehensive health care solutions. iKure applies a unique combination of technology innovation, skills training, and capacity building to create a sustainable health care model that impacts rural life nationwide

Exclusive Interview

Connecting Doctors & Patients Virtually We have created a platform where the doctors would get the patients details over the phone and provide an instant aid to the patient, discloses Varun Anand, Co-Founder, MphRx while speaking to Romiya Das of Elets News Network (ENN)

How did MphRx came into existence?

Can you elaborate the working of your platform?

MphRx (My Personal Health Records Express) was conceived on the idea to provide a solution to the interoperability of patients records started around in 2011, headquartered in New York City. Our product development and R&D is based out of our Gurgaon office. The story actually started with a news article that gained a lot of popularity where a child suffering from cancer lost his life in the US. The child lost his life as his medical records couriered through Fedex to the specialist, which took few days to reach him. The doctor in his statement said that if the medical records would have reached him on time, he could have recommended the drug to elongate his life. This was the moment when Mahesh (President & CEO) realised the need for a solution to make patient data available anywhere and anytime. That was then when I, Mahesh and Chetan Uberoy (Co-Founder) started talking to build a platform which basically allows the doctors and patients to have access to the medical records regardless of where ever they are and share it when required. The initial idea was the patient being the owner all of the data. Once we got into it, we started looking at various things happening in the market and realised that the adoption of technology in healthcare

MphRx works on Minerva, an HIPAA complaint cloud-based platform, claiming to solve interoperability of patients records held in multiple disparate systems. patient engagement and care providerâ&#x20AC;&#x2122;s productivity. For patient engagement: It simplifies health record management and keeps patients connected with their physicians and care teams through the secure and intuitive web and mobile tools giving access to patient records, patient specific dashboard, instant messaging and compliance tools. For physician engagement: It provides the physicians with a comprehensive and unified view of patients records, consolidated from EMR, Lab, and Radiology Information Systems. Also, it equips them with patient communication tools to provide accurate and timely care. We operate in both models where the hospitals can have their own cloud or on our own cloud based in the US (Miami, Florida, and Atlanta). BizEye: It gives actionable, realtime and visually powerful analytics to improve delivery of care, boosting staff efficiency, and increasing business performance. We are opening up our platform to third-party developers as well. We are coming up â&#x20AC;&#x2DC;fisikeâ&#x20AC;&#x2122; which is also the part of the company. It is kind

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Varun Anand Co-Founder, MphRx

is very low. When we started, we got two contracts straight out, one US based, one of the largest privately held imaging networks and the other was Max healthcare in Delhi. While building this platform we were working directly with these two customers. We have been bootstrapped so far. The entire five years we have essentially gone completely on revenues. Today, we have health systems such as North Shore LIJ, Lenox Hill Hospital, Hackensack Max, Medanta, Artemis, Dr Lal Paths to name a few. We got three large partners Agfa healthcare, DELL computers, and Tech Mahindra in past one and a half years. Now, these partners are selling the platform over hundred countries.

Exclusive Interview

of a B2B2C proposition, which will be a patient downloadable app through which they can visit any of the hospitals with their fisike ID and all of their medical records will be signed up to that. Patientâ&#x20AC;&#x2122;s can download the app, load up their clinical data which will get digitise automatically and carry it with themselves when visiting hoapitals.

What regulatory roadblocks are being faced by the healthcare startups? In healthcare, there is no clarity on the regulations, unlike the US and other places. They have clear regulations around patient security, privacy but it India it is not clearly laid out yet. I think that is all for a lack of regulations when it comes to such things specifically around how healthcare data is managed. The healthcare information as is a lot more sacrosanct even than your financial information. But, I think there has to be a lot more regulations specifically dealing with how patientâ&#x20AC;&#x2122;s data is actually handled in the country.

How can these regulations become more flexible? Working with government hospitals

is very difficult right now. But, at the end of the day, nearly 60-70 per cent of the population is served by government hospitals. No matter how many private hospitals one visits unless and until we are tied up with those government initiatives it becomes very difficult to reach the actual masses. Therefore it stands as one big challenge that the government should work on. Also, from the IT strategy perspective, there is no clear mandate from the government in terms of how to patients records have to be kept. One needs a way out to basically record and have access to all of those clinical data. Today, that is not happening, it is all paper-based. There is very little opportunity for startups like us that

delivery but also at an affordable cost. But unfortunately, thatâ&#x20AC;&#x2122;s a big hurdle we all face getting through the government and if that can be opened up it will be fantastic.

What comparison can you draw between Indian and the US healthcare IT market? In India, like I said, there is no regulatory reason to use electronic records, while in the US there is a regulatory reason to do that. The hospitals are adopting technology so that they want to provide services for the patients, where the patient actually comes back to them. In other places, people are opting for technology because there is government reporting mandated.

In healthcare, there is no clarity on the regulations, unlike the US and other places. They have clear regulations around patient security, and privacy but in India it is not clearly laid out yet are actually doing things at a much lower cost than larger companies, to actually reach out to the government hospitals asking them to implement their solutions to improve the care

Where do you see the company heading in the coming years? We have got our presence in Western Europe, in the UK, Latin America, Brazil as well. Middle - East is going really well, we have entered this market. In the next six months, we are looking at opening up our application ecosystem or our app store so that people can come and develop apps on top of this as well. This is where one can add a lot more value to the platform. One of the things that we have also done on the platform is not just to be able to put data together and give patients and doctors access to it but because we use FHIR (Fast Healthcare Interoperability Resources) a new healthcare standard the third parties can also come up and develop an app on top of it. In India, we have got all four regions activated now.

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Industry Speak

Smart Records in Pocket We have made an attempt to change the way healthcare is delivered, along with hundreds of medical records per day, says Abhimanyu Bhosale, Co-founder, Livehealth, in conversation with Elets News Network (ENN) Brief us about the solutions you offer. Livehealth is the first platform that enables healthcare payments in real time. We have made an attempt to change the way healthcare is delivered with hundreds of medical records per day. It is a platform delivering patients medical records on their mobiles, connecting them to healthcare providers. Hence creating an approachable ecosystem for better understanding their medical records. We deliver a seamless mobile experience in healthcare and make providers have more simple, secure and fast accessibility to their medical records and centres. Reducing the delivery cost and improving the efficiency are few of the crucial differentiation. We provide solutions to healthcare providers (diagnostic centres, hospitals, laboratories) to manage their patients information and medical records and to deliver records to patientâ&#x20AC;&#x2122;s smartphone. We help providers better connect with their patients, not just by records but providing daily updates, tips, promotions and packages.

What is the primary market you are targeting? Our primary market is the larger healthcare organisations where medical reports are generated. We focus upon diagnostics, laboratories and hospitals. We believe to provide a reliable solution laser focus is required and that is exactly what we are doing.

What are the regulatory

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world and to try the best to make the medical data private and secure.

Have you received any funding for your venture? We received Angel funding of US$ 300K giving us a boost to improve our product and scale across multiple locations in the country.

What is your business roadmap for coming years? Abhimanyu Bhosale Co-founder, Livehealth

roadblocks you face as a healthcare startup and what is the solution? As a healthcare tech company, we did not explicitly find any particular challenges. As healthcare tech regulations are not setup in India. There is a guideline but not a law. But, as far as a startup, we had a lot of problems dealing with different regulations for settings up the business. As far as guidelines are concerned, we have a whole lot of security guidelines for managing and storing healthcare information and delivery which is inspired from HIPAA (Health Insurance Portability and Accountability Act of 1996) guidelines in USA. We have done our best efforts to make sure the solution abides the guidelines even though it is not a law. On the other hand we see most of the solutions existing in the market not complying with the guidelines making them vulnerable to attacks and data leaks. The solution is to comply with most security regulations across the

We would be scaling to metropolitan cities and reach Tier II and Tier III cities in the country. Till now we have received great feedback from the providers. They like using our product, especially the mobile app for doctors. Hence, we want to get more and more provider get the Livehealth experience and help them grow. On the other hand, as a startup, we are working on some interesting data analytics and insights engines that will be providing doctors and healthcare providers insights about patientâ&#x20AC;&#x2122;s health history and analytics. Also help in other trendbased data analytics such finance and stocks. For patients, we help with tracking and trend analytics for them to manage and track their health.

What is your expectation from Budget 2016-17? We expect to understand the market in terms of scale and development. Our current budget for this quarter should double our number of providers from 175 to 350+. Also, our upcoming budgets are aligned to double our providers every quarter and to have a new product every alternate quarter.

Industry Speak

Healthcare Cashing in on Innovations Regulatory controls in healthcare are largely in place in India, but at the same time, there are many areas where laws need to be revisited to tighten their somewhat loose structuring, observes Ananda Sen Gupta, Founder & CEO, TrackMyBeat, in conversation with Elets News Network (ENN) Give us an overview of your solutions and how are they contributing to better care delivery? Trackmybeat Healthcare (TMB) offers a home-based health and wellness management system to monitor as well as manages the patient’s health. By tracking and analysing a number of health metrics over a period of time, individuals and their physicians can assess the efficacy of various lifestyle choices and medical interventions on health outcomes. Thus, improving their ability to take action to improve general health and wellness for the users. Focused on health fundamentals and targeting lifestyle diseases such as hypertension, diabetes, and cardiovascular disease, TMB provides users with the equipment and monitoring tools to better manage their health. The solution allows the user to have precise control over patient’s health and fitness levels improving the quality of healthcare management and delivery. The solution: • SmartPlan – Personalised, digital health management plan based on the patient’s health reports and doctor’s records. • SmartMonitor – Precise monitoring through wireless medical devices and smart applications. • SmartAlert – Personalised realtime health alerts in case of protocol violation and regular reminders for plan compliance.

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The value to the consumer (the patient or family member of the patient) is high as one is always fully aware what interventions and actions have been planned, where they stand in their treatment process, and also if there has been the impact of the treatment, taking away the day to day worry. The value to the medical organisation, in turn, is high as they are able to keep track of the health of the patients at all time, and can offer customised services leading to higher patient satisfaction, and healthier patients.

What policy barriers do the healthcare startup companies face? Regulatory controls are definitely in place in India for a certain area of work in healthcare. Having said that, there are many areas where structured laws are not in place. Device certification is one such area. Sometimes not having the right regulatory environment is also a challenge. For instance, not having a device certification process can allow a larger, foreign company to flood the market with devices of unknown quality at low price point. Such products may not be acceptable to place in other countries at all. We have not faced any regulatory roadblocks per se, and the startup environment in India is quite open. Our solution is also highly consumer focused and uses the latest worldwide standards in privacy, and stays on the right side of regulation by default.

Ananda Sen Gupta Founder & CEO, TrackMyBeat

What is your business roadmap for coming years? We are starting to see growing traction in home health companies in India. The numbers of patients these organisations are catering to are in tens of thousands, and I believe we will grow rapidly through these agencies. We are also engaging with NGO’s under CSR initiatives to see how we can place our solution in the rural sector in the right way. We are also working on an entry into several international markets. The largest, of course, is the US, where this solution has proven to be an innovative approach to remote healthcare. We have already signed up a US partner to start pushing into the US market. To read the complete article, log on to: http://ehealth.eletsonline.com/

Industry Speak

Seamless Interfaces for Smooth Services MedSmart provides relevant actionable analytic insights and alerts to clinics and hospital stakeholders, says Jyoti Sahai, Co-Founder, Kavaii Business Analytics India Pvt Ltd, in a conversation with Elets News Network (ENN) Give us a brief about the solutions offered by you. How do they contribute towards better healthcare delivery? Kavaii’s MedSmart suite of products offers hospitals and clinics an integrated Hospital Information System (HIS), Electronic Medical Records (EMR), Electronic Health Records (EHR) and Healthcare Business Intelligence (BI) as an easy-to-deploy and cost-effective solution. It is similar to cloud-based HIS solutions marketed in the US, but designed to be cost-effective for the Indian market. MedSmart offers the care providers – hospitals and clinics – a platform to capture all data produced from customer encounters and at the same time through its web portal offering the patients the accessibility to their health records from all points of capture at a single place. MedSmart also provides seamless interface with other operational systems, such as accounting, laboratory management, pharmacy, inventory management, human resource and marketing. It analyses the financial, operational and clinical data, and provides relevant actionable analytic insights and alerts to the various hospital stakeholders. Jyoti Sahai, Co-Founder, Kavaii Business Analytics India Pvt Ltd

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Industry Speak

It has inbuilt KPIs that are relevant to hospitals and clinics. The deployment is available on both local and cloud servers. The solution is flexible to be deployed for a single hospital or for a group of hospitals with combined or individual reporting. It provides advantages to hospitals and clinics to Inform – the stakeholder of financial/operational status, realtime, improved work-flows and datadriven decision-making; Integrating – the various operational and clinical activities of the provider to deliver seamless convenience to both patient and provider for improved patient experience; Investigate – leaks in commercial operations through improved digital audit operational planning; Invest – based on data, both on latest medical technology and patient-centric conveniences improved healthcare delivery; Improve - patient-friendly processes to provide medical care with least friction patient delight.

DICOM, NABH/NABL certification is mandatory. MedSmart complies by ensuring that the data within MedSmart is compliant to ICD 9-10 (and similar other standards for diagnosis, prescriptions and lab reports); the MedSmart interfaces with various medical machines comply with the prescribed data exchange standards and protocols; the software ensures compliance prescribed standards for data storage, data privacy, and data security (such as HIPPA); and MedSmart facilitates compliance to NABH/NABL processes.

What is MedSmart’s primary market?

How does your initiative help overcome these obstacles?

MedSmart’s current target segment is the small and medium-sized hospitals of up to 300 beds in India for our comprehensive solution, and larger hospitals for turnkey projects requiring data analytics to aid data-driven decision making by the stakeholders of the hospitals. While the current primary market for MedSmart is India, we intend to expand our presence in the emerging markets in Asia, such as the Middle East and South East Asia.

MedSmart has in-built checks that ensure compliance to various regulatory processes by forcing the user to necessarily use ICD 9-10 codes for diagnosis, and standardised templates for recording various observations and test reports. MedSmart’s information architecture and delivery process has requisite data security and data privacy built-in. Thus, using MedSmart, healthcare service providers will be able to ensure compliance with various regulatory standards.

What are the regulatory roadblocks faced by the healthcare startup companies? Did you face any? For a typical healthcare organisation or a product directly delivering healthcare services to patients, adherence to various regulatory compliances, such as HIPPA (or similar regulations), ICD 9-10,

What is your business roadmap for upcoming years and the areas of growth you would like to focus upon? The future roadmap for cloud-based MedSmart product is to continue to innovate and simplify the deployment and make hospitals and clinics more efficient. We are coming up with mobile apps for patients/doctors for accessing relevant EMR and EHR, also to complete integration of Pharmacy, Lab Management, Inventory Management, HR, and Campaign Management into MedSmart.

How have you been funding your projects? Do you also go for external funding? Till now Kavaii has been bootstrapped, the entire funding has been provided by the founders and clients. Currently, we are evaluating prospective investors for MedSmart for hospitals and clinics in India.

In 2017, we will be focusing on enhancing clinical analytics, and subsequently, we will be offering benchmarking services, and regular industry insights as a service for the healthcare organisations, etc

What do you expect from the upcoming budget? We sincerely hope that the upcoming budget provides incentives to healthcare service providers for embracing IT and data analysis within hospitals for better patient care. These could come in the form of tax-breaks for expenses in such initiatives. The Government could set up a body for setting standards for “Quality of Patient Care” by using data-backed metrics. As a startup, we hope that the 15-point action plan presented by the Prime Minister during the recent Startup India meet is facilitated by adequate budgetary provisions and rule modifications.

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Industry Speak

Lender With A Difference Arogya Finance has taken up the responsibility to provide medical loans to traditionally un-bankable lot of the society, says Jose Peter, Co-founder & CEO of the company, in a conversation with Romiya Das of Elets News Network (ENN) Give us an overview of your company? Arogya Finance is a social healthcare venture, co-founded by me and Dheeraj Batra in 2010, which offers medical loans to the traditionally un-bankable. Arogyaâ&#x20AC;&#x2122;s approach does not require collateral or income proof and uses an innovative risk assessment tool that allows them to finance people outside the formal banking system. Arogya Finance has partnered with various hospitals and other healthcare providers to ensure that people can access medical loans for themselves and their families. Unexpected healthcare expenses push 40-50 million people into the poverty every year. The company took a step to bridge this gap by launching the Arogya Card that offers pre-approved loans of up to `2 lakhs, at reasonable terms to the card holder and his/her family, by making it available at the right time and place of need. With over 100 healthcare delivery partners and presence in 12 states, we plan to implement Arogya Card across the nation.

What is your opinion on the escalating healthcare startup market in the country? There are multiple challenges in improving the quality of healthcare of Indians. It will take decades to make a significant impact with traditional approaches. This requires nothing less than game-changing breakthroughs to accelerate gains. Innovation is the key and start-ups are at the cutting edge of innovation.

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India is home to 1.2 billion people with a US$ 2 trillion economy and a US$ 100 billion healthcare industry. However, only 17 per cent of Indians have some form of health insurance. 95 per cent of even those who are insured is under insured to the extent of 60 per cent. Of the healthcare spend of five per cent of GDP, public spend is only one per cent of the GDP, leaving 75 per cent of the healthcare expenses to be spent out of pocket by private individuals. Innovative healthcare delivery start-ups are deep diving into this huge opportunity to make healthcare cheaper and to bring it closer to the patient. The healthcare delivery sector is very nascent and will grow rapidly for several more years. The future is very bright. Creating healthcare affordability through Financial Inclusion is another area. On the last count, there are more than 22 online lending platforms slowly taking off and many of them are looking at creating EMI options to meet healthcare expenses. Given the right environment and incentives, these initiatives have the potential to push healthcare spend to beyond the six per cent of GDP mark, leading to the creation of millions of jobs and billions of dollars for the healthcare startups and the Investors.

What is the criterion for selecting a start-up to fund? Major challenges in healthcare in India are awareness, availability and affordability. If the start-ups are focusing on one of these challenges and have scalability, without huge additional investments, it is a venture to invest in.

Jose Peter Co-founder & CEO, Arogya Finance

Is funding requirement in this sector high? Healthcare industry has been expected to be US$100 billion in 2015 and is widely expected to be US$280 billion by 2020. In such a scenario, there is a definite need for huge investments, which may run into billions of dollars yearly.

How long is your stay with the company? In reality, it is three to five years at least. The venture capitalists exist generally happens either with another investor stepping in and taking over or someone strategically acquiring. The IPO option has not been too many, but it has slowly started opening up and may be going forward it might become an option.

What is your companyâ&#x20AC;&#x2122;s upcoming business plan? We currently have our operations in 10 states - West Bengal, Maharashtra, Karnataka, Hyderabad (Telangana), Tamil Nadu, Kerala, NCR, Jharkhand, Bihar, Gujarat. We look forward focusing on our services in the years to come. Accordingly, Arogya Finance will issue 18 lakh Arogya Cards and 2.35 lakh healthcare loans in the next five years and is working to be a 1,000-crore company by FY20 and expand to panIndia operations.

Focus

Achieving the 1:1000 ratio While shortage of doctors and paramedical staff is perennial, the need to inculcate adequate skills in the faculties of medical colleges and the field doctors is acute. The current estimated doctor-population ratio in India is 1:1700 as compared to a world average of 1.5:1000. The MCI has set a target of 1:1000 by the year 2031. For achieving this target and considering the number of existing medical colleges in the country, the present intake by medical colleges in India and the critical mass of doctors have to be rationally enhanced. Aamir H Kaki of Elets News Network (ENN) looks into the reforms needed in medical education in India and how technology can serve as a significant tool in transforming the sector

espite being the highest number of medical colleges in the world, the doctor to patients ratio in India is abysmally low, pegged at 1:1000. However, the immense growth has occurred in the past two decades in response to increasing health needs of the country. The major challenge for regulatory bodies like the Medical Council of India (MCI) has been to balance the need for more medical colleges as well as maintaining and improving the quality standards. The globalisation of education and health care and the country’s potential as

a destination of choice for quality education and health care has brought the issue into sharper focus. The MCI’s Vision 2015 draft committee has proposed wideranging reforms. It cites three main reasons for India’s healthcare woes: • Shortage of physicians (both generalists and specialists); • Inequitable distribution of resources and manpower; and, • Deficiencies in the quality of medical education. The report has proposed reforms such as curricular reform, emphasis

on primary healthcare and family medicine, and strengthening medical institutions by investing in technology. To systematically address the issues and develop strategies to strengthen the medical education and health care system, curricular reforms are needed so that Indian Medical Graduates match or better the international standards. Under the draft, there will be a Curriculum Implementation Support Programme, which will assist the teaching faculty of the medical colleges to implement these changes

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Focus

at their own medical colleges. It is also envisaged that the tools of information and communication technology will be harnessed to enhance teaching and learning.

1:1000 by 2031 While shortages of doctors and paramedical staff are perennial, the need to inculcate adequate skills in the faculty of medical colleges and the field doctors is acute. The current estimated doctor population ratio in India is 1:1700 as compared to a world average of 1.5:1000. The MCI has set a target of 1:1000 by the year 2031. For achieving this target and considering the number of existing medical colleges in the country, it was noted that the present intake by medical colleges in India and the critical mass of doctors have to be rationally enhanced. While improving the numbers will be important, maintenance and improvement in the quality of the doctors with humane content is paramount. Increasing the numbers of doctors alone, without proper and adequate knowledge and

healthcare domain can help bridge the shortage of doctors in the country and spread their reach beyond their local area of practice.”

Technology: Transforming the Medical System The application of IT and computerbased technology in healthcare and medical education system is both rewarding and challenging. The

The introduction of different material based learning aides including computer-based softwares, cloud computing, internet and telecommunications has the potential of changing the face of medical education and healthcare delivery system skill will not prove beneficial to the healthcare system. To meet the set target will take a long time, however, experts believe that the technology can serve as a tool to bridge the gap. As Rahul Narang, Chief Technology Officer, Lybrate puts in, “Most of the countries in AsiaPacific region are grappling with the issue of shortage of doctors. In India specifically, the doctor-patient ratio is skewed with one doctor available for every 1700 people, unlike in European countries. Use of IT in the

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introduction of different material based learning aides including computer-based softwares, cloud computing, internet and telecommunications has the potential of changing the face of medical education and healthcare delivery system. In recent years, extensive development and growth of IT has made vast changes in medical education system in India at both the teaching level as well as research level. The availability of internet

services across every corner of India made data transfer easy, time saving and convenient. As Dr Harish Pillai, CEO, Aster Medcity & Clust er Head Kerala stated, “India is on the cutting edge when it comes to healthcare technology. We can do more in the area of research and development. Typically, most of the hospitals in our country focus more on clinical excellence that is not how a good institution works. A good institution need to have a fair balance of clinical excellence, academics and research, which is needed to retain the talent. We, all in the private sector in India, need the right ecosystem.” The use of IT is slowly progressing in Indian medical education system and is on the rise. It is projected to grow by leaps and bounds in the coming years. Several health and medical experts feel that the new mobile and cloud-enabled applications imply a lot of backend infrastructure readiness from IT – right from secured access, wireless connectivity, proper bandwidth utilisation, to providing security to devices and data. Abhijit Gupta, Founder and CEO, Praxify Technologies informed, “From struggling to get decent broadband bandwidth to set up heavy resource

Focus

driven server infrastructures, India has come a long way in the past two decades. With the advent of cloud and mobility, and the growing demand of ubiquitous access, IT has started playing a strong role of an enabler in the medical infrastructure today.” Technology will be a game changer in the manner in which medical education, training and healthcare services will be delivered in India. The private sector will be the major driving force behind technology adoption in this vital segment. Due to the increasing convergence of technology and healthcare, there is a huge opportunity for providers to improve the experience and operate more efficiently due to augmented association and information sharing among providers. There are lot of players in the market providing innovative technological solutions to ease the medical education, research, healthcare services and overall health outcomes. The innovative digital solution such as Ovid - a research platform which enables healthcare institutions to access world renowned journals, eBooks, databases and many other resources electronically - by Wolters Kluwer, is transforming the healthcare and medical education system. Shireesh Sahai, CEO – India,

In MCI’s Vision 2015, the following modifications have been made in the existing curricula to accommodate the aspirations of the defined goals and competencies:  Newer learning experiences through introduction of foundation courses placed at crucial junctures, clerkships/ student doctor clinical mode of teaching and electives;  Early clinical exposure starting from the first year of the MBBS course;  Alignment and integration (horizontal and vertical) of instruction;  Integration of principles of Family Medicine;  Emphasis on clinical exposure at secondary care level;  Competency based learning;  Greater emphasis on self-directed learning;  Integration of ethics, attitudes and professionalism into all phases of learning;  Encouragement of learner centric approaches;  Ensure confidence in core competencies so as to practice independently;  Assessment of newer learning experiences, competencies, integrated learning and subject specific content;  Acquisition and certification of essential skills. Wolters Kluwer said, “In a hospital setup, professionals need multiple solutions to enhance their knowledge and give best possible treatment to

their patients. Our solutions enable healthcare professionals from any tier such as specialist, primary care physicians, nurses, pharmacists, researchers and medical students to deliver better health outcomes. Our leading innovative digital solutions which are used by healthcare professionals across the globe are UpToDate, Ovid, Lexicomp, Provation, 5 minute consult, Nursing solutions, Healthcare Communication and many more.” The ever-changing scenario of technology in every sphere is forcing the stakeholders to keep abreast of the changes and to take proper measure to upgrade themselves. Even the healthcare and medical education is not untouched with it. Several developed countries around the world are taking several measures to

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Focus

make the medical experts abreast of the latest trends and developments. There is a real need for governments across India to adopt the continuing medical education model, and make it mandatory for doctors to take regular tests to keep themselves updated. Robin Raina, CEO Ebix Inc said, â&#x20AC;&#x153;Globally, some governments have made it mandatory for doctors to obtain continuing education credits. This means if you are a practicing doctor, it is mandatory for you to keep abreast of the latest trends in your field. Ebix offers continuing medical education solutions to practicing doctors to help them obtain credits. Typically, these are three hour online tests approved by top medical bodies like Harvard Medical School and Johns Hopkins, which can be taken thrice a year. In India too, a few states like Jammu and Kashmir have started adopting this model.â&#x20AC;?

The Path Ahead There is a need to set up faculty development institutes that will equip and empower teachers in medical education for discharging their

February / 2016 ehealth.eletsonline.com

The innovative digital solution such as Ovid - a research platform which enables healthcare institutions to access world renowned journals, eBooks, databases and many other resources electronically - by Wolters Kluwer, is transforming the healthcare and medical education system professional responsibilities. The objective of a good medical education should be to produce general practitioners, specialists, teachers and research workers. The factors governing this are the curriculum, medium of instruction, duration of course, admission qualifications, the examination system, teachersstudents relationship, prospects of teachers and students, etc. Besides, it may be mentioned that the medical education should fit in with the needs of the country and the conditions prevailing there. The dependence on technology in the medical education and healthcare industry cannot be overstated, and as a result of the recent development

of brilliant innovations, medical experts and healthcare practitioners can continue to find ways to improve their learning and practice â&#x20AC;&#x201C; from imparting education and training to better diagnosis, surgical procedures, and improved patient care. Whatever the final shape of the mechanism, it owes it to the citizens to create some basic changes in medical education and healthcare system. Policy makers, physicians and those who teach physicians have to open their eyes to the opportunities, realities, and responsibilities available in the vital segment of medical education and healthcare. We need a holistic, radical surgery to restructure the entire medical education system in India.

State Scan

Baddi Shines as the Pharma Capital of India The success story of Baddi, a small town in the hill state of Himachal Pradesh, is the one that every state in the country is striving to emulate. A non-descript town not long ago, today it is a leading industrial and pharmaceutical hub in the country with biggest brands in the market vying with each other to set up and expand in the area, writes Priya Yadav of Elets News Network (ENN)

arely 40 kms away from Le Corbusier’s legacy of Chandigarh, the Baddi-BarotiwalaNalagarh industrial belt, as it is officialy referred to, is now home to country’s leading pharma, FMCG, manufacturing and IT companies. The blueprint of this amazing success story was laid over a decade ago when the Atal Bihari Vajpayee Government sanctioned a massive tax incentive package in 2003 paving way for the small town to rise from

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its obscurity to present status of fame and glory. It’s true that the shifting of major industries to this area has not helped improve the basic infrastructure of roads, connectivity, etc., but that has not deterred the big companies from setting up base here. The town still has what the industry needs the most – adequate power supply, a kind of rarity in our country, proximity to country’s capital, New Delhi and Chandigarh, Amritsar as close neighbours. In

addition, it can boast of a peaceful industrial climate.

A journey down the lane The first units set up base here more than two decades ago- in 1991 and since then it has emerged as Asia’s largest pharmaceutical hub. It has nearly 2500 factories belonging to leading textile companies, pharma companies and FMCG and is credited with generating an annual turnover of `60,000 crore. With its massive development,

State Scan

the small town alone accounts for over 85 per cent of total investment of Himachal Pradesh with nearly `14,000 crore investment made in the area in the past two decades. It has also the credit of employing one of three persons engaged in Himachal’s medium and large industries. Its importance to the hill State can be gauged from the fact that the town chips in half of the state’s total revenues generated from industries. There is hardly any doubt about the fact that the tax holiday scheme approved by the Vajpayee Government in 2003 gave a major push to the area, yet majors like Vardhman Textiles Ltd had already set up factories here, a decade before the centre handed out sops to Himachal Pradesh. The sops included five years of exemption of income tax and 10 years of central excise. Ever since, getting the tax holiday extended has been a major political issue with successive governments. The stakes are high for each political party and it is for no reason. Baddi is home to biggest players in the market. For the pharmaceutical giant, Abbott, Baddi is largest branded generic manufacturing site. And Abbott is not an isolated case. Baddi is India’s unofficial pharma capita. Pharma giants like Cipla, Cadila, Unichem, Dr Reddy’s, Torrent and Glenmark have housed factories here. The town’s contribution to the total turnover of pharma companies is more than significant and only growing. For instance, Unichem’s first factory in the area began production 25 years ago and now it has 36 acre campus in Baddi which houses its four units that chip in over 25 per cent of the company’s gross revenues. Like Vardhman, Unichem too set up base here much before the tax exemption era kicked in.

The other side Baddi is not just about pharma

manufacturing, it also boasts of packaging, textiles, food processing and engineering units. It is estimated that more than `10,500 crore of investment has been made in the district of Solan, where Baddi falls, from 2003 to 2014. The uncertainty over tax exemption to the industrial town not withstanding, the State Government is hoping that big majors will not quit the region just because there are no more exemptions. Vardhman, which is among the earliest settlers in the region, now has nine units here in its 330 acres campus– which includes four spinning, two processing, two weaving and one garmenting. of the total revenue of the company, over 25 per cent is generated here, it is estimated. The company is still investing in the area and expanding its footprint. It is not just the surplus power availability in the region that helped

Mumbai, for which Baddi takes a major credit.

The investment destination Back in the pharma sector, major investments are still happening with pharmaceutical companies considering it a place for good investment. Alkem Laboratories is pumping `60 crore in its new formulations plant at Baddi, while Unichem Labs is already operating a betalactum plant here. USV Limited has an investment plan of `80 crore for its manufacturing facilities in the area, while majors like Glenmark Pharmaceuticals Ltd, Dr Reddy’s Ltd and Indoco Remedies have a `25 crore tablets, creams, medicated toothpaste facility in the area. Bangalore based Bal Pharma too has a `20 crore tablets and capsuling facility in the area. Baddi has multi national companies like Colgate, Palmolive, Procter and Gamble, Hindustan

It’s true that the shifting of major industries to this area has not helped improve the basic infrastructure of roads, connectivity, etc., but that has not deterred big companies from setting up their base here its development, but also cheaper land rates. Industry majors acknowledge that it is not tax exemptions that matter, but also availability of land, power, water – all of which are critical resources for setting up industries. The setting up of industry in the foothills has given an economic impetus to the entire region with its impact felt on the real estate sector as well. Property rates in the tri-city of Chandigarh, Panchkula and Mohali have shot up following development of Baddi. A decade ago the connectivity to the tri-city was not something to be proud of. However, domestic airlines now have stepped up operations in the area, with more than five flights daily between Chandigarh and

Unilever, Cadburys, Johnson & Johnson, which have set up manufacturing facilities here. India’s leading corrugated box manufacturing group Horizon Packs has also set up their packaging unit Monad Technologies Pvt. Ltd. at Baddi. Promed, Delhi based entity is planning to invest `25 crore in Baddi by setting up a facility here even as Hyderabad based Pulse Pharma is pumping `6 crore in the area. Morepan Laboratories has big plans as well, and began two units at `50 crore and `60 crore, and is further expanding with `20 crore biotech research project with US collaboration.

February / 2016 ehealth.eletsonline.com

Government Desk

Sex ratio crosses 900 mark in Haryana

he sex ratio in Haryana has shown an upward trend as for the first time in 10 years, the sex ratio at birth for December, 2015, has crossed the 900 mark with 903 girls per 1,000 boys. The Chief Minister, Manohar Lal, credited the success of the ambitious programme to State’s multi-pronged strategy implemented under the ‘Beti Bachao Beti Padhao’ campaign. While 12 districts have recorded sex ratio above the 900 mark in December, 2015, district Sirsa tops the list with sex ratio of 999 girls per 1,000 boys. While referring to the statistics of other districts for the same period, he said that district Panchkula has registered sex ratio of 961, Karnal 959, Fatehabad 952, Gurgaon 946, Sonepat 942, Jind 940, Rewari

Maharashtra government hikes aid for medical treatment

he Maharashtra government has raised the financial assistance for the medical treatment from CM relief fund and the assistance has also been to cover more complicated and expensive surgeries. The new surgeries such as liver transplant, heart transplant, bone marrow transplant, implanting prosthetic organs have been included in the list said in a statement. Till now, a maximum aid of two lakh was being provided, which has now been increased to three lakh. The liver transplant costs around Rs 8-10 lakh, so the government has added it to the list of procedures it supports and has also raised the cap of grants it can provide.

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931, Mewat 923, Bhiwani and Mahendragarh 912 and Hisar of 906. The Chief Minister said that a target to achieve sex ratio above 950 within the next six months has now been set for the entire State. He said that in fact, the Prime Minister had expressed appreciation for the campaign in Haryana, including the ‘Selfie with Daughter’ campaign, during his visits to Faridabad in September, 2015, and Wembley Stadium in the UK on November 13, 2015. He added that

the Prime Minister had also stated during a public function that Haryana, which was earlier known for killing daughters, is now being recognised for its efforts in saving daughters. Giving details of the efforts made under the ‘Beti Bachao Beti Padhao’ programme in the State, Manohar Lal said that the ‘Beti Bachao Beti Padhao’ Secretariat was established in his office for effective implementation and monitoring of this mission by coordinating the efforts of Health, Women and Child Development and Education Departments. Effective monitoring was carried out through extensive field visits by dedicated teams from state headquarters and regular video conferencing was conducted with DCs and other district officers.

MRs barred from promoting medicines at government hospitals

he medical representatives (MRs) in Odisha will no longer be able to promote medicines at the outpatient departments (OPDs) at government-run-hospitals according to the guidelines issued by the health secretary Arti Ahuja. The six-point guidelines to the chief district medical officers (CDMOs) and supritendents of medical colleges on Wednesday states that the medical officer in-charge of the OPD will ensure restriction on MRs and private firms from recommending their products during OPD hours of doctors on duty. This move is to ensure doctors prescribe medicines available in government-supplied stocks to the maximum possible extent ensuring rational use of governmet stocks and reduce patient expenditure. According to Arti Ahuja, tha government is supplying quality medicines, surgical, suture and

other items to all health institutions. But, it has come to the notice that sometimes doctors are prescribing medicines and consumables to the patients to be purchased from outside when the same or substitute medicines are available at the hospital stores. Under the scheme Niramaya launced by state government lasdt year in May, the government promises 570 medicines free of cost in government facilities.

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Roadmap for Healthier Kerala Kerala, which has emerged as India’s first complete Digital State, not only provides free healthcare services to its citizens, but is also poised to become country’s first state to launch an ambitious e-Health project within a year. The programme would enable the government to go paperless and have digital health record of every individual. In a bid to learn more about the various government-run healthcare schemes for the poor, Vishwas Dass of Elets News Network (ENN) talks to Dr K Ellangovan, Secretary - Health & Family Welfare Department, Government of Kerala Tell us about the healthcare landscape in Kerala and key policy measures undertaken by the Health & Family Welfare Department. Kerala is one of the better performing states in the healthcare sector. Although our policies are like those of any other state in the country, what sets us apart is allocation of larger funds for social sectors— h e a l t h sector, in

particular—despite resource constraints. It has ensured high average density of primary healthcare centres (PHCs) and community health centres (CHCs) per square km. Similarly, the number of healthcare

professionals, both public and private, is very high in Kerala. As a policy measure, we have tried to standardise various institutions. One of the major policy initiatives is to operationalise universal health coverage in Kerala. It implies repositioning of vast network of PHCs and CHCs into centres of comprehensive care, as the assets are not utilised fully…we have a lot of institutions but the number of services are too small. PHCs should be able to handle non-communicable diseases effectively. Repositioning also means that the PHC units should be capable of dealing with diabetes, hypertension or psychiatric problems. We launched a pilot project in three PHCs and the results are very encouraging. The second major policy decision is to reduce out-of-thepocket expenditure. Over the years, the State Government has taken a conscious decision to supply generic medicines free of cost to every PHC in the State. Out of all the threeDr K Ellangovan, Secretary, Health and Family Welfare Department, Government of Kerala

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four states supplying free generic medicines, Kerala supplies the highest number of free drugs. Our aim is to ensure that the cost of medicines incurred by people for chronic diseases comes down. The other reason for high medical costs is diagnostic centres. We are also trying to put up diagnostics centres in association with private players where poor people can avail CT scan, ECG, MRIs and other facilities at nominal fees. We have developed a project to reduce infant mortality rate (IMR). We are aiming for single-digit IMR. Similarly, for maternal deaths, the policy is to involve the private sector, so that we all are on the same page. IMR is surely going to come down once we implement the 13 guidelines prepared in association with the private sector. We have now released an antibiotic guidelines — a programme by various professional bodies, which will disseminate information among people.

by the Government of Kerala for the poor?

What information technologybased measures have been undertaken to improve access to healthcare?

is one of the states where several departments chip in their money for social good; for example, the Finance Department and the Department of Lotteries run a programme called “Karunya Benevolent Fund” that gives a grant up to Rs 2 lakh to people to avail medical services at empanelled hospitals. Similarly, the Department of Social Justice has rolled out a scheme called “Thalomam” for surgery of congenital diseases in children. We are also in the process of launching e-Health project in association with the Government of India, under which we are trying to develop an elaborate and comprehensive e-platform where the health records of individual persons would be captured in electronic platform and used for providing populationand hospital-based services. We have got 21 modules starting from PHCs to medical colleges and planning to launch primary healthcare model by February-end, and

Access to healthcare essentially involves dissemination of information. We have to take information to people. People in Kerala are already quite aware about technology while the Government is also sensitising them. There are financial barriers too. A person goes to a hospital and comes out after spending a substantial amount of money, because services, like lab services, MRI and digital X-Ray, among others, are not available there. As I said, generic medicine supply and promotion of diagnostics or infrastructure in the hospitals is an attempt to remove those barriers, so that the person goes to hospital and avails services without incurring any major cost.

What kind of healthcare schemes have been rolled out

There are a plethora of schemes available for sick people. We have got “Arogya Kiranam”, which is a modified version of Rashtriya Bal Swasthya Karyakram (RBSK) that are given provides for treatment for 30 medical conditions, but the Kerala Government has extended it to all conditions. In other words, RBSK has been improvised to bring more diseases under its ambit, so that more people could benefit. We also run cancer care programmes. Kerala

by January 2017, medical colleges will also be covered. It will be a paperless system to do a research-related work. We are confident that our e-Health project, first-of-its-kind project in India, will be implemented within a year.

Can you please elaborate on achievements of Comprehensive Health Insurance Scheme (CHISS) and how it has benefited people? It’s the largest insurance scheme implemented by any state government.

Over the years, the State Government has taken a conscious decision to supply generic medicines free of cost to every PHC in the State. Out of all the three-four states supplying free generic medicines, Kerala supplies the highest number of free drugs. Our aim is to ensure that the cost of medicines incurred by people for chronic diseases comes down We have three layers — RBSY, CHISS and CHISS Plus. The Centre-approved RBSY is for the people below poverty line, while CHISS is meant for people meeting the criteria of the State Government. Earlier, a lot of people were deprived of availing free medical services, as they could not fulfil the criteria of the Union Government. So, the Kerala Government brought those people under its ambit to help them get affordable healthcare services. Currently, 30 lakh families are enjoying the benefits of CHISS scheme in Kerala. Undoubtedly, the State Government has done a lot of work to bring the poor under the ambit of its healthcarerelated schemes. CHISS Plus is a trust model for all above the poverty line (APL) category people. This health insurance scheme was launched by the government primarily to help families cope with the huge expenses that suddenly burden them when a major ailment, like a heart attack or cancer treatment, is required.

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Affordable No-frills Health Services It is important to invest in clinical services for providing better care delivery to the patients rather than spending on luxury hotel-like infrastructures, suggests Dr Dharminder Nagar, MD & CEO, Paras Hospital, in tête-à-tête with Romiya Das of Elets News Network (ENN) What is our opinion about the present healthcare scenario in India? The present healthcare scenario of our country leaves much to be desired. In urban sectors, the word ‘care’ does make some sense, but most of the country is yet to receive proper healthcare delivery. Both the government and the private healthcare providers have not been able to deliver on this front. The government’s efforts towards the healthcare have also made to make the desired impact; they are more focused on tertiary care, while the private sector has mostly been richoriented. In other words, both the government and the private sector are playing a similar role by creating tertiary care environment in large cities. The government has apparently been less focused to the district hospitals and primary healthcare centres (PHCs), and as for as the private sector, it has not really penetrated across the country other than the metro cities. However, southern India is doing

much better in terms of care delivery as compared to the northern and eastern states of India, which are literally 5-10 years behind their southern counterparts. As a nation, we are perhaps 30 years behind not just the developed world but some of the Third World countries as well.

How is Paras Hospital contributing towards containing the trend of escalating out-ofthe-pocket healthcare expenditure? At Paras, we are quite aware and have over the years focussed on creating

Dr Dharminder Nagar MD & CEO, Paras Hospital

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value for the middle-class population. We try to minimise our per-bed cost when we build a facility, as we do not go for pomp and show, like putting up large chandeliers, double or triple height lobbies, etc., the cost of which is ultimately passed on to the patients. We are delivering value to the patients, both financial as well as qualitative. The service providers should focus on clinical care without compromising on nursing, doctors and support staff. For instance, rather than having 55 front offices, people we can work with 25. But today, there are more front office people than nurses in hospitals. Patient experience in non-clinical services has become more important these days, whereas patients’ experience in clinical services is actually going down and expenditure escalating. Paras has always had this value at the core of its business, strategy and philosophy of delivering value to its patients, treating them with qualitative healthcare services, so as to send them home happy. This is the only way to deliver healthcare to more and more people in an affordable and convenient manner. Delivering healthcare to the top 5-10 per cent of the population or restricting themselves to metros will not work for this country.

perspective. We are slowly adopting Electronic Medical Records (EMR) in our departments, which have shown pro-activeness and willingness. We are taking it as a two-five years’ plan to implement across the board. What we can do is bring in EMR in a phased manner, and at the backhand use Enterprise Resource Planning (ERP); we are using Microsoft Dynamics Navision ERP 2 – HIS, but then talking to each other is mandatory. From the patient’s perspective, data view or record keeping, EMR will become an important tool with each passing day. One can get the best EMR solutions from abroad, but every cost in healthcare comes from the patient’s pocket. So, the value proposition has to be there. It must benefit the patient to the extent

Is IT changing the face of healthcare delivery? What are the solutions adopted by your hospitals?

You have launched mother and child care chain ‘Paras Bliss’. Can you elaborate on this?

IT is one of those beautiful things for healthcare, but it is actually the biggest bottleneck as well. Everybody wants to use it, but nobody finds it easy to use. I’m a firm believer in IT and want that whatever bit is happening in the hospital, I should be able to view on my computer. So, Hospital Information System (HIS) is the core not just for the billing part of it, but also everything else – whether it is statistical data, patient data, etc., both from hospital’s and doctor’s

just got his brain tumor removed, and there are expectant mothers are there to deliver a healthy child. It wouldn’t be an ideal situation. So, we felt the need for a concept like Paras Bliss, keeping the two in separate environments and giving child delivery due importance. We intend to have five 50-bedded Paras Bliss facilities in the next three years, and hope to announce one or two this year itself. We recently opened our Panchkula facility that provides programmes developed to address the apprehensions, fears and problems of expectant mothers. The programmes have been developed with keen clinical insight and supported by ancillary services provide pre-natal solutions. From lactation counselling, mommy

We are slowly adopting Electronic Medical Records (EMR) in our departments, which have shown pro-activeness and willingness. We are taking it as a two-five years’ plan to implement across the board that he is willing to pay for it, and the synergy has to go together. IT in healthcare will become more integral in the coming 10-15 years, and IT dependency will exceed.

All the large hospitals are mostly acute care hospitals, where you see patients coming with various diseases, accidental cases, etc. However, childbirth, despite being a bliss, is stressful for a woman. That being the reason, we have launched a special branch - Paras Bliss - to provide a separate environment to the expecting women rather than allowing an interface with critical patients. Imagine a situation where the next door patient is the one with a cardiac arrest or somebody, who

massage, toddler/infant care to antenatal classes, post delivery weight reduction programme, stretch mark treatment and adolescent care programme – the hospital aims at providing comprehensive medical and supportive care to the community.

What is the expansion plan of the Paras group? We want to be a North India-based player, making healthcare accessible and affordable. We want to fill the gaps created by quality, accessibility and value proposition. As of now, we have 730 beds, and we plan for 2,000 beds in the coming three years. Besides, we also have 10-year plans to add a few thousand more beds. The purpose of the expansion is to meet the unfulfilled demands, whether qualitative, accessibility issues or affordability issues.

February / 2016 ehealth.eletsonline.com

Health Insurance

Preventive Healthcare Push â&#x20AC;&#x201C;

Need of the Hour The efforts of the government is on and private health insurance providers also are rollingout new user-friendly policy plans to bridge the gap and make preventive healthcare a benefit for every India, because only a healthy India will be the engine of a progressive India, writes Rachita Jha of Elets News Network (ENN)

n the eve of World Cancer Day celebrated on February 4 this year, India had more candles than many other countries of the world to blow out on its cake. According to latest reports, the country becomes home to close to one million new cases of cancer every year. This is just the tip of the iceberg, as a larger vulnerable population pool remains

February / 2016 ehealth.eletsonline.com

undiagnosed and live their daily lives in the belief that cancer cannot ail them. It is time we donâ&#x20AC;&#x2122;t wait for the disease to strike, and instead get on the preventive healthcare cycle of health checks regime to get ourselves in good health.

Preventive Health Tax Benefits The health insurance sector has been making several attempts over

the years to increase its penetration and coverage of population under the policy cover. However, lack of incentives and awareness has kept a large section of population away from this. Last year union budget had announced several tax benefits to encourage people to opt for health insurance. This year too, the hospitals and insurance providers are in unison in their demand for tax exemption

Health Insurance

of preventive healthcare checkups. Highlighting the need to focus on preventive healthcare, Anjan Bose, Secretary General, NATHEALTH (Healthcare Federation of India) said, “In order to achieve the government’s stated objective of universal health coverage, the tax exemption on preventive health checkup should be raised from the current `5,000 to `20,000 under section 80-D of Income Tax Act, 1961. We also recommended the government to withdraw service tax on health insurance premium. Healthcare is not taxed for services, so the same principle should be applied for healthcare financing as well.” Service tax on premiums acts as a deterrent to consumers. Healthcare is not taxed for services so the same principle should be applied for healthcare financing as well. Similarly, the common benefit used by most of the tax payers is that of mediclaim. This too needs a close look when structuring preventive healthcare tax. With increase in healthcare spend this too should evolve to benefit all. “In case of health insurance premium, the limit should be increased to at least `1 lakh for individuals and parents below 60 years from current `25,000 and `2 lakh for individuals and parents above 60 years from current `30,000,”

opined Shrikant Soman, CEO, Bhatia Hospital. In case of exemption under medical expenses, `3 lakh for individuals below 60 years be allowed that is not included at present and the limit should be increased to minimum `5 lakh for all senior citizens instead of super senior citizens, he added. Thus as more patients get hospitalised and depend on the insurance claims on their decision of treatment, the hospitals too are looking forward to attractive incentives under the preventive health tax to have more patients and citizens come and avail the health check plans and preventive care services.

Government Bima Push A great start last year, now the insurance sectors wants the momentum to continue with new incentives and perks to make

healthcare affordable for all. The government gave preventive healthcare a major push last year by giving tax incentives to attract people towards insurance cover. In addition, it announced an accident cover of `2 lakh under Pradhan Mantri Suraksha Bima Yojana and Atal Bihari Pension Yojna wherein government onus was taken to contribute 50 percent of the cover. The expectations are high this year too. As speculations trickle down on the revival and mega re-launch of a populist Universal Health Card smart card scheme or Rashtriya Swasth Bhima Yojana (RSBY), it promises to be bigger in its coverage, more intensive in its benefits and driven by IT. The states too have many state insurance schemes running for their citizens and the inclusion of health insurance under them such as the successful Rajiv Gandhi Jeevandayee Yojana in Maharashtra that offers claims cover on many of the prevalent disease conditions and recently implemented Sampoorna Aarogya Keralam. They aim to bring all government health services under one smart card. Upto 2 lakh of assistance from the government will be made via the electronic card. Technology and health benefits will go hand-in-hand in future. The government schemes are fast cashing in on the smart card advantage with biometric identification and a Adhaar authentication becoming more userfriendly. Digital Healthcare seems the next stepping stone for the future of Digital India.

February / 2016 ehealth.eletsonline.com

State Scan

Punjab

De-Addiction Centres Raise Hope

The State of Punjab has been traditionally been high on the narcotic drugs smuggled into the State from bordering Pakistan. While the security agencies are playing their part in curbing the transborder menace, the various drug de-addiction centres are doing exceedingly well in rehabilitating the drug-addiction victims. An in-depth report by Priya Yadav of Elets News Network (ENN)

lame it on Punjab’s ‘strategic location’, or failure of successive governments in the State to check the menace, but the worrisome truth is that Punjab is on a constant high. More disturbingly, it is not just a high number of the youth, middleaged and the elderly, who are in a vice-like grip of intoxication in the State, but increasingly children, as young as eight-years-old, are getting addicted to a plethora of abusive

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substances available freely in Punjab’s hinterland. An alarmingly high quantity of drugs, like heroine, is pushed into India from Pakistan into Punjab, which is the main transit route for the drug smugglers. It is reported that the recent terror attack on Pathankot Air Base was conducted by Pakistani terrorists, who entered India using the route that drug smugglers use to pump in narcotics in the State. Punjab is not just waging a war on the terror

front – Pakistan has launched a proxy drug war in the state, targeting the population, primarily the youth. And the worrying part is that they are winning this battle big time. A recent study conducted by the All India Institute of Medical Sciences (AIIMS), New Delhi has revealed that opioids worth `7,500 crore are consumed in Punjab every year. In a survey that is first of its kind, the National Drug Dependence Treatment Centre at AIIMS has

State Scan

reported that more than 1.23 lakh people in Punjab are dependent on heroin. This means that 0.84 per cent, about 2.3 lakh of the entire State’s population, is opioid-dependant, if artificial substances having the same impact on nervous system as opiates, are taken into account. The survey reveals that opioid-dependent people are spending approximately `20 crore daily on these drugs. On an average, a heroin-dependent individual spends about `1,400 per day. The State Government, acutely aware of the problem, which has become a political issue in elections, has adopted a multi-pronged strategy to deal with the situation. A highprofile committee of experts from the Post Graduate Institute of Medical Education and Research was invited by the Punjab Government to suggest measures to curb the menace. Following this, 27 drug deaddiction centers (DDCs) have been made operational in the State. To provide tertiary level facilities, five Model DDCs (50-bedded each) have been set up at Jalandhar, Patiala and Bathinda and these drug de-addiction centres will work under Amritsar, Patiala and Faridkot medical colleges. The 50-bedded Model Drug Deaddiction Centres at Amritsar and Faridkot have been made fully functional. Continuing its efforts beyond de-addiction to rehabilitation, the Government of

Punjab has approved 21 counseling & rehabilitation centres of 50 beds each, even as the centre at Amritsar is of 100 beds capacity. As part of the strategy, detailed guidelines have been framed and circulated to run these centres. The State Drug Controller has issued the order for supply of Beupronorphene medicine to only licensed DDCs. A computer programme has also been designed to effectively monitor the inflow of patients.

— men, youth, children craving for heroine, synthetic drugs and liquor that the government needs to be really worried about. Punjab is traditionally known to have a very high population of alcoholics, with liquor addiction considered a household menace. So much so that the women in hundreds of villages in the State, who are prime victims of alcoholism, have taken upon themselves to physically uproot or burn the

In all, 27 drug de-addiction centers (DDCs) are operational in the Punjab, and to provide tertiary level facilities, five Model DDCs (50-bedded each) have been set up at Jalandhar, Patiala and Bathinda that will work under Amritsar, Patiala and Faridkot medical colleges Before this, Punjab had reported a widespread use of pharmaceutical or synthetic drugs. The government is struggling to put a number to those addicted to synthetic drugs, as the State’s police are discovering deeprooted distribution networks of those in the synthetic drugs trade. Even as security forces are brainstorming on guarding the country’s frontiers, it is the enemy within that Punjab needs to focus on. It is not just a trickle of terrorists being pushed into the country to wage terror, but an army of addicts

liquor vends in their villages. More than a hundred gram panchayats have given affidavits to the State Government not to allow a liquor vend in their village, because it is devastating families and leaving women penniless and helpless victims of domestic violence. However, the state government itself is high on the money that liquor sales fetch to the state coffers. Data shows that the revenue from excise and sale of liquor has increased phenomenally over the years. The State Government makes more than `5,500 crore in a year from liquor sales, a figure that was `3,000 crore three years ago. In 2014, in the State’s population of 2.77 crore (2011 census), it left 12.15 liquor bottles a year for each citizen. With increasing awareness about the threat that intoxication is posing to the State’s future, various strategies are being devised to tackle the situation. This includes a wide network of drug de-addiction centres, cracking down on the drug mafia, besides adopting advanced techniques in treating drug addicts.

February / 2016 ehealth.eletsonline.com

Exclusive Interview

Kerala to be a Global Destination for Ayush Providing holistic healthcare services to the denizens of Kerala, the Ayush department is aspiring to become country’s global capital of traditional medicines with the help of ICT, informs Dr M Beena, Secretary (Ayush), Government of Kerala to Vishwas Dass and Arpit Gupta of Elets News Network (ENN) What kind of efforts are being taken by your department to benefit people? The state government’s AYUSH department is seven months old as it was constituted on August 2015 in line with the Centre’s AYUSH department. The department to lay emphasis on traditional medicines and for creating awareness about the different systems of treatment like Ayurveda, yoga and naturopathy, unani, siddha and homoeopathy and provide quality medicines and promote cultivation of medicinal plants. AYUSH systems play major role not only in preventing the diseases but in curative aspect too. This system medicine is well accepted by community—particularly in rural areas in Kerala because these are cost effective, socially acceptable, comparatively safe and efficacious. In order to give an impetus to the growth of AYUSH in the state, government has appointed a dedicated secretary level official for the same. Kerala is the third state in the country to have a separate AYUSH department in the government and directors for Indian Systems of Medicine (ISM), Homeopathy and Ayurveda Medical Education.We have a separate Drugs Controller for Ayurveda, Principal and Controlling Officer for Homoeopathy and Chief

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Executive Officer for Medicinal Plants. We have OUSHADHI – the prestigious public limited Ayurveda Medicine manufacturing unit with a turnover of around Rs 100 crores, and HOMCO – a co-operative drug manufacturing unit for homeopathic medicines. The department has formulated KASH – (Kerala Accreditation Standards for Hospitals). Guidelines for AYUSH department aims at improving the quality of healthcare delivery system and to upgrade the AYUSH healthcare institutions to KASH AYUSH level in a phased manner. It is the state’s endeavour to ensure that every Panchayat has its own ayurveda and homoeopathic institution and there by declaring Kerala as a 100 per cent ayurveda and homoeopathic state

What are the different schemes and programmes rolled out by the department? For implementing the programmes of National AYUSH Mission in the state, the government has constituted State AYUSH Health Society. AYUSH department has submitted the State Annual Action Plan for 2014-15 and 2015-16 fiscal of Rs 9.50 crore and Rs 11.06 crore respectively. We have specific programme implemented under Ayush one for anemia in adolescent girls and children in

Dr M Beena Secretary (Ayush), Government of Kerala

Attappady Tribal settlement, a homoeopathic mobile medical unit for the Tribals in Idukki. Few others are school health programme, research study on NCD and cultivation of medicinal plants. The AYUSH department, has also submitted four proposals for an amount of Rs six crore (Rs 1.5 cr for each proposal) under the Central Sectoral Scheme – Public Health Initiatives. The ISM and Homoeopathic departments are conducting various specialty programmes such as Seethalayam, Ayushmaanbhava, Sadgamaya, Chetana Cancer Care centre, Amrutham, Infertility –

Exclusive Interview

Geriatric â&#x20AC;&#x201C; Adolescent- Thyroid specialty clinics through the various AYUSH Hospitals in the state.

How is the department of AYUSH strengthening its services by leveraging IT? The government has decided to Health Management Information System (HMIS) in AYUSH department for the collection of data of OP and IP in hospitals/dispensaries. Department is planning to digitise (e-Health) all AYUSH Institutions in the state. We are planning to give health awareness messages to people through mobiles by way of SMS. Department is planning to use the social media as a tool to propagate health awareness programmes.

What kind of challenges are you facing to improve department of AYUSH and its services for the convenience of people? Infrastructure facilities of AYUSH hospitals have to be improved. All AYUSH hospitals are not having clinical Investigation facilities which are highly needed. State has formulated KASH â&#x20AC;&#x201C; (Kerala

Kerala is working to become the most preferred AYUSH destination state in global map. The state wants to be branded as global capital of AYUSH systems for health care delivery, academic excellence and research by 2025 Accreditation Standards for Hospitals) Guidelines for AYUSH department for improving the quality of AYUSH healthcare delivery system. These hospitals have to be brought up to KASH AYUSH standards. Few challenges faced by the department are lack of research studies, proper documentation and publication in national/international journals. Many are not aware about availability of quality drugs and nonavailability of sufficient medicinal plants among others. Shortage of funds is one of the prominent challenges faced by the department.

Your future plans for the department? We are endeavouring to brand our state as global capital of AYUSH systems for health care delivery,

academic excellence, research and quality drug industry by 2025. Kerala is working to become the most preferred AYUSH destination state in global map. Other plans include establishing AYUSH systems of medicine as the first choice of treatment in primary healthcare, to become 100 per cent ayurveda and Homoeopathic state. We also want to have an exclusive state research centre and establish Kerala as the model for best quality AYUSH education in India. Setting up of warehousing, value addition, marketing and development of infrastructure for entrepreneurs, create more public health initiatives for AYUSH and also begin national institutes for yoga and naturopathy, panchakarma, medicinal plants and homoeopathy.

February / 2016 ehealth.eletsonline.com

International News

BD gets FDA approval for FACSPresto

ecton, Dickinson and Company (BD) has received 510(K) approval from US Food and Drug Administration (USFDA) for its FACSPresto system and FACSPresto system CD4/Hb Cartridge. BDâ&#x20AC;&#x2122;s FACSPresto system is an automated multicolour fluorescent imaging cytometer and absorbance spectrometer, which offers absolute and percentage results of CD4 T lymphocytes and hemoglobin (Hb) concentration in whole blood samples to manage HIV/ AIDS patients. Claude Dartiguelongue, BD biosciences worldwide president said that The FDA 510(K) clearance aligns with BDâ&#x20AC;&#x2122;s purpose of advancing the world of health. The system

provides superior ability to accurately m o n i t o r patients living with HIV/AIDS in a variety of healthcare settings at a reasonable cost further helping to control the spread of the disease. The system featuring a touch screen and languageindependent user interface can process up to 80 tests in a normal day.

Panasonicâ&#x20AC;&#x2122;s new technology can measure heart rate

anasonic along with Kyoto University has developed a new remote sensing technology to measure vital signs such as heart rate, heartbeat interval, and others. The sensing system aggregates millimeter wave spread-spectrum radar technology and signal analysis algorithm, which identifies signals from the body. The high sensitive spread spectrum

radar and feature based heartbeat interval estimation algorithm helps to

measure heart rate and its intervals in real time without placing sensors on the body. The new technology enables casual sensing of vital information such as pulse rate and heartbeat interval remotely, helping in daily health management. Panasonic launched new 4K medicalgrade 32 ultra-high definition (UHD) monitor, designed for the surgical suite in November 2015.

Philips MRI patient monitoring solution gets FDA approval

oyal Philips received 510(k) approval from the US Food and Drug Administration (USFDA) for its MR400, a technology that monitors patients undergoing MRIs. The solution offers ICU - comparable and bedside monitoring in the MR suite for all the patients including those who require anesthesia or with serious medical conditions. The firm has developed the solution to create image artifacts or other interference from the electromagnetic fields when used according to the labeling, helping patients to receive the level of clinical care and monitoring they need. The solution is able to monitor the same vital signs that tracked in the operating room, as well as the ICU unit, including heart rate, oxygen, and carbon dioxide levels, body and surface temperatures and blood pressures. It also provides advanced ECG. The MR400 uses intelligent alarms to warn the

February / 2016 ehealth.eletsonline.com

clinicians of severe patient changes such as desaturation, apnea and extreme bradycardia/tachycardia, similar to traditional patient monitors. Also, using wireless technology it connects with the HER and shares information with IntelliBridge Enterprise to send and receive patient information across the hospital.

Hospital News

Aster DM eyes acquisitions in India

ster DM Healthcare has planned to come out with an initial public offering (IPO) in India for expansion. Chairman and Managing Director Azad Moopen, Aster DM Healthcare said, “There are big opportunities in healthcare in India with a huge demand-supply gap. We are looking to expand our operations substantially.” The company operates a total of 15 hospitals, 80 clinics and 200 pharmacies in the Middle-East and India, and has marked investment of `250 crore in India in 2016 on three hospital projects. Presenty, the major stake is held by promoter family of Azad Moopen and over 30 per cent by PE firms. In India the Aster DM has three hospitals in Kerala, two in

Maharashtra and two in Telangana. It is looking at a total of 2,700 beds in the country across facilities by 2016. This year it will commission a 500-bed hospital in Bengaluru, Aster CMI, besides adding large facilities Aster Medcity in Kochi and Aster MIMS in Kozhikode. The company overall plans a 35 per cent increase in the number of

beds with an addition of 850 beds across Bangaluru (500 beds), the UAE (two hospitals with 250 beds) and Qatar (80 beds). According to Alisha Moopen, Executive Director & CEO (Hospitals and Clinics, GCC), Aster DM Healthcare they will continue to focus on growth in southern and western India. Also, they are open to acquisitions of brownfield projects. The idea is to acquire standalone facility with 250 beds or above if it is in states where the company is already present or a network of multiple units if it is in a new state, she further added. In 2015, the company had a turnover of around `3,800 crore with majority of revenues coming from GCC (Gulf Cooperation Council) operations.

Indo-UK Healthcare to invest `1,000 crore in Haryana

he Haryana government has signed a pact with IndoUK Healthcare Private Limited to establish medical institutions in the state with proposed investment of `1,000 crore. This project is expected to generate employment for 3,000 persons. The pact was signed by Principal Secretary, Industries and Commerce, Devender Singh, on behalf of the Haryana government, and Managing Director and Group Chief Executive Officer, Indo-UK Healthcare Private Limited, Ajay Gupta. Under this agreement, the Haryana government would facilitate Indo-UK Healthcare Private Limited to obtain necessary permissions, registrations, approvals and clearances for the project from the departments concerned in order to ensure the establishment of the project in a time-bound manner. This would be done as per the existing policies and rules and regulations of the state government. The project is likely to commence in 2017. Haryana Chief Minister Manohar Lal Khattar said during his tour to the United Kingdom, Prime Minister

february / 2016 ehealth.eletsonline.com

Narendra Modi and his UK counterpart David Cameron had reached an agreement for expansion of medical services in India with investment of one billion pounds into the Indian healthcare system. This agreement was signed in the same series. Haryana is one of the six states which have signed MoUs with Indo-UK Healthcare Private Limited, he added. Reiterating the state government’s commitment towards providing better healthcare services, Khattar said presently, there are nine medical colleges in the state. He added that the government aims to open a medical college in each district. Apart from this, the establishment of a branch of the All India Institute of Medical Sciences (AIIMS) in the state is currently under process. While a medical university is presently functioning in the state, another one is being established in Karnal and an Ayurvedic University would soon be opened in Kurukshetra, he added. Recruitment of doctors is being carried out in the state to fill up the requirement for doctors as fixed by the World Health Organisation, Khattar said.

Hospital News

Nayati Hospital launches diagnostic and imaging services

athura-based Nayati Multi-super Specialty Hospital has launched their diagnostic and imaging services in the region. The Diagnostic centre was inaugurated by patients who have suffered because of unavailability of comprehensive diagnostic services. Dr R K Mathur, Senior Advisor, Radiology & Imaging, Nayati multi-super-Specialty Hospital, Mathura stated, “It is for the first time in this region that such a unique combination of hiend diagnostic and imaging equipment have been set-up under one roof. Our mission is to provide precise and timely diagnosis to facilitate medical treatment to the people at affordable costs. The installation of this state-of-art diagnostic equipment in the hospital further strengthens our commitment to provide the highest standards in patient care. These equipment will enable our doctors to get best quality images and interpretation by expert radiologists to base their treatment on.”

The Radiology and Imaging department will offer highly advanced neuro, cardiac, spinal, chest, abdominal and whole body diagnostic services to support the clinical departments with better outcomes. One additional facility will be interventional radiology which is now an integral part of any diagnostic and therapeutic service in a hospital with active cancer department. The department will be equipped with high-end equipment radiology department that includes – 1.5 Tesla MRI – with complete neuro and cardiac capabilities. This modality without the use of ionising radiation has the capability of simultaneously imaging any patient’s organs in multiple planes, with split second image reconstruction. Whole body imaging, angiography and other advanced techniques and procedures can also be performed on this MRI scanner in a short duration; 128 Slice CT scanner, a unique ultra-fast multi-slice CT scanner that can image patients with equal ease for trauma, chest, vascular, abdomino – pelvic and coronary angiography, with exquisite digital quality; Mammography – essential for screening and follow-up for breast cancer, as a state-of-the-art imaging modality which is targeted specially for women’s healthcare especially between vulnerable age groups of 35-60 years. The imaging modality also provides a road map for treating surgeons when any suspicion lesion needs to be biopsied or surgically removed. Digital radiology – which provides high-quality x-rays at very low radiation dose; PET CT- a cutting edge technology for evaluation and follow-up for cancer; PACS ( Picture archival & communication system) is a digital platform integrating the hospital information system with the multiple departments and clinicians using radiology services in the hospital. It also enables viewing of the images on mobile devices such as tablets and smartphones.

E-registration facility soon at SMS hospital

he Rajasthan government will be issuing cards for e-registration to the patients visiting Outpatient Department (OPD) at all state institutions. The practice will be initiated at Sawai Man Singh (SMS) hospital. This is initiated in regard to the increase in patient inflow at the OPD. Nearly 1.27 crore patients were registered at OPD in medical centres affiliated to medical colleges and 9.27 crore in state medical institutions in the year 2014-2015. According to the statement given by health minister Rajendra Rathore, in the year 2015 around 35,000 patients per day were registered at the OPD at medical college-affiliated centres. The pilot project to provide e-registration will be launched from SMS hospital next month. The e-registration would help the patients in avoiding long queues at the OPD counter to

get registration or renew it. Also, patients could register online and the administration would provide them the suitable time to meet the doctor.

february / 2016 ehealth.eletsonline.com

Company News

Lazoi appoints Rupak Sengupta as co-founder

azoi, an online healthcare solution provider has appointed Rupak Sengupta as co-founder to spearhead the brand and marketing verticals. The move would use his in-depth experience and brand building skills in order to consolidate Lazoi’s presence in the online healthcare segment. Rupak is a post graduate from XLRI, Jamshedpur and comes to Lazoi with 25 years of experience in building brands and new business extension opportunities. He has been instrumental in conceptualising and launching multiple brand campaigns for reputed industry names such as Bayer, Godrej Agrovet and BCCL. Speaking of the appointment, Lazoi’s spokesperson said, “It will be a great boost for the company as we are in the process of re-building the Lazoi brand as well as in the process of augmenting our existing resources to chart a new growth path which will take the company

to next level. This will also help us in conceptualising innovative revenue streams which will be unique in nature and add more value to the users and transform the company to a truly health solution company. Lazoi will be a game changer in this segment for sure in days to come”. Sengupta said, “I am very excited to be part of the founding team at Lazoi. Having worked in three big corporates in the recent past, I know that we will be able to replicate the start-up success story by focusing more on our core competencies and eliminating all doubts in the minds of all stakeholders in the healthcare business, a world view that I share wholeheartedly. Just in our start-up phase alone, we have demonstrated to our initial customers our ability to deliver service by incorporating the latest technology into their dayto-day processes. We are in the process of changing lives of millions

of Indians by providing them a true world class technology driven healthcare solution.” Rupak has also received several industry recognitions and awards for his stellar performance. In his entire corporate career, he has successfully launched several new products by analysing the customer need and behavior pattern so as to make the product as per the requirement of the end user.

MphRx raises strategic investment from Agfa HealthCare

gfa HealthCare has announced its investment in MphRx, taking a 27 per cent equity stake for an undisclosed amount, as part of their strategic move into the integrated care market. The company is leveraging MphRx’s platform to create a patient centric offering for integrated care. As part of its strategic alliance with MphRx, Agfa HealthCare will be introducing the platform on a global level. “The combined technologies, expertise and people of both companies create a unique and leading Integrated Care portfolio,” states James Jay, Global Vice President, Agfa HealthCare. “We are excited to partner with Agfa HealthCare, a leading global conglomerate in the healthcare IT industry. We are currently deployed across numerous large health systems worldwide, with millions of patient records being aggregated in our platform and expect those numbers to grow significantly with this alliance,” said Mahesh Uberoi, President and CEO, MphRx. As a first step both companies have created a patient

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centric and agile portal for integrated care that can be used by care providers ranging from single facilities to large regional deployments. MphRx is a healthcare IT startup that provides true interoperability to healthcare data, helping patients and providers collaborate during the delivery of care. The company has been one of the first technology companies to adopt the new healthcare standard FHIR and has been creating innovative and impactful cloud-based offerings for the healthcare industry.

Company News

Paras Healthcare appoints new Group Medical Director

aras Healthcare appoints Dr Jatinder Kumar as Group Medical Director to take the responsibility of improving medical care and clinical services such as cost management, utilisation reviews, quality assurance, medical protocol development and maintaining quality of medical services as the healthcare corporate expands its presence to other centres in the country. At present, Paras group runs three super specialty hospitals across the country and two hospitals under the new venture Paras Bliss. According to Dr Dharminder Nagar, Managing Director, Paras Healthcare, “The group is pleased to welcome positive and talented individuals into the growing Paras Healthcare family. We value the space we occupy in the collective conscious of the Indian people and amongst our well-wishers. With Paras set to increase its footprint to 2000 beds in the next five years, manpower and medical processes are two essential components for our growth. The new corporate structuring shall empower and support the units.” Dr Jatinder Kumar did his MBBS from IMS – BHU in the year 1973; Masters in Surgery in the year 1978 from IMS – BHU and M.Ch. (Neurosurgery) from AIIMS New Delhi in the year 1989. He has over 35 years of clinical experience and prominently worked as Neurosurgeon. He has worked with several hospitals, viz., G.B Pant Hospital, RML Hospital, AIIMS, St. Stephan’s Hospital, Max Balaji Hospital in Delhi, Kailash Hospital-Noida, Vimhans Hospital, Sir Ganga Ram Hospital in Delhi are the names of few. He was also instrumental in the initial project phase of Paras Hospitals, Gurgaon. “Along with clinical aspects, I specialise in the organisation and delivery of health care services in India. Paras Healthcare is a strong brand for the common man as it provides world class facilities at affordable cost. It represents a free-spirit which is loved both by the masses as well as the classes. As a new Medical Director it shall be my endeavor to streamline the clinical processes further, introduce more specialties in the units and ensure that quality medical professionals join the institution that has affordability, accessibility and quality as its three tenets for healthcare,” highlights Dr Jatinder Kumar.

Health Aggregator Zoctr raises an undisclosed amount from Brand Capital

umbai-head-quartered Zoctr, a Patient Centric Health aggregator platform has raised an undisclosed sum from the Times Group (Bennett Coleman & Co Ltd.) under its innovative Brand Capital Incubator Funding Model that provides funding for long-term brand building and advertises needs of growth oriented companies against equity participation. Zoctr aggregates home health, telehealth and remote patient monitoring services targeted at post acute, chronic & terminal patients including cancer, stroke, cardiac, kidney and post surgery patients. This is the third round of funding raised by the company in the last nine months. The company plans to use these funds mainly for print, medianet and radio ads for creating category awareness for Home Health as well as brand awareness for the Zoctr brand as synonymous to being the Home Health Leader in the Indian market. The company has ambitious plans of creating a 18-city home health operation touching 45% of India’s population in the next few years riding on the back of deep medical domain expertise, robust operations and a fully integrated technology platform and mobile app. Shrenik M Khasgiwala, Director, Brand Capital, “Our investment model of Incubator Capital fulfils the objective of positively impacting such early stage start-ups in their entrepreneurial journey by giving them superior media access to all Times Group’s properties thus facilitating rapid customer adoption in the marketplace. Zoctr is a unique and disruptive home healthcare aggregator concept with large untapped potential. I believe, with the right customer acquisition model and the media tools to support it, Zoctr can gain a lot of visibility in the market and help them to find the right place in the consumer’s life.” Commenting on the same, Dr Shantanu Nagarkatti, Brand Capital states, “Home Healthcare is the need of the hour and I believe Zoctr can revolutionise the healthcare delivery model in the country with its state-of-the-art home healthcare solutions.

February / 2016 ehealth.eletsonline.com

Pharma Buzz

‘Make in Vietnam’ calls for Indian Pharma companies

Promius Pharma receives FDA approval for Sernivo Spray

ietnamese ambassador to India Ton Sinh Thanh as a part of the ‘Make in Vietnam’ initiative is urging Indian pharmaceutical companies to set up units in that country. According to reports, Thanh said that pharmaceuticals are one of the major items that Vietnam imports from India. Thus, Indian pharmaceutical companies should set up base there as a part of ‘Make in Vietnam’ initiative. The Indian government had offered a credit line of US$ 300 million for trade diversification and strengthening of commercial ties between the two countries. The targeted bilateral trade between the two countries was US$ 15 billion by 2020. In 2014, the bilateral trade was US$ 5.6 billion.

r Reddy’s US subsidiary, Promius Pharma has received the approval for Sernivo (betamethasone dipropionate) Spray, 0.05 per cent from the US Food and Drug Administration (FDA). Sernivo Spray, a prescription topical steroid, is indicated for the treatment of mild to moderate plaque psoriasis in patients 18 years of age or older. The commercial launch of the product is planned for the coming quarter. G V Prasad, Co-Chairman and CEO, Dr Reddy’s Laboratories said, “The FDA approval of Sernivo Spray is a significant milestone for Promius, as it validates our committed efforts and resources to developing differentiated dermatology products from concept to commercial launch. We are delighted to receive a first round FDA approval for the spray. We look to expand our portfolio of medical dermatology products available in the US market.” Promius has conducted two successful multi-center, randomised, double-blind, vehicle-controlled clinical trials in subjects aged 18 years and older with moderate plaque psoriasis to evaluate the safety and efficacy of Sernivo Spray. In both trials, randomised subjects applied Sernivo Spray or vehicle spray to the affected areas twice daily for 28 days.

Alchem International launches third generation Phytomedicine for flu

lchem International launched the third generation phytomedicine called PhytoRelief-CC to combat symptoms of cough, cold and flu. PhytoRelief-CC comes in the form of chewable sugar-free lozenges which contain concentrated and purified molecular extracts of turmeric (haridra), ginger (zingiber officinale), and pomegranate (dantabija). The synergistic effect of these nature-derived

February / 2016 ehealth.eletsonline.com

ingredients offers a host of benefits to quickly and naturally cure symptoms of cough, cold and flu. PhytoRelief-CC has very potent anti-viral, anti-bacterial, immune-modulatory, anti-inflammatory, anti-allergic and anti-oxidant properties. It has been developed using AlchemLife’s proprietary Phytoplex™ technology based on cutting-edge science to deliver unsurpassed efficacy without any side effects. Phytoplex™ technology is Alchem’s proprietary extraction process which isolates active plant molecules in a way that preserves the `natural balance’ and ‘synergistic effects’ present in the original plant material. Raman Mehta, Founder, Alchem International, said, “PhytoRelief-CC provides quick and effective relief

naturally, combining the power of traditional medicinal herbs with cutting-edge science and research. We expect a very encouraging response as there is presently no natural offering in the market that is backed by clinically proven results for the prevention and treatment of symptoms of cold, cough and flu.” Compared to the placebo, PhytoRelief-CC led to reduction of signs and symptoms of cold and flu within two weeks, 83 per cent reduction in bacterial load within three days, and effective anti-viral activity against various strains of influenza. Priced at `199 for a strip of 10 lozenges, PhytoRelief-CC will be distributed in phases across the country at all retail and pharmacy outlets.

Startup

Bridging Doctor-Patient Gap IT in healthcare is transforming the way health services have been delivered traditionally. Players, like Top Doctors Online, are out to bridge the gap between a needy patient and the best doctor available for his ailment

ith the objective to provide the best possible services to every health-seeker in the most convenient and cost effective way, the Top Doctors Online (TDO) came into existence. The idea behind the company is to build a bridge between the health-seekers of chronic diseases and the super-specialist doctors, who are polarised in metros and Tier-I cities of India. TDO - complete health and wellness app - is a one-stop health destination to get a complete resolution to the health concern of people, which is delivered through three sections – Read, Ask and Book. Read: It brings the most searched health and wellness topics in most user-friendly formats and simple language, which is ratified by medical experts. It includes videos, slideshows, articles and Q&As. The aim is to be a mobile medical encyclopedia for the users in simple language and user-friendly format. Ask: For any specific query, one can ask a doctor just at a click of button. One can chat or email or talk to a qualified doctor, and resolve one’s query. One can also call the doctor from the app. The aim is to provide access to doctors – anytime and anywhere and make the chat experience as easy as Whatsapp. Book: It means practically anything and everything of healthcare can be booked for a hassle-free experience. Right from pathology tests to diagnostic procedures, from specialty treatments to book an appointment for second opinion with listed top doctors of India. The aim is to make the entire array of health services easily accessible to the user without any hassles.

Bharat Bhardwaj, Founder & Chairman (L) and Anand Chatterjee, Founder & Chief Executive Officer, Top Doctors Online

The aim of the TDO is to be the Google (search any health information), Whatsapp (easy communication with doctors) and Amazon (access to a wide range of health services) of health. Currently, the app is available on Android platform and soon it will be available for the iOS. TDO is founded by Bharat Bhardwaj, (Founder & Chairman) and Anand Chatterjee (Founder & CEO) With founders from health and technology coming together, TDO has been able built a formidable team to achieve its objectives of becoming the onestop destination for resolution to all health concerns. The company has a 45-member team – comprising doctors, engineers and marketing professionals. The app is helpful to both the people and health professionals. For People/Health-seekers: TDO is one stop destination for a 360-degree solution to concerns and queries of users, with respect to health, wellness

and fitness. This unique promise allows users to get access three sections on the app: Read, Ask and Book. For Health Professionals: It is a unique opportunity for health professionals to reach out to health seekers in need of their services. Such a digital platform helps professionals to reach a larger audience without geographical limits of a particular city. At present, the company is consolidating its operations in India and expanding its reach in the middleeast. With the vision to offer the simplest telemedicine solutions to the demographies, where doctor-patient ratio is poor and at cheapest possible price, TDO is planning to penetrate deeper in India to cater to Tier II and Tier III cities. It is also planning to expand operations to African continent, Middle-east and South-East Asia in the near future. TDO is working on IPRs to differentiate its solutions and creating the patentable technology.

february / 2016 ehealth.eletsonline.com

Startup

Genuine Drugs at Your Fingertips The ecosystem of online pharmacy is working aggressively to take over in the medical domain. In line with this, BigChemist is strategising to build an ecosystem of managed partner pharmacies by investing in an integrated market place that has intelligent point-of-sale systems to make them fully compliant to regulation for effective inventory management, while supplementing income sources and improving profitability

onceived on the vision to provide simple, effective solutions to people in need of medicines online in India, BigChemist.com (A3T Retails Pvt. Ltd) was founded in May 2013 by co-founders Anil Asnani and Arvind Yadav with a seed capital of US$ 1 million. The company offers largest range of medicines, healthcare and lifestyle wellness products across categories and all major brands. It is run by a team of professionals of healthcare, pharmacy benefits, technology, operations and customer management. The team comprises trained nutritionists, counsellors, pharmacists and product experts help service customers in the most professional manner. The company partners directly with the brands and their authorised channels, to ensure strict quality control and deliver 100 per cent genuine products. It has its presence both online as a web portal www. bigchemist.com and a physical store in national capital with partner stores in NCR region. â&#x20AC;&#x153;The company eases the ordering convenience through web portal, telecall, timely notified delivery, returns and payment options, single click reorder, tamperproof packaging make us different from other players. We offer our customers an option to visit us at our physical signature store to experience and interact with the team and see for themselves how we work to service them,â&#x20AC;? say Asnani and Yadav The inspiration for this idea

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Anil Asnani Co-founder, BigChemist.com (A3T Retails Pvt. Ltd)

emerged after the founders colleagues working in the US needed to care of their parents and found that it is very difficult to get services for their medicine requirements. Further, being in such developed market helped them to conceive and develop this idea to measure how the healthcare in India would develop with time. This led to the development of the portal and complemented the understanding of the Indian market. Big Chemist till now has more than 3.6 lakh visitors visiting their website with over 16 thousand registered customers. In the last two years, the company focused on studying the healthcare space minutely. Understanding the key pain point in the supply and demand areas, how the local pharmacies operate, their scope for profit and revenue increase. The company looks for scope in

Arvind Yadav Co-founder, BigChemist.com (A3T Retails Pvt. Ltd)

this domain as the space offers huge opportunity with current market size of over US$15 billion pharmaceutical market with double digit growth rate. They have also been focused on developing their own B2C platform and are presently working on to develop mobile application and B2B platform for supply and demand forecasting fulfillment. BigChemist experiencing 20-25 per cent growth monthly; on an average they are fulfilling around 5500 orders a month with an average value around `700 each. The company plans to spread its operations in eight locations in the coming six months. They are to have one signature store at each major city with partner pharmacy stores around it. The company aims to accomplish a target of 1000 orders per city per day with an average bill value of `900 - `1000.