eHealth January 2015

asia’s first monthly magazine on The Enterprise of Healthcare

volume 10 / issue 1 / January 2015 / ` 75 / US $10 / ISSN 0973-8959

10th

anniversary edition

42-Unorganised and

Unregulated Market Dr Th. Dhabali Singh, Managing Director, Babina Diagnostics

43-Digital Pathology – A Game Changer Dr Mithilesh Chandra, Director, Pathology Consultancy Services

44-3D Printing Revolutionizing

Healthcare Dr Vaibhav Bagaria, Senior Consultant - Joint Replacement & Sports Surgeon, CARE Hospital & ORIGYN Clinic and Lopaa Bagaria, Product Manager - 3D Printing, Timeless Innovation Labs

46-Quality Care is the Key 22-Challenges Faced by

End-Users Mehul Damania, Manager Product Support, Maquet Medical India Private Limited

23-Care Better than Before

Dr Pankaj Raina, PE&CE Principal, Accenture India

24-Patient Safety – A Growing

Concern Chetan Makam, Managing Director, Haemonetics Healthcare India Private Limited

25-The Next Generation of CT Scanners Ratish Nair, CEO, Sanrad Medical Systems

26-Celebrating Technology in

Radiology Dr C Amarnath, Organising Chairman of Tamil Nadu and Pondicherry chapter of Indian Radiological & Imaging Association (IRIA) 2014

27-When Technology meets

Healthcare Padmanabha T K, Head - Healthcare Outcome Services, Wipro Limited

30-Indian Radiological and

Imaging Association 2015 Dr K Mohanan, Organising Chairman, IRIA 2015

31-Meeting the Needs

Dr S Khanna, President, Dharamshila Cancer Foundation and Research Centre

32-Minimally Invasive Cardiac Surgery- The New Revolution Dr SK Sinha, Director CTVS, Paras Healthcare

34-Gaining Momentum

Dr (Prof.) D P Saraswat, CEO, Action

35-Group of Hospitals

E-Network for Healthcare Rajesh Srivastava, Chairman, Rockland Hospitals

36-Medical Landscape in

Oncology Dr Ashok Mehta, Medical Director, Brahma Kumaris’ Global Hospital & Research Centre

38-Making Healthcare

Affordable and Accessible Rajiv Sharma, Group CEO, Sterling Addlife India Limited

39-Delivering World-Class

Healthcare, Affordably Dr Vikram Lele, Director, Department of Nuclear Medicine & PET CT, Jaslok Hospital & Research Centre

40-

Moving toward Consolidation Dr Suvarna Ravindranathan, General Manager, SRL Diagnostics

Dr Kamal Kumar Dutta, Founder Chairman and Managing Director, Ruby General Hospital

51-Health for All - Call to Action 52-Indian Medical Device Summit 53-First Edition of HIM Concludes on a Successful Note

54-PRODUCT LAUNCH

Carestream Introduces Compact Vita Flex CR System

28-Shriram Equipment Finance Company Limited

55-Saint Gobain

editorial

Healthcare Market Set for Takeoff India has been a lucrative medical equipment and devices market, and the year 2015 holds greater promises. The year-end announcement by the government, opening floodgates for FDI in the sector, is sure to see foreign investors making a beeline with their money bags, ready to partner with Indian manufacturers.

Valued at `37,800 crore in 2013, the Indian medical equipment and devices market is growing at an annual clip of 10-12 percent, though imports constitute nearly 80 percent of the market. However, with the government’s decision coming in, what one can look forward to is a boost to the domestic manufacturing activities, which will naturally lead to a decline in the import orders by as much as 60 percent.

Indeed, the situation offers a bouquet of opportunities to both foreign as well as domestics manufacturers.

On the other hand, media reports suggest that the Ministry of Health is planning nearly 20 percent cut in the budget allocation for healthcare for the ongoing its 2014-15. The possible reduction in fund allocation is being attributed to fiscal strains. In absolute terms, the likely cut would be to the tune of about `6,000 crore has been slashed from their budget allocation of `30,000 crore for the financial year ending on March 31. At a time, when hopes have been pinned on Prime Minister Narendra Modi for making basic healthcare more affordable and accessible, it looks like rather ill-timed decision. But what people tend to lose sight of is the fact that a sizeable chunk of the healthcare funds have remained underutilised in the past three years.

If that is the case, one would ask, why not divert the fund for better utilisation in some other segment of healthcare? Well, that remains open to debate. However, what sounds logical is that the withdrawn money can be diverted towards raising skilled medical workforce, as data suggests that doctor-nurse density per 100,000 people stands at an appalling 19. Our skilled workforce is being lured away by developed countries through attractive compensation packages, so we are left with little choice but to multiply the numbers of trained professionals. That remains a necessity if the country is to achieve the goal of Healthcare for All. Wish you a Happy and Prosperous New Year – 2015!

Dr Ravi Gupta ravi.gupta@elets.in

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asia’s first monthly magazine on The Enterprise of Healthcare volume

10

issue

1

january 2015

President: Dr M P Narayanan

Partner publications

Editor-in-Chief: Dr Ravi Gupta

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COVER STORY

Opening Up

New Vistas

Medical technology companies are accelerating their investments in emerging markets, and India remains their prime target because of its large population, growing middle class and improving healthcare infrastructure, writes Anshuman Ojha of Elets News Network(ENN)

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E

ven before the arrival of the New Year 2015, the government has opened up a whole vista of opportunities for the medical technology companies by allowing 100 per cent foreign direct investment (FDI) in device manufacturing segment. While India has already been on the radar of global medical companies as one of the most promising emerging markets, now they have all the more reason to look towards India. Although most multinationals have been somewhat conservative in their business strategy towards and operating model in India, delivering their existing offerings to the premium segments of the market, the shape of things is set to change once and for ever. Now they would need to look beyond their traditional model to survive the competition that is going to only more fierce in the days ahead.

Global Scenario Healthcare, among both providers and payers in public and private settings, is a very costly industry sector. Total global health spending was expected to rise by 2.6 percent in 2013 before accelerating to an average of 5.3 percent a year over the next four years (2014-2017). This growth will place enormous pressure on governments, healthcare delivery systems, insurers,

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COVER STORY

and consumers in both developed and emerging markets to deal with issues such as an aging population, the rising prevalence of numerous chronic diseases, soaring costs, uneven quality, imbalanced access to care due to workforce shortages, infrastructure limitations and patient locations, and disruptive technologies.

Across the globe there have never been more healthcare challenges than there are today. However, these challenges can push stakeholders to innovate in new and exciting ways and to generate scientific, medical, and care delivery breakthroughs that can improve the health of people worldwide.

Most of the countries across the globe are facing a formidable challenge to manage the rapidly increasing cost of healthcare. Although

growth, this means that spending per head is anticipated to rise by an average of 4.4 percent a year from 20142017.

Life expectancy is projected to increase from an estimated 72.6 years in 2012 to 73.7 years by 2017, bringing the number of people over age 65 to around 560 million worldwide, or more than 10 percent of the total global population. In Western Europe the proportion will hit 20 percent; in Japan, 27 percent. The aging population will create additional demand for healthcare services in 2014 and beyond. Concurrently, the number of high-income households is expected to increase by about 10 percent, to over 500 million, with over one-half of that growth coming from Asia.

Governments in many emerging mar-

In 2013, the Indian healthcare industry was valued at US$ 85.92 billion and it expected to each US$ 158.2 billion by 2017 spending rose by just an estimated 1.9 percent in 2012, it is expected to pick up again, with total spending rising by 2.6 percent in nominal terms in 2013 and by an annual average of 5.3 percent until 2017. Given population

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kets are taking note of this economic growth and planning to roll out public healthcare services to meet consumers’ rising expectations.

With aging populations, an increase in those inflicted with chronic ail-

Indian Healthcare Industry Market US$ 85.92 Billion

US$ 98.80 Billion

US$ 158.2 Billion

Year

2013

2014

2017

ments that require more healthcare spending, government initiatives to increase the access to care in both industrialized and emerging markets, and treatment advancements expected to drive sector expansion, pressure to reduce health care costs remains and are escalating. Heavy government debts and constraints on tax revenue, combined with the pressures of aging populations, are forcing health payers to make difficult decisions on benefit levels. Europe remains under particular pressure, and not just in those countries most impacted by the regional economic crisis. After forcing through painful cuts to drug prices, wages and staffing levels, some governments are now using the crisis as a chance to push through broader reforms to health care funding or provi-

COVER STORY

Per Capita Healthcare Expenditure US$ 88.7 Billion US$ 57.9 Billion US$ 43.1 Billion

Year

2008

2011

2015

sion. The hope is that these reforms may make healthcare systems more sustainable in the future.

Indian Healthcare Industry

The medical equipment and devices

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4%

Medical Equipment and Devices

3%

In 2013, the Indian healthcare industry was valued at US$ 85.92 billion and it expected to each US$ 158.2 billion by 2017, growing at a CAGR of 15 percent. India being a country with growing population, country’s per capita healthcare expenditure has increased at a CAGR of 10.3 percent from US$ 43.1 in 2008 to US$ 57.9 in 2011 and going forward this figure is expected to rise to US$ 88.7 by 2015.

The private sector has emerged as a vibrant force in India’s healthcare industry, lending it both national and international repute. Private sector’s share in healthcare delivery is expected to increase from 66 percent in 2005 to 81 percent by 2015. Private sector’s share in hospitals and hospital beds is estimated at 74 percent and 40 percent, respectively, according to a report by Equentis Capital.

There is substantial demand for high-quality and specialty healthcare services in tier-II and tier-III cities. To encourage the private sector to establish hospitals in these cities, government has relaxed the taxes on these hospitals for the first 5 years. Many healthcare players such as Fortis and Manipal Group are entering management contracts to provide an additional revenue stream to hospitals.

the promise of public-private partnerships. From healthcare delivery to diagnostic services to maintenance of medical equipment to provision of 10–12 percent until 2025 implies ambulance services to establishment an overall healthcare spend of of medical colleges, a variety of opUS$ 250–300 billion by then. Medi- portunities exists for Public Private cal technology maintaining current Partnerships (PPPs). Medical technolpenetration levels of 8 percent im- ogy companies are participating in plies a domestic market of US$ 20– PPPs in a big way. Examples include 25 billion. Additionally, the focus on GE Healthcare’s PPP with the governlocal innovation products to drive ment of Gujarat for imaging services access and affordability will be an and B Braun’s PPP with The governimportant opportunity and will be ment of Andhra Pradesh for dialysis equivalent to half of the growth from services.

The opportunities in India are real, existing products / business models i.e. an incremental US$ 10 billion and Medtech companies need to move quickly but with a well-thought-out growth by 2025.

Globally the medical technology strategy for market success. Given the market is expected to be US$ 600 dynamic nature of the Indian healthbillion+ by 2025 implying a manu- care market, companies will need to facturing base of US$ 200 billion by reassess their business and operathen. It is estimated that India will tional strategies on a regular basis.

Multinationals should not assume capture 10 percent of the share by 2025 in line with China’s share to- that the opportunistic approach to day. This will lead to an opportunity this market will work in the future. Indian competitors are improving their of at least US$ 20 billion by 2025.

Bridging the gap between the de- technologies, manufacturing capabilimand for healthcare and the existing ties, and quality standards — all while supply will necessitate huge invest- keeping costs low. In addition, more ments in the next 10 years. Health is multinationals are entering India to a state subject in India and given the capitalize on its market growth.

Competitors are arriving from other fiscal condition of many Indian states, it is unlikely that they will be in a po- low-cost countries, like China, with sition to fund major investments in products that have fewer features for healthcare systems. Realizing its limi- significantly lower cost.

Multinationals that do not develop tations, the government is now actively courting the private industry with a comprehensive strategy and operating model tailored for India risk losing marSales ket share and watching their competitive position erode. Early mov9% ers — either leaders or fast followers — that can quickly develop the right 13% 71% capabilities to support an operating model tailored to the local market stand to generate double-digit, sustainable, profitable growth as India’s healthHospitals Pharmaceuticals Medical Equipment & Devices Medical Insurance In vitro Diagnotics care system reaches milmarket in India was valued at ` 37,800 crore in 2013 at end consumer prices and is growing at 10–12 percent per year. Continued growth rates of

lions of new consumers.

Import Dependence In the years following independence, India adopted an import substitution policy encouraging the development of indigenous industries under the umbrella of a strong public sector.

The medical technology sector however was not on the list of government priorities and there was no significant attempt to build domestic capabilities in R&D and manufacturing. The seeds of import reliance were thus sown in the early years following independence. In subsequent years, the reliance on imports continued despite high import duties and tariffs. Today

cording to a report by PwC. The proportion of imports is highest in the medical equipment and medical implants segments and imports contribute approximately 85 percent of the market. A few indigenous manufacturers in areas such as in-vitro diagnostics, X-ray machines, ECG machines, patient monitoring, and the like have made a name for themselves and can speak of product quality and technical support capabilities.

The medical disposables and medical furniture segment has many domestic players with significant manufacturing capacities. Apart from meeting domestic demand, these companies also export to both, advanced

Approximately 80 percent of the medical technology market belongs to imports approximately 80 percent of the medical technology market belongs to imports. Interestingly, approximately 60 percent of the domestic manufacture of medical technology is exported, ac-

economies as well as developing countries. Domestic companies have created manufacturing capabilities meeting U S Food and Drug Administration (USFDA) standards and but can also

speak of marketing alliances and distribution agreements for tapping the overseas markets.

The last few years have seen an increase in domestic manufacturing of medical equipment. With impetus from various government schemes, India is finally coming to be recognized as a manufacturing destination for sophisticated medical technology. International medical technology companies are also using India as a manufacturing base by either setting up facilities of their own or by acquiring domestic manufacturers. Examples include 3M’s manufacturing plant in Pune, Becton Dickinson (BD)’s manufacturing facility in Haryana, Hollister’s manufacturing facility in India and Philips Medical Systems’ acquisition of Meditronics and Alpha X-Ray Technologies. To encourage domestic manufacturing of medical equipment, the government plans to set up medical technology parks.

Notwithstanding these initiatives, the proportion of imports in the market is unlikely to change in the next five years as newer technologies con-

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COVER STORY

tinue to be launched overseas. With the growth in domestic capabilities and MNC investments in the Indian market, the proportion of imports is likely to fall to approximately 60 percent of the market by the year 2020.

India has to increase bed capacity by adding at least 650,000 beds by 2017

In vitro Diagnostics The Indian diagnostics market is expanding at a rate of 18 percent per annum and the sector has emerged as one of the best segments in the Indian healthcare industry. However, the diagnostic scenario in India is highly fragmented with a large segment of the industry populated by unorganized players. Various factors such as rising prevalence of diseases, improving affordability of patients and increasing penetration of health insurance have contributed substantially to spur the demand for diagnostic services in India. In an effort to match to the increasing demand set by the industry, few organized players, approximately 10 per cent, have taken initiatives to increase their pan-India presence through national networks.

Tier II and tier III cities are attracting a lot of attention from various industry sectors including IT outsourcing, automotive and healthcare services sector is no exception. For the diagnostic sector, these cities represent an area of underserved need, with a growing opportunity to improve health infrastructure. While there is opportunity in these regions, seeking to establish presence which is largely dominated by local players proving to be a challenge for large organized companies. Hence, it is observed that large players partner with these renowned local playe

Hospitals The Indian hospital sector is a key component of Indian healthcare industry with contribution of over 71 percent of total revenues of the industry.

Various incentives at the policy level along with

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legal clearance for FDI have played a great role in driving private sector participation. Most private hospitals are located in urban India with very low penetration in the semi-urban and rural parts. To reach the goals of 12th Five Year Plan, India has to increase bed capacity by adding at least 650,000 beds by 2017. Demand for services and requirement for increasing beds has created huge opportunities for investment in this sector. Increasing investments in this sector from private investors have increased financial risks and thus, the returns the investor expects from his portfolio of investments are much high. Thus, financial performance of hospitals is the key factor that motivates and encourages investments into Indian hospital sector.

Medical Insurance A major part of medical expenses are borne out-of-pocket by the people,

thus more people are realizing the importance of medical insurance which would incur the costs of world class healthcare treatment in the country. India now spends `400,000 crore annually on health, but commercial health insurance covers only `20,000 crore, not only because of low penetration but primarily also because of current health insurance products focus on hospitalization. The recent entry of specialist health insurers appears to have changed the grammar of insurance coverage. Now an industry can shift its focus from secondary and tertiary care and include more preventive and primary care. However, retail segment, and outpatient health spends continue to be virgin territories, waiting to be explored.

A recent World Bank publication stated that about half of the country’s population could be covered with health insurance by 2015, indicating a vast market potential. The awareness about having a health insurance is rapidly increasing due to the rising cost of high end health treatments and thus it has a strong growth potential in the recent years. While, the penetration of the health insurance market is still quite small, it is one of the fastest growing industries in India. The government had introduced the Rashtriya Swasthya Bima Yojna (RSBY) or Government-Sponsored Health Insurance Schemes (GSHISs) to provide the poor with financial coverage. The main objective of the new GSHIS was to offer financial protection against catastrophic health shocks. The scheme has covered more than 120 million poor people and is touted as the largest around the world.

With over 70 percent out-of-pocket expense burden on the consumers, the market is ripe for health insurance entities including global players.

Health insurers are spread across the price spectrum and do not necessarily play the price-sensitive game to win

COVER STORY

premiums.

Star Health is more focused on the low premium segment, while Max Bupa also caters to the high premium segment. But the biggest winner is the customer as we have seen a lot of innovative offerings – mostly from standalone insurers.

Star Health, for instance, has a plan for heart patients and one for diabetes patients. We also have Apollo Munich with its “Restore” feature in which the cover amount gets restored in case it gets exhausted in a particular year.

More companies are now being forced to offer similar benefits, or better them – that too at very attractive prices. With healthcare getting expensive and awareness increasing, more people are going in for sophisticated plans. At the same time, there is also a gradual breakdown of the company group plan support structure. An increasing number of companies are asking employees to share a larger

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part of the premium burden.

The breadth of cover in group plans is also being reduced – like the exclusion of parents from plans provided by the company. The pattern of employee attrition also makes a very strong case for not relying on company-sponsored cover. Firms, on their part, see higher attrition and hence don’t want to invest in expensive covers for workers. Better to offer employees higher

payouts and make the healthier employees happier.

If we see changes in FDI rules as growth picks up in the coming years, we might see more specialized health insurance companies setting up shop in the country. The industry is likely to undergo major reforms. Whichever model evolves, it is clear that the entire healthcare financing and delivery system is poised for a major change.

A recent World Bank publication stated that about half of the country’s population could be covered with health insurance by 2015

Pharmaceuticals The Indian Pharmaceutical Industry has shown immense potential and continues to grow consistently. The Indian generic drug sector is robust and is establishing its presence in foreign markets too. The new- drug sector is also expected to record a healthy growth owing to significant industrywise increase in R&D expenditure and proposed new drug launches. On the concern side, fragmented Indian pharmaceutical market is facing high volatility and uncertainty. Increasing number of drugs in National List of Essential Medicines (NLEM) and price controls, changing FDI Policy, compulsory licensing, aggressive acquisition strategies by MNCs, and declining global generic market opportunity is creating a new normal.

Pharmaceutical companies need to re-visit their traditional growth strategies to succeed in a volatile world.

With 70 percent of India’s population residing in rural areas, pharma companies have immense opportunities to tap this market. Demand for generic medicines in these regions has seen a sharp growth, and various companies are investing in the distribution network in rural areas. The share of generic drugs is expected to grow and it could represent about 90 percent of the prescription drug market by 2016.

The Indian Pharmaceuticals industry is growing at a healthy pace despite the few challenges in the domestic market. There is continued uncertainty over the New National Drug Pricing policy that will have moderate impact

on Indian Pharmaceutical players.

Anything on GST will be closely observed by the industry and any minor steps will not have the substantial impact on the industry.

Healthcare IT The healthcare sector in India is ripened with numerous opportunities for the IT companies to capitalize and grow. While IT previously merely enabled automation, it now affects integration across the entire healthcare delivery value chain. These developments are in line with the need for better collaboration among healthcare providers, payers, and governments to enhance the customer experience. As data is the foremost element that drives customer ownership and engagement, digitization strategies that generate meaningful data will become a central feature of the healthcare industry over the next five years. Healthcare players and IT vendors are already investing in tools that liberate data from organizational silos and put it in the hands of the consumer.

Using an integrated, holistic approach which allows the healthcare organizations to remain flexible to the inexorable complexity, compliance and developments, has necessitated the requirement of information systems in healthcare organization over the years. With greater number of people moving toward better equipped healthcare institutes, technological advancements become an imperative need for such healthcare organizations in order to meet the increasing demand of the population.

Maintaining quality of the healthcare services offered by the organizations along with being cost effective due to rising competition have become a key concern for the healthcare providers in India. IT, in such a case has acted as a key component in order to solve this problem. The usage of technology in healthcare sector has helped in improving various processes such as

With 70 percent of India’s population residing in rural areas, pharma companies have immense opportunities to tap this market patient diagnosis, data management, e-prescription, pathology lab management, scheduling of appointments, case analysis etc.

Digital health knowledge resources, electronic medical record, mobile healthcare, hospital information system are some of the technologies gaining acceptance in the sector. Going forward, the healthcare sector’s spending on IT products and services is expected to rise from US$ 609.5 million in 2013 to US$ 1.8 billion in 2020.

The top three states with highest number of hospitals with HIS installed in India are Maharashtra, Delhi and Andhra Pradesh. Electronic health records market has conventionally contributed the largest share in the market. The Laboratory Information System (LIS) though form a niche

market segment in India presently; however growing systemization and a steep rise in the number of various types of laboratories will stimulate the adoption of LIS adoption in the healthcare information technology market in India in the future.

Strong mobile technology infrastructure and launch of 4G is expected to drive mobile health initiatives in the country. Mobile health industry in India is expected to reach US$ 0.6 billion by 2017.

Telemedicine is also a fast emerging sector in India. In 2012, the telemedicine market in India was valued at US$ 7.5 million, and is expected to rise at a CAGR of 20 percent to US$18.7 million by 2017. With increased private participation, the healthcare sector has also witnessed rise in FDI inflows. As per law, 100 percent FDI is permitted for all health-related services under the automatic route.

The future of healthcare IT industry is predicted to be digital and fully inter-connected. Spurring investments, new hospitals, insurance penetration, and regulatory push and manpower shortages will drive the growth of the industry in the future.

Medical Tourism The cost of medical treatments in In-

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COVER STORY

Mobile health industry in India is expected to reach US$ 0.6 billion by 2017

dia is quite less, when compared to the west and the country has a number of top rated hospital chains/medical staff. India has the most number of US FDA approved drug manufacturing units and its healthcare system is based on western medicine (predominantly). The country also offers a large number of wellness tourism options like yoga, ayurveda, naturopathy, acupuncture, spa/massages, etc. Most of the traditional medicine systems in India focus largely on prevention. However, the country needs to work on increasing efficiency at the immigration to make the travelling experience hassle free for patients and also better infrastructure in terms of highways and roads would add to the overall satisfaction of medical tourists. Affordable hotels, availability of language interpreters are a few areas which also need to be given significant consideration to increase medical tourism in India.

The medical tourism market in India is projected to hit US$ 3.9 billion mark this year having grown at a compounded annual growth rate of 27 per

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cent over the last three years.

The inflow of medical tourists is expected to cross 320 million by 2015. The medical tourism industry in India gets maximum patients for heart surgery, knee transplant, cosmetic surgery and dental care as the cost of treatment in India is considered to be the lowest in Asia, much lower than Thailand, Indonesia, Singapore and Hong Kong.

Government Initiatives The Ministry of Road, Transport and Highways, the Department of AIDS Control and Ministry of Health and Family Welfare have signed a Memorandum of Understanding with an objective of providing HIV preventive services to transport sector workers.

The Central Government has requested the Government of Odisha for allotment of 25 to 30 acres of land for setting up a satellite centre

Investments According to data released by the Department of Industrial Policy and Promotion (DIPP), hospital and diagnostic centers attracted foreign direct investment (FDI) worth `12,413.57 crore between April 2000 and July 2014.

Some of the major investments in the Indian healthcare industry are as follows: w LifeCell, India’s largest umbilical cord blood stem cell bank, plans to set up a public stem cell bank at a cost of `30 crore. w Max India plans to dilute its stake in Max Healthcare in favor of its South African partner Life Healthcare in an all-cash deal of about `794 crore. w TPG Capital is in advanced talks to invest up to `900 crore for a minority stake in Manipal Health Enterprises (MHE). w HLL Lifecare has teamed up with Tata Memorial Centre for constructing a modern women and children cancer hospital at Parel in Mumbai. w BlackBerry plans to launch a healthcare service that will integrate thousands of medical devices to enable early detection of illnesses, in partnership with healthcare technology firm NantHealth, as it looks beyond smartphones in the Indian market.

of the All Indian Institute of Medical Sciences (AIIMS) Bhubaneswar as a super specialty healthcare facility.

India and Maldives signed three agreements after delegation level talks between Abdulla Yameen Abdul Gayoom, President, Maldives, and Dr Manmohan Singh, the then Prime Minister of India, on January 2, 2014.

The pacts included a MoU on health cooperation.

The Union Cabinet has approved the proposal for setting up of National Cancer Institute (NCI) at a cost of Rs 2,035 crore. NCI will be set up in the Jhajjar campus (Haryana) of AIIMS, New Delhi. The project is estimated to be completed in 45 months.

Under the Union Budget 2014-15, some of the major initiatives taken by the Government of India to promote the healthcare sector in India are as follows: w Free Drug Service and Free Diagnosis Service to achieve Health For All w Two National Institutes of Ageing to be set up at AIIMS, New Delhi and Madras Medical College, Chennai w A national level research and referral Institute for higher dental studies to be set up w AIIMS-like institutions in Andhra Pradesh, West Bengal, Vidarbha in Maharashtra and Poorvanchal in UP. A provision of `500 crore made

w 12 new government medical colleges to be set up 15 Model Rural Health Research Centers to be set up for research on local health issues concerning rural population The coming years will see great outof-the-box thinking by the strategists in the field of healthcare, beginning with the way healthcare is delivered.

To begin with, a rise in retail clinics,

in bringing quality in healthcare, be it better nursing communication systems, patient monitoring devices or telemedicine to provide low cost diagnosis to remote patients, etc.

Companies like Blackberry, HCL and HP are already investing heavily in healthcare technology and Google trying to ambitiously woo the consumers for a centralized healthcare data-

The Cabinet has approved the proposal for setting up of National Cancer Institute at a cost of `2,035 crore single speciality, secondary and tertiary care centers are seen coming to the fore including the recent examples of NOVA day care, BEAMS, and Apollo clinics. The tier II/III cities have suddenly become attractive to the healthcare players, especially because of the tax sops and increasing disposable incomes among Indian families across the country and dearth of quality healthcare infrastructure in these locations.

Specially focused on medical tourism, health cities are being designed and executed and hospitals with bed strengths of 1500/2000 which were never heard in the private domain are now coming to light.

Technology will play a major role

base. What is in store for the future of healthcare is limitless.

Challenges Year-on-year, the challenges facing the sector have remained the same.

While we are looking at a US$ 100 billion growth by 2015, the perennial problems facing India are still those arising from malnutrition (infant mortality, lacking overall development), sanitation and access to affordable hospitalization and clinical care.

On the other end of the spectrum, availability of a skilled workforce – both doctors and nursing and support staff – is cringing. Doctor-nurse density per 10,0000 persons of the Indian population is an abysmal 19. Most of the skilled medical workforce is being sought out by countries in Europe and the Middle East and retained by attractive compensation packages there vis a vis India.

Compliance to regulations is still a cause for concern in both government as well as private-run organisations.

What’s more the system suffers from the lack of a quick response and redressal system, with matters related to medical negligence and failure largely relegated as consumer affairs troubles.

Further, we need an effective mechanism to address demand for safe, affordable and quickly available Healthcare for All.

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EXCLUSIVE INTERVIEW

Challenges Faced by End-Users

Different types of surgeries, variety of patient position, and wide demography puts additional challenges in order to maintain patient safety, says Mehul Damania, Manager product Support, Maquet Medical India Private Limited

W

ith the rapid advancements in the anesthesia, needs of clinicians are also rapidly evolving. Gone are the old days when an anesthesiologist required just a machine, which can provide continuous flow device with a ventilator. Today they want facilities and features which can assure adequate oxygenation; handle leaks; full fledge ventilator and gas monitoring; cost of ownership; and many more.

Different types of surgeries, variety of patient position, and wide demography puts additional challenges in order to maintain patient safety.

Considering such challenging needs

FLOW-i is designed and evolved as an anesthesia workstation which can address such challenges.

FLOW-i is a product of Maquet’s leadership in OR technology development. Ideally, the ventilatory capabilities of good workstation should be able to maintain flow rate regardless of lung compliance and airway resistance, and be easy for the patient to trigger.

FLOW-i takes advantage of innovative Volume Reflector (VR) with oxygen-driven design. VR is a rebreathing device that allows partial re-breathing of exhaled gases. In low fresh gas flow settings and in the eventual case of leaks, the circuit will never be empty – ensuring ventilation will remain uninterrupted regardless of surgical constraints, changing conditions or patient position. If there are leaks, the circuit is saturated with oxygen, minimizing the risk of a potentially dangerous hypoxic mixture.

Powerful Interventions FLOW-i is able to optimize pressure,

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flow and enable fast, powerful interventions. This is achieved by a low internal volume and a powerful flow and pressure generator. Less internal volume also enables rapid changes in gas concentrations when needed.

Anesthesia Simplified The lightweight electronic injection vaporizers are placed centrally on the FLOW-i. Switch between agents is performed by a touch on the intuitive display. The vaporizers can be refilled while still slotted in the machine and with one still in use. They are checked during the system checkout, which means no need for calibration. The Desflurane vaporizer does not need to be heated up before use.

Cost-effective Agent Delivery FLOW-i is designed to minimize wastage and unnecessary use of agent.

During automatic ventilation, the main volume of set fresh gas is delivered during the inspiration phase and the fresh gas flow is limited to set minute volume.

EXCLUSIVE INTERVIEW

Care Better than Before

India has an advantage of learning from the global e-Health implementations that have taken place in many countries like Australia, Singapore, says Dr Pankaj Raina, PE&CE Principal, Accenture India Please tell us about your current operations in India and your expansion plans.

data generation.

What are your views on the price sensitivity of the Indian market, and how does your company counter this problem?

India is one of the largest Accenture geographies and healthcare is the major focus for Accenture globally and in India. We are partnering with clients in India not just for strategy but to work as partners in implementation.

It is true that Indian market is price sensitive, but that is true for every organisation that we are competing with. What makes us stand out and overcome this challenge is that we have offerings where we have invested earlier and those offerings fit into the market needs, which are able to offer at competitive price. We also have pricing models, which are unique and relevant in markets like India and offer a win-win proposition.

What are your views on government regulation or any other challenges faced while entering or operating the Indian market?

The government is proactively working to provide the guidelines for standardising the patient records. One of the things was by laying down the guidelines for EMR/EHR for providers. The existing technology infrastructure is challenges as that are basic need for any e-Health roll out. Second challenge we see is the interoperability guidelines between various providers (Public to Private, Private to Public), providers and payers, state and centre ministries and regulatory organisation. Current system is working in silos and there is manual exchange of information leading to with time lag.

Please comment on emerging trends and new technologies.

India has an advantage of learning from the global e-Health implementations that have taken place in many countries like Australia, Singapore.

India healthcare organisations do not have to deal with legacy systems so we see them implementing solutions, which are mature and time tested.

Evidence based protocols enabled clinical application is going to drive the quality and monitor the delivery of care better than before. Patient connecting with the healthcare system is going to be driven by mobile devices, for services and for monitoring the various disease specific parameters.

This will lead to enormous patient specific clinical and behavioural big

What are your company’s offerings?

Our company provides end to end solutions for payers and providers. We structure our offerings across the following business services Health administration Health management Clinical services Connected health Health back office (Functional) We offer management consulting, technology and out sourcing solutions across the nosiness services for healthcare clients.

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EXCLUSIVE INTERVIEW

Patient Safety A Growing Concern

The number one reason people do not donate blood is because they were not asked. I am asking everyone please donate blood – You could save a life, says Chetan Makam, managing director, Haemonetics Healthcare India Private Limited Please tell us about your current operations in India and your expansion plans.

Haemonetics is the leader in blood management solutions. Our products span the entire blood supply chain, from the arm of donor to the arm of the patient. We provides solutions in India through a specialized network of distributors that are supported by subject matter experts in blood collection and separation, cell salvage, leucoreduction, hemostasis, and integrating various solutions into the customer’s practices.

As we see the growing need for safe and appropriate use of blood, which our solutions enable, we will continue to expand in a way that makes most sense for our customers, as part of the global strategy. A third of our revenues come from the Asia Pacific market, indicating the global nature of our business and the need for our products.

What are your views on the price sensitivity of the Indian market, and how does your company counter this problem?

Our products deliver a value that is appreciated by the customers, whether it is getting a single donor platelet (SDP) in time, or salvaging blood for a patient in surgery, where the appropriate blood may not be available or not suitable, understanding the impact of

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various drugs on the coagulation profile of a patient scheduled for surgery or leucoreducing blood to make it safer for patients is the ICU/pediatric/oncology patients. For both the clinician and for Haemonetics, the focus is how these treatment/solutions do benefit the patient. Understanding the value chain is also important – From the time a unit of blood is collected to the time it is transfused, there are a number of steps all of which cost money.

The cost of the unit of blood is usually the least expensive of all the steps.

Educating customers and working with them to ensure that the proper solution is incorporated in their practice is the right way forward.

What are your views on government regulation?

Regulations implemented in the interest of patient safety are good and necessary. The process of registrations and other approvals with the various agencies would benefit if they could be tracked online with a secure website so that there is little ambiguity around time for these approvals.

Please comment on emerging trends and new technologies.

In the area of blood management solutions - we see that a closer interaction between the blood bankers and clinicians to better manage the patient’s care. Leucoreduction of blood components to reduce instances of reactions to transfusions; use of therapeutic plasma exchange to treat neurological diseases; Use of dymamic coagulation tests to understand the impact of various drugs on the coagulation (clotting) profile of a patient. This allows for better transfusion decisions to be made pre-, peri- and post-operatively..

What are your company’s offerings?

TEG: Thromboelastograph – Hemostasis Management Blood Track: Remote inventory management and beside transfusion management system Cell Saver: Autotransfusion system MCS+ : Multi-component system Leucoreduction filters for blood components

EXCLUSIVE INTERVIEW

The Next Generation of CT Scanners The most important factor in sales of refurbished equipment is specialized after sales support says Ratish Nair, CEO, Sanrad Medical Systems What are the products that you would be showcasing at IRIA 2015?

We have a 64 Slice Cardiac CT scanner and a new range of permanent magnet machine that are lighter with as much as 50 percent reduction in weight, faster in performance, and loaded with many newer applications to increase the productivity of the machine manifold.

Please share with us the concept of ‘Make in India’ at Sanrad Medical Systems?

To eliminate the dependency on imports and promote manufacturing in India, we have already begun on our journey to provide healthcare sector CT scanners that are assembled in India. We will be the first to provide CT scanners with slice capacity that is variable in nature. Earlier, to upgrade the device from a single slice to 2 slices or to a 4 slices, one would need to replace the entire machine. This was a huge cost burden for the machine owners.

Our product design will incorporate the facility to change from lower to higher slice scans without the need to replace the machine. We are doing large scale indigenization of products in engineering and software.

The availability of a ready machine in India eliminates the need to import readymade equipment at higher prices, thus making new technology affordable to rural areas also. The

design and planning work has begun in our new facility and hopefully the product will be ready before the end of next year.

Tell us about the growth trends in the radiology market?

The market is on the rise. The growth has been phenomenal for the radiology sector. The refurbished sector itself saw a growth of 20 percent.

There is renewed faith in the preowned medical system with the recent announcement of new stringent rules in installation and use of radiation equipment at hospitals and clinics. This will surely make the set-up safer and well controlled within the prescribed parameters. There is increased awareness on the new rules and is a welcome step by the government to ensure best practices are followed keeping patients safety in mind. The affordability and service offered by our refurbished products has led to an increased demand for these products. The performances of these products are as good any comparable to new system available in the market.

The most important factor in sales of refurbished equipment is specialized after sales support which is required to ensure smooth functioning of these equipment.

Please share with us any suggestions on ways to strengthen the outreach of IRIA 2015?

The IRIA is a premier platform where the eminent names and practitioners from across the country come down to learn, share and network with one another. Although it is largely participated by clinicians are somehow limited to the theme of imaging. There is a need to include the technicians also into the educational and training programmes. There needs to be more awareness amongst the technicians on the various products, technology, and equipment that are available in the market. The association should initiate a ‘Product Rating’ initiative wherein, all the products used by radiologists should be rated by the experts in the association based on their performance and durability.

The complaints against products and companies should also be considered while rating them. These efforts will bring in more transparency among the users and also keep the product providers on their toes to deliver the best of the technology to its users.

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EXCLUSIVE INTERVIEW

Celebrating Technology in Radiology Dr C Amarnath, organising chairman of Tamil Nadu and Pondicherry chapter of Indian Radiological & Imaging Association (IRIA) 2014 reflects on the success of the conference

T

amil Nadu and Pondicherry chapter of Indian Radiological & Imaging Association (IRIA) recently concluded their 67th annual conference that was held from December 19 – 21, 2014 in Chennai. The theme of the conference was ‘International update on muscoskeletal, head and neck Imaging’ and was organised by Dr C Amarnath as the organizing chairman and Dr J Devi Meenal and Dr G Sathyan. It was a great success with high participation from practitioners from Kerala, Karnataka, Andhra Pradesh, Telangana, and Maharashtra in overwhelming numbers.

Highlights The main focus of the conference was muscular skeleton and head and neck imaging. On the first day we had had three parallel tracks and the first day workshop was on obstetrics ultrasound and Doppler and fetal Echo. It was a knowledge exchange platform that the Department of Radiodiagnosis, Stanley Medical College conducted three preconference STAR workshops STAR FetUS that focused on obstetrics USG, Doppler, Foetal Echo, Foetal MRI, STAR MUST with focus on MRI and US Training in MSK, STAR SINE highlighted STAR Imaging of Neck

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with Experts-Head and Neck Demo at the annual conference and was held at Tamil Nadu Multi Super Specialty Hospital, Chennai. These were conducted by senior radiologists Dr Bhupathi Vijay Raghavan and Dr Indrani Suresh from Chennai with Dr TS Ramamurthi from Bangalore. Second conference was on muscular imaging that was conducted by international faculty that included Prof.AT Ahuja from The Chinese University of Hong Kong, Dr M Chandramohan, University of Leeds, UK and Dr Girish Gandikota, University of Michigan, USA. The third workshop was on head and neck imaging had many state faculties that participated. They had excellent quality of teaching material and the workshop was very beneficial from this interaction. The last day saw enthusiastic participation from academicians with excellent case studies in paper and poster presentations.

The conference went a step ahead to academics by addition of personal development workshops such as ‘Teaching the Teachers’ session had ten best cases presented by experts and had young academicians ask their questions to them. There were also career and life management guidance provided. The award for the Prof. T S Swaminathan Young Achiever Award

was given to Dr C Ambarnath for his exemplary work in the field of radiology. The glimpses and hands-on-experience on technology was provided for all participants as the conference had exhibitions and latest state-of-the art devices on display from all the leading companies in the radiology sector including GE Healthcare, Carestream, Sanrad Medical Systems, Siemens among others.

An Enriching Experience As healthcare professionals, we are committed to providing the highest quality of care to our patients. In order to accomplish that, we need to maintain our professional edge by attending courses, viewing equipment and establishing lasting connections with our colleagues. This conference was the first IRIA annual conference organised by Stanley Medical College after almost 75 years of clinical excellence. IRIA 2014 offered a full menu of options - educational opportunities in every subspecialty and in many different formats including case-based reviews, hands-on workshops, symposium and self-study exhibits, and quiz. The organizing committee left no stone unturned in making the participation of delegates a pleasant and fruitful experience.

EXCLUSIVE INTERVIEW

When Technology meets Healthcare Getting pregnant may be one of the most important phases for a woman and her family but often it is not the easiest, says Padmanabha T K, Head - Healthcare Outcome Services, Wipro Limited

A

ccording to UNICEF data (2012), more than 25 million births take place in India every year. Of these, 56 out of every 1000 infants born, die before the age of 5. World Bank data suggests that the infant mortality rate in India is 44 per 1000 live births that include the neonatal mortality rate of 31. A survey conducted by the National Rural Health Mission and the Indian Academy of Pediatrics found that about 75 percent of infant deaths occurred during the first four weeks of birth (or neonatal deaths).

The primary reasons behind infant deaths are issues that expectant mothers sometime face which include prebirth complications, prematurity and low birth weight, neonatal infections, birth asphyxia and birth trauma.

These risks increase exponentially in case of pregnancies achieved through IVF or other assisted reproductive techniques. Dr Kamini Rao, Medical Director, Milann – The Fertility Center, points out, “These cases are on the rise considering changing lifestyles and increased stress levels among women. Such patients require regular medical check-ups and frequent monitoring of fetal development.”

The monitoring involves conducting a CTG or cardiotocograph on patients which requires the patient to travel to the facility. Critical cases require more frequent CTGs, which adds to the stress level.

Wipro saw an opportunity for technology intervention in this scenario and set out to create a mobile based health solution that could assist patients. Mobile health or m-health is a significant breakthrough as it enables medical care to reach the patient as opposed to the patient reaching out to the healthcare provider. This solution enables doctors to monitor patients more frequently and efficiently.

The Wipro solution allows the pregnant mother to perform the fetal monitoring herself from the comfort of her home while her doctor can review the results on his/her smartphone.

The patient can record her vital parameters using a five lead wearable device which passively collects electric signals such as ECG for computing maternal and fetal heart rate and electromyography (EMG) for uterine activity, from the surface electrodes attached to the abdomen. The device records the heart rate(s) by differentiating and analyzing the ECG from the fetus and the mother. Similarly, the device monitors uterine activity by reading the EMG signals generated from the movement of the uterine muscles.

The device then transmits the data to the cloud via standard smartphones using a custom build app. The secure data is available for viewing only to the assigned doctor, who can access it on his/her smartphone. The data is displayed in a graphical format for easy analysis and also sends alert

notifications in case of conditions like tachycardia or bradycardia. This allows the physician to not just access real time data, but also historical reports and keep a close watch on needy patients.

As per Dr Rao, “The device helped the doctor prolong the gestation period from 31 weeks to 36 weeks, in the case of one of her patients, who then delivered a healthy baby.”

The user friendliness of this device makes it most suitable for working professionals who can carry it to work and use it without any medical assistance. It also helps those residing in remote locations, far away from the hospital. Moreover, the device does not involve any sort of emission, hence is completely safe for the mother as well as the fetus.

In the near future, technology companies will look to capture additional physiological parameters to further assist the physicians in decision making.

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company Profile I

Medical Equipment Finance Company Profile

Shriram Equipment Finance Company Ltd (SEFC) is a part of the “SHRIRAM” Conglomerate which has significant presence in financial services. SEFC is a fully owned subsidiary of Shriram Transport Finance Company (STFC) which is India’s largest NBFC with assets under management of over INR 520 billion. SEFC is a leading NBFC in infrastructure equipment lending, having started its operations in October 2010, it has already attained a most prominent position in Construction Equipment Finance space in the country. With a customer base of over 20,000, employee base of over 1200 and Assets under Management of over INR 35 billion, SEFC operates through a wide network of over 165+ branches across India while catering to needs of all classes of customers across the geography of the country.

SEFC has launched Medical Equipment Financing business primarily focusing on diagnostic and dentistry equipments. SEFC intends to aggressively finance equipments like X ray machines, CT scan, MRI machines, Ultrasound, Doppler & Monitors, Mammography machines, Dental chairs & lazers, Dental Radiology equipments, cathlabs i.e. to Diagnosis Centres, Nursing Homes, Hospitals as well as individual Doctors and specialists.

Having started its operations at 15 key cities spread across the country, SEFC aims to expand into 60+ centres catering to all customers in this segment in next 3 to 4 months. Eventually this business will be operated out at all 165 branches of the company.

Shriram Equipment Finance with its focused approach in industry brings in pronounced advantages for both customers and manufacturers:

Simplified & fastest loan processing

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Shriram Equipment Finance has simplified and efficient deal processing system aided with cutting edge technology support to provide shortest Turn-Around-Time in the country. SEFC conclude finance and due-diligence aspects of deal within time that is 50 per cent of industry average TAT.

Largest Retail focused company

Understanding the distributed customer profile across geography, the risks associated with the profile and segment, Shriram Equipment Finance is focused to empower small and medium enterprises/Individuals with easy and attractive finance option available at their doorstep.

Today SEFC is one of the largest retail segment financer in Construction Equipment segment and same would be replicated for Medical Equipment Finance business as well.

PAN India Coverage

Leveraging Shriram Transport’s presence in more than 650 branches, SEFC has manned its operations at 165+ locations thereby covering entire geography of the country. Having started Medical Equipment Financing in 18 branches currently, intends to spread into all 165 locations across the country.

Superior Product Offering

Shriram Equipment Finance with its superior industry understanding and underwriting skills has evolved product offering in terms of asset selection, Loan-To-Value, tenor and other finance terms flexible that is by far the best in the industry.

Covering all & everywhere

Shriram Equipment Finance believes and demonstrates financial inclusion of all asset classes/ models and customer grades with best in industry product offering. Complete coverage to the matrix of assets and customer grades make Shriram Equipment Finance a comprehensive solution provider in this segment.

january / 2015 ehealth.eletsonline.com

EXCLUSIVE INTERVIEW

Indian Radiological and Imaging Association 2015

We aim to promote original research and young talent at IRIA 2015, says Dr K Mohanan, Organising Chairman, IRIA 2015 Please share with us the theme and vision of IRIA 2015?

The 68th edition of annual conference held by Indian Radiological and Imaging Association (IRIA) is focused on young radiologists and promotion of original research. We have somewhere ignored the new generation of radiologists and aim to bring them at the forefront in this mega gathering. We are expecting close to 1000 e-papers and poster presentations from the resident, post-graduate, and graduate students in addition to oral papers from these youngsters. We have also kept awards for best poster presentation to encourage innovative and original research taken up by them. We aim to encourage more young radiologists to start their own practice. Starting your practice is a special session offering perspectives for young radiologists seeking to set up their practice. This will be a platform for them to seek advice from seniors who are at the top of the ladder and begin young. There are ample opportunities for the young radiologists to present their work at IRIA 2015.

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We have invited close to 50 international faculty and 240 Indian faculty handpicked for their exemplary contribution to the science of radiology.

In terms of the academic agenda the 2015 IRIA annual conference is sure to be one of the best in India.

also kept a session on PC-PNBT Act with participation from the government to interact with the practicing radiologists on common challenges.

Tell us more about the efforts of IRIA to promote ethical practices at the conference?

All sessions have been organised based on sub-speciality. There is stateof-the-art onco-imaging and PET-CT. The highlight of our international faculty is innovative neuro-radiology program featuring case studies and mini-workshops. There is a dedicated session on Contrast Enhanced Ultrasound that will discuss from basics to routine practice and beyond, and we have also included dialysis fistula imaging and intervention – an emerging field in radiology for our participants.

As mentioned earlier that our focus is on young radiologists, so we have designed a session Listen, Learn and Do! Step by step How I do it wherein the participants can get guided on basic CT/US guided procedures by experts. Similarly there are All you wanted to know- Fetal imaging/ infertility and Breast Imaging sessions. In addition, there are many hands-on-training and workshops and comprehensive sessions on HCC, integrating imaging, interventional treatment, and recent advances.

Our key objective at the association is also to promote ethical practices in addition to best practices in radiology in India. And to make the most of the presence of radiologist from across the country, we have active presence and participation of top officials from the Atomic Energy Regulatory Board (AERB) at the conference. They will present not just in the academic sessions but have also put up a stall to promote awareness and outreach of the new guideline and rules.

AERB mandates every radiological installation to be registered with them via an online form. This registration will be open at IRIA 2015 for all radiologists who have yet to register them. We have

Please share some highlights of the scientific agenda at IRIA2015?

BUYERS SPEAK

Meeting the Needs The private sector has emerged as a vibrant force in India’s healthcare industry, lending it both national and international repute, says Dr S Khanna, president, Dharamshila Cancer Foundation And Research Centre Please tell us about your current operations in India and your expansion plans.

Dharamshila Hospital and Research Centre is an exclusive cancer hospital with 300 beds. The hospital provides comprehensive cancer care, which includes cancer prevention, early cancer detection, staging, workup, radiation, surgery, chemotherapy, bone marrow transplants, including haploidentical transplants, palliative care, rehabilitation, teaching, training and research.

We are planning to add 100 beds for allied specialities and 50 day care beds.

Patient services • Lab and blood bank • Radiology and imaging • Surgical • Chemotherapy • Blood and marrow stem cell transplants • Other allied • Free/subsidised treatment to weaker sections of the society Attendant services • Free cancer screening • Highly subsidised boarding and lodging facility, close to hospital • Meditation hall Services for community • Cancer awareness lectures • Free distribution of literatures on cancer awareness • Free cancer screening

What are your views on the price sensitivity of the Indian market, and how does your hospital counter this problem?

Most Indian patients do not plan for their healthcare expenses and react violently while paying healthcare bills. People who are members of any healthcare scheme have taken insurance, try to misuse the facility. Being a NGO run, Dharmashila Cancer Hospital’s primary objective is to increase cure rates. Therefore as a policy we treat stage I and II patients at our rates and provide subsidy to patients from weaker section of the society.

What are your views on government regulation or any other challenges faced while operating in the Indian market?

The current government regulations are not any deterrent to operating in the Indian market. The challenges faced while operating in Indian market include exorbitant land cost; High electricity and water rates; Poor health insurance coverage; CGHS fixes rates without any scientific basis and same rates are followed by most Public Health Schemes. The rates do not even cover the cost of services; Inspite of making agreement for release of payment within 30-90 days, most health schemes, insurance companies PSUs, ECHS, ESI, and TPA do not release payment for years; and there is too much corruption in government and healthcare schemes.

Newer technologies have revolutionised cancer diagnosis and treatment and outcomes. Technologies being used at Dharamshila Hospital are cell separation technology for Haploidentical (Half matched) bone marrow transplants and cell therapy for patients suffering from blood disorders; High definition PET-CT with LSO crystal technology for staging cancer and knowing the outcome of treatment; VMAT technology - For giving one tenth dose of radiation to the target organs in 1/3rd time to prevent radiation side effects; and Harmonic scalpels, operating microscopes, high end anaesthesia machines, lasers, LED OT lights and endoscopes for high end cancer surgeries.

What are your hospital’s offerings?

Dharamshila Hospital and Research Centre offers full range of state-ofthe-art services for cancer patients, their attendants, general community, doctors, nurses, and technicians.

Please comment on emerging trends and new technologies. january / 2015 ehealth.eletsonline.com

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perspective

Minimally Invasive Cardiac SurgeryThe New Revolution The best aspect of this surgery is a slight cosmetic scar, early discharge, and mobility experience, says Dr SK Sinha, Director CTVS, Paras Healthcare What is minimally invasive cardiac surgery (MICS)?

Minimally invasive heart surgery (also called keyhole surgery) is performed through small incisions (on sides of the chest), by using specialized surgical instruments. The incision used for minimally invasive heart surgery is about 2 to 3 inches instead of the 6 to 8 inches incision required for traditional surgery. In this surgery the cardiothoracic and vascular surgeons (CTVS) operate on the heart between the ribs and hence do not split/divide the breast bone for heart access. This helps the surgeon by giving him a better view of the heart than open heart surgery and helps the patient as it reduces pain and guarantees quicker recovery. A heart-lung machine is also not needed for this surgery, and a device is attached to heart to stabilize it. The best aspect of this surgery is a slight cosmetic scar, early discharge, and mobility experience.

Is MICS the right choice for me?

Technology and advancements in science are to make our life easier. It is essential for us to embrace the developments. MICS is a novel safe and broadly applicable technique for performing a wide range of complex heart procedures, including single or multiple heart valve procedures, bypass surgery, congenital heart repairs, and reoperations. At Paras Hospitals, the CTVS department has a cumulative experience of performing more than 500 minimal invasive cardiac surgeries on patients from all over the world. If one has been advised

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cardiac surgery and wants faster discharge, easy mobility and less trauma, then one should definitely opt for the same. Then again, who wouldn’t want such an option that saves you from the perils of a traumatic conventional cardiac surgery?

But it should also be noted that not everyone is a candidate for these surgical techniques. The CTVS surgeon will review the results of your diagnostic tests before your scheduled procedure to determine if you are a candidate for minimally invasive surgery. The surgical team will carefully compare the advantages and disadvantages of minimally invasive techniques versus traditional surgery techniques.

If it is so good, why is it not used more frequently or in all heart surgeries?

Minimal invasive cardiac surgery is performed aggressively in developed countries, however in India the trend is yet to be replicated. This delay is due to the gap in expertise, skill and precision. This revolutionizing procedure ensures that patients are treated with minimum scars, less pain and improved results. At Paras we ensure that by proper patient selection the best surgical results are achieved.

Also this is a specialized procedure

• •

• • • •

•

can hide below the breast Less pain and trauma Shorter ICU and hospital stay after surgery: The average stay is 3 to 5 days after minimally invasive surgery, while the average stay after traditional heart surgery is 7 to 10 days Low risk of infection Low risk of bleeding and blood transfusion Quicker return to normal activity Shorter recovery time and faster return to normal activities/work: The average recovery time after minimally invasive surgery is 1 to 2 weeks while the average recovery time after traditional heart surgery is 6 to 8 weeks Division of the breastbone is not needed

From the surgeon’s perspective, are minimally invasive procedures more difficult considering there isn’t direct, open access to the heart?

Definitely! What we are attempting to do is evolving a major cardiac surgery into something similar to a general day care laparoscopic surgery. Just imagine the impact of the same on the psych of the patient. At present the patients are traumatized by the very thought of their breast bone being cut.

At Paras we ensure that by proper patient selection the best surgical results are achieved and not everyone is a candidate for the same.

What do you feel are the key patient benefits for a minimally invasive cardiac surgery?

The benefits of minimally invasive cardiac surgery techniques are many, few are mentioned below: • Smaller incisions • Small scars- in women the same

Skill, precision and the use of specialized instruments is exceptionally essential. A surgeon needs to trust himself and his team of specialists.

Has the percentage of minimally invasive procedures increased over the past few years? If so, why?

Yes, the numbers have increased, however the same is not exponential.

This is because one need skill, precision and training to perform the same.

Moreover, specialized instruments are also required. Hospitals usually either lack trained manpower or do not have the resources for new instruments.

The medical colleges also do not provide any specialized and recognized training for MICS. The same is purely dependent on the will, skill, and learning bent of mind of the doctors. Due to all these reasons the patient awareness for the same is also less. However, with the advent of training programs the popularity and demand of this specialized procedure is definite to rise.

Can you estimate what percent of your operations require some form of minimally invasive procedures?

We try and treat every patient that walks into our portals with MICS. However not every patient is suitable for the same. At present 50 percent of our cases are treated through MICS technique.

What minimally invasive cardiac surgeries does Paras Hospitals offer?

The minimally invasive heart surgery procedures performed at Paras Hospitals have demonstrated that it is a safe and broadly applicable technique for performing a wide range of complex heart procedures, including single or multiple heart valve procedures, bypass surgery, congenital heart repairs, and reoperations.

Most patients are candidates for minimally invasive heart surgery which has become the preferred approach at Paras Hospitals for the majority of our heart surgery patients, including: n Mitral valve repair and replacement n Aortic valve replacement n Atrial septal defects n Coronary artery bypass n Atrial myxoma removal

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buyers speak

Gaining Momentum There is a need to move toward an integrated healthcare delivery system, says by Dr (Prof.) D P Saraswat, CEO, Action Group of Hospitals Healthcare market in India visa-vis the global market For a country the size of India, where Ayurveda was born, and the healthcare ecosystem here remains at an elementary point compared to the global healthcare market. Regardless of India being termed as a potential healthcare industry, the masses do not have free access to the affordable secondary and tertiary level healthcare owing to hi-end infrastructure and technologies being in tier I and II cities. However, much recently, Indian healthcare has suddenly started gaining a momentum by experiencing a new wave of opportunity. Healthcare providers are re-conceiving existing delivery models to bring healthcare closer to their patients. Meanwhile, government intervention is mandatory to pull in new players in the industry.

While the outlook for the healthcare industry is optimistic, there is a need to move toward an integrated healthcare delivery system.

Please tell us about your current operations in India and your expansion plans.

Currently our flagship Sri Balaji Action Medical Institute is multi-specialty super-specialty hospital and another stand alone Action Cancer Hospital are dedicated to nation. Future plans are to set-up a Medical College, Dental College, College of Nursing, and Allied Health College in Delhi and NCR.

What are your views on the price sensitivity of the Indian market, and how does your diagnostic counter this problem?

Rising cost of treatment is matter of concern for administrators where external factors like cost of medicines, importing equipment, instruments, electricity tariff, besides man-power costs are beyond our control. Therefore our endeavour is to render world class quality care at affordable cost through operational efficiencies within the reach of masses. Healthcare insurance sector is synchronising with our motto.

What are your views on government regulation or any other challenges faced while operating the Indian market?

Protocol driven quality service with predictive clinical outcome is the need of the day in Indian hospitals. Care bundles have been evolved and implemented in true spirit. Challenges are to render medical quality as per institutional predetermined protocols, rather than individual clinicians own preferences. Govern-

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ment regulations are to take care of interests of beneficiaries. More often than not, government run hospitals fall short of these regulations where as leading hospitals in private sector abide by these regulations. The disparity in service levels and adherence to regulations force patients to seek care in hospitals in private hospitals.

Please comment on emerging trends and new technologies.

Technology is swiftly changing the way healthcare is delivered across the country. According to a pert cited

by INLEAD, the Indian healthcare sector is expected to reach USD 280 billion industry by 2020, with spending on health estimated to increase14 percent annually. Some of the latest trends doing the rounds in our healthcare sector include telemedicine, telemedicine technology and patient remote monitoring care from the admission to post discharge, multispecialty outpatient clinics, medical city, and medical tourism.

What are your hospital’s offerings?

Based on the parameters of volume of patients, hi-end clinical work, revenue generated and of all perception based on clinical outcomes, Action Group of Hospitals offer its clinical excellence through Action Cancer Hospital, Action Heart Institute, Action Kidney Transplant & Dialysis Centre, Action Institute of Liver & Digestive Diseases, Neurology and Neuro-surgery, Joint Replacement and Sports Injury Centre and Orthopaedic Department.

buyers speak

E-Network for Healthcare

Government as well as private organizations have shown interest in the E-Network based healthcare delivery mechanism, says Rajesh Srivastava, Chairman, Rockland Hospitals

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n the case of healthcare that deals with questions of life and death, the gap between the needs of the society and service providers, unfortunately, is very large. For example, on an average a cancer patient has to travel a distance of up to 500 Kms for treatment in India. What is even more alarming is the fact that 80 percent patients consult a doctor when the recovery is difficult. Against the global average of 0.5 percent incidence of cancer among the minors, India has an average of 15 percent.

Breast cancer which can be easily detected accounts for 25 to 30 percent due to lack of awareness and the cultural factor of women hiding their ailments from the family till it becomes unbearable. The situation is equally alarming in case of many other diseases.

The solution clearly lies in building a healthcare network that can connect the patients with clinics, diagnostic centres, small hospitals, and tertiary care hospitals in a seamless manner through a user friendly system. We have successfully created an E-Network healthcare delivery mechanism in collaboration with ICT and Hitachi. ICT has tested and tried easy to use, mobile based applications, and Hitachi has world class data analytics software. By integrating these with the Rockland medical services software the capability to handle big data

has been multiplied several times.

The Rockland E- Network connects the patients with medical services through an IT and telecom interface in remote areas with centres of excellence in large cities. Patients are the biggest beneficiary of the E- Network model.

Wrong diagnosis or late diagnosis causes huge expenditure on treatment later and in many cases precious lives are lost. The network model connects the patients with the nearest clinic, nursing home or small hospital with the specialist and super specialist doctors of Rockland to ensure early diagnosis of diseases. The network awareness teams ensure that the patient gets full information on preventive care, location of healthcare facilities, cost of treatment, insur-

ance cover, and various government and non-government schemes providing health cover. We will scale up the implementation in a phased wise manner to connect with the doctors in 400 districts of North and North East India.

Hitachi in association with the NDTV network had recently organized a one day conference on Social Innovations for Future in Delhi.

Rockland was invited to share its unique model of healthcare delivery as a strategic partner of Hitachi since 2012 in the area of healthcare.

E-Network based healthcare solutions found ready acceptance at the conference and were widely covered by media as a step in the right direction. Since then, several government as well as private organizations have shown interest in the Rockland ENetwork based healthcare delivery mechanism.

The Rockland E- Network services have also been extended to cover the lesser developed countries of Africa, CIS, Middle East, and SAARC region.

The situation in these countries is similar to what exists in remote areas of India. India’s capabilities in IT, its low cost advantages and a huge reservoir of human resources make it an ideal partner for using India as a base for exporting healthcare to the rest of the world specially the lesser developed countries.

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buyers speak

Medical Landscape in Oncology The challenges of treating patients in our country are enormous. The solutions have to be tailored to their socioeconomic conditions, says Dr Ashok Mehta, Medical Director, Brahma Kumaris’ Global Hospital & Research Centre, Mumbai

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t is recognized that with over a million new patients every year in India and 14 million worldwide and also number of available treatments, there is a great demand for oncologists who are experts in treatment of cancer to deliver appropriate, better and standardized care.

Oncologists are experts in different fields of cancer treatment. Surgical oncologist is a surgeon who specializes in surgical treatment of cancer.

There is trend towards super specialization in surgical oncology such as head and neck cancer, gynecological cancer, breast cancer, and the like.

A radiation oncologist is a specialist

tumor without damaging the normal tissues.

Medical oncologist is a physician who specializes in medical treatment using chemotherapeutic drugs, hormones and targeted therapy. There is super specialty of hematology-oncology to treat blood cancers, cancers of the lymphatic system and carry out bone marrow transplantation. A large number of patients require more than one modality of treatment mentioned above. Ideally, a cancer patient should be seen by various specialists in a tumor board before starting the treatment and a joint decision should be arrived at offering the best option for

High treatment cost is one of the major reasons where cancer care is out of reach for millions of people physician who uses ionizing radiation such as megavoltage X-rays (linear accelerator) or radionuclides in the treatment of cancer. Radiation can be given as a curative modality, either alone or in combination with surgery and/or chemotherapy. It may also be used palliatively, to relieve symptoms in patients with incurable cancers.

Radiation oncologists are supported by medical physicists who plan to deliver the cancericidal dose to the

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treatment. A tumor board may consist of the oncologists and other specialists such as imaging specialists, interventional radiologists, surgical pathologists, intensivists, etc.

PET-CT has revolutionized medical diagnosis in oncology. It combines functional imaging obtained by PET depicting the metabolic activity in the body which is correlated with anatomic imaging obtained by CT scanning.

An obstacle to the wider use of PET-

CT is the difficulty and cost of producing and transporting the radiopharmaceuticals used for PET imaging.

The half life of radioactive fluorine used to trace glucose metabolism (using fluorodeoxyglucose, FDG) is two hours only. Its production requires a very expensive cyclotron. In absence of tumor board many specialists prefer to refer the patients for opinions of other colleagues.

Evidence based practice is being promoted in most parts of the world and has impacted the cancer practice even in our country. Evidence based medicine is a process of systematically finding, appraising and using contemporary research findings as basis for clinical decisions. It asks questions, finds and appraises the relevant data and harnesses that information for everyday clinical practice.

It is a daunting task for a busy clinician since medical evidence base is increasing exponentially. It is virtually impossible for an individual specialist to maintain up-to-date comprehensive knowledge even in his own field of practice. Specialists have not only to treat the patients but have to be familiar with frontline research.

Growing use of web-based technology and electronic decision support help physicians improve overall care of the patients, since the knowledge is not only used by specialists but also in

training resident staff, nursing staff, pharmacists, and other support staff of the hospital. As a busy senior consultant in a practice of surgical oncology, I frequently use Internet and web based technology, online guidelines and protocols, which have been developed across multiple jurisdictions but originate mostly in North America and Europe. Use of these protocols helps to improve overall care of the patients and results in improved long term survival. Staff specialists remain up-todate with latest evidence using other information sources such as journals, research databases, conferences, etc.

Clinicians often use onco-informatics perceived by him to provide high quality support. Resident doctors and fellows specializing in cancer use them more often than others on daily or weekly basis especially chemotherapy protocols.

In our country, patients travel long distances for diagnosis and treatment.

This is not only expensive but entails disruption of family. The challenges of treating patients in our country are enormous. The solutions have to be tailored to their socioeconomic conditions. Multimodal treatment in which surgery, radiation therapy, and chemotherapy, are either used sequentially or concurrently, are very demanding logistically for the patients. For marginal improvement of cure rates statistically it may not be practical to offer prolonged treatment which leaves patients exhausted. Many patients receive toxic treatment with chemotherapeutic drugs with serious sideeffects.

Genomes of tumors have been sequenced. They are more complex than expected. Genetically targeted therapies were introduced in some of the cancers. First commonly mutated genes were identified and seen if these genes are mutated in a particular cancer. Then sequence and identify the mutations to be able to say exactly what genes are defective

in patient’s tumor. We can then figure out signaling pathways affected by the mutations and target them. For example, drugs that specifically address mutations in the EGFR (epidermal growth factor receptors), in one type of lung cancer (adenocarcinoma) when administered to block those receptors, the tumors just melt away.

Some breast cancers which have Her-2neu receptor (human epidermal growth factor receptor) respond to a drug Trastuzumab. Also, TKI (tyrosine-kinase inhibitors) target kidney cancer e.g. Sorafenib, or androgen receptor antagonist drug Enzalutamide for prostate cancer.

In future molecular profiling and targeted treatments could help withhold such treatments from women who have excellent survival rates predicted by genetic sub typing. Potential of molecular profiling and genomic studies can be applied in more individualized approach to breast cancer treatment. Results of molecular profiling studies will have enormous impact.

New genomic tests can look at 1000 genes and by accurately predicting drug response may improve survival by helping oncologist to select the appropriate treatment regimen. At present time very high costs have prevented their widespread use.

Though a number of cancer centers have come up in different parts of country, development of cancer facilities has not been able to keep up with the demand largely on ac-

count of high initial investments, low paying power of general population, shortfall of specialists and skilled manpower. It is estimated that there are about 160 government hospitals and 350 private hospitals providing oncology treatment. However, when recurrences occur or complex surgeries are contemplated many patients prefer to go or are referred to reputed major cancer centers in metro cities where they have to wait long for their turn for treatment. High treatment cost is one of the major reasons where cancer care is out of reach for millions of people.

One of the solutions to provide more cancer centers would be to encourage Private Public Partnership projects with free/subsidized land and concessions in taxes. This will reduce the cost of the project and eventually become more affordable to the citizens.

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buyers speak

Making Healthcare Affordable and Accessible

I believe patients in India are not price sensitive but are value sensitive, says Rajiv Sharma, group CEO, Sterling Addlife India Limited, Gujarat Please comment on healthcare market in India vis-a-vis the global market In modern India, a little less than 20 percent of the world’s population lives on a little over two percent of land surface and collectively enjoy an income of a little above five percent of global GDP. The country is witnessing strong demographic and social changes and population above 65 years has gone beyond 60MM. There has been sharp rise in prevalence and deaths due to NCD (i.e. cardiovascular, diabetes and cancer) leading to a huge gap in access to tertiary healthcare services.

Despite best of efforts in last couple of decades, health outcomes in India and quality of underlying health system significantly lagged those of peer nations. Healthcare spend per capita in India is close to USD 60 as against close to USD 6000 in USA and Australia. The situation is further complicated by inequity in healthcare access across states and demographic segments within the population. Chang-

ing demographics, psychographics and epidemiology will present the private sector with huge challenges and opportunities.

pitals in various stages of completion.

We have also recently expanded our offering of services to include IVF, diagnostics, and home healthcare.

What are your views on the price sensitivity of the Indian market, and how does your hospital counter this problem?

What are your views on government regulation or any other challenges faced while operating in the Indian market?

I believe patients in India are not price sensitive but are value sensitive.

Thanks to Internet, level of awareness amongst patients is extremely high and they expect the healthcare providers to deliver the committed value against treatment cost.

The government has articulated its long term vision to achieve Universal Health Coverage. To achieve this vision, the government will need to lead the journey and acts as enabler for private sector to invest for long term.

Please tell us about your current operations in India and your expansion plans.

We are a regional healthcare chain and till date have remained focussed in Gujarat. At present we have five operational hospitals and three hos-

Please comment on emerging trends and new technologies.

Penetration of IT as enabler of healthcare delivery will go up significantly in time to come. Healthcare delivery will see lot of innovation in healthcare more accessible in terms of reducing costs and increasing value; improving patients’ experiences and outcomes and; hasten the translation of research into the therapies and cure.

What are your hospital’s offerings?

We are a chain of super specialty hospitals and offer all high end specialties including renal and liver transplants. We also offer diagnostics, IVF, and home healthcare services.

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buyers speak

Delivering WorldClass Healthcare, Affordably Nuclear medicine in India is growing rapidly. India is the only country, which offers high end PET-CT scans to our population at extremely low cost at several government hospitals, says Dr Vikram Lele, Director, Department of Nuclear Medicine & PET CT, Jaslok Hospital & Research Centre, Mumbai Healthcare market in India visa-vis the global market Healthcare market in India is growing rapidly. We now have capability of offering world class facilities at lesser cost than developed countries.

Your current operations and expansion plans.

Jaslok hospital and Research centre is a pioneering private hospital in India with over 40 years of existence. It provides state-of-the-art, cutting edge diagnostics, and therapeutic facilities. New satellite centres are being planned. The Department of Nuclear Medicine at Jaslok is considered amongst the leading departments in India offering training for DNB in nuclear medicine. It is among the best equipped centres in India in terms of technology and staff.

What are your views on the price sensitivity of the Indian market, and how does your diagnostic counter this problem?

Indian market is very price sensitive.

The trade-off between providing high quality state-of-the-art diagnostics and therapeutic facilities at afford-

able cost is a difficult balancing act.

Providing packages tailored for specific medical conditions is how our hospital attempts to face this issue.

What are your views on government regulation or any other challenges faced while operating the Indian market?

The speciality of nuclear medicine is very strictly regulated by the Atomic Energy Regulatory Board of the Government of India. No such strict regulations exist for radiology practice. While this attempts to maintain

quality control over nuclear medicine practice, over regulation also tends to stifle the growth and spread of the speciality to Indian cities depriving major chunk of our population of its benefits.

Please comment on emerging trends and new technologies.

In nuclear medicine, emerging trends are for fusion imaging wherein CT and MRI are combined with a nuclear medicine scanner in one machine to give a very powerful diagnostic tool: PET-CT and PET-MR. Targeted therapies for neuroendocrine cancers, lymphomas, and thyroid cancer using radioisotopes are emerging as powerful effective therapeutic options.

What are your hospital’s offerings?

The Department of Nuclear medicine, Jaslok hospital offers every possible diagnostic and therapeutic Nuclear medicine procedure which is being done at major hospitals abroad. Targeted therapies for neuroendocrine cancer (Peptide Receptor Radionuclide Therapy) are being offered at half the cost as compared to abroad.

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buyers speak

Moving toward Consolidation

The need for efficient systems to deliver quality healthcare is much more intensified today and healthcare providers face the challenging mandate of doing more with less, says Dr Suvarna Ravindranathan, General Manager, SRL Diagnostics, Karnataka Indian in vitro diagnostics market The market in India is highly fragmented. It is not surprising given its healthcare delivery structure, but of the estimated one lakh laboratories in India many have just basic facilities and only three to four laboratories are state-of-the-art multidisciplinary core labs. The hierarchy has specialized laboratories on the top, followed by laboratories in hospitals and nursing homes, and finally by small testing centers. All specialized laboratories operate in the private sector. The government at the best has semi-automated laboratories.

Test volumes range from 50 to 100 samples per day for one laboratory located in a small town to several thousand samples per day for a

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major laboratory.

Please comment on emerging trends and new technologies One of the major challenges faced by the new Indian government is to provide affordable healthcare to all.

Healthcare in India, as elsewhere in the world, is facing unprecedented challenges, including the economic burdens associated with rising costs, chronic diseases, and caring for ageing populations. The need for efficient systems to deliver quality healthcare is much more intensified today and healthcare providers face the challenging mandate of doing more with less.

Medical diagnostics is at the center of healthcare delivery and is facing its own challenges. With increasing demand for tests, focus on quality, and accuracy by physicians as well as changing economic paradigm, laboratories are forced to think out-of-thebox to keep functioning.

An estimated 70 percent of medical

decisions are based on laboratory test results. However, diagnostic laboratories in India are limited by means and resources. The thought of investing in an automation system feels like a daunting task, let alone expanding a laboratory or replacing existing systems. But the need for quality and reproducibility as well as the increasing demand for tests with less turnaround-time has only fuelled the need for adoption and use of laboratory automation.

The key challenge for the diagnostic industry is to find innovative and cost-effective ways to improve testing efficiency and eliminate errors. Given the variation of power supply in India, equipment manufacturers must have a clear vision of how to best enhance a laboratory’s capability with their automated equipment.

• Automation gains Since automation for clinical laboratories came into existence equipment manufacturers have been promoting

the benefits of stand-alone and total laboratory automation systems. The crux of their marketing lies in the fact that these equipment save time, reduce manual steps and above all, remove the human element from testing to lower the risk of errors.

Automation makes the process very easy, makes the process and manpower requirement less. Even with less manpower more tasks can be accomplished more efficiently. Even the turnaround time will scale up to significant improvements and the chances of error are minimized to a large extent.

• Automation and quality Leveraging the full capability of automation to drive quality and productivity improvement is the aim of all laboratories. While many believe that automation provides consistent quality, there are many who don’t buy this theory. Lab automation alone will not ensure quality. It will provide reproducibility only to a certain extent.

There is a difference between quality and reproducibility. Reproducibility is something like precision but accuracy will come only if you practice quality. Quality procedures and standards need to be in place.

quite a lot.

Major challenges and opportunities A strong requirement for quality managers who are properly trained and have proper standard operating pro-

pendent laboratories become franchisees in the hub-and-spoke model of the larger players. By 2015, 30 percent of the market is predicted to be organized, which will lead to more automated labs in India.

Automation will extend beyond tra-

Automation will extend beyond traditional robotics to include more mobile systems. Pre-analytical process will get more customized and efficient cedures in place is challenging.

In fact, it is necessary to train and retain competent staff, which is equally challenging. Precision and accuracy are the mark of a good laboratory.

Medical laboratories, through their systems, have to generate results that can be replicated or reproduced in different diagnostic centers.

Outlook Automation in clinical laboratory is gaining pace in India. In future, smaller laboratories will consolidate and feed samples to larger automated laboratories. In the future, this market is expected to become more organized and consolidated as small and inde-

ditional robotics to include more mobile systems. Pre-analytical process will get more customized and efficient.

Clinical laboratory automation involves the integration or interfacing of automated or robotic transport systems, analytical instruments, and pre- or post-analytical process equipment such as automated centrifuges and aliquoters, decappers, recappers, sorters, and specimen storage and retrieval systems. In addition to the electrical and mechanical interfaces of these various components, the computers that control these devices or instruments must also be interfaced to each other and/or the laboratory information system.

• Prohibitive cost of automation Manual labor is readily available and less expensive in India; however in a clinical laboratory automation supersedes manual labor. It requires a huge initial investment compared to the unit cost of the product. In India, automated laboratory equipment are expensive. The best innovation that has come up is the development of customizable automation configurations that allow the flexibility of phased implementation. The cost of automation varies. If an analysis is needed to be interfaced with computers, this will not cost much. However if robotics is taken into consideration then along with automation it will definitely cost

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buyers speak

Unorganised & Unregulated Market Medical diagnostics is ever evolving and is closely linked to the developments in technology and the medical science in general, says Dr Th. Dhabali Singh, Managing Director, Babina Diagnostics, Imphal, Manipur Current operations and expansion plans.

Babina Diagnostics has more than 100 collection centres and franchisees in Manipur and the neighbouring states thereby making our diagnostic centre, the biggest of its kind in the Northeast. We also have joint-venture units in Kohima, Guwahati, Shillong, and Agartala. There are plans for further expansion in other parts of the Northeast and the neighbouring country of Myanmar. In fact, we already have a joint-venture unit in Tamu in Myanmar and we are keeping a close

watch on the political developments there. With the cost advantage we can provide, there is a huge potential for medical tourism here.

What are your views on the price sensitivity of the Indian market, and how does your diagnostic counter this problem?

Ours being a diagnostic centre, my views would be limited to this sector only. Healthcare, in particular, the diagnostics market, is price sensitive.

Looking at the general economic status of the population, particularly, in an economically-backward region, we are at a constant pressure to bring down the rates of tests and investigations so that they become easily affordable to the people.

What are your views on government regulation or any other challenges faced while operating the Indian market?

A major section of the medical diagnostics market is unorganised and unregulated. This has resulted in the mushrooming of a large number of laboratories. Accreditation is still not mandatory in India. Benefits of

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accreditation accrue to both patients and laboratories by way of increased business resulting from enhanced patient confidence, and ensuring quality reports. Medical labs will be confronted with a broad range of medical, legal, ethical and even, human rights issues if they don’t gear up for accreditation and consequent improvement in the delivery of quality services. Other challenges faced by laboratories include the high cost of equipment and reagents and fast obsolescence of technologies. For a laboratory based in a remote part of the country as ours, there are other additional problems like that of connectivity and lack of infrastructure.

Please comment on emerging trends and new technologies.

Medical diagnostics is ever evolving and is closely linked to the developments in technology and the medical science in general. Recent advances in molecular biology and radiology have completely changed the way we see at diagnostics. Of the recent developments, many believe that nanotechnology has the potential to improve the whole healthcare process for patients, right from diagnosis to treatment and follow-up monitoring. The advantages of nanotechnology-based medical diagnosis include rapid testing and early diagnosis. It is believed that emerging modalities such as biochip, microarray, nanobarcode, and nanobiosensers are going to revolutionise the field of medical diagnostics.

What are your diagnostic’s offerings?

Our journey starting from 1983 has been a tremendous experience and we have seen how medical science and diagnostics have changed in all these years. Being the first NABL-accredited laboratory in the entire Northeast, we have the reputation of the leading medical diagnostics service provider in the region.

buyers speak

Digital Pathology – A Game Changer

India has a vast population and international standard of healthcare is being provided by private and government hospitals in metros only, says Dr Mithilesh Chandra, Director, Pathology Consultancy Services, Noida Please tell us about your current operations in India and your expansion plans.

Currently our surgical pathology laboratory is engaged in digital pathology for procuring second consultation in pathology from overseas pathology experts. This facility is being used by the medical specialists as well as the patients particularly for confirming the diagnosis of cancer. We have a panel of expert pathology across the globe that provides opinion.

What are your views on the price sensitivity of the Indian market, and how does your hospital counter this problem?

Indian patients are very price sensitive. Hence we have taken special care of this aspect in our service. We are providing consultation from global pathologists at rates competitive to Indian charges. That is one of the reasons that our service is becoming popular fast.

What are your views on government regulation or any other challenges faced while operating the Indian market?

At present, there is no interference from government agencies in this field and we see a greater positive role of government in the coming years.

Please comment on emerging

Digital pathology is going to be a game changer and usher in era of e-education for medical, dental, nursing, and paramedical students

trends and new technologies.

Digital pathology is going to be a game changer and usher in era of eeducation for medical, dental, nursing, and paramedical students. This is particularly going to enrich education in the field of pathology and histology.

Simultaneously it is going to bring pathology diagnosis from international experts at the door step of Indian patients improving the healthcare.

Government of India can use existing digital pathology platforms for improvement of healthcare services in India. It can be used to start national cervical cancer screening program whereby virtual images of pap smears taken at the peripheral health centres can be transmitted to the digital pathology portals and reporting can be done by a group of designated pathologists. This step by the government will save thousands of lives of women in reproductive age group who succumb to dreaded cervical cancer every year due to lack of cervical cancer screening program.

What are your hospital’s offerings?

Our laboratory is offering consultation in pathology from international experts is providing digital pathology platform to others for their product and services.

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EXCLUSIVE BUYERS SPEAK INTERVIEW

3D Printing Revolutionizing Healthcare 3D printing is likely to open a new avenue for accurate surgical planning and simulation for foot and ankle surgeons, say Dr Vaibhav Bagaria, Senior Consultant - Joint Replacement & Sports Surgeon, CARE Hospital & ORIGYN Clinic and Lopaa Bagaria, Product Manager - 3D Printing, Timeless Innovation Labs.

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any of us may have heard this interesting piece of news coming right from the International Space station. In a unique feat, the ISS was able to install a 3D printer in zero gravity and successfully printed objects that may be used as spares and replacement required to keep ISS operations going on smoothly.

The development is also touted as a stepping-stone for establishing manufacturing hub in outer space. Richard Branson and President Obama were not far off the mark when they touted as 3D printing as one of the most exciting invention of the century that can transform the entire hu-

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man activities and perceptions. While all the attention was focused on the high tech sphere, a rapid turn of event ensured that the revolution was quietly turning a new page in the medical innovation and transforming the way surgeon practice.

The conventional ways to ensure preoperative planning and postoperative assessment in field of medicine was to use the radiographs.

In complex cases many surgeons used CT scan and the 3D reconstruction using specialized software. A recent addition to these existing techniques is prototyping or 3D modeling. In view of their ability to be specific to a patient, they are also called as patient optimized surgical tools or POST. The process involves converting the CT scan images into a machine printable language. These inputs are then transmitted to a 3D printing machine,

which using additive manufacturing technology creates a life-sized model.

Surgeons are increasingly using 3D POST – Patient optimized surgical tool in diverse fields such as orthopedics, joint replacement, maxillofacial surgeries, neuro, and spine surgery.

In orthopedics 3D POST is used in the management of complex primary hips, fracture, and revision cases. In a series of cases reported by the authors this indigenously developed technology was used in case of complex hip surgeries and fracture treatment. All the complex cases had their CT scan done based on which the 3D printing was conducted.

These models were then used for surgical simulation preoperatively and as reference intra-operatively.

These models proved to be of great help in pre operative planning, reducing surgical time blood loss and improved post op outcomes. In complex cases such as difficult primaries and revision condition, 3D POST helped in proper inventory planning, and also aid in deciding and sculpting bone grafts. When done postoperatively, they can provide valuable information about the component positioning.

The technique also provides data to develop patient specific instruments and implants similar to those popular in knee arthroplasty.

Types of 3D Printing

Fused Deposit Modeling This is the most common technology available to surgeons and is also called as additive manufacturing. In this method, a spool of the thermoplastic substance is inserted into an extrusion head that heats this material into a semi solid state. The extruder head then extrudes this semi solid thermoplastic or similar material. Specialized software converts the axial image into a machine printable language that the machine presents layer by layer as a replica of the axial cuts.

Direct Digital Manufacturing In this case the device directly creates the end product. This printed product is ready to use as the machine prints the material that is fit for the end use.

In case of medical field it could be the implants made from innovative materials like titanium, tantalum and also bio ceramics like hydroxyl apatite and Tri calcium phosphate. Having this technology at hand ensures a customized product for patient; this could be wedges, spacers, prosthesis or artificial bone for defects. The enthusiast for the technology believes that in future most prosthesis and implants available would be made using this technology.

Polyjet

like a heat phase of any race, it familiarizes the surgeon to what they can anticipate once the patient is opened up.

This technology helps to create highly precise parts and has added advantage because of its ability to combine different materials and different colors. In a way similar to the inkjet printers employed in day to day life, these printers can help create models with over 1000 physical properties and colors

Intra-operative Reference

Key Areas where 3D printing is likely to Play Important Role in Surgery

Surgeons can plan for the implant – routine as well as specialized. This reduces the work of OR staff, increases turn over time of the operation room and also reduces infection rates and improves over all system efficiency.

Pre-operative Assessment

A real life size model ensures that the surgeon can get a look, feel of the disease pathology in the entire 3 dimension. This is especially useful for orthopedic surgeons, joint replacement surgeons, cardiac surgeons and maxillofacial surgeons. The technology has especial use for oncology surgeons who can plan optimal resections and reconstructions.

Surgical Simulation As a next step the surgeon can not only plan but actually execute the surgical steps on 1: 1 model of the patient. They can choose correct implant, define their placement and also look for an possible errors. Something

The model can be sterilized and kept on operating table. The model can serve as ready reference when ever the surgeon is trying to accomplish a critical step. They can compare the actual pathology and surgical plans on this model.

Inventory Management

Customized Instruments The technology has made great headway in designing patient specific instruments. Once the planning and simulation done at the back end office, appropriate Jigs and cutting tools can be made using rapid prototyping. Several other companies have aggressively taken this and several proprietary devices are currently available internationally.

Customized Implants The day is not far that instead of one size fits all implants, there would be

implants tailor made for an individual and for specific pathology. Not only will this increases the life of the implant, offer better kinematics but also ensure that natural non-damaged parts are retained.

Teaching Tool Traditionally medical students will learn normal anatomy on cadavers.

However this technology enables to study the diseased, fractured part on real time basis. The surgical residents will benefit form the ability to preoperatively simulate the surgery on these models.

Forensic and Crime investigation The crime investigation is all set to get a flip with this technology. The crime investigators can reproduce and reconceive the crime scene and the injury pattern using 3D POST. 3D printing is likely to open a new avenue for accurate surgical planning and simulation for foot and ankle surgeons. These models can also prove to be a valuable teaching tool for students and residents. The future developments in the field can be in form of designing patient/ disease specific instruments and implants. The working group believes that the technology is likely to play important role in joint replacement, orthopedics, tumor resection and also cranio maxilla facial surgeries.

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BUYERS SPEAK

Quality Care is the Key We strongly believe in teaching the community in proper preventive education, so we can all be a healthy nation, says Dr Kamal Kumar Dutta, Founder Chairman What are your views on the price and Managing Director, sensitivity of the Indian market, and how does your hospital Ruby General Hospital counter this problem?

Please comment on healthcare market in India vis-a-vis the global market I am a non-resident Indian doctor based in the United States. We are still in our early stages. Healthcare is low in our priority as a nation. We spend less than one percent of our GDP on healthcare expenditure compared to 5–15 percent in most nations.

At present we have inadequate healthcare facilities and limited personnel to take care of more than a billion people. We have to make healthcare and healthcare education our top priority.

Please tell us about your current operations in India and your expansion plans.

Ruby General Hospital is the first NRI hospital in Eastern India. We are a complete 300 bed multi- specialty hospital, winning the Healthcare Achiever’s Award for the best multispecialty hospital in Kolkata for 2014.

We are opening a cancer center with two state-of-the-art linear accelerators and 200 cancer beds. We are also in the process of procuring some satellite hospitals.

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This is our biggest challenge in reducing costs. We are better in this than most private hospitals. We have a multi-specialty approach to patient care with early testing, which provides early diagnosis and vigorous use of generic medications, which helps reduce our treatment costs. Also, being a doctor with my professional knowledge and constant oversight of costs control, helps in the process. We are obsessed with infection control and want to get the patients out of the hospital as soon as possible.

What are your views on government regulation or any other challenges faced while operating in the Indian market?

Government regulations should be less cumbersome and custom duties on life saving equipment should be removed completely. Medical equipment should have very low customs duties because the ultimate payment of this is done by the patients. They should not be part of the revenue generation of the government.

Please comment on emerging trends and new technologies.

Medicine is evolving and the most important emerging trend is prevention, which is the best cure. This is the only way we can combat the escalating healthcare costs. We must have evidence based treatment, which is done throughout the world. We also have to give importance to annual health checkups, routine cancer screening such as mammograms, pap smears, and colonoscopies. We have to give proper vaccinations, fight obesity, and combat smoking. Then only can we be a healthy country.

What are your hospital’s offerings?

We believe in quality care and constant monitoring of our patient care services. We regularly do Patient Satisfaction Surveys and our goal is to reach 98 percent satisfaction.

We are a complete multi-specialty hospital with a level one trauma centre and a complete range of medical and surgical services. We do from primary angioplasty, paediatric cardiac surgery, and interventional radiology. We have a large nursing school, critical care fellowships affiliated with New Jersey Medical School and our heavily invested in research and education with American Medical Schools and pharmaceutical organizations.

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EXCLUSIVE EVENT REVIEW INTERVIEW

Indian Medical Device Summit The objective was to converge all the stakeholders from the government and private sector at a common platform and facilitate discussions on the challenges within the medical device industry

H

ealth technologies including medicines, vaccines, and medical devices are an indispensable component of an effective healthcare system.

Among these technologies, medical devices provide the foundation for prevention, diagnosis, treatment of illness and disease, and rehabilitation.

The availability, accessibility, and effective use of essential medical devices play an important role in the achievement of health system performance goals and the cost and quality of medical care that a population receives. While local production of technology is one potential way to increase access to medical devices, additional research is needed to understand how to create an adequate environment that will transfer the benefits of innovations and technologies to the most vulnerable and disadvantaged groups.

Some of the key challenges that Indian medical device industry faces are weak regulatory framework, unfavourable duty structure for imports and exports, developing affordable products, increasing labour productivity skills, high capital cost, poor

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public health infrastructure, and approval delays. In order to address some of these challenges and keeping in mind the aim to promote innovation and boosting manufacturing, which will empower Indian Medical Device Industry, ASSOCHAM organised Indian Medical Device Summit on December 19, 2014, New Delhi.

The objective was to converge all the stakeholders from the government and private sector at a common platform and facilitate discussions on the challenges within the medical device industry, focusing on policies and regulation, growth, innovation, manufacturing, quality, compliance, and R&D with an aim to achieve sustainable growth and development by promoting innovation and boosting manufacturing in the country.

Some of the key speakers at the conference were Dr Sanjay Jaiswal, Hon’ble Member of Parliament (BJP), Member standing committee on Health and family welfare, V K Subburaj, Secretary, Department of Pharmaceuticals, Dr K L Sharma, Joint Secretary, Ministry of Health, Ravi Capoor, Joint Secretary, Department of Commerce, Sudhanshu Pandey, Joint Secretary, Department of Commerce, Dr Jitendar Sharma, Head Division of Healthcare Technology National Health Systems Resource Centre, Ministry of Health and Family Welfare, Vineet Gupta, Director Corporate Affairs GE India Industrial Private Ltd, Dr G S K Velu,

Founder and MD, Trivitron Group of Companies, Rajiv Nath, Forum Coordinator, Association of Indian Medical Device Industry (AIMED), Dr G. D Agrawal, Director, G. Surgiwear Ltd, R. K. Narang Executive Director, Allengers, Manoj Singh CEO & MD, Divlabs Healthcare Private Limited.

Inaugurating the Indian Medical Devices Summit 2014 organised by ASSOCHAM, Dr V K Subburaj, Secretary, Department of Pharmaceuticals, Government of India, said that the Task Force constituted by the government to look into difficulties faced by medical devices sector in India will come out with its recommendations in about two months time.

Hinting at the solution for the slow growth of medical devices manufacturing Dr V K Subburaj said “The modalities will be looked at to see that the recommendations are implemented, a conducive atmosphere is created and the tax structure is rationalized so that the country develops in this sector”.

Stressing on the need for a change in the prevailing scenario it was mentioned that the Government is determined to provide lot of employment opportunities to the youth biotechnologists, engineers and others. It was also highlighted that India as a nation cannot afford to have an economy where we import everything to handle our healthcare and that is why we need to boost local manufacturing.

event review

First Edition of HIM Concludes on a Successful Note “The overall expo was very good.

The response from visitors (doctors) was great. Looking forward to the expo next year” – Vijay Dalvi, Janak Healthcare

“T

he India’s premiere hospital infrastructure show, Hospital Infrastructure & Management (HIM), concluded successfully with positive response from the 3256 business buyers who attended, providing the perfect platform for the exhibitor companies trying to win tenders, drive sales and increase market shares in healthcare infrastructure, construction and maintenance.

The three-day exhibition witnessed major industry players exhibiting at the show and a two-day seminar that covered cutting edge topics focusing on healthcare design and infrastructure, such as Delivering optimum space utilisation for your hospital; Identifying a one stop solution for designing and building healthcare projects; Flooring your patients – understanding the importance of vinyl for hospitals; Surgical site infection: innovative solutions for tackling one of the most critical challenges facing hospitals today; amongst various others. The seminar was attended by VIPs from Reliance, Hiranandani, Fortis, Kokilaben Dhirubhai Ambani, Hinduja, Apollo Group and other hospitals along with validated industry buyers including key budget holders for hospitals, as well as policy makers, consultants, health ministry and investors in healthcare projects. Below is feedback from some of the participating exhibitors:

“This is the first time we’re exhibiting and it was a valuable experience. Hospital Infrastructure & Management provided us with the opportunity and learning interface to network with the hospital industry. We thank the HIM team for a job well done and look forward to participating at Hospital Infrastructure & Management 2015” – Salim Khan, country sales head, Redeminet Having delivered a successful first show, Hospital Infrastructure & Management 2015 promises to be bigger and more power-packed catering to the growing demands of this thriving industry.

“It was a nice conference and exhibition, very well organized and much needed for the healthcare infrastructure industry” – Moulik Panchal, Drager “Participating in Hospital Infrastructure & Management 2014 has provided a better insight to what the local healthcare sector needs and how we can improve the quality of healthcare in India” – AjitKothiwale, Stantec

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product launch

Carestream Introduces Compact Vita Flex CR System Flexible System Can Be Operated Vertically or Horizontally to Address Need for Image Processing in Compact Spaces

C

arestream will introduce its compact new Vita Flex CR system that delivers excellent image quality and can be positioned virtually anywhere in a healthcare facility. This new system’s flexible design enables it to operate vertically as well as horizontally, so it can process CR cassettes sitting on the floor, a tabletop or desktop or even from the back of a van. The Vita Flex CR system will be on display at the 2015 Indian Radiology Imaging Association (IRIA) conference.

The affordable Vita Flex CR system can process multiple cassette sizes including: 8 x 10 in., 10 x 12 in., 24 x 30 cm, 14 x 14 in. and 14 x 17 in. This new system can address the diverse needs of imaging centers, private practices, urgent care facilities, smaller hospitals, and mobile imaging operations, as well as orthopedic, veterinary, and chiropractic providers. Vita Flex CR is designed with three modular components to make it easy to install and service. It is available with a choice of two throughput rates—either 30 or 45 plates per hour.

A touch screen allows users to quickly and easily select desired body parts and views to speed the imaging process. Technique information can be acquired

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automatically, eliminating the need for manual entry and the possibility of inconsistent X-ray exposures among different users. A veterinary offering is also available and includes specialized software and cassettes.

“Like our other Vita CR systems, this new model is designed to help facilities of all types and sizes move smoothly and affordably to digital imaging. Carestream’s Image Suite software plays a pivotal role in that transition by providing a comprehensive package of image capture and management capabilities for a very affordable price,” said Amit Singh, general manager for X-ray solutions, Carestream India.

Image Suite software allows patients to be registered on-site or remotely using a Web-based interface. Images can be enhanced using slide bars on the screen to adjust brightness, contrast or detail. Specialized measurement tools provide diagnostic information for orthopedic or chiropractic imaging. Imaging providers can use automatic or manual stitching to paste individual images together to create the long-length view that is desired.

To view information about Carestream products being demonstrated at IRIA 2015, please visit www.carestream.in

COMPANY PROFILE

Aiding Healthcare Sector reach it’s Pinnacle People spend almost 90 percent of their time indoors and breathe between 8,000 and 12,000 litres of air per day

S

aint Gobain India, Gyproc Division; the world leader in drywalls and ceilings promoted its Gyproc Activ’Air board, revolutionary plaster board that uses innovative technology in improving indoor air quality that in turn ensures patients health in hospitals. People spend almost 90 percent of their time indoors and breathe between 8,000 and 12,000 litres of air per day i.e. approximately 15kg of air. It has been proved that the indoor air that they breathe is polluted and that it directly impacts the health of the occupiers. Although it’s an issue for housing and schools that becomes even more critical when healthcare fa-

cilities are concerned. The air inside closed spaces gets polluted by different pollutants released by commonly used entities such as carpets, furniture, cleaning materials, and the like.

Activ’Air helps in improving the indoor air quality (IAQ) by removing formaldehyde (major indoor pollutant) from the air inside closed spaces and converting it into safe, inert compounds that once captured in the board, cannot be released back.

Activ’Air when used in ceilings and walls of healthcare facilities tends to provide healthier environment that facilitates patient’s well-being.

Dry walls play a very important role in healthcare construction, as they

provide faster construction possibilities and durability factors along with impact resistant features. Boards displayed included Rigidur Board- Paperless board for extreme impact resistance, Robust Board for severe impact resistance and Moisture Resistant Board for wet area applications.

The team said “Our solutions offer a range of benefits not only for the hospital infrastructure but also its inhabitants. With faster construction now gaining prominence with parallel emphasis on improving the hospital ambience on functional aspects- The healthcare sector is poised to reach a notch higher while partnering with us”.

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th Annual 4th

March 11, March 2015, Hotel Royal 12, 2015, NewPlaza, Delhi New Delhi

CONFERENCE AWARDS EXPO Healthcare Leaders’ Forum (HLF) examines the value of technology in improving healthcare provision and the efficiencies it brings to healthcare systems.

It’s a platform that brings together healthcare leaders and innovators to share successful new and innovative approaches,firsthand experiences, and lessons learned in plotting this accelerated path to transformation. eHealth welcomes the healthcare industry to join the event to network and exchange strategies with their peers.

Key Speakers at HLF 2015

Dr Neena Pahuja Director General, ERNET, New Delhi

Dr Narender Saini Sectretary General, IMA, New Delhi

Dr Girdhar J Gyani Director General, Association of Healthcare Providers, New Delhi

Rajesh Srivastava Chairman, Rockland Hospital, New Delhi

Prof Sandeep Kumar Director, AIIMS, Bhopal

Dr Shrihari Dhorepatil Founder President, OSSI, MD, Shree Hospital & Diagnostic Center Pvt Ltd, Pune

Dr Ravindra V. Karanjekar Chairman, Quality Healthcare & Research Pvt Ltd

Dr Sandeep Chatrath CEO, Dharamshila Hospital And Research Centre, New Delhi

Bhudeb Chakravarti Associate Vice President & Region Head, NISG, Hyderabad

Dr D P Saraswat, CEO, Sri Balaji Action Medical Institute & Action Cancer Hospital, New Delhi

Joy Chakraborty COO, P D Hinduja Hospital & M R C, Mumbai

Dr Pankaj Bajaj, Medical Director, Cygnus Orthocare Hospital, New Delhi

Dr Rajeev Boudhankar Vice President Kohinoor Hospital, Mumbai

Dr Deepak Agrawal Chairman, Computerisation, AIIMS, New Delhi

Dr Shakti Kumar Gupta Medical Superintendent, AIIMS, New Delhi

hlf.eletsonline.com

Awards are presented to the best practices in the Indian healthcare industry. Award categories include Medical Technology, In vitro diagnostics, Life Sciences, Blood Banking, Health Insurance, Healthcare Delivery Services, Pharmaceuticals, Biotechnology, and Special Awards.

Award

Categories

d Government

d Best

Multi-Speciality Hospital of the Year Single-Speciality Hospital of the Year

d Eye

d IVF

d Best

PPP Initiative of the Year

d Best

Initiative in healthcare

d Healthcare

Entrepreneur of the Year

d Best

Preventive Care Initiative

d Best

Use of IT by a Hospital

d Best

HIS & HMIS Provider of the Year

d Best

Health Insurance Initiative of the Year

d Best

Innovative Use of Technology in Healthcare

d Best

Innovative Use of Technology by a Diagnostic Service Provider

For Enquiries Fahim Haq, hlf@eletsonline.net +91 - 8860651632 Partners @ Our Past Events

hlf.eletsonline.com

news

Transfers of technology by the Government of India to Medical MSME

D

epartment of Electronics and Information Technology (DeitY), Ministry of Communications and IT, Government of India, through National e- Governance Division celebrated Good governance Day on December 25, 2014. This event showcased good governance initiatives and various projects undertaken by DietY and its associated agencies.

As one of the exemplary initiatives of DietY towards good governance in the area of responsible healthcare systems, the event showcased the invention of an incredible Microwave Medical waste Disinfection System – The OptiMaser invented by the Society of Applied Microwave Electronics Engineering & Research (SAMEER), an autonomous body of Ministry of Communications and Information Technology, DeitY, GoI,.

The event also hosted the official Transfer of Technology (ToT) by SAMEER, DietY to S S Medical Systems (I) Private Limited, (India’s fastest growing medical MSME) for the mass manufacture of the OptiMaser.

The ToT was officially awarded by the Honorable Minister of Communications and Technology, Shri Ravi Shankar Prasad to Monish Bhandari, Executive Director, S S Medical Systems (I) Private Limited being recognized for their wider establishment in healthcare centers to ensure responsible and sustainable healthcare system.

Key features of OptiMaser

(a Microwave Medical Waste Disinfection System) • A totally indigenous medical device for the treatment of highly infectious biomedical waste onsite, based on contemporary non burn alternate technology • Kills all virulent microorganisms including (bacterial spores, viruses of HIV, hepatitis, AIDS, vegetative germs, fungi, parasites) within a cycle time of 27 minutes at 90 degree Celsius , with high level of disinfection ranging from 105- 107 log highest known to man (efficacy test done by Haffkine Institute, Mumbai) • It is resource efficient with low carbon footprint as it requires low quantities of water (1 kg/cm2 (g)), very little power consumption (1-3 KWH) and can also run on solar power • Eliminates the chances of secondary infection, hospital acquired Infection (HIV, AIDS, tuberculosis, hepatitis) caused during storage and transport • Ensures zero misuse/reuse by safely disinfecting metallic needles, syringes, plastics, blood bags etc. in medical waste • Highly automated PLC based, plug and play device, requires zero skilled manpower • The device is in line with our Honorable Prime Minister’s initiative for Swachh Evam Swasthya Bharat.

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