eHEALTH May 2015

ASIAâ&#x20AC;&#x2122;S FIRST MONTHLY MAGAZINE ON THE ENTERPRISE OF HEALTHCARE

VOLUME 10 / ISSUE 5 / MAY 2015 / ` 75 / US $10 / ISSN 0973-8959

Special Feature: Healthcare in Rajasthan Exclusive Interview: Jitendra Arora,

Director (eHealth), Ministry of Health and Family Welfare

Health Campaign: Challenges Galore

Prescription for

GROWTH

eHEALTH Magazine

Health Start-ups

ASIA’S FIRST MONTHLY MAGAZINE ON THE ENTERPRISE OF HEALTHCARE VOLUME

ISSUE

MAY 2015

2015 21st - 22nd August 2015, New Delhi

eHealth is published by Elets Technomedia Pvt. Ltd. in technical collaboration with the Centre for Science, Development and Media Studies (CSDMS). Owner, Publisher, Printer - Dr Ravi Gupta, Printed at First Impression Corporate Services Pvt. Ltd., E-114, Sector-63, Noida.UP and published from 710, Vasto Mahagun Manor, F-30, Sector - 50, Noida, UP Editor: Dr Ravi Gupta © All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic and mechanical, including photocopy, or any information storage or retrieval system, without publisher’s permission.

wes.eletsonline.com

ehealth.eletsonline.com | egov.eletsonline.com | digitallearning.eletsonline.com events.eletsonline.com | bfsi.eletsonline.com | smartcity.eletsonline.com Write in your reactions to Education news, interviews, features and articles. You can either comment on the individual webpage of a story, or drop us a mail: editorial@elets.in

MAY / 2015 ehealth.eletsonline.com

TRUSCOPE elit Series

TRUSCOPE Ultra Series

TRUSCOPE mini

TRUSCOPE II multigas

For enquiries contact : sales@schillerindia.com I Website : www.schillerindia.com I Toll-Free No. : 1-800-2098998

Swiss H.Q. : Schiller AG, Altgasse 68, P. O. Box 1052, CH - 6341 Baar, switzerland Indian Corporate Office : Schiller Healthcare India Pvt Ltd., Advance House, Makwana Road, Marol Naka Station, Andheri (East), Mumbai - 400 059. Tel. : + 91 - 22- 61523333 / 29209141 Fax : + 91 - 22- 29209142 E - mail : sales@schilerindia.com, support@schillerindia.com Factory : No. 17, Balaji Nagar, Puducherry - 605 010. CIN : U33110MH1997PTC111307

ARGUS OXM PLUS

Contents

may 2015 | VOLUME - 10 | ISSUE - 05

Cover Story

Prescription for Growth With the initiative of ‘Make in India’ and ‘Digital India’ underway and setting up of new AIIMS, eHealth magazine takes a look at the growth of healthcare industry in the country and the challenges that remain to be tackled as the government tries to maintain a balance between pre-election promises and the post-win fiscal ground realities.

Special Feature

Healthcare in Rajasthan The Government of Rajasthan led by Vasundhara Raje has efficiently crossed all barriers to providing comprehensive healthcare services to the people. Elets News Network (ENN) explores Rajasthan’s active adoption and implementation of the latest technology for the betterment of the healthcare domain

Health Campaign

Challenges Galore

In a bid to find out the challenges for building a hospital in India, eHealth tries to reach out to the industry stalwarts and ascertain what it will take to put healthcare on the fast track in the country

may / 2015 ehealth.eletsonline.com

Flexible and versatile – VARIOP the modular room system In service at more than 6,000 locations around the world: VARIOP the modular room system by Maquet. As the world’s leading vendor of medical technology, Maquet has developed a special understanding for the technical and spatial requirements found in operating rooms. It is upon this exact foundation – and a view towards the requirements of the future – that VARIOP was created. This modular room system is equally suitable for new constructions as well as modification and expansion projects. This has a significant economic impact for hospitals over the long run. Examples of this sustainability include flexibility, time savings and a secured investment. Maquet | The Gold Standard

Maquet Medical India Pvt. Ltd. | II & III Floor, “Mehta Trade Centre” No.1, Shivaji Colony, Sir M V Road, Andheri (East), Mumbai – 400 099, India Phone: +91 22 40692100, Fax: +91 22 40692150, info.india@maquet.com

www.maquet.com

Exclusive Interviews

Digital Push for Healthcare Sector

Jitendra Arora, Director (eHealth), Ministry of Health and Family Welfare

AIIMS Goes Green with Hitachi

27th June 2015, Dehradun

Naotoshi Nishida, Vice President, Infrastructure Systems Company, Hitachi India Private Limited

One Touch Therapy

Expanding the Pie

Survo Ghosh, Founder, HelpMeDoc

Chief Guest

Manpreet Sohal, CEO, Global Hospitals

Modular Operating Room Enhances Quality of Care Dr S Anand Kumar, Chairman, ARS Hospital

Shri Harish Rawat Honâ&#x20AC;&#x2122;ble Chief Minister, Uttarakhand

Programme Chair

Transforming Healthcare Delivery

Yuhgal Kishore Upadhyay, CEO, Sunrise Hospital

IT is the Key to Success

Dr Rajiv Jain, Director, Save Sight Centre

Mr N Ravi ShankerI

Adopt Technology to Sustain in Competition

Chief Secretary, Uttarakhand

Dr Shrihari Dhorepatil, President, Obesity and Metabolic Surgery Society of India

PRODUCT LAUNCH

Carestreamâ&#x20AC;&#x2122;s New 3D Orthopaedic Imaging System NEWS

For Details Contact: Gaurav Srivastava, +91-8527697685 gaurav@elets.co.in uk.eletsonline.com

may / 2015 ehealth.eletsonline.com

50 52 54 56 58

Government Desk International News Hospital News Company News Pharma Buzz

editorial

Healthcare for all It is a globally well-researched fact that unless a country spends a minimum of 5-6 per cent of its GDP on health and the major part of it is from government expenditure, basic healthcare needs are seldom met. India’s public expenditure on health averages 1 per cent of gross domestic product (GDP), while the global norm ranges around 4-5 per cent. This is the lowest when compared to China’s 3 per cent, Brazil’s 4.1 per cent and 8.3 per cent of the US. The country urgently needs to raise public health spending to at least 2.5 per cent of GDP if the NDA government’s promise of universal health coverage is to be fulfilled. The budgetary allocation for healthcare in 2015-16 is Rs 33,152 crore, marginally over Rs 30,645 crore for 2014-15 with an increase of GDP spend from 1.2 per cent to two per cent. While Prime Minister Modi aims to use the ‘Make in India’ and ‘Digital India’ campaigns to make healthcare reach to the poorest of the poor in the country and also mobilising preventive health care under Swach Bharat Abhiyan for building awareness, progress of the programme for healthcare for all has had a halted growth. The government went back on its pre-election promise owing to more budgetary allocations being made for the infrastructure sector leaving less funding available for social sectors to boost economic growth. With a limited financial bandwidth available with the government, the deficit in the public health spending can be bridged by attracting investments from the local and the global players that see India as an attractive market. According to a data released by the Department of Industrial Policy and Promotion (DIPP), the hospital and diagnostic centres attracted foreign direct investment (FDI) worth $2,793.72 million between April 2000 and January 2015. While opportunities exist to attract further investment, there is also a dire need to improve the abysmal ranking India has in the ease of doing business in the country. The government would need to undertake reforms to help place the country on an equal footing amongst countries having favourable, flexible, liberalised and a transparent business environment. There is an urgent need to increase spend on healthcare by the government, closing the existing infrastructure gaps and addressing issues related to workforce scarcity and resource utilisation. All these will require the government and the private sector to collaborate closely in an inclusive and transparent manner. There is also a pressing need to encourage entrepreneurship in the healthcare sector that can open up further investment opportunities. Beginning this edition, we try and profile some promising and interesting health start-ups that indicate the sea of opportunities that exist and that can further be encouraged. eHealth has also launched a campaign in a bid to understand the challenges in building new hospitals in the country (see story in the issue), inviting participation from across various platforms in the healthcare sector. Doing our bid to help the sector, we will be organising Healthcare Summit Rajasthan in the coming month, highlighting the key initiatives of the state to improve and aid the healthcare sector in the state through the various dynamic initiatives taken by the state government. The summit will provide a platform for the healthcare ecosystem to converge and discuss the challenges, strategic solutions, innovations and opportunities for the state of Rajasthan. The journey towards healthcare for all has, well, just begun. Stay healthy and stay connected…

Dr Ravi Gupta ravi.gupta@elets.in may / 2015 ehealth.eletsonline.com

Cover Story

Prescription for

GROWTH There is a need to allocate more funds towards public health in the country and attain universal health coverage. The government along with the private companies are working in partnership to establish a better healthcare delivery system. With the initiative of ‘Make in India’ and ‘Digital India’ underway and setting up of new AIIMS, eHealth magazine takes a look at the growth of healthcare industry in the country and the challenges that remain to be tackled as the government tries to maintain a balance between pre-election promises and the post-win fiscal ground realities.

MAY / 2015 ehealth.eletsonline.com

Cover Story

he healthcare industry has become one of the largest sectors in terms of revenue and employment – and the sector continues to escalate. CII reports that the industry is eyed as the world’s most potential industry with total revenues of approximately US$ 2.8 trillion and within the country this largest industry has approximate revenue of US$ 30 billion constituting five per cent of GDP with an employment to around four million people. According to a data released by the Department of Industrial Policy and Promotion (DIPP), the hospital and diagnostic centres attracted Foreign Direct Investment (FDI) worth US$ 2,793.72 million between April 2000 and January 2015. While opportunities galore, there still lies a huge mismatch between the private and public spent on healthcare. India’s public expenditure on health averages one per cent of gross domestic product (GDP), while the global norm ranges around 4-5 per cent. This is the lowest when compared to China’s 3 per cent, Brazil’s 4.1 per cent and 8.3 per cent of the US. The country urgently needs to raise public health spending to at least 2.5 per cent of GDP if the NDA government’s promise of universal health coverage is to be fulfilled.

The budgetary allocation for healthcare in 2015-16 is Rs 33,152 crore, a little over Rs 30,645 crore for 2014-15. Significantly, last year, in order to meet its fiscal deficit target, the government had abruptly cut the health budget to Rs 24,400 crore. This sudden cut reflected the fiscal challenge the sector faces. Looking at the bigger picture, the total health spend in the first three years of the 12th Five-Year Plan has been about Rs 70,000 crore, way below the Rs 2,68,000-crore budgetary allocation in the 2012-17 period.

As eHealth has launched a campaign in a bid to understand the challenges in building new hospitals in the country (see story ahead in the issue), what makes the scenario even more daunting is the abysmal ranking the country holds in the ease of doing business in the country. Adding on to the existing challenges in the healthcare sector, the bottlenecks in the ease of doing business make it even a harder challenge for the players to push for growth. According to a CII-KPMG – Ease of doing business in India report, to maintain its growth trajectory, India needs to be a relatively attractive investment destination across each of these parameters. The Government would need to undertake reforms to help place the country on an equal footing amongst countries having favourable, flexible, liberalised and a transparent business environment. With Indians bearing maximum of their healthcare spending outof-pocket and with most medical equipment being imported for India, the piped dream of Prime Minister Narendra Modi, the Make in India concept may not be able to work for healthcare sector in the country. Pharma and healthcare are among the 25 identified sectors that have huge scope to draw foreign as well as Indian companies to manufacture in India. Modi had stated that the campaign can act as a catalyst to make healthcare accessible and affordable in India. But with lack of

Roadblocks

There is a growing mismatch between the growing population and the number of hospitals in the country. Statistics reveal that the country has one hospital bed for 879 people. This is far below the world average of 30 hospitals per 10,000 population. India requires 6,00,000 additional beds over the next five to six years, which potentially throws an opportunity of more than US$ 30 billion in the offing at a rapid pace.

MAY / 2015 ehealth.eletsonline.com

Cover Story

favourable tax policies, no ease of doing business being, Make in India seems to be a distant dream. Absence of hospital infrastructure and lack of trained and even availability of health professionals are some of the major roadblocks in the development of healthcare sector in the country.

Roll back on pre-poll promises

With a high priority to the health sector and a proposed universal health plan as part of its manifesto before elections, government is yet to make those promises a reality. Modi government has asked for a drastic cutback of an ambitious health care plan after cost estimates came in at US$18.5 billion over five years. The government had to go back on his pre-election promise owing to more budgetary allocations being made for the infrastructure sector leaving less funding available for social sectors to boost economic growth. World Health Organization (WHO) has shared on the need for India to reorganise its healthcare delivery system with the right mix and distribution of services to achieve Universal Health Coverage (UHC). The heavy burden of out-of-pocket (OOP) expenditure incurred by people needs to be reduced and there is an urgent need for the government to increase public expenditure on health and develop mechanisms for cashless access to health services at all delivery points.

Key Growth Drivers for Healthcare Industry Favourable demographics Increase in lifestyle diseases Emerging middle class and rising healthcare consumption. Growing health insurance penetration Increased investments from PE funds Medical value travel advantage Diversifying delivery models (Source PwC)

MAY / 2015 ehealth.eletsonline.com

Modi-Care

Narendra Modi’s Modi’s manifesto ahead of the last general elections placed very high priority to the country’s health sector and promised a universal health assurance plan for 1.3 billion population. After coming to power in May last Year, Modi declared to unveil a draft policy on Universal healthcare in the country. Following the suit of US President’s flagship health programme, popularly called Obamacare, Modi asked his Health Ministry to prepare the draft plan on those lines in close coordination with the Prime Minister Office and World Bank. The union Health Ministry even set a deadline to roll out their plan from April 2015. In October last year, the ministry informed the Prime Minister’s office that the universalising the health care for entire populace will incur roughly 25.5 billion dollars over four years to the national exchequer. However, just three months later in January 2015, the health department submitted the plan to the prime minister with trimmed projected expenditure of US $ 18.5 billion over five years period. While the scheme has gone into the cold bag for now, industry experts feel that for the next year, the focus should be on fixing the issues in the domestic economy. “The government needs to work on improving the “Ease of Doing Business Index” for the country, encouraging the social sector and making healthcare a priority sector,” says Gautam Khanna, CEO – P. D. Hinduja Hospital & Medical Research Center. According to PwC, report the Indian healthcare industry is likely to witness sizeable growth (12% CAGR) by the year 2017. Various factors contributing to the growth of the industry – there is a demand for healthcare services with the growing population, increasing urbanisation and improved life

Cover Story

expectancy; India is dealing with the burden of communicable and non-communicable diseases, the expansion of emerging middleclass group will impact the private consumption on healthcare which is set to increase from five per cent to 7.5 per cent by the end of the decade; health insurance stimulating the growth of healthcare delivery; investments by Private Equity (PE) and Venture Capital companies; medical tourism growing 35 per cent at present with quality care at affordable price.

Focus areas

According to a McKinsey report, for the healthcare sector in the country trod on the path of ‘Acche Din’, there is a need to increase the spend on healthcare by the government, infrastructure gaps will need to be closed, workforce scarcity and resource utilisation will need to be addressed. All these will require the government and the private sector to collaborate closely in an inclusive and transparent manner. “In India, 80 per cent of the healthcare expenditure is borne by the patients and that borne by the state is 12 per cent. The expenditure covered by insurance claims is three per cent As a result, the price sensitivity is quite high and the highlevel healthcare facilities are not in the reach of patients,” says Dr Rajeev Boudhankar, Vice President, Kohinoor Hospital. A few efforts have already been made to push the healthcare sector on the path to recovery. Government plans to improve access to healthcare with better hospital infrastructure, ameliorate rural healthcare delivery, better senior citizen healthcare, high prioritising chronic diseases, universalisation of emergency medical services. The government also aims to overcome the shortfall of healthcare professionals.

“There is an increased Demand for Health Information”

Professor Suptendra Nath Sarbadhikari, MBBS, Ph.D., Project Director, Centre for Health Informatics, National Health Portal talks about mhealth to Elets News Network What are the changes you have observed in the healthcare industry in the last one year? There is an increased demand for health information, especially from the patients and their caregivers. Apart from getting health and disease information from the web, people are also using mobile applications to get information and often doing home care for medical conditions (mHealth/Tele-home care). What are the key initiatives you think have changed the face of the healthcare industry? A lot of useful mobile health applications are becoming available now. Wearable Health Devices are another area where tremendous growth is expected. What is your department’s immediate focus? The National Health Portal (NHP) is aiming to be the first point of contact (through the Web and mobile applications) for any information related to health or disease. For the persons not yet having access to the Internet, we are going to have a toll free number for voice web through which people can call the number and get all the information available in the NHP. Moreover, the NHP will ultimately be available in all the 22 major languages of India (currently it is available in English, Hindi, Punjabi, Bengali, Gujarati and Tamil). Further, the portal is disabled-friendly too. Initially, it is an informational portal. However, with time, it is expected to evolve into transactional and transformational portal as well.

MAY / 2015 ehealth.eletsonline.com

Cover Story

World Health PPPs INDIA – National Health Assurance Mission INDONESIA – Jamekasmas CHINA – Universal Health Coverage SOUTH AFRICA - National Health Insurance MEXICO AND BRAZIL – United Health System (SUS) GHANA – National Health Insurance Scheme VIETNAM – Compulsory & Voluntary Insurance Scheme SOUTH KOREA - National Health Insurance Program

The healthcare services till now from the government were targeted at rural areas and more specifically at the poor. The National Health Programme shifts to universal healthcare, which means that everyone irrespective of income, age and employment will be covered by healthcare services. (Source PwC) It also aims to implement integrated courses for Indian System of Medicine (ISM) and modern science Ayurgenomics. Reducing costs and out of pocket expenditure by bettering penetration of reimbursement plans, occupational health programmes, key focus on school health program

MAY / 2015 ehealth.eletsonline.com

making health and hygiene part of the curriculum. The increase in the usage of technology by taking mhealth and Digital India Project will further push the reach and the benefits of the healthcare sector in the country. The public-private-partnership (PPP) in the healthcare industry will enable the government to

leverage private-sector expertise and investment to service public policy goals. This in turn can open gates of opportunities for the private firms lowering the barriers to entering the industry. The PPP model will help improving health infrastructure and health services provisions. According to experts, super speciality hospitals and medical colleges, dialysis centres, radiology centres, mobile medical units, primary healthcare centres, skill development for HR are adopting the PPP model. While efforts are on to create a developed world healthcare reach despite developing world infrastructure, government policies and funding will have to support the private players to make healthcare for all a plausible reality.

Cover Story

Grappling with Poor Health Infrastructure Gautam Khanna, CEO – P. D. Hinduja Hospital & Medical Research Center finds National Health Assurance Mission (NHAM) as one of the positive proposed ideas by the government for the growth of the healthcare industry, in conversation to Elets News Network(ENN) How do you see the healthcare industry with a year of Modi governance and what are your expectations for next year? The Modi’s government has done well in raising the confidence of the industry and there is visible action on the ground. This will hopefully translate into benefits for the common man sooner than later. The multiple agreements with other nations will also help boost the economy and will help the country in general. For the next year, the focus should be on fixing the issues in the domestic economy, working on improving the “Ease of Doing Business Index” for the country, encouraging the social

sector and making healthcare a priority sector.

Have ‘achche din’ arrived in the healthcare sector in India? If not, what is the reason and what are your expectations next year? The Government had proposed many good ideas for the improvement and growth of the healthcare sector. The most promising of them was the National Health Assurance Mission (NHAM). It is intended to provide preventive healthcare, tertiary care and financial support to patients. Unfortunately, the project has been kept on hold. This has not only impacted the provision of health care to patients, but also the growth of private health insurance sector. Also, the two per cent budget allocation to healthcare is not sufficient to provide affordable, quality healthcare to patients. The industry at present is struggling with poor health infrastructures and shortage of skilled manpower. Reconsideration of NHAM and focus on improving access, appropriate regulations to ensure quality delivery, enhancement of initiatives for skill development, and standardised roadmap for IT-based health solutions is what we are from expecting next year.

healthcare sector? The focus should be on improving access by incentivising setting up of hospitals in non-urban and metro areas, developing a Public-PrivatePartnership (PPP) model with special incentives for not-for-profit hospitals, improve access to health insurance by linking to Jandhan scheme or Aadhaar card etc., and also increasing health awareness, focus on preventive health.

What are the top 10 issues do you think the health industry would emphasise the government to address? What will be the impact if these issues are not addressed immediately or vice versa? There are various issues such as establishing India as the global hub for quality healthcare and medical technology, commitment to capacity building, favourable taxation policies with special focus on charitable hospitals, Government support

Which are the areas of improvement that needs to be focused immediately in the

MAY / 2015 ehealth.eletsonline.com

Cover Story

to encourage R&D, providing an environment encouraging innovation in services and service delivery, healthcare funding to increase affordability of healthcare, regulations in medical devices, PPP models, incentives for private providers, especially not-forprofit hospitals who work in areas which have been identified by the government as key focus areas, and IT in healthcare. It will be an economic loss to the country if disability-adjusted life year (DALY) increases and health is not a priority area.

How do you see the implementation of mhealth in the country? How much do you think will be the rate of adoption? Currently, mHealth is in its nascent stage. It has been introduced to a separate public and private bodies but at a small and limited scale. With the growing penetration of mobile internet in urban and rural India, mHealth has a huge growth potential. But we need a centralised body where the government plays the central role in imposing regulations and standards for health care delivery and information security. Also, PPP models will encourage innovation where private entrepreneurs come up with innovative solutions and public entities provide the scale and reach. If we manage to provide personalised and quality health services to patients and ensure a security of confidential information, then the rate of adoption should be pretty high. The Modi government also

MAY / 2015 ehealth.eletsonline.com

Budget announcements - Key policy initiatives Some Key Initiatives w Allocation of Rs 33,150 crore for the healthcare sector w New scheme for providing physical aids and assisted living devices for senior citizens living below the poverty line w Preventive health care under Swach Bharat Abhiyan for building awareness w Rationalisation of conditions for FDI in the medical devices sector Social security schemes w Pradhan Mantri Suraksha Bima Yojna to cover accidental death risk of Rs 2 lakh for a premium Rs 12 per year w Pradhan Mantri Jeevan Jyoti Bima Yojana to cover both natural and accidental death risk of Rs 2 lakh for a premium of Rs 330 per year for the age group 18-50 w Atal Pension Yojana to provide a defined pension, wherein the Government will contribute 50% of the beneficiariesâ&#x20AC;&#x2122; premium limited to Rs 1,000 each year, for five years, in the new accounts opened before 31 December 2015 Senior Citizen Welfare Fund Unclaimed deposits of about Rs 3,000 crore in the PPF and approximately Rs 6,000 crore in the EPF corpus to be used for creation of a Senior Citizen Welfare Fund Opening of medical institutes w All India Institutes of Medical Sciences (AIIMS) to be opened in five states namely J&K, Punjab, Tamil Nadu, Himachal Pradesh and Assam w AIIMS like institute to be set up in Bihar w National Institute of Pharmaceutical Education and Research to be set up in Maharashtra, Rajasthan and Chhattisgarh w An Institute of Science and Education Research to be set up in Nagaland and Odisha Source: Grant Thornton

announced to setup institutes on the lines of All India Institute of Medical Sciences (AIIMS) in five states â&#x20AC;&#x201C; Jammu and Kashmir, Punjab, Tamil Nadu, Himachal Pradesh and Assam. The six AIIMS established under the Pradhan Mantri Swasthya Suraksha Yojna (PMSSY) at Jodhpur, Bhopal, Patna, Rishikesh, Bhubaneshwar and Raipur are functional now. According to industry analysts, health insurance market has grown at 30 per cent CAGR over last decade

and the market is likely to pick up pace to reach Rs 390 Bn by 2019 and Rs 860 Bn by 2024. Increase in the Foreign Direct Investment (FDI) cap to 49 per cent, the insurance sector will encourage new entrants in the market. The Union health ministry will be establishing the National eHealth Authority (NeHA) which will be responsible for an Integrated Health Information System (including telemedicine and mHealth).

SUMMIT RAJASTHAN CONFERENCE & EXPO CONFERENCE, AWARDS & EXPO

May 2015, Jaipur

Exclusive interview Interview

Digital Push for

Healthcare Sector National e-Health Authority (NeHA) will have a basic aim to guide the adoption of e-Health solutions at various levels and areas in the country, shares Jitendra Arora, Director (eHealth), Ministry of Health and Family Welfare with Elets News Network (ENN)

What is role of technology in Health sector? Technology can play an important role in overcoming the various challenges faced in Indian health care system, in improving the efficiency of the healthcare system and also in improving the quality and expanding reach of health care services, especially in the context of serving a billion plus population of India. Large scale and sustainable implementation of ICT interventions in health care services i.e. eHealth has a significant potential in addressing such challenges. Ministry is making use of ICT to obtain reliable health information and near real-time data for policymaking, and ensuring efficient healthcare program & service delivery by rolling out a number of IT systems and applications.

Why is NeHA or a similar body essential? Every country during the adoption of national eHealth strategy has focused

may / 2015 ehealth.eletsonline.com

on developing an authority or agency that would take care of key regulatory and promotional issues. It is necessary to maintain the privacy and confidentiality of the patient health records. The National Knowledge Commission (NKC) in 2009 had recommended for establishment of a National Health Information Authority (NHIA), to maintain the flow of information between various health care establishments and provide guidelines in the context of maintenance & use of EHR. Formation of NeHA has been envisaged for regulation, promotion and adoption of eHealth standards and nodal role in eHealth strategies for the country.

What would be the major responsibilities of NeHA? Roles of the authourity will be in areas of policy & promotion; standards development; legal aspects including regulation (privacy & security of health data), health exchange and capacity building etc. The authority would also guide adoption of eHealth solutions and facilitate its implementation by integrating and harmonising the standards. It will also act as

an enforcement agency with suitable mandate and powersand also deal with privacy and security aspects of health data and records.

How would NeHA be set-up and what is the time frame required? The organisation proposed to be created through legislation (Act of parliament). The setting up of the authority will require approval of Cabinet and would require a year for set up.

What is the current status of the process for setting up of the authority? Concept note on setting up of NeHA has been put in public domain for inviting comments and suggestions from various stakeholders. The concept note will be in public domain for a month and thereafter the suggestions received will be duly evaluated for incorporation.It is available on Ministry of Health and Family Welfare (MoHFW) website as well as on MyGov portal. The response obtained so far on the concept note has been quite supportive of the Ministryâ&#x20AC;&#x2122;s initiative and remarks this as being a critical step in the direction of further strengthening and ensuring standardisation (thus facilitating inter-operability) of the Health IT system in the Country.

What is the Indian Government’s focus on using ICT in Health? Twelfth Plan document of Government of India recognises health information system as an important pillar of health care system. In the past, National knowledge Commission (NKC) had recommended extensive use of IT in health care to promote the delivery of efficient health care. It had also recommended to create a nationwide electronic health record (EHR) system. More recently, the Digital India Programme announced covers in its ambit the use of ICT in healthcare for services namely online consultation, online medicine supply, online medical record and pan India exchange of online medical record.

Why is MoHFW implementing electronic medical record (EMR)/ electronic health record (EHR) standards? The large corporate hospitals and some public sector hospitals have started maintaining EHR of their patients. However, these healthcare systems are highly complex, fragmented and use multiple information technology systems. And, these records are not standardised and when a patient moves from one hospital to another, his electronic health record does not get exchanged. Ministry has decided to implement the EHR for seamless information flow and smooth movement of health records of beneficiaries across the hospitals. The EHR stand-

Current ICT Solutions l Mother and Child Tracking

System & Facilitation Centre for efficient delivery of Health care services to expectant mothers and children with an objective of improving IMR, MMR, and morbidity in women and children. l Health Management Information System to monitor delivery of services at facility level has been adopted extensively across the country at district, state and national levels. l Integrated Disease Surveillance Programme for disease surveillance with surveillance units at centre, all State/UT headquarters and all 640 districts in the country, connected through IT network. l “Nikshay” for Tuberculosis control programme, to monitor and track services and status relating to screening, diagnosis, treatment and follow-up of Tuberculosis cases. l Telemedicine- Various tele-medicine pilots have also been initiated in many states over the years, some of them on a large scale. l Mobile Health solutions Swasthya Slate, Kilkari, Mobile Academy have demonstrated good health outcomes by strengthening of health frontline workers.

l Drug Supply Chain Manage-

ment Systems- web-based system to improve supply chain of the drugs, sutures and surgical items have been rolled out in many states. l Hospital Management Systems have been put in place by many hospitals and health centres, supporting administrative and clinical functions and providing electronic medical records. Some states have rolled out state-wide Hospital Information Systems to cover all public hospitals across the state, thus enabling continuity of care within the state l Human Resource Management Systems for optimising human resource utilisation have been in place. l National Health Portal- a citizen portal for health to provide authentic information on health various issues to public and serve as a single point of access for consolidated health information and services has come into operation recently. l Social Media platform – use of MyGov, Twitter, You Tube etc. for dissemination of information & interaction with citizens. Source: MoHFW

The response obtained so far on the concept note has been quite supportive of the Ministry’s initiative ards after wide consultation with domain experts and with the stakeholders were notified by the Government in September 2013.

What are the advantages of using EHR standards? EHR will ensure rationalisation of treatment and avoidance of duplication of investigations. It will also aid improved clinicians’ decision-making by providing access to patient health record information when they need it.EHR streamlines the clinician’s workflow, cuts delays, plugs gaps in care and helps in reducing medical errors.

What is the status of the present EMR and EHR systems in India? Currently in India, there are only a few health service providers, both from both public and private sectors, who have EMR / EHR for patients. But these systems mostly are not as per the standards notified by the government and are not inter-operable.

may / 2015 ehealth.eletsonline.com

Special Feature

Healthcare in

Rajasthan The Government of Rajasthan led by Vasundhara Raje has efficiently crossed all barriers to providing comprehensive healthcare services to the people. Elets News Network (ENN) explores Rajasthanâ&#x20AC;&#x2122;s active adoption and implementation of the latest technology for the betterment of the healthcare domain

ith the various initiatives and schemes implemented by the Rajasthan Government, a poised rise in the health index of the people in the state can be seen. The Vasundhara Raje Government has opened gates for the private players to invest in the state. The Government is working with Public-Private- Partnership (PPP) to provide proper healthcare delivery to improve health conditions of women and child, and improving the nutrition status. Government is going to run a Primary Health Centre (PHC) scheme, Haemodialysis in district hospitals, running CT scan and MRI machine, cancer care units in 17 district hospitals, IVF centre in district hospitals under PPP. Medical health and medical education has got an increased 28 per cent allocation as compared to previous financial year 2014-15. More initiatives were announced including the establishment of eight new blood banks and seven new blood component separation units in the state. Construction of 100 new mortuaries and increasing beds from 150 to 250 in Dausa District Hospital, renovation in District Hospital in Baran, construction of 10 natural medicine centres and development of 400 delivery centres was proposed. The Raje Government has allocated Rs 3 crore expansion of Community Health Centre (CHC) in Sirohi, and Rs 10 crore each for construction works in female hospital in Bikaner and establishment of 10 new mother-milk banks. Providing tablets to ANM in one district of each division is also taken care of on pilot basis. Rs 7 crore are allocated for strengthening food testing lab in Jaipur. The Government will also be starting Healthy Rajasthan Campaign, health and hygiene scheme for the adolescent girls. Recently, the state government has launched mobile portable lab in 10 districts to provide free diagnostic services to patients in rural areas. According to the Union Budget 2015-16, a National Institute of Pharmaceutical Education and Research will be set up in the state. Apart from all these initiatives the state government has also inculcated various e-initiatives in the healthcare sector. The Government with PPP is working on

MAY / 2015 ehealth.eletsonline.com

Special Feature

e-Initiatives by Rajasthan Government ASHA Soft

ASHA Soft is an online system which facilitates the health department, to capture beneficiary wise details of services given by ASHA to the community. It also provides online payment of ASHA to their bank accounts and calculation of total incentive given will be in accordance with the actual health services provided which will help in strengthening of monitoring & management of physical & financial progress. Under National Health Mission, Rajasthan, the responsibility for preparing ASHA Soft has been assigned to NIC unit of Rajasthan State for the cooperation of which ASHA Soft Core Group has been constituted under the directions of Mission Director which is working on the progress of this software with the coordination of NIC. Till now, the profiles of all the working ASHAs have been prepared along with the work plan. The districts have been oriented on this work plan by Mission Director time to time during VC, Meeting of CM&HOs and PMOs. Bank of Baroda has been selected for online payment which will perform this work without any extra fees. The progress of the scheme is being reviewed time to time by Mission Director, NHM for operationalisation of the software on time. After a trial run with the Bank, ASHA Soft will be operationalise in the month of December 2014.

e-Aushadhi

The e-Aushadhi is a web based application which deals with the management of stock of various drugs, sutures and surgical items required by different district drug warehouses of Rajasthan state. e-Aushadhi helps in ascertaining the needs of various district drug warehouses such that all the required materials, drugs are constantly available to be supplied to the user district drug warehouses without delay. This includes classification or categorisation of items, codification of items, etc. The prime objective of a District Drug Warehouse is to supply drugs to the various medical institutes that are associated with the given district drug warehouse.

Pregnancy, Child Tracking & Health Services Management System (PCTS)

Pregnancy, Child Tracking & Health Services Management System is online software used as an effective planning & management tool by Medical, Health & Family Welfare department, Government of Rajasthan. The system maintains online data of more than 13,000 government health institutions in the state.)

Integrated system for monitoring of PCPNDT ACT PCPNDT ACT is an Act to provide for the prohibition of sex selection, in order to stop female foeticides and arrest the declining sex ratio. The website was launched on October 01, 2012 by the National Informatics Centre (Rajasthan) which helps in monitoring of the form â&#x20AC;&#x201C; A, form -F and tracking devices fitted in sonography machines at the registered sonography centres and generates various analytical and geographical reports. It is an intensive inspection drive using technology of all Government district, Subdivision, Community Health Center (CHC), Primary Health Center (PHC) hospitals.

CHRIS â&#x20AC;&#x201C; Computerized Human Resource Information System

It is an integrated streamlined system to keep the employee data.

MAY / 2015 ehealth.eletsonline.com

Special Feature

The Government of Rajasthan is aggressively promoting Medical and Healthcare sector, also offering an opportunity for the private sector to invest in medical and healthcare institutions

MAY / 2015 ehealth.eletsonline.com

every aspect to provide proper healthcare delivery to improve health conditions of women and child, and improving the nutrition status in the state. The Rajasthan Government is running various schemes with the support of latest technology such as ASHA Soft, e-Upkaran, e-Sushrut, PCTS (Pregnancy, Child Tracking & Health Services Management System), IMPACT (Integrated System for Monitoring of PCPNDT Act), Saghan Nirikshan Abhiyaan, CHRIS (Computerised Human Resource Information System). The Mukhyamantri Nishulk Dava Yojna (Chief Minister’s free medicine) was also initiated by the Government under which patients could get free generic medicines from Designated Drug Distribution Centres (DDCs). Recently, the Government has also signed a Memorandum of Understanding (MoU) with Tata Trust and ‘Antara’ Foundation to improve the health status of women and children. The Government of Rajasthan is aggressively promoting Medical and Healthcare sector, also offering an opportunity for the private sector to invest in medical and healthcare institutions (medical, dental and paramedical etc). In order to facilitate the establishment of quality health institutions within the framework of set standards and norms, the Government seeks participation from the private sector for qualitative healthcare delivery. The state has the potential of extending its tourism into medical tourism with its RIPS (Rajasthan Investment Promotion Scheme)-2014 offering concessions and tax benefits for such investments. The state government aims to develop complementary and alternative medicine centres, super speciality healthcare institutions to ensure qualitative delivery of healthcare at pocket-friendly cost. The government also promotes development of centres of excellence for medical care, investment of private sector in medical healthcare institutions and support units (diagnostic centres, blood banks and paramedical training institutions), and promotion of medical tourism.

Strike the perfect

balance...

Agfa HealthCare India Pvt. Ltd. Technosoft Knowledge Gateway, 2nd Floor, B-14, Road No-1, Wagle Industrial Estate, Thane (West)- 400 604 E mail for enquiry: sales.india@agfa.com Mumbai New Delhi Kolkata Chennai 022-40642900 011-42484518 033-22820745 044-42125263

An affordable entry into digital radiography that places you in complete control. One that allows you to make your own decisions when balancing the need for speed versus resolution - without compromising on image quality. That enables you to adapt and adjust your choice on a study-by-study basis and harness the power of Agfa HealthCareâ&#x20AC;&#x2122;s MUSICA2 imaging processing software. That is the CR 12-X. Insight. Delivered. Learn about Agfa HealthCare at www.agfahealthcare.com

Campaign

Challenges Galore

here is a growing mismatch between the growing population and the number of hospitals in the country. Statistics reveal that the country has one hospital bed for 879 people. This is far below the world average of 30 hospitals per 10,000 population. India requires 600,000 additional beds over the next five to six years, which potentially throws an opportunity of more than US$ 30 billion in the offing at a rapid pace. Indian healthcare industry market, which comprises healthcare delivery (hospitals) and allied sectors, is expected to reach at US$ 280 Billion by 2020. The healthcare delivery market is expected to reach US$ 100 billion by 2016, growing at a CAGR of 13 per cent. While building hospitals is an expensive venture, it is also a necessity staring at us. And the multitude of challenges in the entire process makes it a cumbersome affair. Some of the challenges include large capital requirements, location of the hospital, electricity and water, adopting green building strategies, approvals, certifications, licenses, manpower availability, regulations, and guidelines. Also hospitals must be ready to respond to both expected and unexpected changes, such as possible increased regulatory demands, environmental mandates, and future

MAY / 2015 ehealth.eletsonline.com

healthcare innovations. What makes the scenario even more daunting is the abysmal ranking the country holds in the ease of doing business in the country. Adding on to the existing challenges in the healthcare sector, the bottlenecks in the ease of doing business make it even a harder challenge for the players to push for growth. According to a CIIKPMG – Ease of doing business in India report, to maintain its growth trajectory, India needs to be a relatively attractive investment destination across each of these parameters. The Government would need to undertake reforms to help place the country on an equal footing amongst countries having favourable, flexible, liberalised and a transparent business environment. With Indians bearing maximum of their healthcare spending out-of-pocket and with most medical equipment being imported for India, the piped dream of Prime Minister Narendra Modi, the Make in India concept may not be able to work for healthcare sector in the country. Pharma and healthcare are among the 25 identified sectors that have huge scope to draw foreign as well as Indian companies to manufacture in India. Modi had stated that the campaign can act as a catalyst to make healthcare accessible and affordable in India. But with lack of favourable tax policies, no ease of

Dr T P Ahluwalia

Scientist-G (Sr. Deputy Director General) & Head, Division of Health Systems Research(HSR), Indian Council of Medical Research, Department of Health Research, Ministry of Health & Family Welfare, Government of India

“Mobility, simplicity & automation are the three mentras of affordable healthcare. We should focus on mobile soultions, especially in rural areas. Automation should be improved across the country, thereby lowering the unit cost” doing business being, Make in India seems to be a distant dream. Absence of hospital infrastructure and lack of

Campaign

trained and even availability of health professionals are some of the major roadblocks in the development of healthcare sector in the country. At the recent Healthcare Leadership Forum, organised by eHealth magazine, industry players shared their views on the making healthcare affordable and accessible, Narender Saini, Member, Delhi Medical Council shared how the private sector, which is a major player in providing healthcare to people, is affected by paucity of funds. “Hence, taxes levied on the private sector shouldn’t be commercial but at least subsidised. Government has to look at whatever subsidy they are giving must pass on to the patient also. Another important aspect is that rural healthcare that must be strengthened by giving incentives to doctors,” added Saini. Sharing a view on behalf of the private sector, Manpreet Sohal, Chief Executive Officer, Global Hospitals, Mumbai & Hyderabad said, “Public-private partnership can take the healthcare to the next level. Government is also the regulatory authority of the private sector. There should be partnership in equality. Sharing of resources can also make the healthcare very affordable.” India’s high population makes it

PPP in Health Sector:

Dr Girdhar J Gyani

Director General, Association of Healthcare Providers (India)

“For universal coverage of healthcare, Government must spend 50 per cent of more money in the healthcare” an important player in the Healthcare Industry. According to the Insurance Regulatory and Development Authority, the Indian healthcare industry has the potential to show the same exponential

The campaign is looking to find answers to:  Financial challenges  Healthcare reform implementation  Government mandate  Technology aided growth and challenges  Personnel shortages  Regulatory barriers  Patient safety and quality  Care for the uninsured/ underinsured  Patient satisfaction  Physician-hospital relations  Population health management  Proposed solutions Leave a comment below or connect with us on www.ehealth.eletsonline.com

Kavita Singh

Director, Ministry of Health & Family Welfare, Govt of India

“Government and private sector must work in convergence and come out with a model for resultoriented work with whatever minimum resources we have”

 Absence of a PPP policy and strategy for health sector  Little understanding of what constitutes PPP in health  Most private sector health providers in India are noninstitutional providers  Most institutional providers don’t have accreditation or compliance to minimal standards  Lowest commercial bid does not necessarily guarantee better services  Trust deficit between government and private sector growth that the software industry showed in the past decade. “In India, 80% of the healthcare expenditure is borne by the patients and that borne by the state is 12%. The expenditure covered by insurance claims is 3% As a result the price sensitivity is quite high and the high-level healthcare facilities are not in the reach of patients,” says Dr. Rajeev Boudhankar, Vice President, Kohinoor Hospital. He further stresses on the need to increase public funding in healthcare - both Centre and States. Boudhankar shares a slew of recommendations to improve healthcare delivery in the country including increase public funding in healthcare - both Centre and States. To prioritize spending on preventive and primary care including provisioning quality drinking water & sanitation, pest control, and awareness on hygiene and nutrition. Adopting outcome-oriented norms while defining minimum standards, prioritising creation of infrastructure for driving immunization programmes, setting up district-level training institutes for paramedics and nurses are some of the recommendations. In a bid to provide a platform to gauge the “Key Challenges for building a Hospital in India”, eHealth is running a campaign and seeking views from the industry and its stalwarts.

MAY / 2015 ehealth.eletsonline.com

Industry Speak Industry Speak

Haemostasis Testing â&#x20AC;&#x201C; The Way Forward Coagulation remains one of the most important parts of diagnosis in pathology and is routinely suggested as a first line test for disease detection, says Paul Francis Prem, Senior Manager â&#x20AC;&#x201C; Business Development, Transasia Bio-Medicals Limited

he diagnostic segment today comprises a wide array of specialties. With the availability of high-end technologies, it is possible to conduct an in-depth analysis of just about any parameter. Coagulation remains one of the most important parts of diagnosis in pathology and is routinely suggested as a first line test for disease detection. Ironically, the assay is still restricted to only PT/ATT. Evaluation of even the fibrinogen level (FIB) is considered as a special test. Analysers available in the market offer nothing more than the clot based tests (PT/ ATT) and FIB assays. Moreover, all analysers available in India work on the principle of either mechanical or optical detection. Mechanical detection is an age old technique based on viscosity. It is an indirect method and is performed with a metal stirrer/bar/bead in the reaction cuvette. The latest direct measurement method is based on the optical scatter light (nephlometry) principle and makes use of clear reagents. This method offers much more information on clot formation than its predecessor.

Beyond routine coagulation Transasia Bio-Medicals has committed itself to offering the latest, highest quality systems across the globe for over thirty five years now. Understanding the customer needs and going beyond limitations to provide the best solutions, has been its forte, earning it credibility globally. Transasia, along with its subsidiary ERBA Diagnostics, France, has developed a new semi-automated system- ECL series. ECL 105 (single channel analyser) and ECL 412 (four channel analyser) are capable of performing all clot, chromogenic and immunotubidometric assays (haemostasis). These systems employ the most advanced and trusted nephlometry principle for detection. The innovative ECL 412 is the only system of its kind to perform the complete haemophilia and thrombophilia panels. The wider test menu provides an edge over all the routine systems. The measurement of clots at 640nm is the

first of its kind to measure HIL samples. Moreover, the multi-channel operations on ECL 412 enhances the parallel run of either the duplicate or fresh assays, thereby increasing the throughput. The system is capable of providing better calibration data for every parameter, resulting in higher accuracy of reporting. The large graphical display aids in viewing the reaction curve for the assay and analysing the data in correlation with the results. The system uses half the volume of reagents required, thereby making it cost effective with better precision. Nowadays, most laboratories are accredited and have started using LIS. ECL provides for LIS compatibility and data export system. Vis-Ă -vis its counterparts, it offers a wider data storage capacity, an expandable memory and provision for interface and transfer of information. The system is complimented with a validated, high quality, economically priced range of reagents provided by Transasia. By far, the most advanced, the ECL series along with its reagent range, provide much beyond the clot based assays, offered by all other semiautomated analysers in the market. With its unmatched services, the system is best suited to serve not just standalone labs but corporate hospitals, chain labs and referral labs as well. All in all, the system offers all test features of a fully automated coagulation analyser on a semiautomated system.

ECL105 - Semi-automated Analyser may / 2015 may / 2015 ehealth.eletsonline.com ehealth.eletsonline.com

Exclusive Interview

Expanding the Pie Manpreet Sohal, CEO, Global Hospitals, Mumbai and Hyderabad wants his hospital to be known as Centre of Excellence in intensive care and multi-organ transplant hospital in Mumbai

As a Centre of Excellence in multi-organ transplants, please share with us highlights of the hospital in Mumbai? With over 2000 beds, the Group currently has nine state-of-the-art world-class hospitals at Hyderabad, Bengaluru, Chennai and Mumbai and

MAY / 2015 ehealth.eletsonline.com

is one of the most comprehensive multi-organ transplant services in the country. The success of our hospitals is deeply rooted in the vision of its founders that each hospital in India would have various Centre of Excellence departments providing medical care. The journey

at Global Hospitals, Mumbai was started with establishing the stateof-the-art liver and renal transplant amongst various other departments like gastroenterology and GI surgery and today we provide comprehensive medical care unmatched by any in western India in transplant space. We have many first to our credit, which includes a dual lobe surgery, the first in western India, where two donors donated part of their livers to save the life of one patient and another first in Mumbai where a patient underwent dual liver and kidney transplant, receiving a portion of his 21-year-old sonâ&#x20AC;&#x2122;s liver and a kidney from his 49-year-old sister. It would be interesting to mention that Dr. Prof. Mohamed Rela, Director and Head of Institute of liver Transplant Programme have done a unique liver transplant surgery at Global Hospitals Chennai. One cadaver liver that could have been transplanted in one adult patient, was split and was transplanted to two adults patients This was definitely a rare, unique and the first of its kind surgery in India and only about 30 of these have been performed worldwide. With such distinguished doctors occupying the transplant space at Global, it is but natural that the programme shall reach the pinnacle of success. The facility highlights includes world class tertiary care in the main heartland of Mumbai at Parel having 15 single-shell world class OTs, 100 ICU beds, having dedicated transplant ICUs, liver ICUs, surgical ICUs, cardiothoracic and cardiac ICUs, medical ICUs, neuro ICUs and

Exclusive Interview

What are your views on the Union budget 2015-16 for healthcare?

should be extrapolated to healthcare that will encourage more partnership from investors to join hands with government and make a big change in healthcare delivery in India.

Today the GDP spend by the Government of India for healthcare is still much below as compared to others countries of our population

What is your vision for the hospital for the current financial year?

renal ICUs with staff trained to look after patients in the respective areas.

We will foray into oncology with both surgery and radio therapy facilities and are gearing up to offer world class infrastructure and equipment for the same. These will strengthen our abilities of transplant theatres, robotic theatres, cardiac theatres, orthopaedic theatres, surgical gastroenterology, neurosurgery

The ease of doing business in India should be extrapolated to healthcare that will encourage more partnership from investors to join hands with government and make a big change in healthcare delivery in India

size. And the private healthcare sector addresses a major part of the medical needs of the country. This gap needs to be addressed and is possible by a innovative PPP model that makes the most of the land, infrastructure and equipment already existing with the government and the ability of private hospitals to deliver healthcare services. The private players in this partnership should be given the freedom to run the model on an economic model that is sustainable. The ease of doing business in India

Taking cue from the success of liver and renal transplant, we have plans to start heart, lung, intestine and pancreas transplants and have already applied for licences in intestine and pancreas transplant. The centre boasts of successfully running cardiac, neurosurgery, urology, MAS and GI surgery departments and going forward would like to develop Centre of Excellence in bariatric surgery, vascular surgery, and sports medicine in orthopaedics and neuro-intervention radiology.

theatres and minimal access theatres to address the needs of wider range of patients. Our expansion to oncology will be made easy as we have the best in class radiology and imaging facility with Indiaâ&#x20AC;&#x2122;s first 500 slice CT scan, 3 Tesla-MRI, Indiaâ&#x20AC;&#x2122;s 1st, IGS 530- Cath lab with FFR and IVUS, and would be starting the bone marrow transplant, in a facility specially created to treat this disease. With a capacity for up to 400 beds, we are also looking at expansion within Mumbai at other locations as well.

MAY / 2015 ehealth.eletsonline.com

Exclusive Interview

Modular Operating Room Enhances Quality of Care With increased awareness of joint and hip replacement if we could make the procedure components available in India, the cost of surgery will come down and demand for the surgery will surely rise, says Dr S Anand Kumar, Chairman, ARS Hospital, Tirupur, Tamil Nadu What are the various healthcare services offered by your hospital? We are a 50-bedded medium sized orthopaedic hospital located at the heart of an industrial hub in Tirupur, Tamil Nadu that has many garment factories and workers. We felt the need for a specialised hospital in this industrial zone to cater to the daily needs of industrial injuries of workers and also cater to trauma cases. Thus, we began this hospital as an advance centre for joint replacement, orthopaedics and trauma care. Our success from the year of establishment in 2007 has been driven by our expertise in offering specialised care with state-of-the-art equipment and team of doctors to treat injury and trauma patients to help them get back to their normal lives. We have ensured that we have the best of technology and medical equipment in the hospital. This alone has helped us achieve 10,000 surgeries till date, of which more than 500 were complex procedures involving knee and hip replacements. Our specialities include total knee replacement, total hip replacement, accident and trauma care, shoulder, foot and ankle surgery, spine surgery, arthroscopy and sports medicine.

The importance of state-ofthe-art Operating Room (OR) and OR equipment is high in case of surgical procedures, have you invested in any new

MAY / 2015 ehealth.eletsonline.com

technology for the same? As our hospital caters to primarily the orthopaedic and trauma procedures, we realised that to ensure high-quality patient care on a daily basis, ease of surgery for our doctors and success rate of procedures offered by the hospital, required a state-of-the-art OR (Operating Room) as a critical infrastructure. We have invested in VARIOP - most advanced modular OR from Maquet, which offers exceptional functionality and flexibility in all our disciplines. This is a first installation in southern India. Developed in line with real world OR requirements, the modular table Alphastar PRO ensures optimum results for all orthopaedic and trauma interventions. Modular components allow for quick and easy configuration and adjustment, creating more efficient and costeffective operating rooms. It also offers surgeons exceptional stability and ergonomic design for precise patient positioning and optimal access to the surgical site along with Volista Lights

and Pendants. We are also the first hospital in Tamil Nadu to have Orbic 3D high-end C-arm with 3D functionality that is best suited for intraoperative use in orthopaedic, trauma and spine surgery. It helps for precise imaging and perfect visualisation with integrated intraoperative 3D imaging. We have ensured our OT abides by the NABH standards and for that we have ensured a bacteria free environment with seamless walls, laminar flow and air pressure standards maintained at all times.

What are the ways the ‘Make in India’ programme announced by the Central Government can benefit the healthcare sector? The opportunity for ‘Make in India’ in the healthcare sector is huge, especially if we consider our procedure of joint replacements that has all its components imported from other countries. This makes the surgery cost go high and keeps many patients away from the replacement option. India could host most of the R&D and production of these medical devices within its territory. Thus, with increased awareness of joint and hip replacement if we could make the procedure components available in India from Indian manufacturers or production units of these companies operating in the country, the cost of surgery will come down and demand for the surgery will surely rise to benefit more patients’ lead healthy lives.

Exclusive Interview

Transforming Healthcare Delivery Yuhgal Kishore Upadhyay, CEO, Sunrise Hospital strongly recommends the implementation of the Unique Hospital Identification (UHID) number and card for better and convenient diagnosis and treatment. He also shares his plans of opening 100 more IVF centres in India with Elets News Network (ENN). How do you see IT and healthcare going hand in hand? Definitely, IT has a major role in every sector. In healthcare, if you take the examples of US or Canada the patients there do not carry their medical history with them; they are issued with UHID number. In my opinion, both government and private hospitals should issue UHID card similar to Aadhaar card. This implementation will make the diagnosis and treatment convenient for both the doctor and the patient. For instance the Patients is getting treatment through insurance company and the doctor prescribed MRI, the report should be uploaded on the system, so that the patient does not have to go for another MRI again and again.

What IT solutions are deployed in your hospital and how do they help in the betterment of the hospital? We have installed software in our hospital that carries all the data from administration work to the discharge of the patient. Secondly, we issue a UHID number and card that creates a database of the patient making it easier to access the medial history of the patient. The patients can carry while they visit to any of our setups â&#x20AC;&#x201C; Sunrise Hospital, Arihant Hospital, Privat IVF Clinic, Sunrise Lifeline Private Limited â&#x20AC;&#x201C; and their medical history will be available with each centre. We also provide 15 days training to the new employees. For instance person joining with the lab section is trained with the lab module. Similar training is also provided with the reception module.

At present, what is the prime focus of your hospital? We aim to provide an affordable treatment to the patients. We coming up with IVF chain and we already have opened up two IVF centres. Our focus is to open 100 more IVF centres in India. We are also open for distributing franchise.

What steps need to be taken for the betterment of the industry? For the betterment of the healthcare industry the government and the private hospitals should stand together. We generally see long queues at government hospitals as they provide free treatment to the economically weaker sections (EWS) and pays to that particular hospital. In my opinion the government should adopt small nursing homes, hospitals and fund them making proper distribution of the patient. The government should fund private hospitals as well.

may / 2015 ehealth.eletsonline.com

Exclusive Interview

IT is the key to Success There is no healthcare without medical technology and in recent times the practice pattern has changed in a big way, says Dr Rajiv Jain, Director, Save Sight Centre, New Delhi What IT solutions have you deployed in your organisation? We are trying to go paper-less. We have deployed electronic medical record system. A patient does not have to fill any paper as we record everything online and all the records are on cloud. For instance, optometrist stored the vision records, the lens power and the like, on cloud, then doctor can access the record details online. We also send soft copy of the reports to the patients on their registered email Ids. Number of patients’ prefers hard copies as well. We are also planning to start a facility for patients, so that they can access their reports online. Going online has increased our return on investments and patients feel the difference. This is something we are proud of.

There is lack of efficient adoption of technology in hospitals. What is the reason behind this? The adoption of technology to share and store the information will take lot of time. One needs a dedicated team to look after the software and other related issues. No doubt it will increase the overall operational cost. Translating the cost into getting more business is a challenge. We have to change with time and adopt technology.

What are the popular new technologies in healthcare sector? Few technologies regarding patient care and patient comfort like e-appointment are very popular. We are now planning to start ‘e-consultancy’

MAY / 2015 ehealth.eletsonline.com

service on web, allowing patients to upload their details online for consultancy if they are unable to visit the hospital. These are the things we are looking forward to.

How do medical technologies remove existing paradigm in health sector? There is no healthcare without medical technology. What we have seen in recent times that the practice pattern has changed in a big way. Patients do not want to visit hospital again and again. Nowadays, patients are happy to take consultation over phone or Skype. I have a few patients, who ask me to come on Skype for consultation. Today, doctors are equipped with more IT tools.

How can technology be leveraged in an affordable manner in the healthcare sector? We are planning to put Fundus camera software to enable this. It’s a kind of primary care, where these vans with cameras will go to villages where patients of diabetes will be screened. Photographs will be done and will be sent to us. If someone has any disease, they will be called by us. We will not be charging anything for this as it is based on public-private partnership (PPP) model and there is social responsibility clause with big corporate funding it.

What more needs to be done in healthcare sector to make it in tune with the present scenario? First, awareness among doctors as well is people is very important. Doctors should aware of the medical conditions of the patients and where they should stop as per their specialisation. Same as I cannot treat all patients, I can only treat eye care patient as I am retina specialist, I can’t treat every eye ailment.

How did you find the recently held elets Healthcare Forum 2015? One of the most important things I received from this forum is knowing about the current industry trends. The event also provided me an opportunity to listen to views and opinions shared by policymakers, decision-makers, prominent industry leaders, hospital administrators and senior level executive at one common platform.

Exclusive Interview

Adopt Technology to Sustain in Competition Training of manpower is essential and staff should be regularly updated on the current trends, believes Dr Shrihari Dhorepatil, President, Obesity and Metabolic Surgery Society of India. IT and healthcare go hand in hand. What you have to say on adoption of IT in healthcare sector? As business or service industry, India is leading globally in IT sector. Unfortunately, IT is not much seen in healthcare sector where it is most needed. Big corporate players are now adopting the technology at a fast pace. IT is required at primary and secondary care as data is generated at these stages. However, it is missing. We need to adopt technology in order to sustain in completion with global players. At Elets Healthcare Leaders Forum, I heard some statessuch as Tamil Nadu and Rajasthan are doing wonderful job in generation of useful data through Asha health workers. The adoption of IT is going forward; we are hopeful.

Elets Healthcare Leaders Forum is an interesting platform for knowledge-sharing on hospital management, e-health, ICT, affordable healthcare, etc. Such forums help us meet people from the industry and provide the best healthcare services.

You mentioned about your multi-speciality centre. What is your key focus in adoption of technology?

IT is required at primary and secondary care as data is generated at these stages. However, it is missing. We need to adopt technology in order to sustain in completion with global players Hospitals are using IT for registration and billing. But we have to go way beyond. Clinical data is very important. It should be created and shared with not only network hospitals but others too. It will make healthcare affordable for patients. Moreover, training of the manpower is also very important. The staff should be updated on the current trends.

How did Elets Healthcare Leaders Forum help you expand your horizon? I am a surgeon with more than 25 years of experience. I have developed my surgical skills and knowledge through various national and international conferences, which helped me evolve from being a simple surgeon to pioneer of bariatric surgery concept in India and founder of a healthcare centre.

MAY / 2015 ehealth.eletsonline.com

Health Start-ups

Bringing Patients and Doctors Closer Lybrate is a web as well as mobile based app that bridges the gap between doctors and patients

ounded by former professionals from Facebook and Snapdeal in June 2013, Lybrate is an online platform and a mobile-based application where 80,000 doctors from varied branches of medicine are currently listed to attend to the queries of patients, without charging a penny. While the platform

MAY / 2015 ehealth.eletsonline.com

offers patients the opportunity to seek multiple opinions from the doctors, it helps the health experts build their reputation online and allows them to practice beyond boundaries. It is a healthcare platform bringing patients and doctors closer, empowering patients to get the right advice at the right time. The companyâ&#x20AC;&#x2122;s service is

need will be able to succeed. We are here to address the problem that there is no access to doctors and want to bridge the gap between the doctor and the patient at one platform. People are not aware of healthcare apps. This particular app allows the patient to ask questions anonymously to the doctor. There is

presently available in all the major cities including New Delhi & NCR, Bangalore, Mumbai, Chennai, Kolkata and Hyderabad, among others. The online service can be accessed on any iOs or Android Smartphone. Lybrate has more than 30 employees and is based in New Delhi. The Venture Capital firm Nexus Venture Partners backs the company. With strong network health experts, Lybrate acts as the online Out Patient Department (OPD). The company has raised US$ 1.23 million in seed funding from Nexus. â&#x20AC;&#x153;Indian is such a vast country with varied needs there is no one player, anybody who is able to address the

need for the use of technology both by the doctors and the patientsâ&#x20AC;? said Saurabh Arora, CEO, Lybrate. In the next five years, the company aims to have maximum number of doctors on the Lybrate platform so that health care becomes accessible to the 1.2 billion population of India. We strive to reach more and more people, especially in the rural areas and bring them the access to doctors from across the country, on the back of deeper penetration of internet services in the country and growing Smartphone usage. For more information visit: www.lybrate.com

Health Start-ups

Never Miss a Dose COD is an personalised medicine reminder service targeting medicine on-adherence

OD Healthcare Private limited, founded by Yashu Kapoor & Pitambar Jha in August 2014, provides services and solutions in the healthcare sector, for the people, who face trouble in managing their disease or medication. Their service - COD Medi Alert – is a personalised medicine reminder service. It targets Medicine Non-Adherence, which is regarded as an ‘invisible epidemic’ by the World Health Organization (WHO) studies has shown that the treatment of chronic illnesses or Non-communicable Diseases (NCD) does not yield full benefits because approximately 50 per cent of patients do not take their medications as prescribed. provision to set a reminder calls in your own voice through our Natural Speech Synthesis Engine via Phone Call, SMS, email or WhatsApp to their loved ones, multiple times a day. The personalised calls can be sent in Hindi and English languages, and also an option of customisable medicine schedule and reminders. The COD Healthcare singularly focuses on capitalising the commonly used mobile and digital media to bring about healthy behavioural changes

in the lives of the customer’s with their services. The company aims to great traction in the B2B space with hospitals as partners. Presently, the company is in touch with some of the renowned hospitals in the country and is in process to deploy B2B Medi Alert service in Metro Hospitals and Heart Institute. At present, the company has 1618 employees with an aim of growing at a very fast pace as we are hitting traction among B2C:(Self service portal for Caregivers to set up the

The app focuses on capitalising the commonly used mobile and digital media to bring about healthy behavioural changes in the lives of the customer’s with their services

service for their loved ones) and B2B: (Hospital Enterprise Segment: to Boost the Patient Satisfaction Level and increase the revenue numbers in terms of High Conversion Rate and Retention Rate). They raised the round of early stage funding for Rs 2cr by the angel investors: Mahesh Bansal and Kidar Nath Bansal. “Currently, our attention is focused towards fulfilling the high demands for our first service offering: COD Medi Alert, which is creating a niche vertical in the industry and growing at an unprecedented scale. We are currently deploying our services at Metro Group of Hospitals and are launching a pilot run at Apollo Hospital. Other than that, we are sitting on table with the decision makers of at least five big tertiary care Hospitals, where the deal is at the last stages” said founder Yashu Kapoor. For more information visit: www.codmedialert.com

MAY / 2015 ehealth.eletsonline.com

Healthcare Start-ups interview

Health Concession Programme with MED Health Card The MED Health card is an discount card offering consumer driven healthcare savings programme

edhealth Cliniq was founded as a part of Vipul Group health vertical on May 2014, which already has entities focused on Health Insurance for IPD care and Corporate/Retail wellness. The company has come up with two programmes - Medhealth Card & Medhealth Store. The MedHealth Card is an individual discount card that offers consumer-driven healthcare savings programs for individuals, employers, and their employees. By aggregating the purchasing power of hundreds of thousands of consumers nationwide, the account members are enabled to discounted rates. It is membership in a discount healthcare savings program along with free OPD that will help reduce the expense of obtaining care and treatment. There are four versions of the card namely MedHealth Silver, Gold, Diamond and Platinum that provides free OPD consultation service, cash discount at Apollo and other pharmacy’s, and cash discount at Diagnostic Centers. The card can be purchased from www.Medhealthstore.com and is transferable within the family members. The MedHealth Cards mobile application provides Live Health chat for health related queries and for medical opinions. It also acts as an electronic medical record management tool, where you can store and access all your medical documents in MedHealth Cliniq EMRM Portal. “We seek to become a one-stop solution for all healthcare products and ser-

may / 2015 ehealth.eletsonline.com

vices. And to provide this seamlessly, we have tied with over 150 Clinic’s, 150 Hospitals, 120 Diagnostic Centers, 200 Pharmacies & 50 Spa’s & Gymnasiums” said Dr. Sudhir Kumar, Chief Executive Officer Medhealth Cliniq. While MedHealthstore.com is a wellness product e-commerce website, which provides various healthcare and personal care products. The Company that owns Medhealth Cliniq is RTS Rural Technologies Solutions Private Limited which has been a preferred player in the smart card domain and participates in Government-sponsored mass enrollment schemes for health insurance of BPL individuals like RSBY (Rashtriya Swasth Bima Yojna). It consists of 135 employees and the organisation is funded by its current set of investors including the Vipul Group. The organisation in its one year of

operation reached out to over 25 major cities in the country touching all metropolis and urban centers of India where it has created formidable network of Hospitals, Doctors, Clinics, Pharmacies, Diagnostic Centers and other wellness centers where the customer can show his Medhealth Card and avail substantial discounts on services. Over the next five years, Medhealth Cliniq has the vision to reach out to all the cities in India and do tie-ups with over a 100,000 providers who shall be extending preferred services to Medhealth Card holders through a structured OPD insurance scheme. There are significant investments in marketing and technology that are planned to take the entire platform on smart cards and through mobile devices. The online wellness store shall also become an independent wellness market for the retail customers to access and enjoy.

SUBSCRIPTION ORDER CARD

Product Launch

Carestream’s New 3D Orthopaedic Imaging System

arestream is partnering with leading orthopaedic and sports medicine specialists to develop a new three-dimensional medical imaging system (investigational - not available for commercial sale) for capturing images of patient extremities (knees, legs, feet, arms and hands). Initial clinical studies will focus on

the advantages of using cone beam CT (CBCT) technology in the diagnosis and treatment of knee injuries. This system is designed for use by orthopaedic surgeons, who met at the annual American Academy of Orthopaedic Surgeons conference. Imaging systems based on CBCT technology can be used in treating orthopaedic conditions. Carestream’s

new CBCT system is designed to provide weight-bearing images of knees, legs and feet, which are difficult to obtain. “We are focused on applying CBCT technology for extremity imaging because it offers excellent visualisation of soft tissue and bone with systems that are smaller and more affordable than CT systems,” said Diana L. Nole, President,

This system may be adopted for use in urgent care facilities and clinics, athletic training facilities, and orthopaedists’ and other specialty practice offices

May / 2015 ehealth.eletsonline.com

Digital Medical Solutions, Carestream. Carestream’s new extremity system may be adopted for use in urgent care facilities and clinics, athletic training facilities, and orthopaedists’ and other specialty practice offices. “This system could make it easier to obtain diagnostic exams immediately following an injury and help improve evaluation and treatment,” Nole explained. Nole added that Carestream is working with top orthopaedic care providers and leading sports medicine experts to help guide current and future product development initiatives. The company’s development efforts include an agreement forged two years ago between Carestream and the Buffalo Bills with the goal of aiding Carestream’s understanding of the use of advanced medical imaging technology in early detection and monitoring of player injuries. This partnership continues to focus on the need for new technology to help address key concerns in sports medicine.

Government Desk

PM Modi Unveils Healthcare Tourism Portal

The Prime Minister Nadrendra Modi launched India’s Healthcare Tourism Portal www.indiahealthcaretourism.com during the Global Exhibition on Services (GES) held in the capital. The portal is developed by the Union Government’s Department of Commerce and the Services Export Promotion Council (SEPC) covers hospital and travel related information in India. At present, the portal covers 124 accredited medical facilities including 93 medical centres, 30 Ayurveda and Wellness centres and one special category centre. Among these 74 facilities are located in tier I cities and the rest are in tier II cities. The Healthcare Tourism Portal also carries details such as costs related to treatment in hospitals, visa and travel formalities, tariff options on stay etc.

West Bengal Government to Provide Free Treatments in Government-run Hospitals

he West Bengal government will soon be providing treatments of all types of cancer, cardiac problems and blood disorders free of cost in state government-run hospitals and medical colleges. This announcement was posted on Chief Minister Mamata Banerjee’s official Facebook account. The post also states that the services provided would include all types of medicines, radiation therapy, surgical procedures such as open heart surgery, bypass surgery, repair and replacement of valves and insertion

of different types of implants like stents and pacemakers. The scope of treatment of blood disorders including blood cancer, thalassemia, alplastic anaemia, homeophilla etc would also be enhanced to offer universal coverage.

Assam Government yet to complete the preparatory work to implement Food Security Act

request for allocation of food grains under National Food Security Act, 2013 (NFSA) was received from Government of Assam. Before implementation of the Act, States and Union Territory (UTs) are required to complete various preparatory activities and have to certify their preparedness. As per the status of preparedness

may / 2015 ehealth.eletsonline.com

Delhi Government to Implement Clinical Establishments Act

reported by Assam Government, they have not completed all the required activities and has been requested to complete all the preparatory activities before release of foodgrains under the Act. This was informed by the Minister of Consumer Affairs, Food and Public Distribution, Ram Vilas Paswan in a written reply in Lok Sabha.

n order to provide affordable and better service standards in healthcare services, the Delhi government intends to enforce Clinical Establishments Act. Under this act the maximum cost of medical procedures would be laid out and the services would be standardised. The Clinical Establishments (Registration and Regulation) Act allows health authorities to conduct inspections, penalise or cancel licenses of hospitals if found charging unreasonable price from the patients. States such as Arunachal Pradesh, Himachal Pradesh, Mizoram and Sikkim have till now opted to implement the law. It is also in force in all the Union territories. The Clinical Establishments (Registration and Regulation) Act passed by Parliament in 2010 and notified in 2012 provides registration for all hospitals, nursing homes, daycare centres, diagnostic labs and clinics run even by single doctor. It also covers all recognised systems of medicine including homeopathy, Unani and Ayurveda. Note: To read the Clinical Establishments Act visit http://clinicalestablishments.nic.in/En/1061-actpage.aspx

Host partner

Government Desk

CCRH to Tie-up with Homeopathy Research Organisations

he Central Council for Research in Homeopathy (CCRH) - an autonomous body under the AYUSH department of Union Health Ministry is planning to tie-up with top homeopathy research organisations to boost the healthcare industry. This came against the backdrop of the World Homeopathy Summit hosted by Global Homeopathy Foundation in collaboration with CCRH. According to Bhagwant Bishnoi, Indian Deputy Permanent Representative to the UN, while addressing a session of Commission of Population and Development, almost 400 per cent increase in federal funding and investments in healthcare systems, efforts in improvement have begun to show results. He added that the governments National Rural Health Mission and other innovative health interventions have led to increase in life expectancy increase in immunisation of children, and substantial drop in under-five, neo natal and maternal mortality rates between 1990 and 2013. India’s inclusion is a special challenge and responsibility, given its vast social, regional and economic diversity.

India Eyes on Achieving MDGs on Child Mortality, Maternal Health

ndia aims to achieve the Millennium Development Goals (MDGs) of reducing child mortality and improving maternal health in 2015 with the increase in funding in healthcare system. According to Bhagwant Bishnoi, Indian Deputy Permanent Representative to the UN, while addressing a session of Commission of Population and Development, almost 400 per cent increase in federal funding and investments in healthcare systems, efforts in improvement have begun to show results. He added that the governments National Rural Health Mission and other innovative health interventions have led to increase in life expectancy increase in immunisation of children, and substantial drop in under-five, neo natal and maternal mortality rates between 1990 and 2013. India’s inclusion is a special challenge and responsibility, given its vast social, regional and economic diversity. MDGs are eight international development goals that were established following the Milennium Summit of the United Nations in the year 2000, following the adoption of the United NationsMillennium Declaration.

may / 2015 ehealth.eletsonline.com

World Health Day 2015

Focuses on Food Safety

hese days a wide spectrum of illnesses is caused by foodborne diseases, to recognise the urgent need to address this problem, the World Health Organization (WHO) has dedicated this year’s World Health Day on food safety. As per the WHO, contaminated food can cause more than 200 diseases - and foodborne and waterborne diseases that cause diarrhoea are estimated to kill 2 million people each year worldwide. Food safety, nutrition and food security are inextricably linked. Unsafe food can lead to various health problems like dairrhoeal disease, viral disease, reproductive and developmental problems and even cancers. According to Dr Poonam Khetrapal Singh, Regional Director, World Health Organization, South-East Asia Region, “Foodborne illnesses are usually either infectious or toxic in nature. These illnesses may occur through the consumption of food or water contaminated by bacteria, viruses, parasites or chemical substances. Foodborne pathogens such as Salmonella, Escherichia coli, or Campylobacter can cause severe illnesses or even death. Chemical contamination can lead to acute poisoning or long-term diseases such as cancer. Examples of unsafe food include uncooked foods of animal origin, and fruits and vegetables contaminated with faeces and chemicals.” The WHO experts have enumerated five key points for safer food. These include cleanliness, keeping the raw and cooked food separate from other foods, cooking thoroughly especially meat, poultry, eggs and seafood at 70 degrees Celsius, keeping food at safe temperatures, using safe water and raw materials.

International News

Medtronic gets CE Mark for its Smallest Pacemaker

edtronic plc has announced that it has received CE Mark of the Micra Transcatheter Pacing System (TPS), one of the world’s smallest pacemakers According to a company release, at less than one-tenth the size of traditional pacemakers, the Micra device provides the most advanced pacing technology available while being cosmetically invisible and small enough to be delivered with minimally invasive techniques through a catheter, and implanted directly into the heart. Micra do not have lead wires and is implanted into the heart through a catheter. Eliminating leads is a good thing for patients, since lead migration and the potential need for extraction can lead to complications. “Unlike traditional pacemakers, the Micra TPS does not require leads or a surgical ‘pocket’ under the skin, so potential sources of complications are eliminated - as are any visible signs of the device,” said Philippe Ritter, MD, cardiologist at Hôpital Cardiologique de Haut Lévêque and Centre Hospitalier Universitaire (CHU) Bordeaux. The device was awarded CE Mark based on results from the first 60 patients (at three months) in the Medtronic Micra TPS Global Clinical Trial. The trial is ongoing and will continue to evaluate the safety and efficacy of the device through a single-arm, multi-centre study that will enroll up to 780 patients at approximately 50 centres in 20 countries. Initial results from the Micra TPS Global Clinical Trial will be revealed for the first time at a late-breaking clinical trials session at the Heart Rhythm Society’s 2015 Annual Scientific Sessions in May. “Our cross-functional teams have been working for years to redefine engineering limits and production capabilities by radically reducing the size of medical devices by more than 90 per cent while continuing to innovate upon the existing technology,” said Brian Urke, vice president and general manager of the Cardiac Rhythm and Heart Failure’s Brady business, which is part of the Cardiac and Vascular Group at Medtronic. “We believe our investment in this research is transforming cardiac care and will provide more and better therapy options to patients.”

Lima to Acquire Unicompartmental and Total Knee Products of Zimmer

immer Holdings unicompartmental and total knee products within European market to be acquired by Lima Corporate, an Italy-based company. The deal between both the companies will be effective one on the completion of merger between Zimmer and Biomet. According to John Flannery, President and CEO of GE Healthcare, the product will be marketed in Tier-II and Tier-III cities in India and also be exported to many other counties in South East Asia. Under the signed agreement, Lima will acquire Zimmer Unicompartmental High FLex Knee (ZUK) and Biomet Discovery Elbow System to sell within the European Economic Area (EEA) and Switzerland markets.

may / 2015 may / 2015 ehealth.eletsonline.com ehealth.eletsonline.com

Philips Unveils CareSage - New Predictive Analytics Engine

R According to Luigi Ferrari, CEO Lima Corporate with the launch of Physica, the acquisition of ZUK puts the company as a serious player in the knee market. Focussing on their historical markets, the EEA and Switzerland markets fit best to their strategy. As per media reports the deal will allow Lima to receive the non-exclusive rights for the manufacturing, marketing and sale of an exact copy of the vanguard Knee in the EEA.

oyal Philips has launched a new predictive analytics engine CareSage to help health systems to support population health management. CareSage will offer analysis of real-time and historical data from healthcare providers and Philips Lifeline, to proactively identify patients to reduce avoidable hospitalisations. Developed based on Philips HealthSuite Digital Platform - an open could-based platform - helps to secure collection and analysis of health and lifestyle data from multiple sources and devices. According to company release, CareSage uses Philips Lifeline’s AutoAlert technology and wealth of aging and health data to focus on senior patients when they return home after a hospital visit or home healthcare period.

International News

St. Jude Medical Plan to Acquire Spinal Modulation for US$ 215 Million

t. Jude Medical has announced that it has exercised the company’s exclusive option to acquire Spinal Modulation, Inc., developer of the Axium Neurostimulator System. After making an investment of US$ 40 million on June 13, the Minnesota device maker is paying US$ 175 million up front with a possibility of additional payments to acquire the company based in Menlo Park, California. Once complete, the acquisition of Spinal Modulation, Inc. will further support St. Jude Medical’s mission to help physicians tailor treatment to a patient’s chronic pain condition to achieve superior outcomes. Stimulation of the dorsal root ganglion (DRG) with the Axium system has been shown to provide meaningful relief for patients battling chronic pain, and is especially useful for treating focal pain areas often

challenging to treat using traditional spinal cord stimulation (SCS), according to a company news release. “Physicians need a range of options to effectively treat chronic pain, and our acquisition of Spinal Modulation is part of our ongoing commitment to providing physicians new and innovative therapy options,” said Michael T. Rousseau, Chief Operating Officer of St. Jude Medical. “Dorsal root ganglion stimulation with the Axium system is highly complementary to our current chronic pain product portfolio, and acquiring this technology will further our ability to partner with physicians to reduce the burden of

US Food and Drug Administration Approves Biotronik’s Implantable Cardiovascular Defibrillator

iotronik, a cardiovascular medical technology has obtained approval from the US Food and Drug Administration (FDA) for its Implantable Cardiovascular Defibrillator (ICD). It can deliver ultra-high energy on the first shock. Biotronik’s Inventra DX is the only system that can provide ultra-high energy on the first shock, offering better protection to patients. The firm has also received approval from FDA for its Itrevia DX system, a less invasive therapy with an algorithm that can identify successful pain-free therapies for each patient and dynamically re-apply them as required. According to Marlou Janssen, President, Biotronik the physician experts in the field of electrophysiology have indicated that meaningful therapeutic innovations available in Itrevia and Inventra ICDs such as high energy options, DX systems and CLS make it easier for physicians to tailor therapy and improve the quality of life for their patients. As per media reports the complete Itrevia family, including Itrevia VR-T, Itrevia DR-T, and Itrevia HF-T were approved together.

chronic pain.” “St. Jude Medical has a legacy of bringing new, innovative therapy options to patients suffering from chronic pain, and we believe adding DRG stimulation to their chronic pain portfolio will have a number of benefits to patients worldwide,” said David Wood, President and Chief Executive Officer of Spinal Modulation. “We’re proud of what the Spinal Modulation team has built over the past 10 years, and see great potential for St. Jude Medical to continue expanding access to DRG stimulation therapy for patients who may benefit from additional therapeutic options.”

Foxconn Ventures into Healthcare Market

ontract electronics company Foxconn to venture into the healthcare market by teaming up with US medical device companies. According to media reports, the company is in talks with Varian Medical Systems to obtain the rights to sell radiation-treatment devices in china. This comes after Foxconn acquired an undisclosed stake in Sotera Wireless Inc., last year. As a part of the agreement, Foxconn will make sensors and batteries used in Sotera’s medical devices, and has become the United States company’s exclusive sales agent in China. The company has diversified over the past years by venturing into new areas including telecom services, mobile software and e-commerce. Its expansion into the medical devices market comes as it searches for new growth engines and clients amid rising competition in consumer electronics assembly. Apple Inc, which accounts for about half of Foxconn’s revenue, has been diversifying its suppliers to assemble its iPhones and iPads in recent years.

may / 2015 ehealth.eletsonline.com

Hospital News

Institute for Musculoskeletal Problems Launched

ax Super Speciality Hospital, Saket has launched a specialised institute for all musculoskeletal problems – Max Institute of Musculoskeletal Sciences (MIMS). The institute aims to identify, resolve and provide expertise for all muscular and skeletal issues under one roof. The Institute will comprise of 70 beds and will provide dedicated end to end medical services for all musculoskeletal problems of people ranging from minor pains or injuries to the extremities impacting regular movement. MIMS will also undertake research in musculoskeletal disorders and will promote disease prevention through evidence-based interventions. Dr. S.K.S Marya, Chairman and Chief Surgeon, Max Institute of Musculoskeletal Sciences said, “In India, the most worrying issue is the patient’s attitude towards musculoskeletal problems. By 2040 India would have 274 per cent more people in the age group of 64 and above and hence the requirement for joint reconstructions would also be higher. They usually come at a debilitating stage and try to postpone a joint reconstruction to the last stage possible. As compared to 2013, we witnessed an increase of approximately 25 per cent in the number of patients reporting with musculoskeletal problems in 2014 and expect a further increase of approximately another 25 per cent in 2015 as well. The need of the hour is to identify the factors responsible and create strategies at state and national level to address them”.

may / 2015 ehealth.eletsonline.com

Indian Spinal Injuries Centre Launches Department for Arthroscopy & Orthopedic Sports Medicine

ndian Spinal Injuries Centre (ISIC) has launched a Department of Arthroscopy & Orthopedic Sports Medicine to diagnose, treat and manage injuries and joint problems of the patients effectively. This will help in early rehabilitation of the sports person with coordination between the surgeon, physiotherapist and the sports trainer. Arthroscopy is a super specialty division of Orthopedics. Arthroscopic surgery also commonly known as the “key hole surgery” involves a minimally invasive procedure a pencil sized camera and sophisticated instruments are introduced with small incisions to diagnose and treat problems of joints with very high accuracy. Arthroscopic procedures are performed on knee, shoulder, ankle, elbow, wrist, hip joints and small joints of foot and hand, and are very useful for treating sports injuries, as well as various joint problems affecting the common man at all stages of life. “In India, there is a glaring paucity of advanced sports medicine facilities. This is why we see most of our professional sportspersons head to foreign shores for treatment and rehabilitation. A lot of our athletes who cannot afford to travel abroad are often left without adequate support with shortened careers. One of the prime objectives of establishing a dedicated sports medicine facility is to fill this void. We want to help sportspersons from across the country get back to their field with the best of help,” says Dr.H.S.Chhabra, Medical Director & Chief of Spine Services The ISIC’s Orthopedic Sports Medicine provides a wholesome and comprehensive treatment modality from treatment to rehabilitation to management to help the athlete return to active life. The Centre has a team of five Sports Medicine Consultants, who are internationally trained and super-specialise in treating specific joints of the body. No other hospital has such a huge team dedicated to only Sports injuries. The department has dedicated Senior Sports physiotherapists, and facilities such as the largest solar heated hydrotherapy pool in India, and bio-mechanical analysis of sportspersons.

Global Hospital Spreads Chain to Tanzania

lobal hospitals spread across Hyderabad, Chennai, Bangalore and Mumbai has introduced a 125-bedded multi-speciality hospital in Zanzibar, a semi-autonomous region in Tanzania. The hospital is opened in association with Turkey’s Group of Companies. According to a company release the hospital facility is known as Tasakhtaa Hospitals, an associate of Global Hospitals India is located at Stone Town in Zanzibar. The hospital will provide primary and secondary care services, with some level of tertiary care, and will also focus on promoting health and wellbeing of the citizens while preventing outbreak of diseases.

Company News

Practo Acquires Fitness App Fitho

he doctor search engine Practo Technologies Private Limited has acquired Fitho Wellness – a digital fitness solution app for an undisclosed sum. Practo is all set to expand its services into the preventive healthcare space by the year end. The founders of Fitho, Dhruv and Prachi Gupta will join Practo, with Dhruv taking on the role of Product Head for Preventive and Prachi taking on the role of GM Operations, New Segments. Practo also acquires the proprietary algorithm and recommendation engine which automatically suggests custom diets and exercise regimes to users based on their lifestyle, fitness requirements and food preferences. “It is the next step in our mission to make a single health app which offers consumers a more comprehensive solution ranging from preventive to curative healthcare.” said Shashank ND, Founder & CEO, Practo. Dhruv Gupta Founder & CEO, FitHo says, “We’re really excited to join Practo and integrate our technology and expertise with Practo’s offerings.” Photo Caption: (L-R) Dhruv Gupta, Founder & CEO, FitHo and Shashank ND Founder & CEO, Practo.

HealthKartPlus is Now ‘1mg’

dit Batra, currently CEO and President of Merck Millipore, has been appointed to lead the combined life science business of Merck Millipore and Sigma-Aldrich once the acquisition of Sigma-Aldrich has been successfully completed. The planned US$ 17 billion transaction remains subject to customary closing conditions and regulatory approvals, which the company expects to have completed in mid-2015. Until then, Merck Millipore and Sigma-Aldrich will continue to operate as separate companies with Udit Batra and Rakesh Sachdev, President and CEO of SigmaAldrich, running both organisations independently. Rakesh Sachdev will serve in an advisory capacity, as needed, to ensure a smooth transition. Karl-Ludwig Kley, Chairman of the Executive Board of Merck said, “The appointment marks another important step in the acquisition of SigmaAldrich as it provides stable and strong leadership and continued customer focus during the crucial months of integration planning and beyond.”

Merck Appoints Udit Batra to Head Combined Life Science Business

dit Batra, currently CEO and President of Merck Millipore, has been appointed to lead the combined life science business of Merck Millipore and Sigma-Aldrich once the acquisition of SigmaAldrich has been successfully completed. The planned US$ 17 billion transaction remains subject to customary closing conditions and regulatory approvals, which the company expects to have completed in mid-2015. Until then, Merck Millipore and Sigma-Aldrich will continue to operate as separate companies with Udit Batra and Rakesh Sachdev, President and CEO of Sigma-Aldrich, running both organisations independently. Rakesh Sachdev will serve in an advisory capacity, as needed, to ensure a smooth transition. Karl-Ludwig Kley, Chairman of the Executive Board of Merck said, “The appointment marks another important step in the acquisition of Sigma-Aldrich as it provides stable and strong leadership and continued customer focus during the crucial months of integration planning and beyond.”

may / 2015 may / 2015 ehealth.eletsonline.com ehealth.eletsonline.com

Company News

MAX Healthcare, Deakin University to Collaborate for Health Data

Carestream Earns Highest Rating for DRX-Revolution Mobile Systems and Room-Based DRX Systems

C D

eakin University in partnership with Max Healthcare will be working on data analytics for healthcare. The project aims to develop predictive model to enhance healthcare management. Both have signed a Memorandum of Understanding (MoU) to operationalise this collaboration. Both partners are bringing ‘big data’ to work for medicine with its huge records of patient history – with data on admissions, diagnosis and outcomes, spanning a huge inventory of images, computerised records and registries and the consequent untapped potential to identify critical safety issues, as well as service and clinical efficiencies. As part of the agreement, Max Healthcare and Deakin University will jointly address this pressing need by leveraging

verified techniques in data analytics to support clinical decisions. The outcomes are critically important from economic, patient safety and systems perspectives. The immediate project will focus on heart disease, specifically on patients with index admission (symptoms) of Acute Myocardial Infarction (AMI) or Stroke. A joint team will analyse the data, extract relevant features and build validated machine learning model for specific prediction task. The resultant model will be jointly held and shared by the teams at Deakin and Max healthcare as a prototype programme. Once successful, the model would be subsequently piloted at Max Healthcare on prospective cases over a period of one year and the predictive accuracy would be calculated and shared with Deakin team.

GE Launches India Designed CT Scanner

E Healthcare launched a new CT (Computer Tomography) scanner that is designed, developed and manufactured in India. The four-slice scanner is manufactured at GE’s facility at Whitefield in Bangalore. According to John Flannery, President and CEO of GE Healthcare, the product will be marketed in Tier-II and Tier-III cities in India and also be exported to many other counties in South East Asia. As per media reports manufacture 200 units per annum and scale it up to 1,000 units a year depending on the demand. At present, there are around 3,500 CT scanners used in Indian hospitals, which is about a fifth of China’s size.

arestream’s DRX-Revolution Mobile X-ray System and its DRX-Evolution and DRX-Ascend systems earned high marks from customers for system performance, reliability, installation and service repair quality in MD Buyline’s Market Intelligence Briefing (2015 Q1). The DRX-Revolution was the highest rated portable system and Carestream’s DRX room-based platform tied for the highest rating in the DR room category. MD Buyline reports for imaging systems are based on user satisfaction ratings in the following categories: system performance, reliability, installation/ implementation, applications training, service response time and service repair quality.

According to MD Buyline, the DRX-Revolution boasts a unique system design with a collapsible tube column, tube and line visualisation software, grid alingment, high KW power capasity, built-in caddies...and other progressive design features.” The report notes that many hospitals are adding Carestream’s small-format DRX 2530C cesium iodide detectors to meet the need for high-resolution imaging in the neonatal intensive care unit (NICU), as well as orthopaedic surgery and other applications. It also stated that “users praised Carestream’s customer service, troubleshooting and knowledgeable staff.”

may / 2015 ehealth.eletsonline.com

Pharma Buzz

Pharma Industry to Create 45,000 more Jobs in 2015

rowing pharma sector market, has opened the doors to job opportunities. In this year itself the industry expects to create 45,000 more jobs in the country. In response to this requirement Healthcare research institute IIHMR University has opened applications for MBA in Pharmaceutical Management. Dr. SD Gupta, President, IIHMR University said that, according to Mc Kinsey report - India Pharma 2015 – Unlocking the Potential of the Indian Pharmaceutical Market said that the Pharma industry has immense opportunities and has a projected market growth of US$ 24 billion by 2015 and US$

55 billion by 2020. Through discussions by the Pharma Industry experts it was evolved that Metro and Tier-I markets will make significant contributions to growth, driven by rapid urbanisation and greater economic development. The hospital segment will increase its share and influence, growing to 25 percent of the market in 2020. Various sectors that will be creating most of these jobs in the Pharmaceutical industry would be, sales, marketing, supply chain management, KPO, health and Insurance, medical value travel/tourism, corporate hospitals, contract manufacturing(CRAMS), consumer health care. The allied industries that will be creating jobs would be Banking (evaluating projects for loan - health and pharma related), state health sector, general insurance etc. The states that will benefit from this MBA programme would be Punjab, Karnataka, Madhya Pradesh, AP, Telangana, Gujarat, Maharashtra (Mumbai, Vdharbha) etc, he added. He also said that with these growing trends the industry is facing many challenges such as need for the best talent in the industry, rising customer expectations and restricted discovery and development process the growing need of 1500-2000 pharmaceutical management professionals will be required in both AP and Telangana.

Mankind Pharma Moves on ‘Make in India’ Path

ankind Pharma is all set to launch the API factory by this year to promote affordable drug manufacturing in India. The initiative will incur a huge investment in the pharma sector with a focus on Zero defect, Zero effect by making drug manufacturing affordable by 20-30 per cent. According to R C Juneja, Chairman and Founder, Mankind Pharma, the Government plans to make in India the third largest pharma market by 2020 with a rate of 20 per cent global export in generics. The company is coming up with an API centre in Rajasthan which will be functional by end of this year and will give boost to the pharma industry by manufacturing affordable drugs in the country. The company revealed that the Indian pharma industry of worth Rs 1.20 lakh crore has an API of about Rs 50,000 – Rs 55,000 crore. Out of 10,000 manufacturers, about 70 per cent are into drug formulation, and rest 30 percent are into manufacturing.

may / 2015 ehealth.eletsonline.com

Sun Pharma Teams Up with Israel University to Develop Oncology Drugs

un Pharmaceutical has collaborated with Israel’s Technion University, to develop anti-cancer drugs. Both have entered into a worldwide research and license agreement, as quoted in Sun Pharma’s official statement. “The Technion is delighted to partner with Sun Pharma to advance this project through preclinical development process. This collaboration is an excellent example of interactions between academic discovery and pharmaceutical companies demonstrating the valuable contribution academic institutions can make in bringing new products to help patients worldwide. We sincerely believe this agreement represents the beginning of a long and fruitful relationship between the Technion and Sun Pharma”, added Ciechanover and Binah. “This collaboration is part of the various initiatives that Sun Pharma is taking to enhance its specialty pipeline. Mutually beneficial partnerships with independent research institutes, especially world renowned institutes, such as the Technion, is our preferred route to bring to the market, innovative products for unmet medical needs” said Kirti Ganorkar, Senior Vice President, Business Development, Sun Pharma.

SUMMIT RAJASTHAN CONFERENCE & EXPO

May 2015, Jaipur

dig it

al L

ING

6th Annual

2015 KNOWLEDGE EXCHANGE, Higher Education

3rd