eHealth April 2016

eHealth Magazine

volume 11 / issue 04 / April 2016 / ` 75 / US $10 / ISSN 0973-8959

Technology would be a Game Changer in a manner as Healthcare services are addressed in India

Vice President & Co-owner, eClinicalWorks

Event Report Technology for Patient Delight

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

Issue 04

April 2016

EDITOR-IN-CHIEF: Dr Ravi Gupta EDITORIAL TEAM

HEALTH Managing Editor: Raghav Mittal Senior Assistant Editor: Nirmal Anshu Ranjan Assistant Editor: Kartik Sharma Senior Correspondent: Arpit Gupta SALES & MARKETING TEAM: eHealth

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Contents

April 2016 | VOLUME - 11 | ISSUE - 04

10 Cover Story - eClinicalWorks

12 Cover Story - EHR

EHR Chronicled Health Record At Fingertips While implementing an Electronic Health Record (EHR) solution will improve quality of care and patient safety, there are other compelling reasons for EHR implementation by Healthcare providers in India

16 Cover Story - LiveHealth

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Government

Corporate

Manoj Jhalani Joint Secretary (Policy) Ministry of Health & Family Welfare Government of India

Sunil Sharma Joint Secretary Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) Ministry of Health & Family Welfare Government of India

Lifetrenz EHR Helps Build Smart Hospitals

Vibhor Jain CEO Atlanta Healthcare

Michael Sullivan Vice President-Healthcare Solutions Schneider Electric

Dr Jitendar Kumar Sharma Head- Healthcare Technology Division & Director, WHO Centre for Medical Devices, National Health Systems Resource Center, Ministry of Health & Family Welfare Government of India

Dr Deepak Agrawal Chairman Computerisation All India Institute of Medical Sciences (AIIMS) New Delhi

Suresh Sarojani Chief Technology and Innovation Officer HCL Healthcare

Startups

Event Report

Technology for Patient Delight

Tracking Patients’ Medical Adherence in Real-Time 56 Keep Your Health Records Handy 57 eKincare - Easy Like Clicking a Selfie

news

49 50 51 52 53 54 8

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News Updates International News Hospital News Company News Pharma Buzz Product Launch

editorial

Trust Tech for Treatment No industry touches and influences human lives more than those involved in the domain of Healthcare. Prime Minister Narendra Modi on innumerable occasions has given voice to the phenomenon of slipping into poverty due to ailment in the family. As substantial efforts, like Swachh Bharat Mission, are being made by the government agencies to ensure a disease-free society by invoking the preventive aspect of healthcare, the therapeutic domain is also abuzz with action. The issues of Accountability, Quality and Expediency, which have been a challenge even with the best of the brands, are being addressed significantly by the pervasive use of technology. How Electronic Health Record (EHR) is gaining trust and reliability in an increasingly expensive healthcare regime has been dealt with at length in this issue. “Healthcare Leaders Forum”, organised by Elets Technomedia Pvt Ltd in Delhi last month, saw a galaxy of luminaries, especially the CIOs from the healthcare industry, coming on one common platform. The key takeaways from the day-long proceedings have also been featured in this issue, which covers in greater detail about the issues and challenges faced in deployment of IT across hospital divisions. The enterprise of healthcare is expanding its footprints catalysed by a wide variety of innovative products and services spearheaded by healthcare startups. This issue features a couple of them as well. It is our pleasure to inform you that the portal of eHEALTH magazine has been revamped with a new set of features for furthering engagement with our readers. I invite you to visit the same and make it a daily must-visit portal for getting the next and best trends in healthcare. You may like to send in your opinions, articles and viewpoints at eHEALTH Blogs available at http://ehealth.eletsonline. com/blogs. Your magazine is now available on eletsonline mobile app as well. You can download the same from Google Play Store or Apple Store, depending on the mobile platform you are using. Wish you a ‘healthier‘ month year ahead!

Dr Ravi Gupta ravi.gupta@elets.in

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Cover Story

eClinicalWorks

eClinicalWorks Offers Smarter, Faster Technology for Patient Care eClinicalWorks has implemented innovative solutions in various hospitals in India to offer high quality healthcare services through a robust technology backbone, write Sameer Bhat, Vice President & Co-owner and Aakash Shah, Director Sales India and International Market of eClinicalWorks, for Elets News Network (ENN)

ealthcare industry is experiencing a steady and stable transformation the world over, majorly with Information Technology playing a core role in every aspect of healthcare value chain ensuring faster adaptability of advanced technologies, reduction of service costs and provision of quality healthcare at affordable prices. Sameer Bhat, Vice President & Co-owner, eClinicalWorks says that the private sector will be the major driving force behind technology adoption in the Indian healthcare segment to optimise costs and effectively manage operations. IT solutions will become an integral part of process management, patient care and the management information system (MIS) in hospitals. The convergence of healthcare with upcoming technologies such as cloud computing and wireless technologies will play a key role in improving accessibility and meeting the challenge of manpower shortage. â&#x20AC;&#x153;The coming years are expected to witness greater deployment of tools such as telemedicine, Hospital Information Systems (HIS) / Hospital Management Information Systems (HMIS), online or Electronic Medical Records (EMR) etc.,â&#x20AC;? adds Bhat. The healthcare sector is poised to embrace cloud computing in a

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The healthcare sector is poised to embrace cloud computing in a big way in the coming decade. Cost-effective cloud-based solutions are expected to drive increased adoption of HMIS and EMR big way in the coming decade. Costeffective cloud-based solutions are expected to drive increased adoption of HMIS and EMR. The various benefits that can be derived, such as easy accessibility irrespective of geographical location, fewer errors, fast response in times of emergencies and patient convenience among

others will drive increased adoption. To drive improved efficiencies, more hospitals are likely to seek automation for their workforce management, administration, finance, billing, patient records and pharmacies. Another important area where IT has been a capable tool in healthcare

eClinicalWorks

institutions is in moderating costs while providing improved technology to tackle diseases including those related to lifestyle. Here, cloud platforms play an important role. eClinicalWorks has implemented innovative solutions in various hospitals in India to offer high quality healthcare services through a robust technology backbone.

Opportunities & challenges in India With recent initiatives in Digital India campaign as well as the smart phone boom during the past few years, the Indian healthcare sector is still lagging behind other areas in terms of technology adoption. This is exactly where we see opportunity. With the average age of people in India being 26, a large portion of the population is tech savvy and demanding smart services from the healthcare providers and, at the same time, physicians are looking for better technologies to provide more informed decisions for patients at the point of care.

eClinicalWorks strategy to penetrate Indian market “Our strategy for India is simple – to provide a technology at the point of care (for hospitals, clinics, diagnostic centres etc.) which is smarter,

faster and more convenient,” says Aakash Shah, Director Sales India and International Market, eClinicalWorks. “It would not be surprising anymore that when you visit your doctor or physician, you may find him using an iPad to note or store your medical records. Rapidly transforming medical technology and the availability of high-tech diagnostic and therapeutic equipment together with changing practice pattern of doctors has revolutionised the way health care is being delivered today,” Shah adds. The technology shift has cast itself over the field of healthcare, bringing with it a digital transformation in the way doctors and patients interact. The integration of information technology and network has now become the centre of the ‘new era’ where both, digital and human aspects, are pivotal to the complete patient experience. Today, patient care experiences are top of the mind in the healthcare industry across the globe. Healthcare technology solutions are able to modernise medical care, reduce costs, avoid redundant or duplicate tests / procedures and mechanise manual processes.

Cover Story

Rapidly transforming medical technology and the availability of high-tech diagnostic and therapeutic equipment, together with, changing practice pattern of doctors has revolutionised the way health care is being delivered today Aakash Shah, DirectorSales, India and International Market – eClinicalWorks

About eClinicalWorks eClinicalWorks is a privately-held leader in healthcare IT solutions. The company has more than 4,300 team members worldwide, with Indian presence at Ahmedabad, Mumbai and Bangalore and 1,15,000 doctors using its solutions, customers include physician practices, hospitals, health centers, departments of health, accountable care organisations and convenient care clinics. 12 eClinicalWorks customers have received the prestigious HIMSS Davies Awards during the past seven years, honouring excellence in Electronic Health Record implementation. For More Details Log on to: www.eclinicalworks.com or Call on +91-9108525536

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Cover Story

EHR

EHR – Health Record on Fingertips Implementation of Electronic Health Record (EHR) solution has the potential to improve the quality of care and patient safety, but that’s not all; there are numerous other compelling reasons for EHR adoption by the healthcare providers, writes Arpit Gupta of Elets News Network (ENN)

lectronic Health Record or EHR can be defined as the aggregate, standardscompliant electronic record of health-related information of an individual. It is created and gathered cumulatively across more than one healthcare outlet and is managed and consulted by licensed clinicians and staff involved in the individual’s health and care. It is interoperable and can be shared across authorised care givers. It was in August 2013 that the Ministry of Health & Family Welfare, Government of India (MoH&FW) approved the Healthcare IT and EHR standards for India, placing the country amongst the few countries in the world that boast of approved EHR standards. Subsequently, in March 2015, MoH&FW announced the intent to set up a regulatory body for digital healthcare delivery in India — National eHealth Authority (NeHA), with powers to ensure adoption of approved EHR standards by healthcare organisations. Both are important milestones and acknowledge the Government’s serious intent to ensure adoption of EHR

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technology by providers, which will contribute to enhancing care quality and patient safety, among other objectives.

multifold, both for the patient as well as the organisation (hospital / Clinic/ heath centers) that implements it.

EHR Vs EMR

For care on the go

An EHR is very different from an EMR (Electronic Medical Record), although the terms are often used interchangeably, which leads to confusion. The key differentiators could be that an EMR may not be compliant to any standards — though there are EMRs that comply with certain standards, all EMRs are not standardscompliant, whereas an EHR has to be standards-compliant — and is created, gathered and managed by staff from a single healthcare organisation, and is not interoperable with other care givers. Both from a patient’s health needs perspective, and from care quality and safety angle, EHRs are the right choice and they contribute immensely to a healthcare organisation’s ability to deliver safer and better services. Adoption of EHRs is a natural progression for any organisation that would like to be ahead of the competitive curve. The benefits of EHRs are

Dr Shuchin Bajaj, Founder Director, Cygnus Medicare, says, “India today has a floating population, which means a person may be born in Patna, gets educated in Delhi, does his Masters in Pune and settles down in Bangalore for his first job, and couple of years later moves to Mumbai for better prospects. With EHR this person can continue having a nomadic lifestyle but have his health records digitally secured and available at his fingertips in any emergency situation. The EHR will also help the doctor or the hospital in faster turnaround time to start treatment thus saving the time and effort in getting historical investigation and case papers prepared.” Overall the health industry and

EHR

the Government are moving towards implementing EHR on a very big scale in the near future. “For prevention, diagnosis and treatment of adult diseases, many a time a specialist has to be consulted. Specialists in Internal Medicine, who are commonly referred to as Internists, are often called upon to act as consultants to other physicians to help solve puzzling diagnostic problems. Hence, in such cases EHR gives a complete historical perspective to the Internist, who could be sitting in another corner of the world, as EHR helps in making him available the all-crucial data and suggesting the line treatment,” Dr Bajaj adds.

Adaptability challenge Traditional solutions are still practised and managed at mom-and-pop clinics and hospitals, as patient loyalty, especially with the older generation, has mostly been with their family doctors for all generic ailments and consultancy. This mindset of both doctors and patients has to change. Fortunately, this practice is now changing with the next generation, which is open to the idea of change and looks forward to specialist and best treatments. EHR not only requires a defined process but also disciplined implementation practice: one may buy the most expensive Mercedes, but if we don’t have anyone who can drive it, it’s a wasted investment. “Hence, the biggest challenge we see is data being captured in a structured format across different geographic and in real time over the years, which means it has to be followed as a standard practice irrespective of people, practice or locations.” Also, technology is drastically changing on a day-to-day basis, so creating an EHR system that is adaptable across newer technology solutions that are quicker and faster is a challenge. The system cannot be redundant and has a short lifespan and has to last an entire life cycle of a generation, according to Dr Bajaj.

Besides, while 4G last mile connectivity would be required to implement this in remotest of remote places, India as a developing country has its limitations when it comes to lastmile connectivity.

Playing it safe Digital/electronic health records are the way forward in India but the major problem is with maintaining proper records: patients usually don’t keep their proper health records, and because of that their follow-up treatment sometimes becomes an issue. Duplication of medicines also happens because of keeping improper record. Maintaining proper EHRs will ensure that such slips don’t occur. Not only private but some of the Delhi Government hospitals are also going the EHR way, which is a positive move. Dr Rohan Khandelwal Breast Onco-Surgeon, W Pratiksha Hospital says, “EHRs are very useful in managing all ailments, especially breast cancer. Our patients remain under monitoring for long durations and proper health records help in better care. Earlier, I used to maintain the records of my breast cancer patients in a self-designed special book, but these days I have started using the EHR platform at W Pratiksha Hospital, and it is extremely user friendly.” Despite EHR, doctors still like to write their prescriptions and integrating hand-written notes with EHR is a major challenge. Another problem faced by doctors is that operative and examination diagrams cannot be made on EHR and these have to be separately uploaded. “Also, it feels impersonal to be typing during the clinical encounters. I am aware of some incidents, where patients have given a negative feedback regarding this issue.”

Cover Story

IT’s omnipresent Explaining how has IT as a part of medical infrastructure evolved in the country over the past two decades, Ashok Jain, Founder, Lifespan says, “It is fast becoming an integral part of medical infrastructure. It is becoming central to healthcare and its influence is being felt most in hospitals, chain of clinics, diagnostic Labs, etc. Every aspect of medical and healthcare is getting automated for patient’s delight. Basic things, like appointments, billings are a no-brainers, but printed advice (having the proverbial doctor’s bad handwriting on prescriptions), Electronic Medical Records, follow-up consultations through Video/ Tele/ Email/Apps, remote diagnosis and patient feedback system, among others, keep patient-doctor connected.” Major challenges faced by hospitals or chains of clinics in adoption of IT are adoption of automation by medical personnel, availability of good software, making software and medical teams work in tandem, required investments and hassles of filing IT returns, and adoption by patients. “Lifespan Chain of Clinics (33 clinics) is highly automated. From a call center to appointments, from visits to prescriptions, from diagnosis to Electronic Medical Records, from Web to a Mobile app — everything is automated, IT-enabled and connected. We have spent over Rs.2 crore+ on this. There is no other way – IT is the future,” Jain concludes.

Shift in trend Today, better-informed consumer need more control over the care they want, where they receive it, and how much they are prepared to pay for it. The trend is moving away from institutionalised care in hospitals to community-based care at a lower cost.

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Cover Story

EHR

As people live longer, clinical initiatives are moving from focussing on single-illness episodes towards strategies that embrace the needs of people with a number of associated chronic diseases. The aim is to strengthen the individual’s capacity to self manage their care and to develop flexible systems that are organised and financed around their needs. Healthier citizens generally cost less. Effective care in the community demands digitisation of information as well as interoperability between software solutions, so that individuals and care-providers are connected to a responsive healthcare ecosystem. Each care-provider needs to be aware of what the others have done or will be doing to minimise duplication of effort and the possibility that vital issues will be overlooked.

home medications through an initial nursing assessment in the EHR can greatly improve patient safety. Dr Archana B, Founder & Principal Consultant, Health Corniche, opines, “Everyone who needs to know should have access to the information necessary to ensure that people lead long, healthy and productive lives. The reality is that the cost of healthcare in the world’s major economies is growing at an unsustainable rate. Many healthcare organisations are largely dependent on the desperate IT systems currently installed and many are still burdened with archaic processes. As a result,

Elertronic Health Records ensure that all clinical documentation is done without any ambiguity and captures important data, such as allergies, clinical findings, diagnosis, procedures, Med, Lab/ Radiology orders etc EHRs also help improve quality of care through easier preventive care, point-of-care enhanced clinical decision support, clinical alerts, reminders and medical information leading to improved provider decision making, rapid and remote access to patient information, easier chronic disease management, integration of evidencebased clinical guidelines, sharing of information between care providers etc, resulting in better continuity of care and saving time.

Ambiguity given a go-by Electronic records also ensure that all clinical documentation is done without any ambiguity and captures important data, such as allergies, clinical findings, diagnosis, procedures, Med, Lab/ Radiology orders etc. Capturing all known allergies of a patient with possible reactions and also known

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medical errors arise, operational costs increase and the quality of care compromised.” Interoperability of healthcare IT systems, both within and beyond traditional care locations, and the progression towards collaborative care is key to improving the quality, efficiency and safety of care while ensuring the security of information exchange. Clinicians and individuals should be empowered to provide faster, insightful and more accurate diagnosis and deliver quicker treatment decisions supported by evidence-based information.

EHR on Cloud Evolution of Cloud-based EHR is happening at rapid pace. Dr Archana further says, “We can expect major part of healthcare services to move on to Cloud and this will enable healthcare

provider to offer cost-effective and efficient healthcare services. Hospitals use Cloud-based EHRs to store pathology and other diagnostic reports, maintain and store patient records/ billing/claims, integrate third-party or local applications and connect all stakeholders, including patient.” Most healthcare providing organisations face interoperability challenges. Often they deploy multiple applications within a best-of-thebreed environment that do not easily communicate with each other, even though conforming to messaging standards. The disruption or absence of timely information flow between care providers and departments impacts negatively patient treatment as well as health outcomes, and ultimately increases the cost of treatment. This problem is compounded when otherwise unconnected institutions and/or GPS seek to share information. Wing Commander (Retd) C K Babu, Chief Operating Officer, dWise Healthcare IT Solutions, observes, “An EHR with an integrated good Clinical D e c i s i o n S u p p o r t System (CDSS) will enhance patient safety manifold. There are tangible ROI on an EHR implementation, in terms of lower cost of healthcare delivery, plugging revenue losses due to unbilled clinical services, reduction in clinical errors and medico legal cases, continuous care quality improvement, improvements in operational efficiency, increased patient satisfaction and customer retention, etc., to name a few.” Hence, use of EHR platform addresses the interoperability challenge by providing an easy-to-use platform that enables software solutions to share information when needed and in the required form, ensuring seamless integration.

Cover Story

LiveHealth

LiveHealth Delivers Medical Records Ensuring Patient Safety LiveHealth is a platform that delivers medical records to your mobile, connects you with your health providers and helps you better understand your medical records, write Abhimanyu Bhosle, CEO & Co-Founder and Mukund Malani, CTO & Co-Founder, for Elets News Network (ENN)

nhancing patient care has been the primary focus in the adoption of technology by healthcare providers. Patient’s information and medical record is a vital documentation for communicating the patient’s condition across the healthcare ecosystem and organising their care. Electronic Health Record of patient has become an important aspect in this information workflow, and using Information Technology results in improving quality and efficiency of patient care. LiveHealth introduced the technology at the right point in the healthcare ecosystem. It provides EMR solution to healthcare providers, specifically to diagnostic centres and laboratories to create and manage their patients’ information and medical records and to deliver them to patients and their connected healthcare providers as an EHR on a smart phone. Thus, ensuring accuracy in the digitisation of patient’s medical records at the first place and creating an approachable communication system around these medical records. Prevention of medical errors is a challenge while ensuring patient safety. LiveHealth ensures best performance guarantee and accuracy with seamless interfacing of medical instruments at the diagnostic centres and auto validation of test results. Besides eliminating manual errors, interfacing improves TAT.

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Mukund Malani, CTO & Co-Founder and Abhimanyu Bhosle, CEO & Co-Founder, LiveHealth

LiveHealth provides an EMR solution to the diagnostic centres and laboratories, using which doctors and lab technicians can create and maintain their patients’ medical records in customisable formats for lifetime Quality of testing is one of the cornerstones in the diagnostic process and eventually in the quality of patient care. We, at LiveHealth, understand that and our quality control module enables the diagnostic centres to quantify and measure the quality of their testing. Digital technology – smart phones, tablets, and web-enabled devices have transformed our daily lives and the way we communicate. When we go to buy a car, they can pull up our

entire credit report. But if we go to a hospital emergency room, they can’t see our medical records. With EHRs, our health information is available whenever and wherever it is needed. That’s why we need an EHR, so that the healthcare professionals can provide us better healthcare based on our complete medical information. Increased interoperability between EHR systems and patients’ mobile devices enable digital doctorpatient engagement and telehealth

LiveHealth

technologies. This would be an asset for promoting health and wellness and managing chronic illnesses. EMRs help the providers to track the data, identify patients who are due for preventive care and monitor certain trends & patterns in the patient health. Thus improving the overall quality of care delivered to the patient. LiveHealth provides an EMR solution to the diagnostic centres and laboratories where the doctors and lab technicians can create and maintain their patients’ medical records in customisable formats for lifetime. Doctors can view, get notified and approve reports from anywhere via mobile app. LiveHealth also provides a EHR solution where different labs can instantly deliver patients’ medical records, which can be accessed by the patients and their healthcare providers via smart phones in a easy and seamless way. Labs can promote health packages, send health tips and newsletters and engage with their patients. LiveHealth enables the patients to book appointments, pay online and receive their lab reports as soon as they are processed. All this happens on a single secure cloud platform.

Cover Story

Today, over 85 per cent of patients associated with 200+ LiveHealth powered diagnostic centres have preferred to access their health information electronically. To date, LiveHealth has catered 6.1 million diagnostic reports (monthly 1.5 million) to around 3 lakh patients and their 30,000 Doctors The medical reports delivered to the patients on LiveHealth platform are easy to read and have the reference ranges for test results displayed in an effective manner. Also, the biggest difference between normal reports and ours is that we enable doctors and pathologists to give a conclusion or diagnosis, which is usually not present in normal reports. Patients can upload and store their existing digitised medical records on LiveHealth and access them via mobile. In the long run this helps them identify trends and patterns in their health. Today, over 85 per cent of patients associated with 200+ LiveHealth powered diagnostic centres have preferred to access their health

information electronically. Till date, LiveHealth has catered 6.1 million diagnostic reports (monthly 1.5 million) to around 3 lakh patients and their 30,000 Doctors. With EHRs, patient’s health information is available at one place. So this may reduce time and cost on unnecessary or duplicate medical tests. EHRs enable enhanced communication between the healthcare providers around the patient’s health records improving overall efficiency of patient care. Providers spend considerable amount of time doing paperwork tasks such as filling forms, processing billing requests, creating reports. EHRs can help them streamline these tasks, significantly decreasing costs and increasing practice efficiency.

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Interview

Paperless & Cashless Healthcare Ecosystem Manoj Jhalani, Joint Secretary (Policy), Ministry of Health & Family Welfare, Government of India, in an interaction with Arpit Gupta of Elets News Network (ENN) lays emphasis on promotion and adoption of Electronic Health Records (EHR) as it provides timely and improved quality of care to the patients avoiding any kind of duplication and saves cost. He also throws light on various other IT initiatives undertaken by the Government

he role of information technology in healthcare is vast therefore the Government has been working tirelessly since last two years to create an ecosystem which is paperless and cashless, and works electronically to offer services anytime anywhere. With the increasing penetration of mobile phones, the Health Department has introduced many mobile applications for the ease of citizens. Mother and Child Tracking System (MCTS): We have introduced an application Mother and Child Tracking System (MCTS) – a webenabled name based system to monitor and ensure delivery of full spectrum of services to all pregnant women and children. More than 16 crore pregnant women and children have been registered in the system since its inception and the database is constantly growing day after another. Kilkari: We have also developed another application called Kilkari, which means a baby’s gurgle. It provides health advice through voice messages over mobile phones to pregnant women and mothers, according to the stage of pregnancy or

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age of the newborn child. Every week the pregnant women or the mother of an infant receives an audio message from one of the specialist doctors depending upon the stage of pregnancy or the age of the infant. We are also planning to take up a large scale screening of citizens above 30 years age for Non-communicable diseases (NCDs), hypertension, diabetes and common cancer like oral cancers to create a database. Thereafter, we will create a system for follow ups for continuing care which will be reflected in EHR. Electronic Health Records provide timely and improved quality of care to the patients avoiding any kind of duplication. It will also ensure privacy and security of patients’ data. With the permission of patients, the data can be transferred and transmitted to the doctors across facilities. The Central Government has notified EHR standards and big work is going on in metadata and data standards. It would facilitate and help create applications which will be able to talk to each other. That apart, applications are also being developed in EHR having different facilities. The Government has initiated

Manoj Jhalani, Joint Secretary (Policy), Ministry of Health & Family Welfare, GoI

NIKSHAY – a web based solution for monitoring of TB patients, Integrated Disease Surveillance Programme (IDSP) to detect and respond to disease outbreaks quickly, Drug And Vaccine Distribution and Management Systems which is being implemented across 24 states, Hospital Management Systems, Telemedicine programmes and Teleradiology for facilitating radiodiagnostics, Teleopthalmology etc. e-RaktKosh: We have launched a national application on blood bank called e-RaktKosh which captures all the data of blood banks in public and private sector. We are trying to integrate all the technologies into this application so that people can use it on their mobile and access the availability of blood of required blood group and different kind of blood resource. We have a wide array of applications both with the Central Government and the state governments, and it touches the population anywhere between few lakh to 20 crores. But the major problem is that those hundreds of application have still not been integrated into the process workflow. This issue needs to be addressed at the earliest.

Interview

Creating the Regulatory Framework for eHealth The Ministry of Health & Family Welfare is seriously looking at bringing Electronic Health Record (EHR) system in the country to build a right kind of ecosystem in healthcare, says Sunil Sharma, Joint Secretary, Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), Government of India, in an interaction with Arpit Gupta of Elets News Network (ENN)

Sunil Sharma, Joint Secretary Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), Ministry of Health & Family Welfare, Government of India

n 2010, the Organisation for Economic Corporation Development (OECD) had identified four core objectives of ICT implementation in healthcare in a survey (a) to increase the quality and efficiency of care (b) to reduce the cost of clinical services (c) to reduce administrative cost of running healthcare system, and (d) to introduce entirely new models of healthcare delivery

The Ministry of Health and Family Welfare has undertaken a lot of eHealth initiatives aligning them with Digital India programme, along with

the aforesaid objectives. On eHealth front, the Government of India is working on creation of eHealth records. This is going to be one of the major emphasis areas. Of course the task is quite challenging as the records are currently not available in electronic form. The health and medical records are kept fragmented and also a bit of it is in manual form. Mobile Apps: We have launched a large number of mobile apps to encourage good and healthy living, to educate and inform people how to have cleanliness and avoid spread of diseases, and also to help them know about the common symptoms of diseases and seek advice required that time. For public health system in India, we have taken several initiatives including Mother and Child Care system. A lot of healthcare provisions have been made under this scheme to deal with the entire pregnancy lifecycle. National eHealth Portal: The Government has launched a national health portal in which all these applications and a lot more information would be available for people. On a whole, preventive and promotive aspects of health are addressed out there. Telemedicine: We are also focusing on Telemedicine in which the focus is to deliver healthcare in the remote areas where doctors are not available. Patients can seek specialty input and

consultation using this facility. The gain is not just in the form of expert opinion with respect to the particular case of the patient but also with respect to the doctor sitting in the district hospital itself. It is a professional learning for him. It has two fold advantages. NeHA: Having health records in electronic format needs regulation. The very idea behind National eHealth Authority (NeHA) was to provide the same as well as to promote electronic health records as well. Some actions have already been taken for this purpose. A draft has been prepared in this regard and national consultation is being sought with the Central Government and all stakeholders including state governments. Electronic Health Record (EHR) standards have been notified in 2013 by the Government of India. It would certainly provide help in continuity of care and also much better help to the common people who have to avail the health services. EHR is available electronically and is interoperable across hospitals and may be across countries. The Ministry is very seriously looking and considering how to bring electronic health record system in the country. The need of the hour is to build an ecosystem which is collaborative encompassing all stakeholders and players covering the multiple dimensions of healthcare.

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Corporate

Lifetrenz EHR Helps Build Smart Hospitals Three years back dWiseHealthcare launched its ‘Lifetrenz EHR Platform’ for the Indian Market, and in this short period has been recognised as the most promising Healthcare IT platform in the country, say top company officials, in an interaction with Elets News Network (ENN)

WiseHealthcare, started its foray in Healthcare IT back in 2011 with a ‘HIS & EHR’ product that was launched in the US market. Their product in the US market was certified by ONC for both hospitals and ambulatory (primary care) for ‘meaningful use’ Stage 1 in 2011 and Stage 2 in 2013, and was the only Indian product to achieve all these certifications in the US back in 2013. The product was well received in the US market and the clientele grew to 20 hospitals on the platform, before it was acquired in January 2015 by a leading Healthcare IT player in the US. Three years back dWise launched its ‘Lifetrenz EHR Platform’ for the Indian Market, and in this short period has been recognised as the most promising Healthcare IT platform in the country. “On our EHR platform we have signed up clients of varying sizes,

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from 15 bedded hospital to 1,200 bedded hospital, and this shows the adaptability of our platform for very small to very large hospitals. With NABH accreditation becoming mandatory for hospitals to be able to service various government insurance schemes, hospital scan no longer depend on traditional HIS systems and it is becoming necessary for Hospitals to move to EHR systems. This need has been further compounded with IRDA also considering mandating NABH accreditation for Hospitals to be able to service even private insurance policies. This makes it mandatory, for providers wanting to service patients covered by health insurance, to get themselves NABH accredited. NABH on their part has come up with ‘Pre-accreditation Entry level’ standards (which are different from full accreditation) to enable small & medium hospitals to get

accredited,” says Wing Commander C K Babu (Retd) who is the Chief Operating Officer at dWise Healthcare. He continues, “Hospitals can take help of NABH consultants for their initial assessment and get their accreditation the first time. However when it’s time for reassessment of their accreditation, it becomes unaffordable to bring in a fleet of consultants to help them with the renewal due to budget constraints and that’s where the EHR comes in, capturing all the data elements automatically and providing hospitals the necessary dashboards and metrics to measure compliance to various standards & objective elements.” Dr. Pramod Jacob, the Chief Medical Officer of ‘dWise Healthcare’ is an aluminous of CMC Vellore, and after practicing in India for few years, did his MS in Medical Informatics in the US and worked for EPIC in the USA, the largest Healthcare IT company in the world, and was part of EPIC’s first hospital in-patient rollout. He says, “The biggest challenge dWise faced when we wanted to enter the Indian market with an EHR platform was the lack of a good ‘Drug Information Framework and Knowledgebase’ for the Indian market, like the ones available in the US, without which you cannot build a ‘Clinical Decision Support System (CDSS)’, which is an essential part of a good EHR Platform. We had to take it on ourselves to build a ‘Drug Framework’ and ‘CDSS Engine’ based on Indian Pharmacopeia and we are proud to say that we have built the first and only

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one of its kind product, covering more than 110,000 packaged drugs sold in this country and growing, and it’s on this strong foundation that our EHR platform resides”. “Hospitals are challenged with rising operational cost year on year, and profitability going to South. A simple comparison with the automobile industry will tell you that when a ‘Maruti 800 Car’ cost Rs 56,000, an ‘open heart surgery’ cost Rs 1,50,000. Today when the cheapest car costs Rs 3,00,000, an open heart surgery costs Rs 75,000,” says Mr. Biswas, Chief Marketing Officer at dWise Healthcare. Biswas Continues, “More and more hospitals today realise that attempting to reduce their operations cost further down to remain profitable will not work, as the operational costsof Indian Healthcare providers are the lowest in the world already. Rather they have to innovate and use technology and other means to get smarter to increase their revenue and improve profitability. One of the areas they have to re-look is the way they use technology today. Is the HIS software they use today smart enough to make their hospital a smart hospital? Does the current HIS comply with the ‘HIT & EHR’ standards published by the Government of India? Will it help them bring in new customers and improve Patient Engagement & Patient Safety concerns that they are trying to address? Will it automatically ensure no service ever goes unbilled & plug revenue leaks?” Sandeep Raizada, CTO at dWise Healthcare says, “Some people use the terms Electronic Medical Record’ and ‘Electronic Health Record’ (or ‘EMR’ and ‘EHR’) interchangeably. But they are not the same, the difference between the two terms is actually quite significant. The EMR term came along first, and indeed, early EMRs were ‘medical’. They were for use by clinicians mostly for diagnosis and treatment. In contrast, ‘health’ relates to ‘the condition of being sound in body, mind, or spirit; especially freedom from physical disease or pain,

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the general condition of the body.’ The word ‘health’ covers a lot more territory than the word ‘medical’ and EHRs go a lot further than EMRs. EHR by definition and design is about health record of a Patient across their lifetime and across multiple providers/Hospitals. ‘Continuity of Care’ and ‘Longitudinal Care Record’ are cornerstones of its design and the big differentiator is standards compliance and portability of patients’ Health Records electronically.” Sandeep continues, “A case in point is in the US, a legislation by the name ‘Meaningful Use of IT in Healthcare’, had to be passed for software vendors to move from EMR to EHR way back in 2009. What does the name of the Bill

and measure operational efficiency.” Sreejith P, Head of Product Development at dWise Healthcare says, “The Lifetrenz EHR platform has been built keeping total cost of ownership for our Indian customers in mind. We have carefully chosen the technology stacks to ensure our customers don’t need to pay for any licenses for RDBMS or Desktop OS etc. Our end user applications work on Ubuntu, Windows or Mac desktops apart from Android or IOS tablets. Our architecture provides hospitals the option to subscribe to a Multitenant Cloud Platform or Private Cloud platform or even opt for an onpremise installation based on their budget and needs.”

With NABH accreditation becoming mandatory for hospitals to be able to service various government insurance schemes, hospital scan no longer depend on traditional HIS systems and it is becoming necessary for Hospitals to move to EHR systems itself imply? It implies that ‘the EMR was not a case of meaningful use of IT in Healthcare’ and a legislation was required to force them to change.” “Smart Hospitals can’t limit themselves with using IT only in their non-clinical functions. They need to implement standards compliant EHR Systems to ensure that their clinical workflows are also IT-enabled. An integrated ‘HIS with EHR’ will ensure that cross departmental workflows are enabled, and disparate departments of a hospitals work together as one revenue generating engine,” says Ramesh Sharma, Chief Strategy Officer at dWise Healthcare. He further says, “EHR enabled clinical workflows will ensure that no clinical service rendered ever goes unbilled, and will plug revenue leakages in hospitals. With cross departmental workflows, the discharge process in a hospital can be reduced to just 15 Minutes, one of the ways to increase patient satisfaction

“The Lifetrenz EHR platform have enabled all our customers to improve operational efficiency both on their clinical and non-clinical workflows, reduce costs, and reduce clinical errors. The EHR platform has allowed our customers to be better engaged with their patients and experience improved patient satisfaction. Our Hospital customers have also been able to drastically reduce their capex on setting up the hospital. We have been extremely sensitive to the fact that most hospital projects experience budget and cost overruns by the time they are ready to go operational and we have supported them with very innovative financial models to work with us.” concludes Joseph Alexander, CEO of dWise Healthcare. For more information on ‘dWise’ and their ‘Lifetrenz’ suite of Healthcare IT products, please log on to www. lifetrenz.com

Interview

Technology Changes Healthcare Delivery, Once And For All Innovations in healthcare industry, such as Healthcare ATM and Teleradiology are happening and these technological interventions have completely transformed the traditional pattern of healthcare delivery, says Dr Jitendar Kumar Sharma, Head- Healthcare Technology Division & Director, WHO Centre for Medical Devices, National Health Systems Resource Center, Ministry of Health & Family Welfare, Government of India, in an interaction with Souvik Goswami of Elets News Network (ENN) Give us an overview of the National Health Systems Resource Center (NHSRC) under the Union Ministry of Health & Family Welfare, Government of India. Every country has got three broad categories of institutions under the Ministry of Health. First kind of institutions deal with planning & research, second category of institutions deal with programme support & implementation and the third category of institutions deal with training & capacity building. Many a times these roles do overlap. NHSRC is a technical support institution for policy development and implementation support under the National Health Mission for the Ministry of Health & Family Welfare, Government of India.

What are the main functions of the Healthcare Technology Division in NHSRC? Healthcare Technology Division at NHSRC is Worldâ&#x20AC;&#x2122;s fourth and South East Asiaâ&#x20AC;&#x2122;s only WHO recognised center for medical technology. Hence while it works for Ministry of Health & Family Welfare, we quite often share our reports with the WHO on aspects pertaining to medical devices and healthcare technologies.

The Healthcare Technology Division has five broad functions. Firstly, Health Technology Division supports in formulation of specifications for devices procured under National Health Mission. We believe that the rational specification leads to better competitiveness thus improving cost effectiveness in procurement without compromising quality and safety. Secondly, we support state governments in implementing comprehensive equipment maintenance and life cycle management. Thirdly, the division of healthcare technology supports in design & implementation for providing for technology intensive services. Fourth function is support in policy formulation on issues such as duty correction, trade impact assessment etc.

Dr Jitendar Kumar Sharma, Head- Healthcare Technology Division & Director, WHO Centre for Medical Devices, National Health Systems Resource Center, Ministry of Health & Family Welfare, Government of India

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Fifth, strengthening infrastructure and health system under which we provide technical support for setting up of medical devices testing laboratories, medical devices manufacturing parks. To elaborate with an example, India did not have a single dedicated medical devices testing lab. We developed technical reports on how to go about it and subsequent to Government’s approval, four labs are now under development. But the golden line is that globally there was no reference document available on how to develop a medical devices testing laboratory. The reports developed by Healthcare Technology Division are now on website of WHO as a global reference document. We also conceptualised that reduction in medical device manufacturing costs could be achieved if government can make capital investment on common manufacturing facilities and now, these are being implemented.

You are also working as an Advisor (Health & Medical Technology) to the Chief Minister of Andhra Pradesh, where country’s first Medical Technology Manufacturing Park is coming up. In the era of Make in India and Startup India, how much significance does this initiative carry? Let us first look at why the medical device manufacturing industry did not pick up in India earlier. The reason is that the medical device manufacturing requires certain high investment facilities which are too capital intensive for individual manufactures to invest upon. But if the Government could provide for high capital intensive facilities, the cost of manufacturing will reduce as manufacturers will not need to spend for the capital intensive common facilities. With this in mind, we conceptualized the idea of a medical devices manufacturing park in

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Vishakhapatnam in which common manufacturing facilities will be provided by the government under PPP model of the central government departments. These facilities can be used by the manufacturers on user fee basis. Besides, upto 150 manufacturing units would be created with built up area of approximately 1 acre to be given on 99 years lease. Apart from this, showrooms, industry R&D centers, incubation centers, rapid prototyping centers, electromagnetic interference testing laboratory and other such facilities wouldl be built, so that manufacturers could use these at affordable costs. According to estimates, `10,000 crores worth of medical equipment could take place in any such park. This will be Asia’s first medical device manufacturing zone with

played by technology in providing quality healthcare services and building health infrastructure in a country like India? There are already few states in India, where every single x-ray machine is now teleradiologically linked. It means that the service provider provides for image capturing, digitisation, transmission and reporting and the cost is less than a dollar per x-ray. Other one is Healthcare ATM. In this, a multi para monitor is attached in the primary healthcare centre, where there is no doctor. It takes all the vital signs of the patient and transmits it via GSM as SMS without requiring internet to a doctor sitting at remote location. Medicines are prescribed for common ailments which are dispensed at

The reports developed by Healthcare Technology Division are now on website of WHO as a global reference document common testing and manufacturing facilities. We are hopeful that park will be ready to use by 2017.

Throw some light on ‘National Healthcare Innovation Portal’. The Health Technology division of NHSRC is also supporting the Ministry in the process of identification, assessment and uptake of innovative health technologies. The process of innovation uptake is facilitated through ‘National Healthcare Innovation Portal,’ which can be accessed at www.nhinp.org. Innovators can use this platform to upload necessary details of the innovative technologies which could have a positive impact on health. The assessment of technologies includes assessment of efficacy, risk, cost, legal and social aspects concerned with technologies.

How important role will be

the particular primary health care center through a vending machine. The Health ATM is being piloted in Himachal Pradesh, Odisha, Andhra Pradesh, Uttar Pradesh and Madhya Pradesh. All these innovations are technology intensive and have tried to solve a given problem in a nonorthodox manner. The important part will be how we can harness the Public Private Partnerships. The partnership with the private sector needs equipoise to ensure that public health capacities are complimented and not substituted. Harnessing modern technology will be key driver for the health sector to move forward.

The views expressed in the article are personal views and do not necessarily reflect the views of any organisation or government with which the individual is affiliated to.

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Atlanta Healthcare Air Purifiers Cut Pollution Down to 0.1 Micron Atlanta Healthcare is providing sustainable, economical and at the same time cutting edge solutions to the problem of air pollution. With wide variety of air quality solutions on offer, ranging from air purifiers to breathing pollution masks, we hope to be able to help people breathe pure and lead healthy lives, both indoors and outdoors, says Vibhor Jain, CEO, Atlanta Healthcare in an interaction with Elets News Network (ENN)

ir pollution has been a significant concern in India for more than a decade. It’s just that it never got the right attention. One of the key reasons for the same is that on occasions the health impact of air pollution is long term and therefore people tend to ignore the short term symptoms. On the other hand, the aggregate impact of air pollution on health is quite visible with increased cases of asthma, bronchial diseases and extreme ailments including fatigue, lower fertility, cancer and heart diseases in India, and one of the many causes for this is worsening air quality. In our assessment public awareness and education has to be the basic building block to handle this epidemic. In this context, over last 7 years Atlanta Healthcare has focused a lot on consumer awareness and education across segments. From making people aware of professional hazards linked to quality of air they breathe, to educating mothers, kids and other segments on causes and it’s remedial; Atlanta Healthcare’s endeavor is to help everyone breathe pure air. While various initiatives to curb air pollution get executed, Atlanta Healthcare in parallel is offering effective products in the form of Air purifiers and pollution masks to not only help the impacted segment

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breathe pure and stay health but also save millions of kids and new born from bronchial diseases. Atlanta Healthcare developed iClusterTM Technology (Intelligent + multi-stage synchronised filtration Technology), which focuses on eradicating various pollutants present in Indian environment. A single filtration technology cannot eradicate all pollutants and therefore for effective purification, multiple filtration technologies need to work in tandem. Atlanta Healthcare air purifiers are being deployed at homes, offices, restaurants, hotels, bars, hospitals, IVF centres, currency chest, data centres and a host of other applications. Atlanta Healthcare air purifier’s use iClusterTM technology which includes a series of filtration technologies working in tandem from HEPA, ULPA, activated carbon, molecular sieve, PCO, cold catalyst, to UV, Ionizer and ESP. This provides an end-to-end solution for improving indoor air quality. Further from a particulate size standpoint, our air purifiers provide purification up to 0.1 micron depending on the product. Atlanta Healthcare is in active consultations with Governments and municipal authorities to help work out implementation plan to curb air pollution. Our recent collaboration with UK based Cambridge Mask Co. to offer

Vibhor Jain CEO, Atlanta Healthcare

military grade pollution masks is testimony to our concern over air pollution and provide best products to our customers. Atlanta Healthcare Cambridge masks blend the best of British technology and aesthetic elements. The family friendly N99 certified antipollution masks use filters developed by the British Ministry of Defence to filter bacteria, viruses, gases and small pollution particles such as PM2.5. These masks have 3-layer filtration with primary filter layer and three-ply micro particulate filter, and Military grade carbon filter to provide a complete solution in totality.

Interview

IT Gives AIIMS Greater Transparency, Accountability All India Institute of Medical Sciences (AIIMS) has very mature IT systems in place with full featured EMR, HIS, stores, billing and PACS across the campus, says Dr Deepak Agrawal, Chairman, Computerisation, AIIMS New Delhi, in an interview with Arpit Gupta of Elets News Network (ENN) How IT as a part of medical infrastructure has evolved in the country over the past two decades? IT has revolutionised healthcare delivery across the globe and particularly in public sector hospitals. India can similarly harness the power of IT to dramatically improve the quality of services provided by the government run hospitals. AIIMS has been at the forefront of this technology enablement and has been able to fine-tune its processes to better serve the 3 million patients who visit this institution every year

What are the IT investments made by AIIMS in the initial years? The initial investment was on hardware and on the local IT team which has paid handsomely over the medium to long term.

Do you see a shift in perception among users (non-medical and medical) viz-avis IT applications in healthcare? There has been a dramatic shift in the acceptability of using IT among all classes of users in the healthcare sector and I believe that this change

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is due to the rise of social media like Facebook as well as smartphones which has made people use IT as an integral part of their daily lives.

How does AIIMS use IT to scale up healthcare? We have used IT to revamp our workflows and processes so that the system is more transparent and accountable to the common man. AIIMS is the only hospital in India to have an online appointment system that is accessed by lakhs of people from across the globe every year.

What drives innovation? Is it strategy or the availability of a specific technology? I believe leadership and a conducive ecosystem are essential to drive innovation.

How does AIIMS use IT to ensure common patient experience across all branches? AIIMS has very mature IT systems in place with full featured EMR, HIS, stores, billing and PACS across the campus. In addition innovative IT solutions like online appointment system have been designed in-house.

How do you see the future of IT driven hospitals in India? India is still at a nascent stage in implementing IT in healthcare and the future is extremely bright due to availability of IT resources, interest of all shareholders and absence of legacy systems in majority of hospitals in India.

Dr Deepak Agrawal Chairman, Computerisation, AIIMS New Delhi

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Schneider Electric Plans Big Investments in Health Sector Smart cities will have smart healthcare system, and to make healthcare system smart, we have to have smart hospitals, says Michael Sullivan, Vice President, Healthcare Solutions, Schneider Electric, in an interview with Souvik Goswami of Elets News Network (ENN) Give an overview of the health vertical in Schneider Electric, especially keeping in mind the Indian healthcare scenario. Schneider Electric is providing intelligent integrated infrastructure to enable hospitals enhance their financial efficiency, patience experience and patience safety. Investment flow coming from private firms into the health sector and attracting medical tourism- these are the current trends in Indian market. We have to understand that even this market is growing, we have to be prepared in terms of maintaining standards and the attractiveness of what is being offered to grow that market.

What according to you can be the potential regions in India, where medical tourism can be promoted and nurtured? The tourism specific regions can be made as an attractive medical tourism destination. For example, I can mention Gujarat, Kerala and Southern states, Delhi, Rajasthan and Goa. These are coming up as an effective medical tourism destination. A lot of hospitals are being built in these regions mainly for two reasons - good infrastructure and tourism attraction.

How Schneider Electric develops solutions keeping in mind the needs of the customers

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Michael Sullivan, Vice President, Healthcare Solutions, Schneider Electric

in India and worldwide.? The majority of the new private

hospitals and some of the bigger and advanced government hospitals

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in India are not much different compared to the global scenario. We have to keep in mind the Indian scenario while providing solutions. In Schneider Electric, health vertical has been given immense importance and it is part of the 7 strategic verticals where investment has been done. It’s a 30 billion Euro company. We have set up a network of solution architects and dedicated key account managers, who are co-creating solutions with the customers, hospitals. These kinds of teams tries to understand the core processes and challenges of the hospitals in creating solutions and then all these are discussed in our global structured lab then. There we are able to test, validate and document those solutions and then those are shared worldwide with the global community. The innovations are happening with the customersIndian customers, customers in Gulf, Australian customers etc.

What are the focus areas for Schneider Electric’s healthcare vertical in India? Both the government and private hospitals are important for us. The energy efficient buildings can be the priority for the government hospitals. Private hospitals can be focused more on energy efficiency, as well as patient satisfaction and experience. That is why both the government and private hospitals are important for us as we provide both kinds of solutions. Nowadays, most of the hospitals are moving towards the technology driven process much like hotels where customer satisfaction carries importance.

What are the best global practices that can be incorporated in India scenario? The hospital rooms are generally 60-70 per cent occupied on average in a year. So, the 25-30 percent of the rooms, which are not occupied,

energy is being wasted. Either lights are on or some way other, energy being completely wasted in these unoccupied rooms. To get rid of this problem, we have come up with a solution by getting connected through the protocol HL seven through Hospital Admission Discharge Transfer System to detect when someone is coming in or when he is being transferred. It is connected through Building Management System. And by this, lights of a particular hospital room can be controlled. This is related to energy efficiency. On the other hand, we have created a mobile app that can be

embarked upon ambitious Smart City programme. What according to you will be the importance of Smart Health in Smart Cities? Smart cities will have smart healthcare system. To have smart healthcare ecosystem, we need to have smart hospitals. Schneider is making investments to develop smart hospitals world over, especially in the area of ITOT (Information Technology Operational Technology). We are making huge investments in bringing e-health connected all the way to intelligent infrastructure. Intelligent infrastructure makes the foundation of smart healthcare

Schneider Electric has been contributing to the concept of ‘Make in India’ of the Government for the last one decade. We have 31 plants, where we are not only manufacturing for India but also exporting outside used more by private hospitals which focus more on patient delight. A patient, who is coming for a day surgery, he/she can carry his own device and our application can help him/her to control the light in his room. With camera, he/she can also see which guests are in lobby to meet him or her, noise level can be checked and LED lighting of the room can be controlled. And it can be done just through a mobile app and simple use of technology. This can help reduce the stress of patient and also can enhance patient’s experience. But to make this happen, we have to be engaged with a particular hospital from its early days. Hospitals need to have a technological specialist like Schneider Electric in the preconcept phase of building a hospital to develop an intelligent integrated hospital.

The Government of India has

system. We think that the important part is connectivity in terms of creating smart cities and smart hospitals. To make smart hospitals, we need to bring in intelligence and connectivity.

Share with us Schneider Electric’s vision for India with regard to the health sector. India is growing fast and global leader in IT. A lot of innovations are going to happen here. It is very important for us to be here and to co create solutions with Indian customers. We are making big investments in health and can grow significantly in India. The government is also taking right steps in right direction. Schneider Electric has been contributing to the concept of ‘Make in India’ of the Government for the last one decade. We have 29 plants, where we are not only manufacturing for India but also exporting outside.

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HCL Healthcare Raises the Bar HCL Healthcare aims to create a new benchmark in primary healthcare in the country by making a positive impact on prevention and management of diseases, and raising the awareness levels of communities, says Suresh Sarojani, Chief Technology and Innovation Officer, HCL Healthcare, in an interview with Arpit Gupta of Elets News Network (ENN) How has been the journey of HCL Healthcare so far? HCL Healthcare has been founded to create a positive impact on people’s lives by shifting the focus from disease and treatment to prevention and wellness. Our aim is to create a world class health system by leveraging advances in diagnostics and information technology, and raising the overall standard of healthcare delivery in India in an outpatient setting.

We have completed two years in our business and have built six health centers in Delhi and NCR including one corporate health centre. We have our health centers in Gurgaon, Dwarka, Delhi and Noida. We have already seen more than 20,000 customers.

What facilities does HCL Healthcare offer? HCL Healthcare centers are designed as outpatient family care centers. We have 6 to 7 core specialties such as Internal medicine, gynaecology, dental, orthopedics, pulmonology, dermatology, ENT etc. We also have visiting doctors for many other specialties. Our proposition is that if a patient walks into our health centre, they should be able to get what they need to manage their conditions and also for long term disease management. We have tied up with Quest Diagnostics to perform lab tests. We have pharmacies in all our clinics. We also have imaging facilities such as ultrasound and x-ray. We have high end medical equipment to perform sleep study and assessments. We also offer a

range of customised health packages in all our centres. We focus on three aspects – clinical quality, service quality and patient engagement. We have received lot of good feedback where patients talk about less waiting time in HCL healthcare, doctors spending lot of time with patients and our staff doing regular follow up. Our Gurgaon centre has become the first multispecialty family health centre in North India to receive the NABH accreditation while other centres are in process of getting accredited. We provide seamless appointment facilities for our customers from our website www.hclhealthcare.in .

What is the role of technology in ensuring better healthcare? Today, everybody is talking about technology innovations in healthcare, which is great, but it is not just the technology which is needed, but the operationalisation of technology. There is no reason to talk about patient engagement, patient portal and mobile apps before having a good Electronic Medical Record system (EMR). We have invested on a comprehensive EMR system deployed in our private cloud. We are focusing on getting the foundation absolutely robust by having an institutionalised process for electronic medical records. We have enabled various clinical processes integrated right Suresh Sarojani Chief Technology and Innovation Officer, HCL Healthcare

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ASIA’S FIRST MONTHLY MAGAZINE ON e-GOVERNANCE

ASIA’S FIRST MONTHLY MAGAZINE ON THE ENTERpRISE OF HEALTHCARE

ASIA’S FIRST MONTHLY MAGAZINE ON ICT IN EduCATION

A quALITY MAGAZINE ON BANkING ANd FINANCE

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into EMR. We are institutionalised the usage of EMR across all stakeholders such as nursing staff, clinicians, general practitioners, fulltime doctors or visiting doctors. Deployment of electronic medical record helps us to deliver our promise of personalised patient engagement through patient portal and mobile application. Our patient portal and mobile applications are completely integrated with EMR. So, now patients can log in and check their medical records. They can print their personal health records (PHR) or carry it with them in mobile phone. They can track and update their allergies, conditions, medications right from the portal and mobile application, Patients can also message to our clinic staff. We are also launching tele-consult feature which is integrated with patient portal. Earlier, we have done this for our corporate customers and now we will now launch it for broader customer base for clinical follow up and consultations. Patients appreciate tele-consult because itâ&#x20AC;&#x2122;s a big convenience for them for regular follow-ups and to stay in touch with the clinicians. We are also packaging tele-consulting with our products like diabetes management

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HCL Healthcare has set up world-class family care centres in Gurgaon, Dwarka, Delhi and Noida.... Gurgaon centre has become the first multispecialty family health centre in North India to receive the NABH accreditation while others are in process and Healthy heart care packages. We are also deploying a highly personalised patient engagement and CRM platform where patient receives relevant health information and educational materials from their clinicians.

Brief us about EMR and integration progress in HCL Healthcare. In other countries like the US, mostly clinical leaders drive EMR implementation and clinical innovation projects, while in India, CIOs drive these projects. In our system, we have clinical leaders sponsoring the EMR project and driving the operations. The process should be designed such that the usage of EMR does not affect clinician productivity and empowers clinicians to provide better care for the patients.

We have integrated the system with laboratory so that lab results come directly to EMR. We have also integrated with drug decision support system to check drug â&#x20AC;&#x201C; allergies interactions. This increases patient safety as the system checks whether the prescribed drug has an interaction with patient reported allergies. We are building a culture where nurse coordinators support the doctors by asking patient about their medical history and allergies information. We work very closely with the hospitals in clinical ecosystem. We have signed MoUs with hospitals to provide continuity of care for our patients. Now that having a good EMR system, it becomes extremely easy for us connect with any hospitals and provide a seamless experience for our patients.

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Event Report

CONFERENCE | AWARDS | EXPO

Technology for Patient Delight

2 nd MARCH 2016, LE MERIDIEN HOTEL, NEW DELHI

Insights on Technology for Patient Delight

(L-R) Amitabh Nag, Jaikant Singh, Dilip Patil, Gyanesh Pandey, S K Panda and Manoj Jhalani release special edition of eHEALTH magazine at 6th Healthcare Leaders Forum in New Delhi

With the objective to discuss the growth and future of the IT in the healthcare sector in India, Elets Technomedia Pvt Ltd organised the 6th edition of its flagship Healthcare Leaders Forum in New Delhi. The deliberations happened in the one-day conference included challenges and advancements in the Indian healthcare sector and emerging technologies in the field of Hospital Information System, Patient Data Management, Security Services (data & infrastructure), Document & Imaging Solutions, Patient Record Management (Wrist Band Barcodes), Technology in advance Radiology. Joint Secretaries from Ministry of Health, Government of India, along with CIOs, CTOs, CEOs, IT heads of leading hospitals spanning across the entire healthcare fraternity and technology solution providers brainstormed about the future of healthcare in India. We hereby present important views of the key stakeholders shared at the forum. For accessing the detailed conversations held at this engaging forum you may visit http://ehealth.eletsonline.com/hlf

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Event Report

Inaugural Session

ICT-Enabled Healthcare - Technological Interventions for Public Health

The biggest public hospital in Delhi â&#x20AC;&#x201C; Safdarjung Hospital â&#x20AC;&#x201C; will be IT-enabled and completely paperless in next six months Gyanesh Pandey CMD, HSCC (India) Limited

With the increasing penetration of mobile phones, the Health Department has introduced many mobile applications for the ease of citizens, but they are not integrated into the process workflow. This issue needs to be addressed at the earliest Manoj Jhalani Joint Secretary, NHM (Policy), Ministry of Health & Family Welfare, Government of India

NSDC will provide fund for setting up training centres for health at the interest rate of 6 per cent per annum for 7 years

Dignitaries visit expo stalls

Jaikant Singh Head, Partnership & State Alliance, National Skill Development Corporation

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Event Report

CONFERENCE | AWARDS | EXPO

Technology for Patient Delight

2 nd MARCH 2016, LE MERIDIEN HOTEL, NEW DELHI

We need to have lots of training programmes and deployment mechanism to proliferate IT culture across villages and districts

Telemedicine is a boon for the rural population of India who do not have enough money to avail quality healthcare

Amitabh Nag Country Manager-Public Sector, HP Inc

S K Panda Director, DGS&D, Ministry of Commerce & Industry, Government of India

Corporate Presentation HP is moving from big paper to Big Data because it is the only way to drive healthcare in a manner where it becomes transparent with patients and doctors

Priyansh Bawa India Solution Manager, HP Inc

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We run countryâ&#x20AC;&#x2122;s biggest sperm bank to mitigate the problem of infertility, which is found in 15 per cent couples in the population of 1.2 billion

Dilip Patil Managing Partner, Trivector Biomed LLP

Event Report

CONFERENCE | AWARDS | EXPO

Technology for Patient Delight

2 nd MARCH 2016, LE MERIDIEN HOTEL, NEW DELHI

Session 2

Changing Dynamics of Hospital Management & Healthcare Delivery Session Moderator

With the help of IT, we have been able to revolutionise our service delivery, improve transparency and provide quality and cost-effective service to the common man

Deepak Agarwal Chairman, Computerisation & IT, AIIMS, New Delhi

Right technology used by the right set of people with the right attitude of workflow and process efficiency will enable healthcare delivery to be really effective, maximise and be the most delightful clinical outcomes Technology is beneficial for healthcare system for affordable, accessible and quality healthcare. It has reduced the cost of healthcare but a regulation is required to keep a tab on the legal aspects Dr Ajay Lekhi President, Delhi Medical Association

Arvind Sivaramakrishnan CIO, Apollo Hospitals, Chennai

Mobile phones can be used by doctors or consultants to capture information and support ASHA workers to provide better healthcare to people in rural areas

Veneeth Purushothaman CIO, Fortis Healthcare Limited, Gurgaon

april / 2016 ehealth.eletsonline.com

Event Report

With the implementation of technological innovations, we could increase the EBITA from 10 to 15 per cent and reduce the cost of packages for the patients

Prashant Singh CIO, BLK Super Specialty Hospital, New Delhi

Using HMS or HIS in a uniform way enable sharing patientsâ&#x20AC;&#x2122; records seamlessly from one platform to another. It also saves cost The Government is very clear about digitisation and hospitals can save a lot by putting their data on cloud Kapil Mehrotra Head-IT, Artemis Hospital, Gurgaon

Dr Shuchin Bajaj Director, Cygnus Hospitals, New Delhi

Corporate Presentation In India, doctors want to do things very fast. Our smart application eClinicalWorks enables them to chart all clinical notes of a patient in less than three minutes and it can be directly deployed on IOS or the Android tablets

Aakash Shah Director-Sales, National and International Market, eClinicalWorks

april / 2016 ehealth.eletsonline.com

Event Report

CONFERENCE | AWARDS | EXPO

Technology for Patient Delight

2 nd MARCH 2016, LE MERIDIEN HOTEL, NEW DELHI

Session 3

Technological Intervention in Hospitals Enabling Accurate Diagnosis & Judicious Medication Session Moderator

Machine to machine communication can improve the telemedicine, telehealth, ehealth solutions etc., as they can transmit data without human intervention using telecom network

Sushil Kumar Dy Director General, Telecommunication Engineering Center, Department of Telecommunication, Ministry of Communication & IT, GoI

Almost 40 per cent of patients are making online appointment through patientsâ&#x20AC;&#x2122; portal which enable them access to all clinical information, radiology reports etc

State governments can submit innovations happening in their respective states on National Health Innovation Portal and ask for funding from the Central Government for the upscale of those innovations in their annual budget which they take from the Centre Dr Jitendar Kumar Sharma Director, WHO Collaborating Centre for Priority Medical Devices & Health Technology Policy, National Health Systems Resource Centre, NHSRC, Ministry of Health & Family Welfare, Govt. of India

Ravi Shankar. S CTO, Kovai Medical Center and Hospital, Coimbatore

We can introduce technology to automate different healthcare processes which can ease the management of the healthcare institutes as well as the patientsâ&#x20AC;&#x2122; empathy

Shuvankar Pramanick CIO, Paras Hospital, Gurgaon

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Delegates and guests listen to the speakers

Event Report

With the help of technology, we have implemented ‘Smart OPD’, ‘Smart Laundry’, ‘Smart Docs’ etc kind of unique initiatives for patient delight

N K Ramakrishnan CIO, Sir Ganga Ram Hospital, New Delhi

For better patient care, we have implemented an integrated EMR system which starts with the doctor entering protocol in the system and it immediately goes to the nurse, pharmacy etc Jai Prakash Dwivedi CIO, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi

We promoted technology to benefit the patients by giving an opportunity to register their mobile number for OTP service from the hospital, and on the basis of OTP we give discount to the patients

Gunjan Kumar CIO & Head- New Initiatives, Regency Healthcare, Kanpur

The Government of India is working on creation of eHealth records. The very idea behind National eHealth Authority (NeHA) was to provide the same as well as to promote electronic health records. EHR standards have been notified in 2013 by the Government. It would certainly provide help in continuity of care and also much better help to the common people who have to avail the health services

Sunil Sharma Joint Secretary, Pradhan Mantri Swasthya Suraksha Yojana, Ministry of Health & Family Welfare, Government of India april / 2016 ehealth.eletsonline.com

Event Report

CONFERENCE | AWARDS | EXPO

Technology for Patient Delight

2 nd MARCH 2016, LE MERIDIEN HOTEL, NEW DELHI

Session 4

Technology Making Healthcare Accessible and Affordable to All Session Moderator

Technology will not as such improve the quality of healthcare until the system is in place on the ground. Primary, secondary and tertiary healthcare with functional linkages improve efficiency

Dr Rajiv K Jain Additional Chief Medical Director (Health & Family Welfare), Ministry of Railways, Government of India

Affordability and accessibility for people living in rural areas and urban slums are different from the Tier-II and Tier-III population. Technology cannot treat a patient, though it enables

Technology can bridge the gap among various components of healthcare infrastructure, human resources, like drugs, vaccine & pharmaceutical, IT etc., to provide affordable, equitable and accessible services to the patients Dr Sandeep Namdeo Mahatme District Collector, North Tripura

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

Technology is improving quality of healthcare without any doubt. eICU is a big help for the people of remote areas who are not able to reach hospital on time

Dr J Sivakumaran COO, Kovai Medical Center and Hospital, Coimbatore

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Earlier we had around 70 per cent cash patients and 30 per cent credit, and now it is 55 per cent credit. Most of the patients are coming under the net of various government schemes or any insurance company

Neeraj Lal Group COO, Sunshine Global Hospitals, Gujarat

Event Report

We are taking care of all aspects of IT infrastructure in our hospital that includes HIS, EMR, Feedback Management System, Integrated Child Health Record, and so on

Alok Khare Vice President- IT, Jaypee Hospital, Noida

Technology adoption should start with the operational and clinical members of the hospital to increase efficiency and to deliver effective healthcare at reduce cost to the masses Syed Kadam Murshed Head-IT, Medica Group of Hospitals, Kolkata

We have four basics in our hospital â&#x20AC;&#x201C; accessibility, affordability, quality and dignity. With the use of technology, we are trying to take our services to next level

Dr Sudhir Gupta Director, Cygnus Hospital, New Delhi

Awards

april / 2016 ehealth.eletsonline.com

News Updates

Govt Launches New e-Health, m-Health Initiatives on ‘World Health Day’

nion Minister of Health and Family Welfare J P Nadda has launched several new e-Health and m-Health initiatives to mark the World Health Day. Nadda launched the Ministry of Health and Family Welfare’s new Swastha Bharat mobile application for A to Z information on diseases, symptoms, treatment, health alerts and tips. He also launched ANMOL-ANM online tablet application for health workers, e-RaktKosh initiative and India Fights Dengue mobile application. This year, the Government’s main focus is on diabetes. Therefore, the theme of the World Health Day 2016 is “Scale up prevention, strengthen care and enhance surveillance”. “We need to focus on the youth and adolescents of the country in our efforts to prevent and combat lifestyles diseases such as diabetes,” stated J P Nadda speaking on the occasion of ‘World Health Day 2016’. He added that prevention and awareness about non-communicable diseases which are largely linked with our way of living, dietary habits, lack of exercise etc., will go a long way in ensuring that the country remains healthy. India can reap the benefits of its demographic dividend only when the youth of the country grow up to be healthy citizens, he stated. ANMOL is a tablet-based application that allows ANMs to enter and updated data for beneficiaries of their jurisdiction. This will ensure more prompt entry and updation of data as well as improve the data quality since the data will be entered ‘at source’ by providers of health services themselves. The Minister stated that since the application is Aadhaar-enabled, it will help in authentication of the records of field workers and beneficiaries. As part of this event the Health Minister also launched ‘e-RaktKosh initiative.’ It is an integrated blood bank management information system that has been conceptualised and developed after multiple consultations with all stakeholders. This web-

based mechanism interconnects all the blood banks of the State into a single network. The Integrated Blood Bank MIS refers the acquisition, validation, storage and circulation of various live data and information electronically regarding blood donation and transfusion service. Such system is able to assemble heterogeneous data into legible reports to support decision making from effective donor screening to optimal blood dissemination in the field. Nadda said, “This initiative will be of great use to persons and families in need of blood transfusion. The application will enable not only information of the nearest blood bank on a mobile but also of the availability of the particular blood group in a given radius.” Launching another mobile application ‘India Fights Dengue’, the Minister said that this application will find wide use. As the fight against vector borne diseases, especially dengue, can be won only with effective community participation, this app empowers the community members how to contribute towards prevention of dengue. The Health Minister also released the Guidelines for Dialysis Centre in a PPP Mode. He stated that soon every district in the country will have the facility of a Dialysis Centre operated under the PPP mode to leverage the potential of the private sector. These expanded facilities will help the renal disorder patients and reduce the out-of-pocket expenditure incurred on dialysis. At the event, Nadda also unveiled the findings of the ICMR India DIABetes (INDIAB) Study Phase I, along with WHO Global Report on Diabetes, WHO India Technical Report on Diabetes in India. “These will have a wealth of information to guide and fine-tune health policy,” said Nadda. He also informed that the Ministry, along with World Health Organisation (WHO), has taken the lead and developed a Multi-Sectoral Action Plan involving nearly 40 Ministries and Departments. He further added that we must continue efforts to make this Multi-Sectoral Action Plan a success. Shripad Yesso Naik, MoS (Health) stressed on the importance of awareness generation regarding non-communicable diseases. He stated that traditional systems of medicine within the AYUSH systems have the potential to prevent and treat many NCDs. He also stated that as part of the efforts to mainstream AYUSH in the country’s healthcare system, AYUSH Centers have been started in many AIIMS and AIIMS-like Institutions. Addressing the gathering, Jitendra Singh, MoS (DONER and PMO) highlighted the breaking down of the rural-urban divide in terms of dietary habits, lifestyle and prevalence of diseases patterns. He stated the increasing prevalence of diabetes among the younger population is a matter of grave concern. These thoughts were echoed by Henk Bekedam, WHO representative to India who noted that the trends in India map with the global trends where fast growing urbanisation is followed with a shift from communicable to non-communicable diseases.

April / 2016 ehealth.eletsonline.com

International News

Apple’s CareKit to Help People Monitor Their Health Better

pple announced CareKit, a new software framework designed to help developers enable people to actively manage their own medical conditions. iPhone apps using CareKit make it easier for individuals to keep track of care plans and monitor symptoms and medication; providing insights that help people better understand their own health. With the ability to share information with doctors, nurses or family members, CareKit apps help people take a more active role in their health. “We’re thrilled with the profound impact ResearchKit has already had on the pace and scale of conducting medical research, and have realized that many of the same principles could help with individual care,” said Jeff Williams, Apple’s chief operating officer. “We believe that giving individuals the tools to understand what is happening with their health is incredibly powerful, and apps designed using CareKit make this a reality by empowering people to take a more active role in their care.” CareKit will be released as an open source framework next month allowing the developer community to continue building on the first four modules designed by Apple, that include: • Care Card helps people track their individual care plans and action items, such as taking medication or completing physical therapy exercises. Activities can automatically be tracked and entered using sensors in Apple Watch® or iPhone; • Symptom and Measurement Tracker lets users easily record their symptoms and how they’re feeling, like monitoring temperature for possible infections or measuring pain or fatigue. Progress updates could include simple surveys, photos that capture the progression of a wound or activities calculated by using the iPhone’s accelerometer and gyroscope, like quantifying range of motion; • Insight Dashboard maps symptoms against the action items in the Care Card to easily show how treatments are working; and • Connect makes it easy for people to share information and communicate with doctors, care teams or family members about their health and any change in condition.

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“With ResearchKit, we quickly realized the power of mobile apps for running inexpensive, high-quality clinical studies with unprecedented reach,” said Ray Dorsey, MD, David M. Levy Professor of Neurology at the University of Rochester Medical Center. “We hope that CareKit will help us close the gap between our research findings and how we care for our Parkinson’s patients day-to-day. It’s opening up a whole new opportunity for the democratization of research and medicine.” Developers of health and wellness apps are excited to build these CareKit modules into apps for Parkinson’s patients, post-surgery progress, home health monitoring, diabetes management, mental health and maternal health. • Sage Bionetworks and the University of Rochester are using CareKit to turn the mPower ResearchKit™ study into a valuable tool to help better inform patients about their condition and care providers about treatment. • The Texas Medical Center is designing apps to guide and support care pathways for its 8 million patients to improve their health through enhanced connectivity

with their care teams. • Beth Israel Deaconess Medical Center will provide patients with more insight into their own chronic care management through home health monitoring devices that securely store data in HealthKit™. • One Drop is empowering people with a better approach to managing their diabetes. • Start, by Iodine, helps people on antidepressants understand if their medication is working for them or not, and helps their doctors deliver more informed care. • Glow, Inc. will incorporate CareKit modules into its pregnancy app, Glow Nurture, to guide women through a healthier pregnancy.

Hospital News

BLK Super Speciality Hospital first to install ECP in India

LK Super Speciality Hospital is the first hospital in India to introduce Extracorporeal Photopheresis (ECP). This is an advanced mode of therapy to treat patients with Graft Versus Host failures (GVHD) following transplants. Extracorporeal Photopheresis is an intensive procedure which involves the removal and collection of a portion of a patient’s blood cells mainly white blood cells (eglymphocytes). This therapy is highly used for treating patients with problems associated with cutaneous (skin) T-cell lymphoma (CTCL) such as mycosis fungoides (MF) or Sezary syndrome.

One of the most advanced technologies of its kind, ECP is a procedure in which blood is removed from the body and treated with ultraviolet light and drugs that become active when exposed to light, the blood then returned to the body. This offers a ray of hope for patients suffering from GVHD

(Chronic Graft-versus-Host disease) mainly involving the skin and gastro intestinal tract. ECP minimizes any kind of adverse effects on patient’s organs such as kidney, liver, heart, and lungs with the only reported incidence of side effects at less than 0.003%. ECP treatment does not take a heavy toll on the patient’s immune system but only helps in reducing and eliminating their needs of immune suppressive therapies. Department of Hemato-Oncology & Bone Marrow Transplantation at BLK Super Speciality Hospital, New Delhi has successfully completed over 500 transplants and introduces ECP for the first time for Indian patients.

Fortis Healthcare First in India to Monitor and Publish Clinical Outcomes for Cardiology

ortis Healthcare as part of its efforts to strengthen its core value of patient-centric health services became the first private Indian healthcare chain to monitor and publish clinical outcome data for major cardiology procedures, based on global norms specified by the International Consortium for Health Outcomes Measurement (ICHOM). These norms enable comparison with best in class results world-wide and allow hospitals to analyse and understand how they stack up globally on factors that determine clinical outcomes. Bhavdeep Singh, CEO, Fortis Healthcare Limited said, “We are committed to the delivery of value based medicine and in bringing about greater predictability in outcomes. Fortis has always pioneered initiatives that improve the quality of healthcare while making the system transparent and open. It further reinforces the measures we are taking to enhance medical care through evidence based protocols that will also provide patients a clear view of the medical options available and the results expected.” Based on the data, the Fortis Escorts Heart Institute has shown exemplary results and stands out among its peers in a number of areas that top the best available cardiac touchstones globally. Dr Ashok Seth, Chairman, Fortis Escorts Heart Institute said, “This is a huge step towards institutional accountability and doing the best for your patients. The analysis and audit of results in an internationally standardized manner helps us to

deliver the best practices in angioplasty and bypass surgery and provides a benchmark to know what we are doing well and what we can do better. It is also the litmus test in our patients about the openness we endeavor to maintain for patients to take informed decisions.” Fortis Escorts Heart Institute (FEHI) as part of the ICHOM Coronary Artery Disease Steering Committee became the first Asian hospital to implement the ICHOM Coronary Artery Disease Set for monitoring clinical quality, the incidence of postoperative complications (kidney failure, heart attack, wound infections) in patients undergoing Coronary Artery Bypass Graft (CABG) and Percutaneous Coronary Intervention (PCI). Dr Bishnu Panigrahi, Head-Medical Strategy and Operations Group, Fortis Healthcare Ltd said, “There is a lot of rigour in the process. Following the adoption of the ICHOM methodology, it takes nearly two to three years before stable data becomes available for analysis.”

April / 2016 ehealth.eletsonline.com

Company News

Essentra Acquires Pharmaceutical Assets of Bangalore-based Kamsri

ssentra, a leading global provider of specialist packaging and authentication solutions, has expanded its footprint and capabilities with the recent acquisition of the pharmaceutical assets of Kamsri Printing & Packaging Pvt. Ltd. based in Bangalore, India. Headquartered in the UK and listed on the FTSE 250, Essentra has c. 9,000 employees across 33 countries. The company, which has been present in India for 16 years, currently employs 170 people in Bangalore and through this acquisition will create an additional 120 local jobs. Essentra also has a successful joint venture with ITC in Filter Products, which includes a further two manufacturing facilities and 150 employees. PT Sreekumar, Managing Director – Asia for Essentra, said: “With its highly complementary product

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range, Kamsri provides us with an entry point into the attractive pharmaceutical and healthcare industries in India, thereby reinforcing our global packaging capabilities and enhancing the opportunities for our customers. Our Health & Personal Care Packaging business now has a manufacturing presence in North America, Europe and India, and ships our extensive range of innovative products to 75 countries worldwide.” The acquired cartons manufacturing assets which will incorporated into Essentra’s existing site which opened in late 2013, and accommodates manufacturing, warehousing and commercial infrastructure over 70,000 sq. ft. General Manager – Essentra India, Narayan, said: “Continued growth in the local market, and its increasing status as a high quality, competitive

manufacturing base, make India a key opportunity for the Essentra Group. The end-markets for our specialist components, such as healthcare and industrial products, are sizeable and well-established, with annual growth of up to 20%. Following the acquisition of Kamsri, our immediate focus will be adding their cartons capabilities to our existing tear tapes and securing solutions for packaging; however, we plan to further extend our specialist packaging range over the coming year.”

Pharma Buzz

Novartis Launches Drug for the Treatment of Moderate-to-Severe Psoriasis in India

ovartis Healthcare Private Limited (NHPL) announced the launch of Scapho (secukinumab) 150 mg, for the treatment of moderate-to-severe plaque psoriasis in adult patients. Scapho is an injectable medicine and the first interleukin-17A (IL-17A) inhibitor to be approved in India. This approval marks a significant milestone in the treatment of psoriasis, providing a new and important first-line biologic treatment option for patients who are candidates for systemic therapy. Secukinumab was developed for the treatment of moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy with a recommended dose of 300 mg. Secukinumab has demonstrated a statistically significant improvement in clearing psoriatic lesions as early as 3 weeks. “This is groundbreaking news as clear skin can now be a reality for patients struggling to cope with psoriasis,” said Dr Anchala Parthasaradhi, Director - Anchala Skin Institute – Hyderabad. “Most psoriasis patients are not content with current therapy options including the earlier biologics and there is a significant unmet need. Secukinumab seems to be a promising treatment for psoriasis and can provide patients a better chance of achieving clear or almost clear skin. Importantly this therapy comes as an alternative to treatments that have significant side effects,” she added. “At Novartis, our mission to discover new ways to improve and extend people’s lives underscores our values and we are very happy to launch Scapho in India for the treatment of moderate to severe psoriasis,” said Jawed Zia, Country President, Novartis India. “This signifies an important turning point in the treatment of psoriasis in India. Patients in India, can now benefit from this treatment as it has the proven ability to offer clear or almost clear skin,” Zia added. The key treatment goal for psoriasis patients is achieving clear skin. In clinical studies, 70 per cent or more patients on secukinumab 300 mg achieved clear skin (PASI 100) or almost clear skin (PASI 90), during the first 16 weeks of treatment and importantly, this was maintained with continued treatment in the majority of patients up to Week 523. Data from the Scapho clinical trial programme also showed a significant positive relationship between achieving clear to almost clear skin and psoriasis patients’ health-related quality of life.

april / 2016 ehealth.eletsonline.com

Product Launch

LAURA Smart - a Simple, Quick, Smart Solution for Urinalysis L

AURA Smart, recently introduced by Transasia BioMedicals Ltd., India’s Largest In-vitro Diagnostic Company, is the latest, compact urine strip reader. It’s objective photometric evaluation and semiautomated technology simplifies sample processing and provides accurate results. The compact size and easy operations of LAURA Smart make it an ideal choice for a clinical laboratory or for use by medical professionals of different specialties. A perfect choice for routine chemical urinalysis, LAURA Smart comes with the following features:

Two measuring modes Standard (60 sample/hr) & a special working mode Smart Timing that provides an elevated throughput of 240 samples/ hr. While in the standard mode one strip incubation is counted at a time, in the Smart Timing mode, four incubation periods are counted in parallel, enabling a four times higher throughput.

Quick and accurate quality check benefit • LAURA Smart performs a simple and fast automatic self-check and calibration at each start-up. • Special control strips and software enable a sophisticated quality control of the optical system. • The precision and accuracy of the reader and the strip can be verified simultaneously through quality checks using liquid controls such as URINORM or other third party liquid controls.

Strip type flexibility • In order to offer, full range of chemical urinalysis, LAURA Smart is compatible with different types of test strips for different parameters. The strips are automatically

April / 2016 ehealth.eletsonline.com

identified by the reader without the need for a manual setting. • The different strips used are DekaPHAN (10 parameters), TetraPHAN SG (4 parameters) and MicroabluPHAN Laura strips for Microalbumin & Creatinine ratio calculation

Effortless operations • Easy operation via touch screen • Simple maintenance • Portable mode using batteries LAURA Smart comes from the ERBA group entity, Erba Lachema that has 40 years of experience in the development and manufacture of urine analysers and strips.

Startup

Tracking Patients’ Medical Adherence in Real-Time Simplicity of use, technology penetration and common identification number for the patients are the major challenges in Electronic Health Records (EHR) implementation, say Kunal Kishore Dhawan, CEO, Gaurav Gupta and Shourjo Banerjee, Co-founders, Navia Life Care, in an interview with Arpit Gupta of Elets News Network (ENN) Brief us about Navia Life Care, it’s products and services. We believe ourselves to be an innovative health-tech company. We have started our journey by focusing on an important yet overlooked problem in the healthcare space in India - Medication Adherence. We are connecting multiple healthcare stakeholders to increase patient medication adherence. It is estimated that 22 per cent of patients don’t adhere to prescribed treatments, and 1 out of 5 hospitalisations in the US are a direct or indirect result of this. Our mobile app offering - Navia, is a personal treatment manager, which acts not only as a medicine reminder but an adherence tracking system for patients. Designed for patients, this app allows them to not only help them take their meds on time, but also keep track of their treatments, and their progress in the same. Connected to this, on the backend, is a dedicated dashboard for medical professionals, whether they are in hospitals, clinics or running their own practice. The dashboard allows them real-time access to their patients’ adherence records, medicine history etc. We are also providing compliance solutions to hospitals and pharmaceutical companies through which they can increase patient adherence, and thus increase drug

sales (for pharma companies) and improve patient engagement.

What are the major challenges in EHR implementation? Healthcare systems across the globe are complex, more so in India due to the diversity, along with an added factor of stark difference between the approach and quality of public and private players. One major challenge is simplicity of use because we have one of the poorest doctor to patient ratio in the world. We need technological solutions that are smart and simple to use at the doctor’s end. Second challenge is that technology penetration among smaller healthcare providers in urban and rural areas is very low. Healthcare providers are happy using manual systems and seem reluctant to move to technological solutions. Third challenge is that there isn’t a common identification number for the patients across platforms and a central repository that can securely collect data from various resources is missing. EHR and technological health solutions are very important as they are highly scalable, and thus capable to handle large patient data, extremely valuable from the Indian perspective. Additionally, in a country with such a fragmented health ecosystem, they

Kunal Kishore Dhawan CEO, Navia Life Care

have the capability to connect different stakeholders and make the lives of both patients and providers easier.

How do you see the evolution of EHR market in coming days? EHR market is evolving slowly and a slow growth is important for long term sustainability. A lot of capacity building is required and the stakeholders have to be educated, which shall take its time. Startups in this space will have to communicate with each other and create sustainable solutions keeping in mind the diversity of the market.

How far EHR has been able to penetrate in Tire 2 & Tire 3 cities? Early adopters to technology are metro cities in India. But bigger hospitals have adopted electronic tools in Tier 2 and Tier 3 cities as well. Big diagnostic laboratory chains have also adopted to electronic mean of data management in these cities. Patients have started using mobile apps for better health management across the country, agnostic to the city size. Tier 2 & Tier 3 cities are greenfield for technology companies. But getting doctors (or other medical professionals) in these cities/towns to adopt technologies will need a huge mindset change, and thus be a challenge.

april / 2016 ehealth.eletsonline.com

Startup

Keep Your Health Records Handy The Government should keep EHR at a highest priority and also make it compulsory for the healthcare service providers to transfer the patients’ health records under a common platform, which will be a boost for the country’s healthcare scenario, say Mayank Harlalka, Founder & CEO and Ashank Harlalka, Co-founder, Medical U I, in an interview with Arpit Gupta of Elets News Network (ENN) Brief us about Medical U I, it’s products and services. Medical U I aims to develop a complete digital infrastructure for both doctors and the patients. For doctors, we are creating a clinic management tool which enables them to concentrate more on the patients easily. Similarly, we also create a medical unique identity of the patient combining their country code and their phone no. which makes easier for the patient to retrieve their medical or health records easily in the future. Medical U I comprises a team of young and enthusiastic people working to make this possible. Another service which we have added to Medical U I is also based on the market research we have done. About 3/4th of people about to undergo a major surgery opt for a second opinion or third opinion. So, we are getting the best doctors in our panel so that the patient can easily go for the second or the third opinion.

What are the major challenges in EHR implementation? Well, there are many challenges which we need to cope up with this. The first being internet penetration. As per some sources, internet penetration is approximately 20 per cent in India which is much lesser than developed countries like US, Australia etc. The second challenge which we have come across is that the common people are not much aware about the

april / 2016 ehealth.eletsonline.com

usefulness of EHR. We have come across people having chronic or long term disease like cancer facing difficulties in maintaining their health records. The most shocking challenge which we think is the healthcare facility’s ideology. They are mostly unwilling to transfer the patient’s health record in a common platform. And we have also come across certain hospitals which charge as high as `500, just to store a patient’s health records on their server. EHR is undoubtedly very important in today’s scenario. It helps a person manage his/her lifetime medical records, which makes the diagnosis of the patient easier and accurate. This directly or indirectly improves the healthcare industry of India. EHR also helps patients avoid repeating the tests which makes them economically viable for them.

How do you see the evolution of EHR market in coming days? With the initiative of Digital India, it is evident that the healthcare industry would very soon be digitised. We can in fact see some organisations having EHR in their service, but that’s not their prime focus. It is just a small segment of their product/service. Many other individual healthcare facilities (diagnostic centers / hospitals) also provide EHR, but the major concern is the interoperability of the health

Mayank Harlalka Founder & CEO, Medical U I

information of an individual. If a patient goes to a hospital, it will give you the electronic record under its health portal. Similarly in another hospital, he will have to access through their health portal. The patients now have more than 10 different log-in to maintain their health records. This is the challenge that has to be evolved into a single platform where all health records of the patient will be available. It like a social security number. That’s where we step in with a prime focus on interoperable EHR management system. Through a platform like this, all the healthcare facilities can store the records under one unique ID of the patient, thereby making it much convenient for the later to have an access.

How far EHR has been able to penetrate in Tire 2 & Tire 3 cities? As mentioned earlier, there are challenges which have to deal with, such as internet penetration and awareness about EHR. So, this is making it little difficult to penetrate in the Tier 2 and Tier 3 cities. But, as quoted by Sir Richard Branson, “Every Risk is worth taking as long as it’s for a good cause, and contributes to a good life.” Keeping that in mind, Medical U I is developing a platform which will be beneficial even for the most rural section of the country.

Startup

eKincare - Easy Like Clicking a Selfie eKincare empowers you to take charge of your health by enabling you to monitor critical medical info and making it available anywhere, anytime. It provides you a user-friendly platform to view reports, says Kiran K Kalakuntla, Founder and CEO, eKincare, in an interview with Arpit Gupta of Elets News Network (ENN) Brief us about eKincare, it’s products and services. eKincare, is a Hyderabad based VC funded healthcare startup that uses patent pending technology to monitor their critical medical information and view it anywhere anytime. Consolidating your and your family’s medical history with eKincare is as easy as taking selfie and it’s free! Just take a picture of your medical records using the eKincare app. It then helps spot health risks from your historic data before their onset, provides a personalised health plan to beat those risks and connects to the right service provider at the right time. Below are the 3 core areas where we focus to make medical data meaningful.

 Personal health record Now consolidating your and family’s medical history with eKincare is as easy as taking a selfie and it’s free! Access them anywhere, anytime or share with a doctor with a simple click

 Personalised health assessment eKincare’s proprietary algorithm and process extracts the info from those medical records to assess an individual’s medical condition, spot health risks early and provide a personalized health score

paid out of pocket. Also, the health care system is fragmented and none of them are connected or talk to each other. Example: In several multiple speciality hospitals, they have multiple EHRs that don’t talk to each other. Hence, the most critical need of health records - continuity of medical information is lost. Hence, PHR is the right approach in Indian ecosystem, where the user is given access to upload their medical records and is the owner of the data. In addition to the above mentioned reasons, the other main issue with EHR is health history is stored in the form of documents and not in the form of data (0s and 1s) to be able to analyse the information and provide meaningful outcomes. This is the core of what we are trying to solve at eKincare.

How do you see the evolution of EHR market in coming days?

 Connecting to the right service provider eKincare intelligence provides personalised recommendations for follow ups – whether be a health check, vaccination, medication etc. and connects the right service provider.

What are the major challenges in EHR implementation and how important is it in today’s scenario? EHRs are great in the western scenarios where the hospital systems talk to each other and health expenses are borne by the health insurance company. Hence, the EHRs have been built for doctor and hospitals to collect patient data for insurance companies to better assess claims and medical history. The data entered in one hospital flows to another doctor. But in Indian context, the end user is at the center of the universe and majority of the health expenses are

Today there are multiple modules like LIMS, HIS, EHR etc. which have their own standards and protocols. For example: The standard reference lab ranges vary from lab to lab. We believe this is going to evolve in the coming years, where there would be a single standard and protocols like in the west for capturing, storing the data (like ICD10, LOINC Codes, HL7 etc.) which helps for better population analysis. EHRs are going to evolve into Personal Health Records (PHRs) for the above mentioned reasons, as today I might go into Apollo that has a EHR where my information is captured, but tomorrow if I go to a clinic close by house the continuity of information in Apollo’s EHR is lost since the information from the clinic is not flowing back.

How far EHR has been able to penetrate in Tire 2 & Tire 3 cities? We have had customers from all over the country including Tier 2 and Tier 3. PHR adoption in these cities is directly proportional to the smartphone penetration as it is now easy consolidate one’s medical history by just clicking picture from our app.

april / 2016 ehealth.eletsonline.com

Book Space in May 2016 Edition

asia’s first monthly magazine on The Enterprise of Healthcare

Cover Story

Telemedicine, Teleconsult & Video Conferencing: Accessibility of healthcare facilities in the remote areas of India has always been a challenge. Having direct interaction with a specialist is nearly impossible for many patients since most specialist doctors live in cities, while 70 percent of India’s population lives in rural areas. Here comes the need of Telemedicine, Video Conferencing, Mobile Healthcare Apps and other health devices, which also help the industry’s growth. Heart and blood pressure monitors can now wirelessly transmit the patient’s data to mobile phones or a central online database accessed by telemedicine centres. eHEALTH Magazine’s cover story for May edition focus on Telemedicine’s need, demand and reach. Reaching to the Unreached is the prime focus for the same. Engaging both policy makers and service providers in order to reach to a conclusion.

Previous  Edition

Special Feature

Clinical Chemistry Analyzer: The global clinical chemistry analyzer market was valued at $8,965.00 million in 2014 and is poised to grow at a CAGR of 5.52% between 2014 and 2019, to reach $11,728.01 million in 2019. Rapid growth in the diagnostics market, increase in the healthcare spending, and increasing incidence in lifestyle disease will drive the growth of the market. Furthermore, increasing awareness for preventative healthcare, increase in aging population, increase in reagent rental agreements and increasing demand for laboratory automation will aid the demand for clinical chemistry analyzer products.

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 Direct Reach to Pan India Private & Government Hospitals, Medical Colleges and Diagnostic Centres.  In-depth research on the story. Touch upon small to big market through Interviews & Articles.  Exclusive Interviews of the Industry Experts.  Engaging Leading Hospitals Through the Corporate Profiling Every Month. Deadlines for Above: Artwork : 23rd April 2016 Editorial : 21st April 2016

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