Ehealth august 2013

asia’s first monthly magazine on The Enterprise of Healthcare

volume 8 / issue 08 / August 2013 / ` 75 / US $10 / ISSN 0973-8959

Creating

Hallmark of

Medical Excellence Sunanda Singhania,

Executive Director, PSRI

Raghupati Singhania,

eHealth Magazine

ehealth.eletsonline.com

Chairman and MD, JK Tyre & Industries

Special Issue

23-24 July, 2013

Hyderabad Hyderabad International International Convention Convention Centre Centre Hyderabad, Hyderabad, India India

volume

08

issue

8

contents

ISSN 0973-8959

Dr (Prof) Jagdish Prasad ‘Ensuring affordable treatment to all will make India healthy’

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policy Dr Arun Panda, Joint Secretary, Ministry of Health Ajay Prakash Sawhney, Principal Secretary, Department of Health, Medical and Family Welfare, Government of Andhra Pradesh

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Ashvini Danigond, CEO and Executive Director Manorama Infosolutions

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Priyanka Shetty, Head - British Life Sciences, a British Biologicals CompanyAshvini Danigond, CEO and Executive Director Manorama Infosolution

leaders speak Sunanda and Raghupati Singhania, PSRI

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Dr Rakesh Tandon, Medical Director & Head of Department for Gastroenterology

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Dr Sanjiv Saxena, Head of Department, for Nephrology & Renal Sciences

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Jasdeep Singh, Facility Director, Fortis Hospital, Shalimar Bagh

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RADIOLOGY

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special focus

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JP Pattanaik, Healthcare Business Analyst, United Health Group Information Services Pvt Ltd

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Ajai Kumar, Founder and Chairman, HCG

zoom in

4

Dr Sanjay Saran Baijal, Director of Interventional Radiology, Medanta, The Medicity

expert speak

Amit U Jain, IT Specialist, Hosconnn

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Dr Rajesh Garg, Director and HOD, Neurology, Paras Hospitals, Gurgaon

Kaushik Shah, Proprietor, KS Biomed

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Wido Menherdt, CEO, Philips Innovation Campus

Sadananda Reddy, Managing Director, Goldstar Healthcare Private Limited

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eindia special coverage

august / 2013 ehealth.eletsonline.com

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

08

issue

8

August 2013

President: Dr M P Narayanan

Partner publications

Editor-in-Chief: Dr Ravi Gupta group editor: Anoop Verma

Editorial Team

WEB DEVELOPMENT & IT INFRASTRUCTURE

Health Sr Assistant Editor: Shahid Akhter Sr Correspondent: Sharmila Das governance Assistant Editor: Rachita Jha Research Assistant: Sunil Kumar Correspondent: Nayana Singh education Senior Correspondent: Pragya Gupta, Mohd. Ujaley Correspondent: Rozelle Laha Sales & Marketing Team National Sales Manager: Sunil Kumar, Mobile: +91-9910998067 Assistant Manager: Vishukumar Hichkad, Mobile: +91-9886404680 (South) Manager - Sales: Douglas Digo Menezes, Mobile: +91-9821580403 (West) Assistant Manager - Sales: Bhupendra Singh, Mobile: +91-9910998066 (North)

Team Lead - Web Development: Ishvinder Singh Executive-IT Infrastructure: Zuber Ahmed Information Management Team Executive – Information Management: Khabirul Islam Finance & Operations Team General Manager – Finance: Ajit Kumar Legal Officer: Ramesh Prasad Verma Sr. Manager – Events: Vicky Kalra Manager – HR: Sangeeta Biswas Associate Manager – Accounts: Anubhav Rana Executive Officer – Accounts: Subhash Chandra Dimri

OUR UPCOMING EVENTS 9th

Subscription & Circulation Team Sr Executive - Subscription: Gunjan Singh, Mobile: +91-8860635832 Design Team Assistant Art Director: Shipra Rathoria Team Lead - Graphic Design: Bishwajeet Kumar Singh Sr Graphic Designer: Om Prakash Thakur Sr Web Designer: Shyam Kishore Editorial & Marketing Correspondence eHEALTH - Elets Technomedia Pvt Ltd Stellar IT Park, Office No: 7A/7B, 5th Floor, Annexe Tower, C-25 , Sector 62, Noida, Uttar Pradesh 201309, email: info@ehealthonline.org Phone: +91-120-4812600 Fax: +91-120-4812660

india’s premier ict event 23-24 July 2013 Hyderabad International, Convention Center, Hyderabad

Knowledge Exchange

KOVALAM 30 Aug-1 Sept 2013, The Leela, Kovalam, Kerala

ehealth does not neccesarily subscribe to the views expressed in this publication. All views expressed in the magazine are those of the contributors.

The magazine is not responsible or accountable for any loss incurred, directly or indirectly as a result of the information provided. ehealth is published by Elets Technomedia Pvt. Ltd in technical collaboration with Centre for Science, Development and Media Studies (CSDMS) Owner, Publisher, Printer - Ravi Gupta, Printed at R P Printers G-68, Sector 6, Noida, UP, INDIA & published from 710 Vasto Mahagun Manor, F-30, Sector 50, Noida, UP, Editor: Dr. Ravi Gupta © All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic and mechanical, including photocopy, or any information storage or retrieval system, without publisher’s permission.

September 2013, Patna, Bihar

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Financial Inclusion & Payment Systems 24-25 October 2013, Eros Hilton, New Delhi

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editorial

Technology Will Fill the Void In another two and half month prescribing medicines through an SMS will become a reality. The State Government of Madhya Pradesh feels that this step will compensate, to a large extent, shortage of doctors in Madhya Pradesh. Beginning this Gandhi Jayanti - October 2nd - prescriptions of some 7,700 government doctors can come in the form of mobile text message and will be accepted by state-run health centres and provide free medicine to people.

Many medical practitioners are today keen to use mobile devices for providing “right advice at the right time� to their patients. My interactions with a good number of healthcare fraternity has led me to the realisation that today there exists a broad agreement on the issue of using new technologies to fill demand supply gap of medical staff in primary and secondary care set-ups in villages. Both government and private institutions have stated making use of telemedicine, mHelath, etc, to extend healthcare in the far-flung areas.

The August Edition of eHEALTH carries interactions with many key stakeholders. For example, you will find interviews of Dr (Prof) Jagidsih Prasad, Director General of Health Services, Ministry of Health & Family Welfare, Govt of India, Dr Arun Panda, Joint Secretary, Ministry of Health, Ajay Prakash Sawhney, Principal Secretary, Department of Health, Medical and Family Welfare, Government of Andhra Pradesh. These interactions only lead us to the conclusion that we are now steadily towards innovative solutions in healthcare.

I would also like to tell our readers that the August 2013 issue of eHEALTH will be launched by the Chief Minister of Andhra Pradesh at the prestigious eINDIA2013 Summit, being organised on 23-24 July, 2013, at the Hyderabad International Convention Centre, Hyderabad, in the presence of many key officials from the Centre and States who are playing a stellar role in implementation of new healthcare initiatives in the Country. If you are there at the eINDIA 2013 summit, then you might already have received your copy of eHealth.

We look forward to seeing you at eINDIA 2013. After all, it is very essential that all sections of society participate in the discussions on the ways by which the scope of healthcare can be further improved in the country. While we have scored lot of successes in this area, there exists room for lot of new initiatives to be launched.

Dr. Ravi Gupta ravi.gupta@elets.in

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Message Andhra Pradesh is in the forefront in use of Information Technology for improving governance in India. Application of IT in major citizen welfare programmes like Aarogyasri and NREGS has enabled total transparency and accountability in their implementation.

Our unique G2C and G2B service delivery platform “Mee Seva”,is serving as a one stop solution for delivering services anywhere, any time. Mee Seva currently offers 153 citizen centric services through more than 6800 CSCs spread across the state. Mee Seva currently offers services pertaining to 11 departments i.e. Revenue, Registration, Municipalities, Power Distribution, Civil Supplies, Police, UIDAI, Transport, Education, Industries & Commerce and IT&C Departments. Additional 154 services pertaining to 10 departments are being developed and would be offered through Mee Seva in the next 4-5 months. Mee Seva has already completed more than 2 crore transactions since inception.

It gives me immense pleasure to share that the Government of Andhra Pradesh is the partner state for the ninth edition of eINDIA 2013, India’s premier ICT event which is being jointly organised by Elets Technomedia Pvt Ltd along with other partners at Hyderabad International Convention Centre, Hyderabad, India, between 23rd– 24th July, 2013.

I welcome all the delegates, thought leaders and change agents participating in the event. I look forward to their participation in what promises to be an immensely enriching event.

Leaders Speak

“Our foray into

Healthcare is focused” JK Tyre & Industries Chairman and MD, Raghupati Singhania and his wife Sunanda — two names synonymous with philanthropic programmes, help to address the challenges facing our nation and local communities.

They admit with a typical candour that the raison d’etre behind their foray into healthcare is a sense of social responsibility. They share their views and vision with Shahid Akhter, ENN

Raghupati Singhania

Chairman and MD, JK Tyre & Industries, loves to live by the philanthropic tradition and his interest varies from promoting adult literacy programmes to go-karting

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Please tell us about the legacy and inspiration behind the establishment of Pushpawati Singhania Research Institute ?

Our social outreach is diverse and wide spread across the country. It is not confined to hospitals but schools, educational centres, university, clinics, health care facilities, prisons and other non profit projects and organisations with the aim of uplifting the

Sunanda Singhania

Executive Director, PSRI, is one of the few individuals who is personally inclined to serve the sick through the wider corridors of a hospital life and living. These programmes are already functioning at different places.

When we moved to Delhi, we explored the existing healthcare scenario and discovered a lacuna in the treatment of digestive disorders, though 70 percent of the population were afflicted by gastro related problems. Also there was no precise specialty centre for liver and kidney. This prompted us to combine the three medical verticals at PSRI.

Who were the pioneers and what was their vision ?

My elder brother, Late Shri Hari Shankar Singhania and other family members were the pioneers who envisaged the idea of PSRI. Initially the vision was to create a world class tertiary care centre for gastroenterology and nephrology. The other element was to promote clinical research and establish PSRI as a seat of teaching and training as well.

We took the onus of managing the institute since its inception and we have ensured our best.

JK Group’s healthcare mission is laudable but why have you confined yourself to a single hospital ?

We are keen to carve a niche for ourselves, rather than set into motion the proliferation of hospitals that are mushrooming today. PSRI is hallmark of excellence. It is

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Leaders Speak

ment can boast of its premier classification and certainly the highest patient processing unit of Delhi.

We are NABH accredited. Our surgical facilities and our experts have created national and international records and appreciation for rare surgeries. With the passage of time, we have built a whole gamut of support facility.

Personally, I feel elated and a sense of satisfaction prevails when I talk to patients and get their feedback. Patient referrals have stated pouring in from different parts of the country and the world.

‘We aim to be the leaders in our chosen specialties through excellence, dedication, team work & quality services’ reckoned as Southeast Asia’s first and India’s foremost institutes providing advanced and comprehensive medical and surgical treatment for diseases related to the digestive tract, liver and kidney. Besides global recognition, we promote and encourage research and our doctors are invited internationally.

Clinical research in our select specialties have been recognised by Indian Council of Medical Research (ICMR) and Director of Science and Technology.

What are your future plans ? Any roadmap for expansion and growth ?

We have undertaken a major expansion of the institute. Facilities for liver transplant, cath lab and cardiology services are being added. All these will be housed in a new building, which is coming on the same premises along side. We expect all these to be completed within two years time. With

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How far do you think that the hospital is trying to accommodate the global innovations and advantages in technology ?

We take pride in our chosen specialities and our endeavour is to be at par with the best. In fact our infrastructure is already the latest but we keep updating whenever the need arises by way of acquiring something that is still better.

It is precisely for this reason that PSRI hospital is reckoned and respected as a premier referral centre.

What are your other social welfare projects? How do you meet your social obligations by way of community outreach ?

How has the journey been so far and how do you feel when you look back ?

We took off in 1996 with 37 beds, six bedded ICU, four dialysis machines and just one OT with a very basic endoscopy unit. Today our growth is manifold and our services too have multiplied. Now PSRI has 106 beds, three critical care areas (Medical ICU, Surgical ICU and post transplant ICU). Endoscopy unit of gastroenterology department and hemodialysis unit of nephrology depart-

this expansion, the number of patient beds will be doubled. Bed numbers will also increase in the critical care units, dialysis stations and endoscopy facilities, apart from these, several allied support services will be added. we are not averse to outstation expansion plan but prefer to grow on our existing structures. We consider Mayo Clinic or Cleveland’s Clinic as our role model.

Tele medicine is another area where we constantly working with several African & SAARC countries.

PSRI is hallmark of excellence. It is reckoned as Southeast Asia’s first and India’s foremost institutes providing advanced treatments

Our corporate social responsibility seems to be endless. As and when we find an opportunity, we love to involve and evolve. World health days are best celebrated at PSRI and on any given pretext we reach out for free health awareness talks, health camps and knowledge based scientific sessions.

Our reach is not just confined to select centres but we have various projects like Parivartan (mother and child programme) that aims to uplift and educate the women in villages and towns. We have adult literacy programmes and education for prison inmates in –Mysore. We promote sports by exploring and nurturing the talents within. These are just to name a few.

leaders speak

“We manage one of the busiest endoscopy units in the country�

Dr Rakesh Tandon, Medical Director & Head of Department for Gastroenterology, PSRI, in conversation with Shahid Akhter, ENN

-clock, to handle all diseases related to digestive system, pancreas, gall bladder, intestines, liver, etc. We perform around a 1,000 endoscopic procedures in a month.

Besides kidney transplants with 100 percent success rate, we offer comprehensive clinical care and services related to kidney. Several new surgical procedures, like laproscopic thoracotomy have been introduced in liver, pancreas and bile duct surgery.

Kindly give an overview of the prevailing scenario of gastroenterology in India?

What technological advancements can be expected at PSRI?

Gastro disorders are on the rise. Consider the fact that 60-70 percent of medicines that people take are gastro related. Contributing factors are numerous but to enumerate a few, I can mention, sanitation, hygiene, infection, contamination, food quality, etc. In fact, almost all diseases are dependent on what you eat. Diseases like diarrhoea, cholera, typhoid, dys-

entery and hepatitis can be prevented by improving and introducing hygiene, sanitation and water purity. A simple check on tobacco and alcohol consumption will greatly impact and improve the upper gastrointestinal tract.

PSRI is known for its prowess in gastroenterology, kidney and liver diseases. What are the unique services?

We are fully equipped, round-the

Upper endoscopy is used to explore ulcers in the food pipe, stomach or the upper small intestine. It is achieved via fibreoptic tube that is inserted through the mouth. Another upper endoscopy is ERCP where obstruction to the flow of bile can be removed via stents. Colonoscope is used to examine and screen the rectum and the lower end of the small intestine for cancer, passage of blood in stools, constipation, etc. Capsule endoscopy and enteroscopy are applied to reach out the sections untouched by routine upper or lower endoscope.

How does the Indian gut and technological advancements in gastroenterology compare with the West?

Dr Rakesh Tandon

The Indian gut is more tolerant. Our bowel movements are more uniform as we are given to traditional belief of daily morning bowel movements. However, at times we are over concerned and this ignites the brain which gets tensed and leads to functional disorder by disturpting the bowel.

In the West, fecal transplantation is in vogue though it is yet to be FDA approved. In India, Ulcerative colitis, and Crohn’s diseases are less common. The impact of packed food, lifestyle changes, surge in contamination, choice of food and alteration in food habits have certainly changed the Indian gut scenario.

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leaders speak

Awareness is Needed

for Renal Care

Dr Sanjiv Saxena, Head of Department, for Nephrology & Renal Sciences, PSRI, filters his thought on the kidney scenario in India. He shares his concern with Shahid Akhter, ENN Kidney disease has assumed worrisome proportions in India.

Why so?

Kidney is a late entrant by way of awareness as well as healthcare approach. Its stoic nature makes it appear less potent but in reality it is just another life-threatening disease.

Ten percent of the Indian population is said to be suffering from chronic kidney disease. High blood pressure and diabetes impact kidney

and no less than 60 percent of kidney patients suffer either from diabetes or high blood pressure. All this is attributed to lifestyle changes, preference for fast food and sedentary life and to some extent genetic factors.

There are just 1,000 nephrologists in India . Why do we have such a poor build up in this vertical?

A decade back, there were around 200 cardiologists and there were few

medical students willing to take up nephrology. Medical fraternity was lured by the heart and there were few takers for the nondescript kidney. It was never appreciated and therefore was less popular as a separate entity.

Besides financial constraints and lack of awareness, the prevailing infrastructure is inadequate. Good treatment centres are to be found only in the metro cities with dialysis centres that are few and far.

Is it true that symptoms associated with kidney problems appear very late and this complicates the treatment?

The kidneys are ever busy and equally silent workers. We don’t take notice of kidney problems, until they are damaged and by the time kidney problems manifest themselves, it is usually too late. Once there is kidney failure, it is incurable. Lack of awareness leads to ignorance about prevention and timely assistance, which is very crucial.

Why only 2-3 percent of kidney failure patients in India get treated. Has anything been done to improve this scenario?

Kidney treatment by way of transplant or dialysis is expensive. It incurs huge costs and we need to think of ways to lower them. In the US, 80 percent of the cost is government’s responsibility. Also there is health insurance. We too need to wake up before it is too late.

What are the technological advancements most recently introduced in renal care at PSRI?

Dr Sanjiv Saxena

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PSRI hospital is one of kind and a pioneer in nephrology. We have a stateof-the-art Dialysis Unit. We have 22 dialysis stations which run in shifts, round-the-clock. We also have provision for portable dialysis. On an average, 50- 70 patients are dialysed daily.

We have a well organised organ transplant programme as well.

policy Policy

‘Ensuring affordable treatment

to all will make India healthy’

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“If you want to develop any place, make the roads and the place will get developed itself. When you say that doctors are not present in rural areas, take infrastructure there and doctors will reach there” says Dr (Prof) Jagdish Prasad, Director General, Health Services, Ministry of Health & Family Welfare, Government of India.

In conversation with Nayana Singh & Kartik Sharma, ENN

At the helm of Indian Healthcare, what is your opinion about the status of the health sector? What is your vision for healthy India?

Human body is disease prone; it’s natural to fall sick. However, at the same time it is required to ensure that people get proper treatment and affordable drugs. It is the responsibility of the Government of India (GoI) to make treatment available to all. In the context of healthy India, diseases will always avail, but once the government will start providing healthcare in every segment of the society – be it urban, rural or slum – then only we will be able to call our country a healthy country.

In this regard what kind of strategies are you adopting?

As you know, in our Constitution, health comes under the look after of state governments. The GoI is to facilitate the infrastructure or can introduce relevant national programmes, which are 100 percent sponsored by the Central Government. But ultimately it’s the responsibility of the state governments to implement such schemes. Our National Rural Health Mission (NRHM) programme was introduced by the GoI seven years back with the purpose of providing rural health services. It was an appropriate step when you know that 77 percent of population stays in the rural areas.

In India, 27 percent of the population lives in cities and the rest 73 percent in villages, but the ratio of doctors is reverse. In urban areas there are 73 percent of doctors, whereas in villages they are only 27 percent. To improve this situation, GoI has provided incentives to respective state governments to employ and arrange adequate number of doctors. The Central Government has funded schemes like Accredited Social Health Activist (ASHA) and Auxiliary Nurse Midwife (ANM) at the local level, to the people who can im-

“State governments haven’t utilised telemedicine so far, but now we are putting up a proposal and we are connecting district hospitals to medical colleges. We are going to provide necessary funds to these states so that every district should be connected to at least one medical college” munise the cell, who can bring pregnant ladies for health check-ups, and these people are paid for their work.

There is an acute shortage of health personnel in India. What steps is the government taking to increase the number of health personnel in India?

There is no any crisis of doctors in the country, but the problem lies with their distribution and categorisation.

If you take account of all ayurvedic and homeopathic doctors, then the total number is not inadequate. The GoI has taken initiatives in the past years and has increased the number of seats of undergraduates. It has also allowed up to 250 seats per medical college if the facilities are adequate.

Initially, the limit was of 150 students only. This is a great achievement. Now

we are producing more than 45,000 doctors per annum. Similarly, the number of undergraduates which was only 11,000-13,000 has now increased to 2.3-2.4 lakhs. Moreover, the GoI is providing funds to hospitals with more than 300 beds for building medical colleges. Recently, the GoI upgraded 116 medical colleges, which shall increase the intake of students by 10,000.

What is the role of technology in medical studies?

Technology has great relevance in medical studies. For instance, telemedicine needs to be used extensively in the medical colleges, however, only a few practioners are using it at the moment and the Government has not implemented it fully. Moreover, Internet penetration is lacking, which needs to be upgraded as well.

What is the status of IT adoption in medical colleges?

Today we can demonstrate and telecast surgery procedures. For example, most hospitals in Delhi have video conferences to telecast surgery procedures live to students, which is a big achievement with the rising number of students.

However, the use of IT in medical education is only 10 percent, and there is scope for further expansion.

How can IT be used to address the inadequacy of doctors in rural areas?

We are coming up with a proposal where we are planning to connect district hospitals to medical colleges and we have already chosen a few districts for this. This will ensure critical patients in remote areas to have live conversation with specialists sitting in big centres and get the timely treatment.

This type of arrangement is going to be financed under the telemedicine aid of the planning of the GoI. So we will help the State Government to develop this system. Even we are planning to connect Primary Health Centres and

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17

Policy

Government has planned to build three categories of trauma centres in every district. First, trauma centres should be built after every 100-150 kilometers with all the facilities in the districts.

Second, is to build them after every 350-700 kilometer of distance on the highways which should be a state-of-the-art trauma centre. Finally we want to have trauma centre ambulance services, which means at anytime we have an ambulance ready to pick up the patient

Central Health Centres through telemedicine. Now if any outbreak of the disease happens then immediately national system of disease control will get to know about this. It is 24 hours service. This is the virtue of IT. GoI has also started a programme which screens around 2 crore diabetics and the result is available online.

What is the current state of infant mortality rate in India?

It is undoubtedly decreasing but not an extent that it should be. Under the NRHM, although infant mortality and maternal mortality rates are decreasing in states such as Kerala, but there are states such as UP, Bihar, Odisha, Jharkand, Uttrakhand, Rajasthan, which are not faring well on this count.

States need to take health as their topmost priority, which is not happening currently. Other than government’s initiations, it is also necessary to educate and empower women, which I can assure, will bring down the mortality rate within 10 years.

Which states are performing successfully in curbing infant and maternal mortality and how?

All Southern States and West Bengal are doing well because their respective governments have given due at-

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“In India, 27 percent of the population lives in cities and the rest 73 percent in villages, but the ratio of doctors is reverse. In urban areas there are 73 percent of doctors, whereas in villages they are only 27 percent”

tention to these issues. A leader’s vision is very important. If government takes care of healthcare and education, then most of the things will improve. If you want to develop any place, make the roads and the place will get developed itself. When you say that doctors are not present in rural areas, the main reason for that is lack of infrastructure development.

A public official in our country enjoys

all facilities like big house, security and a nice vehicle even in any location of the country by just clearing an exam whereas doctors who sacrifice their half of life to become a doctor can’t even get a proper place to sit and check patients. Then how you are expecting a doctor to go in rural areas, first of all government should develop the infrastructure and security.

These are the important things which government doesn’t understand. For financial security, you have to give incentives to doctors who are going to rural areas; salaries need to be doubled. Besides, our health education needs improvement too, and should be rural-orientated since the beginning. MCI has to modify and should give training to MBBS students from third and fourth year in reputation, and doctors and teachers should also go to the villages.

How will PPP model help Improve the scenario?

We are always open to Public Private Partnership (PPP) model, but if you consider the situation in India, industrialists don’t want to invest in hospitals. They all must invest 10 percent of their profit for people. If they do like this, then our country will be the best in the world.

What is the status of HIV’AIDS control in our country?

It has come down tremendously. This is because of GoI initiatives. We have opened blood checking system to a great extent. Definitely the awareness and education among the people has increased.

How are you supporting organisations like NACO? NACO is well supported by Government of India and also globally. The government doesn’t have dearth of money, but what we need to do is whatever money we have, the states should utilise it properly.

Introducing Introducing Introducingthe the thenew new new DIRECTVIEW DIRECTVIEW DIRECTVIEWVita Vita VitaCR CR CRSystem System System Available Available Available Available with with with with Carestream Carestream Carestream Carestream Image Image Image Image Suite Suite Suite Suite mini-PACs mini-PACs mini-PACs mini-PACs solution solution solution solution Improved Improved productivity productivity productivity productivity - First - First -- First First image image image image inin 50 in in 50 seconds 50 50 seconds seconds seconds and and and and fast fast fast fast processing processing processing processing � �Improved ��Improved time time time time (40+plates (40+plates (40+plates (40+plates per per per per hour) hour) hour) hour)

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POLICY

Introduced during the seminar, ‘Harnessing Medical Technology for Inclusive Healthcare in India’ in June this year in New Delhi, the new Bill which will replace the Drugs and Cosmetic Bill 2007, will have a separate chapter on medical devices and the same will soon be put up before the cabinet.

Dr Arun Panda, Joint Secretary, Ministry of Health, talks about the Government’s plan of putting the Bill forward.

In email interaction with Ekta Srivastava, ENN

DR ARUN PANDA

Redifining Drugs and Medical Devices Industry What is the new bill is all about that is going to replace the Drugs and Cosmetic (Amendment) Bill?

The new Bill is a more comprehensive one as compared to the pending one since 2007. It would take care of the suggestions of the Parliamentary Standing Committee with respect to the 2007 Bill. It would also take care of the objections of the stakeholders to the provisions of the 2007 Bill.

What is the Government’s plan of action to regulate medical

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devices which are used in an unregulated manner?

The selected and critical categories of medical devices are already regulated effectively under the present provisions of the Act and rules were being made there under. The new Bill also has an exclusive chapter on regulatory provisions for medical devices.

How will the new Bill regulating the medical equipment industry bifurcate it from drug manufacturing?

The medical devices are presently

considered as drugs and hence regulated by the same regulatory provisions as those for drugs. The new Bill would bring them out of the definition of drugs and there would be separate and exclusive regulatory provisions for medical devices.

Most of the devices are still imported and very expensive; will this Bill bring some relief to domestic medical industry?

Pricing aspects do not fall within the purview of the Drugs & Cosmetics Act, 1940.

“Medical devices are presently considered as drugs and hence regulated by the same regulatory provisions as those for drugs” How is the government planning to strengthen its regulatory body-Central Drugs Standard Control Organisation (CDSCO)?

In the 12th five year plan, Government of India has allocated ` 1800 crore to extend financial supports on procuring technically qualified manpower and establishing more laboratories, training academies, diagnostic labs, and capacity building Source: FICCI

Strengthening CDSCO is a continuous and ongoing process. CDSCO has a sanctioned strength of 584 staff, including 264 staff of Central Drug Testing Laboratories. It has also engaged 250 contractual staff for the last several years to assist it in performance of its increased work load. The Ministry is continuously engaged in strengthening the organisation. In the first phase, 216 posts have been created during 2008-09 and the labs were provided sophisticated new testing equipments. Now 165 more posts have been recently created. It has been proposed to create additional posts in the CDSCO. There is an outlay of `1800 crore for strengthening CDSCO during the 12th Five Year Plan.

Any plans of Government to lower the healthcare cost of the people, which is a major challenge today?

Bringing the healthcare costs of the people down is one of the top-most agenda items of the Government.

The Government has continuously been taking measures for promoting generic drugs which are much affordable as compared to branded drugs.

The Ministry has published a National List of Essential Medicines (NLEM), 2011, the objective of which is that the drugs included in it are adequate to meet the common contemporary health needs of the general population of the country. It is the general

obligation of the health administrators to ensure abundant availability of these drugs in the country.

The primary purpose of NLEM is to promote rational use of medicines considering the three important aspects i.e. cost, safety and efficacy.

Furthermore, it promotes prescription by generic names. The NLEM is revised and updated from time to time in the context of contemporary knowledge of use of therapeutic products. The NLEM, 2011 consists of 348 medicines belonging to 27 therapeutic categories such as antineoplastic, anti-cancer, immunological, anti infective cardiovascular, ophthalmological preparations, diuretics, anti-allergic etc. After publishing the NLEM, 2011, the Ministry requested the Department of Pharmaceuticals to bring all drugs in NLEM, 2011 under the price control regime of Drugs Price Control Order (DPCO). The new DPCO, 2013 has already come into effect, which brings the 348 essential drugs in NLEM 2011 under price control.

How do you think the Government can take help of technology in improving India’s healthcare industry?

Increasing investment in healthcare technologies, especially through research and innovations for drug development and discovery, bringing new and more sophisticated technologies into the country, etc will definitely change the face of healthcare industry in time to come. Government has taken suitable measures in this regard to facilitate FDI in Pharma Sector.

AUGUST / 2013 ehealth.eletsonline.com

21

POLICY

The Classic Case of

Aarogyasri The Andhra Pradesh Government has undertaken several initiatives for delivering quality healthcare to its citizens. Several new schemes have been launched,� says Ajay Prakash Sawhney, Principal Secretary, Department of Health, Medical and Family Welfare, Government of Andhra Pradesh. In conversation with Mohd Ujaley, ENN You have been serving in many different departments. How has your experience been as an IAS officer?

Experience has been very nice, but it is not a singular job. Every few years we are posted in a new job so it becomes a new challenge. We have to learn the new assignment, understand the major issues and then implement sufficient measures for the growth of the sector. I have worked earlier as the deputy secretary medical and health department AP Government. So it is good to be back into this sector and reacquaint myself

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with this department.

During the last few years, Andhra Pradesh has emerged as a major IT hub. Several initiatives have been taken to improve governance through the use of ICT. Where do you place the health department in terms of using ICT? Earlier there were only 27 mission mode projects under the National e-Governance Plan, and health sector was not being covered. But now we are covering both education and healthcare. Within Andhra Pradesh there have been many initiatives to implement ICT. In fact, we have implemented ICT quite well in Aarogyasri. It is a very unique scheme and it has more than 100 hospitals, including government and private, which are networked together. Every single Aarogyasri case that goes to the hospital is tracked electronically and once the diagnosis is done a preauthorisation letter is taken from the Aarogyasri trust for going ahead with surgical or other procedures. That is one of the major areas where ICT is being used and we can build upon that in many ways. Aarogyasri trust uses ICT for almost all other activities. So this is a model scheme for us which encourages us to take up ICT in all the other verticals as well.

Tell us about the mandate of the Aarogyasri programme? What kind of impact is the scheme having on the ground level?

Aarogyasri has been a pioneering programme; it empowers the poor people to use those medical services which they otherwise can’t afford.

Young children who are born with hearing impairment have benefited from this programme where a cochlear implant has actually helped them avoid deafness. This kind of implant is unimaginable for poor person, but under Aarogyasri programme it is

possible. Around 83 percent of the population is covered under the Aarogyasri programme where they are delivered free of cost treatment. So this has become a model scheme for other states as well. Though Aarogyasri has attracted a lot of criticism, still it has managed to full the requirements of a large percentage of the population.

How can the health department overcome the issue of Anaemia and other health related issues that many poor people in the state are facing?

There are three sectors where we have taken adequate steps. One is reduction in the maternal mortality ratio, second infant mortality rate and third is malnutrition. Last year a new programme was launched by the name Marpu, which means change. Through this scheme we are trying to bring about major change in the manner of which we tackle these change. So health, women and child development and self-help group at the field level have come together to address these issues. So under Marpu, 20 interventions have been taken up, starting with early registration of each pregnancy, identification of high risk cases and also the anti natal check-ups.

Taking care of maternal nutrition, birth planning, early initiation of breast feeding, entire cycle of immunisation, post natal care, immunisation against acute respiratory infection are some of the key features of Marpu.

Which are the new initiatives in the health sector that you are planning to come up with?

There are six different areas that we are currently working on. Major one is strengthening of MCTS which will happen in collaboration with other departments. We also want to equip the AMN’s with devices which will report the service deliver activities closer to real time. If we use mobile technology then it will help us to capture data in more real time and help

us look at the shortcomings and help us improvise. So MCTS has to be enhanced as a package in itself. We have to provide linkages with other departments as well where the convergence between anganwadis and health activities can happen more effectively.

We can also use the services of the local self-help groups in addressing the issues. The second major area that we are looking at is implementation of ICT inside hospitals. We have looked at examples elsewhere in the country, keeping that in mind we have prepared a pilot programme which will be implemented in few of the hospitals with comprehensive e-hospital kind of a package. Along with this we are also looking at the supply chain of medicines and equipment which are required in a hospital. The fourth factor is use of IT in human resources.

The fifth area that we have identified is the court cases, managing the legal cases effectively and the sixth area is paramedical education and tapping the institutions offering courses in paramedical education.

Most young doctors do not enjoy the prospect of having to serve in the rural areas. How do you plan to tackle the issue of MBBS doctors not opting for rural areas?

The Southern States are in a slightly different position. In Andhra Pradesh we have almost 41 medical colleges and each year there are more than five thousand doctors graduating as MBBS. In the PG level also we have significant capacity. The step which government has taken is that in case of MBBS it is mandatory for the fresh graduates to serve in a rural area and for specialists to serve in a government hospital. We are also training the paramedic staff for delivering efficient healthcare and in most circumstances it has proved to be fruitful. Under NRHM also we are trying to address this issue.

august / 2013 ehealth.eletsonline.com

23

ZOOM IN

Health IT Ensures

Efficient Care

Amit U Jain, IT Specialist, Hosconnn, goes candid in saying ‘Health IT in India is predominantly HIS driven’ What are the components of Health IT? Which one is the strongest? Kindly support your opinion with facts & figures.

Health IT in India is predominantly HIS driven. In the Indian context, in the absence of basic regulations and legislation for EMR/EHR, HIS fits in the scenario in a better manner. Most of the hospitals prefer deploying HIS aka ‘mini ERPs for hospitals’ which not only handles patient related financial data but also data relevant to demographic details, clinical data, diseases classification (ICD-10), internal patient movement, turn-around-time (TAT), time at Point of Service (PoS), Patient Care Cycle (PCC), Internal Customer Audits

What are the new trends of Health IT in India? What are the new developments that have happened in this field?

Electronic Prescription Pad (EPP): To write prescriptions on ordinary paper and a digital copy saved on software for future reference and retrieval. Radio Frequency Identification (RFID) is a wireless technology used for transmitting the identity of person, object, or entity in the form of a unique serial number from one device to another.

RFID will give HIS to track and match the right patients with the right procedures. This helps reduce malpractice by eliminating human errors. It may be a combination of real time locating systems such as: tracking the equip-

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amit u jain

We provide the following solutions to Indian healthcare Hospitals / Nursing Homes Software Doctors’ Boutique Clinics Software Pathology Laboratories & Diagnostic Centers Software Blood Banks Software Specialised Mediclaim Modules ment, patient location, and tracking of medications being administered.

What are the top five strengths and weaknesses of Indian Health IT? Kindly explain.

Five strengths are fresh and unbiased

approach of key stakeholders, ease of adaptability in new setups, increased awareness at various stakeholder levels, availability of IT resources not only in metros, but even in tier II and III cities / towns, in person support to software ‘customer’. Weaknesses are lack of legislation for maintaining EMR/ HER, lack of regulatory authority for quality standards in Health IT, lack of IT training in medical curriculum, health insurance still in nascent stage, catering only to the ‘creamy layer and resistance to new technology adaption at the level of software ‘customers’.

In providing solutions to hospitals and to others, what kind of challenges you face?

What are your suggestions to improve it?

I feel there is a lot of ambiguity pertaining to expectations from the management and software ‘customers’ in the hospital, lack of acceptance and appreciation of computerisation by medical, paramedical and other healthcare specialists, lack of standards in hospitals functioning leading to over customisation of the software according to the needs and practices of the hospital, Perception of IT as low priority area, resulting to miniscule budget for implementing HIS are some very challenging areas for us. To improve the scenario I think IT training should be a part of medical / paramedical training programmes / curriculum, IT should be perceived as an ‘investment’ rather than cost.

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expert speak

IT Helps Improve Hospital Infrastructure ‘Information technology is a critical contributor to transform care delivery’, ,says Abel Garamhegyi, Managing Director, Barco India The healthcare IT sector in India is on a constant growth path.

What kind of positive impact will this growth have on the healthcare delivery segment?

Information technology is a critical contributor to transform care delivery and helps improve the quality, safety and efficiency of healthcare delivery. The possibility of innovative new technology that is simple to use, costeffective and helps data to be portable – is a phenomenal change in how care could now be delivered. Additionally, the information could also be used to standardise the delivery process inside the provider’s facilities.

The biggest impact of good information technology systems will be on improving upon the inefficiencies in existing procedures inside Indian hospitals. India lags behind in terms of hospital infrastructure and manpower. The adoption of IT will help hospitals develop innovative and efficient healthcare infrastructure necessary for rural and urban population. IT solutions, which can help improve asset optimisation, schedule doctors/clinicians, pharmacy orders, lab test orders etc are needed on priority.

What are the challenges faced by the IT companies while designing a process system for Indian hospitals?

There are several challenges in integrating IT into the healthcare system in India. Few of them include lack of standards, cost of IT systems implementation, lack of IT expertise, reluc-

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Abel Garamhegyia

tance of medical, nursing and other staff to adapt, fear of technology failure (paper systems appear more reliable); poor support from vendors and lack of other infrastructure support.

Lack of education/policies and guidelines is making it an uphill task. Systems integrators need to have an open yet planned approach and should work with solutions that make the system future proof, with easy upgrades and match the global standards of quality and service.

What kind of business process solutions do you offer for hospitals and physician practice groups?

With a legacy of superior image quality and smart technological innovations, Barco has a solid reputation for delivering dependable display systems and visualisation solutions that are central to the provision of quality healthcare. Our comprehensive prod-

uct offering includes leading-edge displays for radiology, mammography, surgery, dentistry, pathology and modality imaging, along with clinical displays for healthcare specialists, digital OR systems, and point-of-care devices.

Barco as a display and visualisation company has made sure that healthcare providers and medical professionals get the best display solutions ensuring faster and accurate diagnosis.

Medical professionals needs simpler and more efficient systems to do their job efficiently, this is what Barco aims to provide specially for digital operating rooms and bed side solutions.

What are your business plans for India? What opportunities you foresee of the Indian healthcare IT sector?

Good system only works with the good doctor but not necessarily even the system is good the doctor is good and they cannot work together because the interface is not reliable and that’s where Barco comes in, the Barco displays they are always the same, always reliable and this is our opportunity number one.

Hospitals who have already infrastructure but the number of patients are rising and rather than investing in real estate they can use the infrastructure more efficiently and there comes Barco’s Nexxis solution. When they say the same operating room, much more operating hours, less maintenance hours, less cables etc. more effective.

This is our opportunity.

Are you ready to face the future?

Nexxis Networked digital operating room Nexxis for operating room is a fully IP-centric solution for uncompressed image distribution in the operating room. Shorten operating room setup times and face the growing number of patients. See high-quality images, without delay, for the best hand-eye coordination. And transform your surgical suite smoothly to face changing imaging requirements. Result? Betterworkflow, future-proof performance, and efficient operating room utilization.

Key benefits: Uncompressed video & audio distibution High - resolution imaging Near - zero latency Real- time communication Interaction between OR & all over the world

www.barco.com/nexxis

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www.barco.com/barcoindia

expert speak

Caring the Critically Ill Dr Sai Pravenn Harnath, Chair, Disaster Response Network Steering Committee, American College of Clinical Pharmacology (ACCP), Consultant Intensivist and Pulmonologist, Apollo Hospitals, Jubilee Hills, Hyderabad, talks about the technology driven Critical Care in India. In conversation with Ekta Srivastava, ENN How the modern day hospitals are serving Critical Care to patients?

ery I think there is much to be learnt from each other. The ease with which patients can access care if they can afford it is perhaps easier in India.

However the lack of strict enforcement may be allowing poor standards in some areas. The laws and structures like the NABH are all there - stricter regulation is required. In the US I believe you are guaranteed a basic level of quality wherever you go. They have established some basic standards all over and enforce it. Of course they have their challenges too.

Modern hospitals are now spending a lot of effort in Critical Care since the volume of patients has gone up.

More importantly we are now able to rescue patients who would not have survived in the past. This is due to a successful interaction between technology and the critical care team.

How the community and district hospitals can take advantage of offering Critical Care?

Many patients in urban or suburban areas do not have the facility to stay locally for critical care. They are often transferred to bigger cities. Using education and tools like remote monitoring these patients can be locally managed. The community hospital can be the main base for the region.

What are the challenges that hospitals face in delivering Critical Care in India?

The cost of doing excellent critical care with safety and competent management is high and a big barrier. At the same time lack of evidence based protocols and the irrational use of various treatments is a big challenge.

In the future the role of initiatives by groups like the Indian Society of Critical Care Medicine, Apollo Hospitals Center of Excellence in Critical Care and ventures like remote monitoring will help overcome the barriers.

In the future, we will face a lack of

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Dr Sai Pravenn Harnath

What CCU facilities do you have in your hospital?

‘In the future, we will face a lack of critical care beds and doctors as well as trained nurses to a greater magnitude.

This needs urgent attention’

We have a good and diverse team of critical care experts with backgrounds in Anesthesia, Medicine, Pulmonology and access to all subspecialists at all times. The technology is the latest and given the international certification we have from the JCI we have to constantly stay on top of our quality measures.

The ICU bed strength is almost one hundred. The future is exciting since we will be using cutting edge technology and advanced training to enhance our care. Since we get patients from all over India and the world we have the experience and capability of handling even the most complex ailments. I look forward to a great era for criticalcare in India and all parts of the world-I think the time has come for critical care. Magazines like yours have done a great job highlighting these issues and we as doctors are grateful for this opportunity.

critical care beds and doctors as well as trained nurses to a greater magnitude. This needs urgent attention.

What is your opinion about the growing nursing homes around the country?

Having seen both the Indian and the American model of healthcare deliv-

eINDIA

Special Coverage

awards The eINDIA Health Summit 2013 Awards has been conceptualised to celebrate and acknowledge the unique and innovative initiatives in the healthcare domain. Based on the overwhelming response, the eHEALTH August Edition has brought special coverage to highlight the innovations and solutions those have been submitted under the different categories of eINDIA Health Summit 2013 Awards. The subsequent pages have talked about the special projects that have impacted the Indian healthcare in a great way. The coverage has been differentiated as per their respective categories that includes:

eINDIA Health Summit 2013-Categories • mHealtvh Project of the Year • PPP Initiative of the Year in Healthcare • Civil Society/ Development Agency Initiative of the Year • Health Insurance Initiative of the Year • Telemedicine Initiative of the Year • Innovative Use of Technology by a Hospital • Innovative Use of Technology by a Diagnostic Service Provider • HIS & HMIS Provider of the Year

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eINDIA

Special Coverage

Government Initiatives

Name of the project

Healthcare & Academics Management & Information System Applicant: GGMC and Sir JJ Group of Hospitals Implementing agency: Hewlett Packard India Sales Private Limited

About the project: The Government of Maharashtra (GoM) has awarded the contract to Hewlett- Packard India Sales Pvt Ltd through a competitive bid process as an outsourced model to draw IT enabled services for the operations of 14 Government Medical Colleges and 19 teaching hospitals attached, by implementation of an HMIS for the purpose of education, training, research, patient care and related activities, at these locations.

Objective: Computerise, centralise and outsource the management of patient data to increase efficient delivery of healthcare services and reduce patient waiting times.

Target Group: The HMIS implementation will cover 14 medical colleges and 19 hospitals across the state of Maharashtra.

Strength areas: Project is based on the Build Own Operate Refresh (B-O-O-R) model. An Outsourced service model with custom designed furniture to safeguard IT hardware from thefts and damages in public sector. All patient data including the radio images, diagnostic reports in digital format resulting in cost saving. All patient data is available in electronic format, across locations making it impervious to damage. The project has audit trail facility to plug loopholes and pilferage Achievements: • Unique Health ID issued for around 50 lakh patients and 10 lakh EMR created in 9 hospitals • Cash collection process is simplified and transparent with around 90 percent increment over manual process • Reduction in the patient waiting time at registration and consultation area by more than 90 percent • No loss of patient data including X-ray, CT, MRI images as they are stored digitally in Local server • Improving the accuracy of patient’s investigation report as every specimen is linked to a unique MRD

Key challenges:

Jaijit Bhattacharya

We have sailed through challenges like huge patient volume, non standard maintenance of data, handholding of user’s in real time environment, creating departmental champion, inconsistency in capturing data & outdated equipments.

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eINDIA

Special Coverage

Name of the project

Software for Assessment for Disability (SADM) Details of the Applicant: Maharashtra – Directorate of IT GoM

Organisation Website: http://it.maharashtra.gov.in/SITE/ Home/Home.aspx

About the project: SADM is a web-based software application that allows a scientific assessment of disabilities.

It is an eGovernance initiative taken by the Government of Maharashtra in order to bring transparency and objectiveness for calculation of the disability percentage. In this approach, the doctors are instructed to enter only the parameters of the person into the system.

Objective: Computerise, centralise and outsource the management of patient data to increase efficient delivery of healthcare services and reduce patient waiting times.

Target Group: Disabled persons Strength areas: The application has a comprehensive database (name, designation & registration no) of the doctors, it captures photograph, Aadhaar and scanned copies of proof of address of all applicants, the application is linked to Aadhaar (UID) as well. SADM does duplication check – applicant once registered/issued certificate gets flagged. It generates comprehensive reports which are in public domain.

Achievements SADM successfully did scientific assessment of disability degree as per Gazette 2001, Government of India. So far, more than 21000 applicants registered, with around 16000 certificates already issued. It has processed standardisation, generation of a computer based Disability Certificate with unique ID. Moreover, bogus cases are weeded out due to duplication check.

USP: It is a web-based software application that allows a scientific assessment of disabilities. It brings in transparency and objectiveness in calculation of the disability percentage by minimising the subjectivity and discretion element of doctors. Its helps in removing duplicity and maintains a centralised datbase for PWD (Persons with Disabilities) as well as medical board doctors.

Five key challenges: There was no centralised date of birth of disabled/ medical board doctors. Now SADM provided them to keep information in digital mode. There were issues like subjectivity and doctors’ discretion in giving disability recognition, They also have faced resistance from medical fraternity which we have overcome by training and building confidence.

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Rajesh Agarwal

eINDIA

Special Coverage

technology including medical, information, communication, fleet etc.

Name of the project

1-0-8 Emergency Response Services Applicant: GVK Emergency Management and Research Institute

Organisation Website: www.emri.in Implementing agency: GVK Emergency Management and Research Institute

About the project: GVK EMRI pioneered the concept of integrated emergency response service under PPP model with Government of Andhra Pradesh in 2005, through a single toll free number 108. Service is totally free to end user, and most beneficial to those at bottom of the pyramid.

Objective: To serve every citizen of India in case of emergency, with appropriate pre-hospital care, through single toll free number 108.

Subodh Satyawadi

Target Group: Entire population of India

Strength areas: Integrated emergency response services for any kind of emergency through single toll free number 108. It is a successful programme that runs under Public Private Partnership mode. It’s a totally free service. It conducts research and capacity building system in emergency medicine and management.

The project has integrated multiple

Achievements: So far the emergency system has responded to 2, 03, 13,445 emergencies, 108 intervention has saved 6, 91,808 lives.

211378 deliveries assisted by trained paramedics in amby/scene reducing maternal/infant mortality. 2989842 road traffic accident cases have been attended (till 31st May 2013). This service has the ability to serve in remotest areas through innovative reach by boat ambulance, dolis etc.

So far we have trained more than 9000 doctors, 12000 nurses, 20000 EMTs, 23000 first responders.

Five key challenges: Till today, the awareness level about the 1-0-8 service is low. We don’t have any law to protect confidentiality of EMS patient care records. The poor medical infrastructure at receiving hospitals is also a great challenge.

focused on improving the standards of care based on universally acceptable guidelines and evidence based practices. The partnership with NABH has helped spread the message of standardisation and accreditation and created platforms for creating and adopting evidence based practices.

Objective: Improving the standards of care based on universally acceptable guidelines and evidence based practices.

Target group: Hospitals and clinicians.

Strength areas: It enhances the operational efficiency of the clinicians and ensures positive outcomes. The initiative shares best practices by industry experts that will accelerate learning process. It is a unique way to ensure continuing education for the healthcare professionals.

Upgradation of Standards & Practices in Healthcare in India Name of the project

Applicant: 3M & NABH Joint Initiative Implementing agency: NABH

About the project: 3M Health Care has for long been

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Achievements: We have developed training modules using professional services expertise and global knowledge support. Through this project, we have worked out mechanisms of delivery, promotion and revenue generation for NABH. Challenges: We sailed through challenges like module design for workshops, spreading awareness etc.

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CPT, SNOMED, NABH, NABL, JCI.

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eINDIA

Special Coverage

Health Center (PHC) in 1981. In 1985, a new building was constructed and it started functioning as an additional Primary Health Center with six sub centres and a village panchayats covering a population of 37,562 in and around Morappur village in Tamil Nadu.

Objective: Effect of NRHM for PHC Target Group: All needy people Strength areas: Before this centre, most of the people were dependent on the private clinics or had to travel for far flung areas. Thus the PHC has successfully extended healthcare to these people.

Dr Jeevanantham

Name of the project

Effect of NRHM in Upgrading Primary Health Centre Applicant: Primary Health Centre, Tamil Nadu Implementing Agency: Primary Health Centre About the project: The Morappur Panchayat Union Dispensary was started in the year 1978 in a small house near the Morappur bus stand and was named as Primary

Name of the project

Challenges: It was difficult to make people accept the idea initially, it was also a challenge before us to create neat and clean environment with minimal staffs. It was difficult to implement 24 X 7 staff availability. However, with appropriate strategies, we were able to face these hurdles.

Objective: To improve the nutritional

NUTRITION MISSION – An Effort to combat Malnutrition in Rural Ahmedabad with Community Participation

status and to decrease the prevalence of malnutrition in the rural children of Ahmedabad district. One more objective was to decrease the child mortality rate.

Applicant: Health Branch District

Target group: Children, their parents

Panchayat

and the general community.

Implementing agency: District Pan-

Strength areas: Approximately 1, 44,772 children were surveyed. Malnutrition was accurately identified by digital baby weighing machines. The project has launched web application MATRA for monitoring in scientific way. Capacity building of 2,700 workers of health & ICDS department was done who can work as ‘agent of change’ forever.

chayat

About the project: As per NFHS III reports, the percentage of malnourished children in Gujarat is 45 percent and in Ahmedabad it is 35 percent. The government reports had also indicated that there was a significant prevalence of malnutrition in the Ahmedabad district.

Thus, to improve the nutritional status of the children of the rural Ahmedabad, the District Panchayat, Ahmedabad had undertaken a special initiative by the name of ‘The Nutrition Mission’.

36

Achievements: This is the first PHC which has library with IEC materials, medicine, nursing care, books etc. It is also an eco-friendly hospital with well maintained premises. The centre has been included for Janani Sunaksha Yojana and Dr Muthulakshmi Reddy Scheme funds.

AUGUST / 2013 ehealth.eletsonline.com

Achievements: The number of severely malnourished children was reduced by more than 50 percent in two years. The number of moderately

malnourished children was reduced by more than 30 percent in two years.

Moreover, child mortality ratio was also reduced from 20 per 1000 live birth in 2011 to 18 in 2013.

Key challenges: Challenges like how to identify malnutrition accurately, accurate documentation of huge data, and availability of fund for implementation etc which they sailed through successfully.

Name of the project

Ability Gujarat Applicant: Commissionerate of Health MSME and Research

Implementing agency: Tata Consultancy Services

P K Taneja

About the project: Web based application for identification, registration and issuance of Disability Certificate to PwDs (Person with Disability). The application aims at registering all disabled people of Gujarat and creating a centralised data repository at state level which in turn will streamline the process of disability assessment and certification.

Target: All persons with disability (PwD)

Name of the Project

Beti Vadhaao Web Portal Applicant: The Comissionerate of the Health and Family Welfare Department(HFWD), Government of Gujarat Implementing Agency: The Comissionerate of the Health HFWD

About the Project: For effective implementation of PC & PNDT Act and saving the girl child, The Comissionerate of the HFWD Government of Gujarat has introduced a comprehensive web portal having inbuilt facility to fill the form F online and to do data analysis, which will help to locate wrong dowers, thereby strict implementation of the Act gets ensured.

Objective: Save the girl child

Strength areas: Registration of PwC on Internet manual forms with unique identification code which allows doctor to issue certificate from any location and intimated the PwD once registration was complete.

Query module to identify location & type of disability making is easy to organise camps with target.

Achievements: Duplication and fraudulent activities have reduced as application keeps track of information with ease in addressing queries related to registration, assessment and issuance of certificate.

Tracking the total number of PwD and educating them about website and process of registration.

Incorporating key validations of PwD Act overcome by inputs from various specialists. Technology and design issues overcome by open source technology design with max use of mouse instead of text.

Target Group: Ultrasonography units of the state who are registered under the Act

Strength areas: Hassle free filing of form F online, use of application in identifying the suspected cases to save the girl child etc.

Achievements: The web portal has improved birth ratio from 903 to 909 which is above national average.

All registered sonography units have come under one ambit. Moreover, due to this web portal 75 percent sonography units are registered online also the manual reporting of form – F supported with online reporting.

Key challenges: Making the form F online was the biggest challenge. For that we had to go through multiple meetings with NIC & experts. We had to train and sensitise the stockholders to use the online system. We have done it by organising workshops at district level.

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eINDIA

Special Coverage

Target group: State nodal agency, hospitals, insurance agencies, third party agency, beneficiary, MoLE.

Strength areas: This is the only RSBY data management system that is linked to State, MoLE, TPA databases and these databases were being used to empanelled hospital for monitoring of patient treatment and claim details. The project also enables state to monitor the progress of enrollment, treatment, and claim drilled down to village level.

Name of the project

RSBY Chhattisgarh Data Management System Applicant: Health and Family Welfare Dept GoC

Implementing agency: Cybertech Software and Multimedia Private Limited

About the project: The project is a

data management software which has centralised grievance redressal system that tracks the grievances received through the toll-free number and collect data from different sources and consolidate to give decision support reports.

Objective: To have a multidimensional data management system that gives clear picture on RSBY implementation.

Name of the project

XLN – Xtended Licensing & Laboratory Node Applicant: Food and Drugs Control Administration Implementing agency: Food and Drugs Control Administration

About the project: XLN- Xtended Licensing & Laboratory Node, is a web based IT solution and an innovative, time tested, replicable, scalable & user friendly solution to add value to regulatory services provided FDCA, Gujarat to G2G, G2B & G2C. XLN has been replicated in six other states and six other states are waiting.

Key challenges: As the demography data was improper collection of information and rectification was done many times. Due to the absence of the updated data generating report for SNA was a problem.

Target group: District offices, laboratory, pharmacy council, CMSO, dealers, retailers & wholesalers, FDCA head office etc.

Strength areas: XLN restricts pharmacist to work in one pharmacy only and prevent illegal multiple enrollment.

It ensures quick and effective recall of “Not of Standard Quality” medicines through mass messaging. Also it provides information in public domain, regarding dealers, NSQ drugs, blood banks etc.

Website: http://xlnfda.guj.nic.in/login.aspx

Achievements: The solution helped to establish better planning and execution of duties by drug inspectors through various alerts thorough XLN. It gives SMS alerts to all dealers for NSQ drugs, better recall from market and protection of public health. So far the solution has won two national awards and one state level award.

Objective: To provide better, speedy, transparent and

Key challenges: Challenges like shortages of hard ware

hassle free services to citizen, business community and government departments.

38

Achievements: With the facility the state government resolves the complaints of the BPL families. The SNA can monitor the enrollment at village level and take action where the enrollment is very low. Various alert reports on hospitalisation show the triggers on hospital side fraud detection

AUGUST / 2013 ehealth.eletsonline.com

which they overcome by extending working hours and other government offices also helped.

and surgical care for the catastrophic illnesses involving hospitalisation, surgeries and therapies. Quick Response Coded (QR Coded) Plastic Cards are issued. The total sum assured for the BPL family is of ` 2, 00,000/- per family per annum on family floater basis.

Objective: To improve access of Below Poverty Line (BPL) families to quality medical and surgical care.

Target group: BPL families Strength areas: MA Yojana has biometric technology; it is a web based platform for all transactions. Under the scheme the entire beneficiary will be able to use his/her “MA Card” in any MA empanelled hospital. It is a safe and fool-proof mechanism which ensures cashless and paperless transaction.

Applicant: Health & Family Welfare Department, Gujarat

Achievements: Till now approximately 42 lakh beneficiaries are being identified for MA Yojana and 15.60 lakh MA card have been printed and distributed. 277 kiosks have been set across state for enrollment at doorstep of the beneficiaries. 61 hospitals with top notch facilities and equipments are empanelled for providing medical treatment. Till date MA Yojna has approved 8080 claims worth ` 18.27 crore.

Implementing agency: Health & Family Welfare Depart-

Challenges: We faced challenges like improving enroll-

ment, Gujarat

ment and hospitalisation, lack of capacities at different levels, transaction monitoring and control etc.

Name of the project

Mukhyamantri Amrutum Yojana

About the project: MA Yojana provides quality medical

monitor field level implementation of various social welfare schemes/ programms. eDoc application has cut down dissemination time of the document to three second and brought down the cost per transaction to ` 1.50. This apart, it also acts as e-Library for all circulars 24×7.

Its usage has improved effectiveness of service delivery at grass root level (ie, Anganwadi centre level, located in villages).

Name of the project

Innovative Technique of Document Sharing in Govt System Implementing agency: Women and Child Development Govt of Chhattisgarh

About the project: Software has been designed to cater to specific needs of government departments and eknowledge level of ministerial staff. eDoc is the pioneering innovation of its kind, whereby government documents shared with its 27 district units and MIS is generated to ensure that the district node not only receives the document but also has viewed/downloaded/printed, and thereby started action expediently

Objective: We envision that such implementation would result in making actions and decisions faster.

Target: Filed units within the department of the government Strength areas: It is a very cost- effective technique to supervise and

USP: Saves a lot of paper used in government creates 24×7 virtual library of dispatches. In government setup, there is post of dispatch staff round the day he is busy with inward and outward post. Under new system this manpower is freed for other office activities.

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eINDIA

Special Coverage

Name of the project

Innovative use of Technology by Diagnostic Service Provider – NIC Applicant: SIO NIC Implementing agency: Nic About the project: The ever decreasing child sex ratio (CSR) has been cause of concern.In inida the ratio has shown a sharp decline from 976 girls to 1000 boys in 1961 to 927 as per the 2001 census. In Rajasthan it was 909 in 1991 and in 2001 it reached to 886.In accordance with the provision of PCPNDT Act 1994, NIC Rajasthan has developed an online system to monitor each case of sonography of pregnant woman anywhere in the state at any of the sonography facility registerd in the state. Software provide the online form F for center registered to report to appropriate authority.

Form F of every pregnant woman whose sonogrpahy test is conducted is reported online by every centre.

All soography centre in the state have been enrolled with the medical,

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Health & Family Welfare Department.It provide online surveillance system of government for prevention of sex determination to save girl child.Centre details including available equipments like sonography machines and personal involved are also available online.The web based Software http://pcpndt.raj.nic.in is launched on October 1st, 2012 by the Medical Health & Family welfare department and It is developed by National Informatics Centre ,Rajasthan State Centre, Jaipur. It is monitoring tool for Form F under PCPNDT Act. And implemented all across the state for more than 1400 sonography centres. This will provide monitoring of about 1400+ centres which are registered with department for ultra sonography.

Objective: To provide mobile application.

Target group: Implementation of PCPNDT Act is effort to improve Child Sex Ratio (CSR) by the government.All Pregnant woman who come for sonography at any of the registered centre and centre which are involved in sonography need to

inform in Form F to the appropriate authority as per provision in the PCPNDT Act.

Strength areas: It is web based online software to provide form F reporting from centres to government. It is developed using ASP .net for front end and SQL Server 2008 R2 as back end.

It has SMS integration for monitoring by government authority Five key challenges: It is implemented on all registered sonography centre with medical health & family welfare department. Which is 1400+ in the number. Daily details of form F is being entered by these centre regarding sonography centre.

It provides daily monitoring by the department on these centres and department keep eye on these centre and can find the exceptional reports.

SMS based solution is provided to the centre and also to the department which help the centre and department higher authority to monitor the activity. Every sonography machine has a tracking device which records the sonography report. It provides the data to department in the case of suspicious activity.

eINDIA

Special Coverage Telemedicine

Name of the project

Use of Nurses in Teleconsultation for Patients in Remote Areas Applicant: Department of IT JPNATC AIIMS

Implementing agency: Department of IT JPNATC AIIMS

About the project: New Cadre of Nurses has created a group called Nurse Informatics Specialists (NIS) that connects the nurses posted in the Emergency Department (ED) to help patients when patient calls in the call center. Their calls get transferred to this NIS. In case of medical queries, nurses look up the EMR and discusses query with concerned doctor in ED and gives answer. A ‘teleconsult’ note in the EMR

is then entered.

Objective: To evaluate tele-consultation using nurses to handle patient queries

Target group: Follow up patients in remote areas

Strength areas: The project is using nurses and call center as human ‘middleware’ instead of expensive equipments. With 24X7 availability of telemedicine this is an end to end integration of software and manpower.

Achievements: User friendly and single point of contact for any telemedicine consult (call centre number 011-40401010), the system provides 24X7 resolutions of the queries.

Key challenges: Convincing admin-

Dr Deepak Agrawal istration to involve nurses in telemedicine and integrating software.

Motivating nurses, training call center staff and documenting each telemedicine episode in EMR has emerged as the biggest challenge for the project.

try consultation and follow-up from various hospitals in Kerala. The system avoids the difficulties faced in treating prisoners and their security threats and transportation issues.

Objective: Provide right consultation from right person in right time to the prisoners.

Target group: Prisoners.

Strength areas: Telemedicine system for prison is a project based to have the electronic medical records of prisoners with teleradiology, telecardiology and telepsycahtry facility for the prisoners.

Name of the project

Telemedicine for Central Prison Applicant: CDAC Implementing agency: Central Prison Kannur About the project: The Project is implemented at Central Prison Kannur, Kerala for providing timely consultation and treatment to the prisoners. The system helped the patients in prison by early detection of disease, psychia-

Achievements: It reduces the cost behind the transportation of prisoners to the hospital and the risk involved on transportation. With the initiative we have timely and effective consultation of prisoners.

Key challenges: At first convincing doctors about the need of the system and then convincing prisoners because some of them felt that it obstructs their chance to go outside the prison. Training prisoners on how to operate the system and implementing difficulties in high secured places are the other challenges that project is facing.

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41

eINDIA

Special Coverage

critical care specialists too. The local providers remain an integral part of the team with immediate intervention and follow up.

Name of the project

InteleICU

Applicant: Healthvision Private Ltd Implementing agency: Healthvision

Achievements: Piloted successfully and this technological solution has been developed for Indian setting in addition to various remote access methods. The device has been created in collaboration with Philips and hospitals have already witness a good return on investment.

Private Ltd

About the project: This project has been initiated with a mission to expand the availability of expert of critical care specialist at all times to all regions of India. Their experience dealing with this process for the United States has helped develop the project thinkers and they have tailored the project as per the need of the country. They provide remote, live, streaming video connectivity to interact with the bedside clinical team and speak with the patient from a command center.

Objective: Bring critical care within

Name of the project

OTTET Telemedicine Network Applicant: Orissa Trust of Technical Education and Training

Implementing agency: Orissa Trust of Technical Education and Training

About the project: With the motto to bridge the demand supply mismatch of doctors and patient and facilities, the project focused on installation of eHealth and Telemedicine infrastructure in PPP mode with the Government of Orissa. First project of its kind exploring potential of employment generation for creating a mass of semi-skilled productive workers to provide access to healthcare of 51,000 villages.

Objective: Receiving medical relief should not be beyond the means of any human being. Reduce both direct

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the reach of all.

Target group: Critically sick patients.

Strength areas: Remote viewing of all clinical data and patient interaction becomes feasible at all times including monitors, images etc and the project has direct access to

Key challenges: The major challenges that the project initiator face are mainly broadband connectivity, enrollment of hospitals and staff, managing technological issues and cost.

cost and out of pocket expenses.

Target group: The urban and rural population of Odisha.

Strength areas: This is a unique enterprise built on PPP model which is first of its kind in the country in such dimension. Creating a mass of semiskilled productive health workers to provide healthcare at the doorstep, the project has the involvement of the government partners for design, implementation of network under strict guidelines. The project aims at generating potential employment among unemployed rural youth and women segment of the society.

Achievements: The project has access to quality healthcare to the rural population living in far-flung areas.

It has provided globalisation of medicare along with de-commercialisation of medicare.

Key challenges: To meet the requirement of bandwidth, partnered

KN Bhagat with different service providers and created skilled manpower combining Public Health with IT using local unemployed youth. Other than this, selecting and deploying eHealth infrastructure at no costs to government and synergy of government, corporate and civil society for sustainable development.

eINDIA

Special Coverage

mHealth

Name of the project

Automated SMS System in Emergency Department

tors regarding arrival of emergency in an automated and accountable manner.

Applicant: JPNA Trauma Centre

Target group: Specialist doctors on

AIIMS

call in Emergency department

Implementing agency: Department of

Strength areas: It keeps a track on the average time taken by each doctor to visit the patient and if concerned doctors does not arrive in time than a sms is sent to the higher authority.

IT JPNATC AIIMS

About the project: Patients coming to emergency departments (ED) are initially seen by the physician on duty who then decides which specialist doctors to call for each patient. This takes up valuable time. First in India, as soon as ED physician evaluates the patient, an automated sms is sent to concerned doctor(s) with the patient details and urgency of attending the call.

Objective: To intimate specialist doc-

Achievements:It allow the timely notification of arrival of patients to doctors in Emergency and allows quality control for the doctors as each doctors has ‘time to attend ‘ information in prior.

Key challenges: Doctors were initially unhappy as they were receiving lot

of sms’s . Then regulatory limits on daily sms cap were also a challenge which was overcome using multiple sms cards. Maintaining an up to date daily database of doctors on call was challenging.

nal and infant mortality in rural India. It concentrates on regular pre-natal monitoring of health & nutrition status of pregnant women, safe institutional deliveries etc.

Objective: To increase in institutional deliveries in government sector and to bring down the cost of basic healthcare.

Target group: Expectant mother & infants, especially in rural areas.

Name of the project

MAARPU -’the change’ Applicant: National Rural Health Mission Andhra Pradesh(AP)

Implementing agency: Department of Health & Family Welfare

About the project: Maarpu, a health initiative, was taken up as a pilot project in Karimnagar District (AP) in July 2011 and after successful implementation scaled up for implementation in state of Andhra Pradesh in September 2012. The programme focuses on the reduction of mater-

Strength areas: Use of technology to make institutional changes to improve health parameters especially IMR & MMR. Improved service delivery by community participation through SHG & mid course rectification, use of SKYPE to keep a real time watch on functioning of this programme, use of Mother & Child Tracking System and sending regular SMS alerts to the pregnant women are some of the strength areas of the project.

Achievements: Improved health parameters, increased institutional deliveries & reduced IMR&MMR. The initiative has benefitted poor to access government health machinery.

Key challenges: To reach healthcare to farflung,inaccessible villages was a real challenge which we sailed through using technology. A lacuna in experience & training was overcome by holding various hands on training sessions.

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eINDIA

Special Coverage

Name of the project: Janani

A Mother Child Dyad Care System

Applicant: Public Health Department, Nagpur

Implementing agency: Riddhi Management Services Pvt Ltd

About the project: Janani is a system for frontline health workers (ANMs and Doctors at PHCs) to help them deliver timely and quality services to pregnant women and children. A combination of Internet telephony and server based computer program, Janani has a GIS backbone. The project has been implemented at Katol Taluka of Nagpur district. The taluka has 30 Sub-Centres and 3 PHCs. Objective: To minimise chances of missing out any healthcare service to any mother or child.

Target group: The frontline health workers, taluka health officer, district health officer and administrators

Strength areas: The system is generating reports on high risk mothers and low birth weight children, by bringing the best knowledge of

Janani-Shishu-Suraksha-Yojna-Jaipur health practices to the ANMs and where they are capturing data without flaw. The project is helping in improving inter-departmental convergence.

in Healthcare of the Year through PPP” in e-Maharashtra Award. Till date it had captured medical history of 2000 mothers and children.

Achievements: Able to take confi-

hension of ANMs about keying in huge data and using new technology like use of smart phone.

dence of India’s top five laboratories has been adjudged as “Best Initiative

Name of the project

eMedLabs IPM Applicant: National Informatics Centre Implementing agency: Directorate of Institute of Preventive Medicine

About the project: The Institute of Preventive Medicine, Public Health Laboratories and Food (Health) Administration is a multi-faceted department with process of achieving preventive healthcare. It plays a vital role in the socio- medical and healthcare of the population of the State of Andhra Pradesh.

Objective: The organisation aims to provide laboratory services in all laboratories to diagnose diseases through pathology, microbiology and biochemistry.

Target group: Internal, Government officials of the department and water works department. External Citizens

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Key challenges: In removing appre-

requiring diagnostic services, State Government employee

Strength areas: Incite testing and reporting through mobile phone using the user-friendly software loaded on the mobile. The website gives information about the availability of blood in blood banks.

Achievements: Since 2007, nearly two lakh tests were conducted and then investigation reports were messaged to treating doctors (harnessing mobile technology). Total 30 drinking water sample takers are there covering the twin cities regarding which smses were straight away send to the concerned society.

Key challenges: In order to serve a large number of concurrent users, handling scalability, handling concurrency, online services like transparency, accuracy, scalability, availability are drawn as the major challenges. Being a Government organisation, the software analysis, design, development services were also rendered.

eINDIA

Special Coverage

Innovative Use of Technology by Hospitals

PACS and HIS (Hospital Information system) were integrated to work in sync for better data integrity. Centralised Voice Recognition system ensures faster reporting.

The results and images can be made available for online distribution.

Objective: Key objective of the project was integration with existing HIS to achieve patient data integrity. It has significantly improved the report turnaround time and accuracy of diagnosis for the physicians.

Target group: Radiologist /referral consultants / patients

Name of the project Picture Archival & Communication System (PACS) Applicant: P D Hinduja National Hospital and MRC Implementing agency: P D Hinduja National Hospital and

Strength areas: PACS reduces report turnaround time, it has effective archival of images, helps in research and clinical stuadies plus it integrates speech recognition system.

Achievements: PACS manages of high patient work load, gives remote access of images for reporting outside the hospital.

MRC

Key challenges: Having data integrity between all depart-

About the project: Distribution of diagnostic images and

ments for accuracy and security were the main challenges of the project.

results using PACS was implemented at Hinduja Hospital.

Name of the project

introduced information and communication technology to extend the benefits by overcoming all the social and geographical barriers.

Applicant: Department of Health and

Achievements: Recommended by the Planning Commission of India in the 12th five year plan the project has screened more than 233291 patients till 31st May, 2013. Out of the total patients screened till date, 44 percent are women and 56 percent are men.

Tele-ophthalmology helps in reducing the unnecessary patients transfer to secondary eye care centre.

Tripura Vision Centre (Tele-ophthalmology) Project Family Welfare, Govt of Tripura

Implementing agency: Infrastructure Leasing and Financial Services Ltd

About the project: Tripura Vision Project has set up 40 Vision Centres in the state and linked them to the IGM Hospital based in Agartala through wireless network connectivity to provide ophthalmology consultation to patients.

Objective: The aim of the project is to combine advance in medical science & ICT to offer effective primary & preventive eye care services.

Target group: Rural population of a size approximately 27.16 lakhs in

Tele-opthamalogy remote areas.

Strength areas: The project focuses on the accountability for every single project through cost-effectiveness and efficient way of delivering eye care and pro-citizen with vibrant approach. The project has also

Key challenges: ICT tools can’t bring much change to the lives of people unless and until coupled with human interest and attitude because eye care services involves lot of images to be taken and transmitted to the doctor and without the interest of the people it was not possible.

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eINDIA

Special Coverage

Health Insurance

About the project: The software provides a Graphic User Interface (GUI).

It generates statistics and reports to support better planning, facilitate online documentation and biometric base digital signature. The application has three level architecture, SQL base databases, application broker and browser base user interface.

Objective e-Hospital aims to manage the ever expanding volume of health information, and harnessing the latest in IT. Sir Ronald

Target group: Patients, professionals, administrators, healthcare providers.

Strength areas: The project has Name of the project

e-Hospital – Sir Ronald Implementing agency: Sir Ronald Ross Institute of Tropical Communicable

emphasised more on empowering employee in computer who don’t even cleared Xth standard. It has reduced the task of compilation of reports required to be sent to State and National level tropical and communica-

ble diseases monitoring authorities, as the system automatically generates the same based on digital OP and IP registers.

Achievements: Designed to optimise the existing manual processes with the existing human resources, the system generates the performance reports and disease surveillance report.

Key challenges: The major problem is the computer illiteracy so instead of training them for the computer usage they were demonstrated that only clicking will do the job.

USP: It gives access to live digital electronic medical records database for data-mining, analysis, research and education for the benefit of the graduate, post-graduate and researchers in the field of tropical and communicable diseases.

Name of the project Data Management System for Oncology Applicant: Vellayambalam CDAC Campus Tiruvananthapuram

Implementing agency: Regional Cancer Center Thiruvananthapuram

About the project: Data Management System for Oncology (DMSO) is an Electronic Medical Record (EMR) System for oncology with para-meterised data capturing. DMSO implemented at various specialty clinics of Regional Cancer Centre Trivandrum such as head and neck, breast cancer, pediatric, medical oncology, chest and gastro. It also manages the entire activities in the surgery, anesthesia and chemotherapy.

Objective: Clinical information data capturing for better care of cancer patients, research and step forward to design a decision support system.

Target group: Cancer care providers Strength areas: The project has a strong collaboration with engineers and doctors in the field of cancer care

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covering all clinical information of cancer patients. This system will lead to decision support system with computer interpretable clinical guidelines.

Achievements: Integrated with existing HIS and telemedicine this chemotherapy management and surgery module reduces the work load of doctors with automated with TNM calculation and staging.

Key challenges: Challenges occur in gathering domain knowledge from specialist and implementing edit tracking mechanism and integrating HIS. There was deployment in an open source environment with more than 1,75,000 patient traffic/ year.

eINDIA

Special Coverage

Health Insurance

provide cashless critical care, diagnostic and investigation to the beneficiaries with free health camps once in a week by the network hospitals. It also have PPP implementation model of service delivery with government entering into agreement with insurer.

Rajiv Gandhi Jeevandayee Arogya Yojana Name of the project

Applicant: Collector Office Aurangabad

Implementing agency: Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY)

About the project: Government of Maharashtra is implementing the RGJAY across the state to assist about two crore of Below Poverty Line (BPL)

and Above Poverty Line (APL) families from health expenditure unaffordable for the household.

Objective: The objective of the RGJAY is to improve access of BPL and APL families (excluding White Card Holders)

Target group: BPL and APL families with an annual income less than ` one lakh

Strength areas: The project aims to

Name of the project

Chief Minister’s Comprehensive Health Insurance Scheme Applicant: Government of Tamil Nadu

Implementing agency: Chief Ministers Comprehensive Health Insurance

About the project: This is a lofty insurance scheme launched by the Tamil Nadu State Government through the United India Insurance Company Ltd to provide free medical & surgical treatment in government & private hospitals.

Objective: Main objective is to provide free quality medical & surgical treatment in government & private hospitals so low economic status people can access multispecialty hospital.

Target group: Member of a family whose annual family income is less than ` 72, 000/ certified by, VAO and Srilankan refugees, widowers, old age pensioners, orphanages.

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Achievements: It brings out the transparency and efficiency in the system with improved secondary and tertiary healthcare to the poor.

Better outreach than the paper based Jeevandayee Scheme of Maharashtra. Pre-authorisation and claim payment occurring within the defined turnaround time.

Key challenges: • Awareness about the scheme and the mobilisation of the beneficiaries to the hospitals.

• Patient identification & authentication as the data received from FCS was not digitised.

• Detecting & controlling fraudulent and unethical practices by the hospitals.

Strength areas: In order to maintain transparency and to empower public, details of scheme is made open to access all via web. It is open to all members to view their balance amount via cmchis.com site by entering smart card no. IT is used to deliver service in time. Pre-auth, claims, fund transfer etc are monitored using “TAT”. 1.27 core 37 kb smart card has been distributed for eligible members.

Achievements: With more than 1.27 crores of family being covered, this project provides high end procedure to cover liver, renal and bone marrow transplant. Entire process starting from pre-auth to claims amount settlement is through the Scheme ICT portal. Mandatory Screening camps where conducted and patients were mobilised and also online tracking done. So far 3,80,699 beneficiaries amounting to ` 834,89,10,219 .

Key challenges: To restrict misuse patient referred via government hospital alone made eligible to introduced diagnostic center .ENT/OG/ortho/optha procedurre are reserved for government hospital to avoid misuse/abuse/ overuse of procedure.

eINDIA

Special Coverage

Name of the project

Mobile Claim Application for Rashtriya Swastya Bima Yojna (RSBY) Implementing agency: ICICI LOMBARD General Insurance

About the project: The role of mobile phones as an alternate claim registration device is noteworthy. Since it works via a wireless mode (GPRS) for claim intimation.

Objective: To provide the rural hospitals with a unique application to register patient claims that is independent of the internet connectivity physical infrastructure

Target group: Below Poverty Line (BPL) beneficiaries in Puri district (Odisha state)

Strength areas: Completely paperless and cashless process, the first time in mass health insurance projects

eINDIA

Special Coverage

to launch mobile claim transaction application. It works on wireless technology (GPRS) eliminating problems due to faulty wired network earlier and completely offline module reducing the dependency on live Internet connection in rural areas.

Achievements: Reduction in claim registration TAT at |the hospital’s end to leading more claims in same time.

Due to high cost of laptop more providers are filling applications to register for the mobile application. In a similar way mobile applications are being implemented in Punjab OPD. Key challenges: Complementary mobile handsets were given to those hospitals who could not procure the required handset. Then there has to be fraud control to avoid misuse of the application. Then there was rigidity on the part of the doctors to learn a new application.

HIS and HMIS Provider

delivering management information system. They have around 150+ projects running across Pan India and Worldwide.

Objective: To deliver affordable and international standard compliant HIS globally

Target group: Hospitals, medical colleges, clinics, diagnostic chains, pharmacy chains

Strength areas: It creates analytical reports for management and decision makers by providing information on department performance and financial insights to hospitals

Name of the project:

Care Enterprise HIS V.12.0

Applicant: Akhil Systems Private Limited Implementing agency: Akhil Systems Private Limited About the project: Akhil Systems Pvt Limited has the experience of more than 18+ years in providing Hospital Information System (HIS) and specialisation in

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Achievements: Conforms to both Indian and International standards, they provided solutions to 20 bedded to 1800 bedded hospitals. Their major achievement consists of implementation the solution in less than a month in 700 bedded BL Kapur hospital, New Delhi Key challenges: In most of the cases signing-off the SRS document period increases which delays project implementation. Generally hospitals do not use standard database so its stretches time of implementation. In hospitals, IT department gets least importance so it’s difficult to get data from hospitals end.

ing in quality assurance for healthcare organisations and patients. BackBone is a patient-centric application integrated with the management information that modern hospitals require.

Objective: BackBone captures the process of the patient’s journey in the hospital thereby reducing interdepartmental oral communication and giving the opportunity to go paperless.

Target group: Hospitals Strength areas: It can be access from anywhere and anytime with customizable and integrated workflow.

Integration is done with the 3rd party devices/ software’s.

Improves work efficiency of the employees and information is needed whenever required.

Name of the project:

BackBone @ Yenepoya Medical University

Applicant: Yenepoya Medical University Implementing agency: Aosta Software Technologies India Limited

About the project: Backbone Health Information Systems (Backbone HIS) package is made of a suite of modules that are designed to increase productivity while assist-

Achievements: The project has improved interpersonal relationship between departments and collection, turnaround time analysis and are moving towards getting the accreditation. The process has better control over patient care.

Key challenges: We have overcome challenges like training middle level users and end users to adapt controlled workflow, deliberating roles and responsibilities, EMR implementation for doctors, payroll implementation and implementing TAT.

Name of the project:

Lifeline Suite

Applicant: Manorama Infosolutions Pvt Ltd Implementing agency: Noble Hospital About the project: Lifeline Suite is an integrated new generation hospital management ERP solution designed especially for the healthcare industry.

Objective: To provide turnkey integrated IT solution to take care of all departments of a multi-specialty hospital operating from multiple geographical locations.

Target group: Healthcare providers and receivers Strength areas: The role is based on the user management added to the system that makes application user friendly with additional features of logging of every minute transaction in the system. In telemedicine capabilities, a patient at a rural clinic could consult specialist in urban hospital.

Achievements: At a time 320 users concurrently use the system without any errors for three years. Implementa-

tion was done with installations on 120 machines and training completed within three months. Achieved WHO compliance on all protocols used in system, provided NABH & NABL accreditation.

Key challenges: To understand the need of the staff, doctors and management was exhausting. As they were not PC savvy, training was carried out with patience, even during night to train all staff. For super-specialty domains of healthcare, they need to hire consultants to understand and design solution.

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51

product review

Digital Radiology

with an X-Factor

Designed for small to mid-size hospital radiology departments, imaging centers, clinics the latest DR technology based on wireless detectors saves space, costs and offers positioning flexibility

T

he system’s floor-mounted design saves space and reduces installation costs, while the wireless, cassette-size DRX detector provides exceptional X-ray positioning flexibility. The DRX detector can be moved from the wall stand to the table and can handle tabletop exams.

Higher volume facilities may want to use two detectors to enhance productivity. The DRX-Ascend features innovative TechVision™ technology that allows technologists to view digital radiography exams, change generator techniques and preview images using a touch panel screen mounted on the tube stand. Allowing a technologist to remain at the patient’s side during the exam simultaneously enhances care and productivity. The DRX detectors can be shared with room-based and mobile imaging systems to make the most of the capital investment. For example, a hospital could use the DRX detector in its mobile X-ray system for early morning portable exams and then place it in the DRX-Ascend system for daytime imaging studies.

eXtra edge The key features that offer an advantage include positioning flexibility with the portable, wireless DRX-1 detector, deluxe tube stand provides extended freedom of movement, innovative quiet-lift elevating float-top table, advanced imaging technology allows full remote generator control from within the same exam room and

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floor-mount design saves space and reduces installation costs. Mr Prabir Chatterjee, Managing Director, Carestream Health India, says, “The CARESTREAM DRX-Ascend System is well suited for smaller rooms, imaging centers and orthopedic applications. This floor-mounted DR system delivers high-end features at an affordable price.” An innovation for the technologist, Carestream TechVision™ Technology offers multicolor touch panel screen mounted at the tube stand hand grip allows the technologists full remote generator control for AEC & manual technique selection from within the exam room.

The technologist is able to remain close to the patient during exams, improving patient care and productivity.

TechVision™ provides full 2-way generator integration with the DR console for control and display of generator

parameters as well as DR Image Preview and study management within the exam room. Image recall allows review of any previous image for the current patient.

Wireless detectors At the heart of the DRX Family is the world’s first wireless, cassette-sized detector that works across all DRX imaging equipment. These detectors offer portability since sharing of DRX detectors is possible with room-based and mobile imaging systems in the DRX family. For example, a hospital could use the DRX detector in its mobile x-ray system for early morning portable exams and then place it in the DRX-Ascend system for daytime imaging studies. This eliminates the Wireless connectivity to eliminate the hassles and hazards of cables and reduce the risk of infection.

Specialty

Radiology

Treating Patient with Minimal Invasion

Having done major work in Gastro Intestinal interventions, management of Budd Chiari Syndrome and Portal Hyper Tension, Dr Sanjay Saran Baijal, Director of Interventional Radiology, Medanta, The Medicity, has a strong belief in the developing technologies to help patients. In conversation with Ekta Srivastava, ENN

Could you please give us brief idea about Radiology?

Interventional Radiology (IR) offers targeted, minimally-invasive therapeutic approaches that are viable alternatives to surgery. Some of the most common procedures include angioplasty, stenting, thrombolysis, embolisation, radiofrequency ablation, and biopsy. Interventional radiologists use their expertise in reading X-rays, ultrasound and other medical images to guide small instruments such as catheters through the blood vessels or other pathways to diagnose and even treat the disease percutaneously (through the skin). These procedures are typically much less invasive and cheaper than traditional surgery.

How is interventional radiology making difference in treating portal hypertension?

Dr S S Baijal

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The role of the radiologist in the management of Portal Hypertension (PHT) has undergone a significant metamorphosis over the last few decades. Initially, it was limited to determining the presence and cause of PHT, using angiographic techniques such as percutaneous splenoportography, transhepatic portography, and arterioportography. For many years these procedures were conducted frequently for planning surgical treatment; later, they were replaced by safer and equally reliable modalities such as USG (ultrasonography), CT scan and CT angiography (CTA) and MRI and MRI angiography (MRA).

Progressively, the focus changed from diagnostic to therapeutic procedures. Interventions involving the portal venous system were introduced in the 1970s, beginning with transhepatic embolisation for control of gastric and esophageal variceal bleeding. The subsequent decade saw expansion in the variety of therapeutic interventions, with procedures such as transjugular intrahepatic portosystemic shunt, portal vein recanalisation,

balloon-occluded retrograde transvenous obliteration of varices, hepatic venous outflow angioplasty, and revision of surgical shunts being rapidly introduced one after the other. Since then radiological interventions have become established methods in the treatment of PHT.

How has the impact of IR been on the treatment of liver tumour?

In cases of liver tumour , image guidance has evolved as very effective giving a lot of benefit with a very simple treatment, quick recovery time and a low risk .It has a very good advantage where a patient would otherwise not be a good candidate for surgery or chemotherapy, particularly when the disease is at an early stage. The procedure is known as radio-embolisation treatment, however, multiple rounds of imaging are employed for treatment staging, planning, guidance, and follow up. Plus, the procedure itself uses radiation to kill the tumour. Interventionlist’s can identify the tumour-feeding vessels and be more selective when planning liver embolisation.

Radioembolisation begins with an angiogram to map the vasculature of the abdomen and plan therapy delivery. A CT scan is then administered to determine the size of the tumour or percentage of involvement of the liver to calculate the dose needed to treat the tumour. During the treatment, we need to get the catheter in place, and we use angiography to see how the blood is flowing as we deliver microspheres. There is then also follow-up imaging with CT, MRI, or PET.

Tell us something about Robotic Arms. What changes will these make to the IR? This new technology means a broader group of patients who have complex diseases can now be operated on in a safe and less invasive manner, at the same time, this technology offers speedy recovery . Whereas surgeons

‘It is our belief that robotic systems will be an important part of future interventions, but more research and clinical trials are needed.

The possibility of performing new clinical procedures that the human cannot achieve remains an ultimate goal for medical robotics’ would normally feed the catheter into the patient’s body by hand, the robot gives greater precision thus minimising risk of damage to the wall of the patient’s blood vessels .The procedure can also be completed quicker.

It is our belief that robotic systems will be an important part of future interventions, but more research and clinical trials are needed. The possibility of performing new clinical procedures that human’s cannot achieve remains an ultimate goal for medical robotics.

Even technologies like 3D imaging, 3 TeslaMRI and Angiograpy had made very significant changes in radiology.

What are some of the major problems that the radiologists in India are facing currently?

In tertiary set-ups, the owners can afford such kind of instrumentations and achieve the desirable or positive outcome, but in India we are not having so many super specialty centres.

There are so many medium class setups which may not afford these expensive equipments, nevertheless they may have very good radiologists.

What is unique about Medanta’s

Radiology department?

Medanta has one of the best equipped radiology departments with almost all the latest technology with Digital Mammography unit, Bone Densitometry Unit and Computed Radiography Units. The HIS and RIS are fully functional. The PACS is under installation. Apart from this, the department plays a very important and significant role in the overall healthcare delivery system and academic activities of the hospital. It also provides platform for research activities and plans to conduct various educational and research activities in near future.

As the Director of Radiology what major initiatives have you taken so far for the well-being of patients in the hospital?

As technology advances and highquality imaging equipments become more widely available, IR is able to offer patients and referral physicians a host of new treatment options .In the past, we as radiologists were only given some forms filled by clinicians or surgeons for some kind of investigations, radiologist did not know what was the actual case and what the clinician wanted to see. But now we are working as a team with surgeons and clinicians to give them best idea of investigation for every patient. Even as an interventional radiologist we are also treating many patients with minimal invasive procedures.We are also capable of doing many of the procedures such as bed side treatment thus increasing the chances of survival for very sick patients whom we can’t shift to the procedure rooms.

What’s your message to the budding radiologists?

The only thing is that everyone should not have theoretical knowledge but also have the practical know-how of the specialty and in this new era they should not only think as the radiologist but also as a clinician and surgeon too.

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zoom in

Refurbished Radiology Market

Opportunities Galore

By Kaushik Shah, Proprietor, KS Biomed

A

s the specific need of upgrading existing facilities of a radiology diagnostic set up increases, it obviously increases concerns for investment and also of selecting the modality which is viable for the diagnostic set ups. This situation has lead to a wonderful opportunity for refurbished product solutions in India. Of course along with very few authentic organisations involved in refurbished business, there are many small time un-authentic fly-bynight players who try their luck in this segment. This situation is very fragile for refurbished market as it reduces the confidence in overall refurbished market. That is the reason why face value counts a lot for any supplier in this segment.

Post-sale service Indian radiology market is price conscious but at the same time investors neither want to compromise in quality nor are they ready to accept any risk factors for service support system.

Post sale service is one of the prime worry for anyone who is considering refurbished products. Due to the short term gain oriented companies, this concern has grown very high in current time when refurbished market is grown to the level of an industry in itself. This is the main reason why it is important for any buyer to consider overall service and commitment of the organisation from which they are buying. One need an experienced team of engineers and enough updated spare stock as part of support system. Also more number of satisfied

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Kaushik Shah customers adds very strategic value to develop confidence of new customers. Other aspect that works very well to increase face value of an organisation is the specialisation on selected products. As the focus of sales and service support remains for few selected products only, one can plan better procurement and maintenances in much customer centric way.

Mammography and BMD (DEXA) In current time, majority of diagnostic set ups are already equipped with XRay, Ultrasound, CT and MRIs. They are left with two choices only. Either to upgrade there current modality which is in use or else consider investing

in additional modality like mammography, BMD, OPG and others which normally was not taken initially considering high cost of equipment and low viability risks. We realised need of this concept and completely redefined equations of owning costly modalities like mammography and BMD (DEXA).

There were many players in CT and MRI refurbished segment but none in this segment four years back. Also traditionally mammography and BMD (DEXA) equipments are very sturdy, easy to maintain and relatively easy and cost-effective for maintaining spare inventory. Ageing of equipment does not become an issue in these two modalities unlike CT and MRI where old equipments are considered old generation units with limited life. More so, in Mammography and BMD(DEXA), the quality of hardware and upgraded software versions make them so perfect for current time that there remains hardly any actual need of investing in new age units.

With many successfully installations all over India of mammography and BMD (DEXA) over the years, the market is opening up to the growing needs of same in all segments of radiology in rural and urban segments as well. These two modalities also have lots of value in developing a single diagnostic center with a onestop solution for a complete radiology set-up. In sync with market trends, we specialise in mammography and BMD (DEXA) systems for refurbished segment with some very specific need based solution for high end colour doppler.

s 3rd International Exhibition on Health, Medical Equipment & Hospital Infrastructure

“Leveraging Technology for Transforming Standards of Healthcare...”

Gujarat University Exhibition & Convention Centre

Highlights of Hospital Tech 2012 CII’s Flagship exhibition on Medical Equipment and Healthcare Infrastructure Over 70 exhibitors Participated the event leading companies like Force Motors, Siemens, DePuy Medical, Draeger, Zimmer, Omron, Attune, Mahindra & Mahindra, Hosmac, Easy Care, Janak Healthcare, Kopran Laboratories, Kimberly Clarke, Meditek Engineers, United Surgicals and ISS Integrated Facility Services to name a few……..

“Health & Hospital Conclave 2012” was held along with the exhibition Some of the leading professionals from healthcare fraternity at Health & Hospital Conclave were: Dr Rajiv Modi, Cadila Pharmaceuticals; Dr Vikram Shah, Shalby Hospitals; Dr Vivek Desai, Hosmac; Dr Abhijat Sheth, Apollo Hospitals; Prof (Dr) K V Ramani, IIM Ahmedabad; Dr Sajan Nair, Narayana Hrudayalaya Hospitals; Mr Nandakumar Jairam, Columbia Asia Hospitals; Dr Bharat Gadhavi, HCG Hospitals; Dr Nitin Shah, SAL Hospital; Mr S Srinivasan; Siemens; Mr Vishnu Kalra, J&J, Singapore; Mr Sanjay Banerjee, Zimmer; Mr Arvind Gupta, SBI; Dr Adheet Gogate, HealthBridge Advisors; Mr Ishwar Dutt Sharma, Apollo Munich Health Insurance Co. Over 100 plus senior level delegates attended the conclave.

Exhibitor Profile Hospital Equipment / Surgical Products Diagnostic/Laboratory Equipment Medical consumables/ Disposables Rescue and Emergency Equipment Facility Management & Support Services Communication and Information Technology Medical Waste Management systems Hospital furniture, Equipment & Fabrics Energy Saving Devices Yoga & Fitness Centres

Ambulance/ Medical Vans Medical Gas / Air conditioning Financial Institutes / Private Equity Construction and Engineering Interior Designing / Consultancy Firms Lighting and Electricals Hospital Accreditation Security Systems Healthcare Institutes Health Insurance Companies

Visitor Profile Doctors Surgeons Veterinarians Pathologists / Biochemists Microbiologist Therapist Hospital Owners / Directors / Managers

Hospital Administrators Investors for Healthcare Industry Medical Service Providers Distributors Dealers & Retailers Government Agencies & Officials NGOs / Defence

For further details please contact Alpa Antani Head - Trade Fairs (WR) Prakash R. Boga Executive Officer alpa.antani@cii.in prakash.boga@cii.in Confederation of Indian Industry (WR) 105 Kakad Chambers, 132 Dr Annie Besant Road, Worli, Mumbai 400018.

Tel: +91 22 24931790 Extn 438 | Fax: +91 22 24939463 / 24945831 | Mobile : +91 9821024284

ZOOM IN

Providing

Complete IT Solutions

Sadananda Reddy, Managing Director, Goldstar Healthcare Private Limited (GHPL) thinks cloud solutions are helpful in addressing the rising cost of healthcare Kindly tell us about the Hospital Management and Information system solution, developed by Goldstar?

Goldstar Healthcare Private Limited has developed complete comprehensive Hospital Management and Information System that provides end-to-end modules/features. The solution is developed on latest Microsoft dot net technology supports on MS SQL database and addresses all the departments in the hospital. The modules are integrated with each other based on the functionality.

With over two decades of exposure and experience in healthcare, how do you visualise and evaluate the IT transformation?

If we look at 10 to 15 years back HMIS means only billing software either outpatient or in patient billing some places registration and doctor appointments.

None of us has any budget for HMIS, Electronics Dara Processing means buying some computers and printers and keeping computer peripherals. We were using maximum as Excel to compile and compare the data,mostly used word for everything.

Today the healthcare industry is undergoing a substantial transformation and is progressively more looking to improve service delivery under the impact of an evolving end user profile, disease patterns and increasing

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sadananda reddy

healthcare costs. According to research firm Frost & Sullivan, a large number of healthcare facilities in this region are leveraging Information and communication technology (ICT), to boost service delivery and improve return of investment.

Efficient, affordable and timely delivery of quality healthcare services is becoming a priority for healthcare companies. Emerging technologies such as cloud computing, big data analytics, advanced visualization tools, mobile and social technol-

ogies can revolutionize healthcare delivery.

Cloud computing and cloud services not only addresses the challenge of rising healthcare costs by significantly reducing capital expenditure for healthcare providers, it also provides them with the flexibility and agility they require in the dynamic Asia-Pacific market. As per the report, almost 30 per cent of healthcare providers across the region are currently using cloud computing and cloud services while a number admit that this is a key technology focus for their budget in the near future. CIOs in the healthcare sector believes that mobile phones including smart phones and even tablet PCs are becoming the most popular communication channel for physicians.

In what way do you assist in enhancing operational efficiency?

Our Team of experts, who has extensive knowledge of more specific healthcare sector with various discipline will assist on the healthcare projects from inception till commissioning. The focused approaches that provide innovative solutions to the customer and the entire process shall be monitored through our collective approach. We identify and calculate the problems in each and every stage and take the proactive measures in related events to control the cost and time.

PIN*****

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‘Science behind life’ Priyanka Shetty, Head - British Life Sciences, a British Biologicals Company, talks to ENN about the opportunities in infant and baby nutrition segment

What is the rationale behind the launch of British Life Sciences, considering the parent company, British Biologicals is mainly in medical nutrition?

priyanka shetty

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British Biologicals, a pioneer in the field of nutrition, caters to all age groups, i.e. from pediatrics to geriatrics. There was scope for us to include infant and baby nutrition. Considering the highly sensitive nature of infant and baby nutrition, and the potential in terms of the market size, we felt that a separate department was needed to address this. As a well-known global nutraceutical company with

manufacturing units in India, this is the right time for British Life Sciences to enter the market.

With a large repository of product/ segment knowledge and over two decades of research in the field of medical nutrition, we knew that we had the wherewithal to address the needs of our youngest customers – infants and children.

“We are not just another life sciences company.

We are the science behind life” What is the market size of Infant nutrition products in India?

What factors are helping the growth of the sector in India?

The Indian baby food market is estimated to be around ` 22 billion and rising. India is no more the country it used to be a few decades ago. More and more women are entering into the mainstream work force. Her career is not ‘flexi’ or ‘optional’ anymore. The modern Indian woman is the mother who prefers to get back to her job/ career soon after delivering her child.

The modern Indian woman is also the mother who understands nutrition and how to supplement or fill in gaps in her child’s nutrition. British Life Sciences is at the helm, enabling her to tackle these lifestyle changes with offerings which ensure nutrition for a better life of her child.

Tell us about your products?

From the Life Sciences stable we currently have two products- one for infants and the other for babies. MMS Infant Formula is the substitute for

Mothers milk, which is recommended to mothers who are unable to breastfeed their babies for various reasons.

MMS uses only the highest quality ingredients and its composition is superior to any other competing product in the market today. It provides optimal nutrition for infants and is the ideal substitute for mothers’ milk.

Mum’s Care is a specially designed organic baby cereal which provides all the essential nutrition for babies above six months of age. With our in-depth study and research in baby foods, corroborated by study findings elsewhere in the world, we found that organically grown produces are much more nutritious than conventionally grown ones. This prompted us to bring out India’s first organic baby cereal, a fact which we are proud of.

“The modern Indian woman is the mother who understands nutrition and how to supplement or fill in gaps in her child’s nutrition”

What are your plans on organic baby food?

Recent studies have shown that organic food is the best form of nutrition, especially for infants and babies. With the amount of toxins and preservatives present in most infant nutrition products, their consumption often leads to serious health complications. Also, children are more susceptible to the risks of pesticide exposure. Hence, going forward, we

are of the opinion that organic baby nutrition products would become a benchmark for safe and trustworthy baby foods.

What are the challenging areas for you? How do you sail through them?

The traditional Indian baby food market is dominated by MNC’s who have been operating for many years.

They have firmly established their brands in India. The challenge is not to compete with the MNC giants, but to break the clutter and carve a niche for ourselves in this segment.

British Biologicals, our parent company has been a pioneer in the field of medical nutrition in India. It is trusted not only by the consumers across 21 countries, but also by the medical fraternity who prescribe these products. Using the research experience of our parent company, we have been able to develop superior quality and formulation of our products in British Life Sciences. So our products not only have exclusivity, but also a strong and trusted brand backing to ride on. Success for us is only a function of time then.

Tell us about your short and long term plans?

At British Life Sciences, we believe that we are not just another Life Sciences Company. We believe that we are the Science behind life. Our vision is to provide the best quality products to all our discerning consumers and this remains our ultimate goal.

We have covered the infant and toddler age group for now. Going forward, we would be introducing more nutritional products intended for children up to 12 years of age. These are currently unavailable in the Indian market. We are excited about the future prospects of our fledgling enterprise and are confident of our success.

august / 2013 ehealth.eletsonline.com

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IT as an Enabler

Ashvini Danigond, CEO and Executive Director Manorama Infosolutions feels IT in healthcare has been crucial yet it needs to explore some new medical services

What kind of business process solutions do you offer for hospitals and physician practice groups?

We have a complete Hospital Information Management System for multispecialty hospitals, with patent management, back office management and integrated finance accounting Similarly we also have solutions for diagnostic centers, Document Management systems and telemedicine.

ashvini danigond

Tell us about the healthcare IT scenario in India?

The Healthcare IT requires a proper awareness and adequate allocation of funds, man resource & research.

It should further restructure / reform the scenario not just to find health solutions in metros but also for the common man residing at a very remote location in our country.

IT has started playing an effective role in hospital management, but it still needs to explore with different medical services. IT can reach anyplace, anytime with single experts of medical faculty. It needs to be handled by a good district network of public health, Government of India. The healthcare practice needs to incorporate globalisation with healthcare IT advantage, under the support of World Health Organisation (WHO).

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“The Indian hospital management does not allocate good enough budget for the required IT infrastructure and software” What are the challenges faced by the IT companies while designing process system for Indian hospitals?

The Indian hospital management does not take into account or does not allocate good enough budget for the required IT infrastructure and software, which hampers implementation of the ‘best’ solution for the Hospital. Even after the systems are implemented, the lack of awareness of the medical fraternity regarding the usability of the system loses the purpose of automation.

Kindly elaborate on company’s capabilities to provide quality processes that deliver service consistency in addition to supporting risk-mitigation and service disruption mitigation.

We have a retrospective processes to supervise the entire life cycle of software development, implementation and maintenance. The development is executed using agile methodologies with development stages being debated among the development team, and the updates done in a small incremental proportion. This methodology makes evident in advance the possible shortcomings and loopholes in the process of software development.

A constant contact is maintained with the customer to appraise the development strategies and status. This guarantees the best possible delivery of customer’s expectation and lessens the risk associated with non-conformance of software to the requirement specification dictated by the customer.

This ensures us 100 percent customer retention.

Special Focus

Staying in

Safe Hands

Health insurnace is one of the fast growing sectors in India. Though, the concept is a few decades old, the sectors has witnessed tremendous growth recently

By JP Pattanaik, Healthcare Business Analyst, United Health Group Information Services Pvt Ltd

T

he evolution of Third Party Administrators (TPAs) and cashless facility go hand-in-hand.

TPAs have contributed significantly in streamlining the processes and providing unbiased services to millions of customers. Of late, the industry is experiencing a shift in thought. Many insurance companies have in-house claims administration units.

Health insurance may be defined as an individual or group purchasing healthcare coverage in advance by paying premium to meet the expenses of unforeseen health related ailments.

Thus, it is an arrangement that helps to reduce the financial risks involved with an individual or a group when falling sick and in need of medical attention. Health expenditure in India is nearly six percent of the entire GDP with current public spending of 1.4 percent as against five percent recommended by the World Health Organisation (WHO). At present, the insurance coverage is negligible, covering about 15 percent of total population through different forms of the total health insurance. Most of the public funding is for preventive, primitive and primary care programmes while private expenditure is largely for curative care.

High financial burden, due to health related expenses, is a major cause of debt among the lower middle class and

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JP Pattanaik

of healthcare expenses is growing at a rapid pace, the importance of health insurance as a financial risk management tool is bound to grow.

Evolution of TPAs in India The evolution of health insurance can be divided broadly into two phases.

The first phase can be referred as the phase before dawn of the millennium and the second phase post dawn of the millennium to the present.

The year 2001 witnessed the rise of the Third Party Administrators (TPAs) in health insurance industry. TPAs are regulated by Insurance Regulatory and Development Authority (IRDA) and mandated to provide healthcare related services. The claims servicing and other administrative activities are now outsourced to the TPAs, at a remuneration of four to six percent of the premium collected. Till date, 29 TPAs are in operation. With the introduction of TPAs, insured could avail cashless benefits.

It was felt that the introduction of TPA will ultimately benefit the consumers. The objective of introducing TPAs was to improvise on customer services, and also bring about a reduction in the claims ratio by greater pro-active involvement in the area of claims administration. Introduction of TPAs as an important stakeholder brought in its own complexities into

‘Health expenditure in India is nearly six percent of the entire GDP with current public spending of 1.4 percent as against five percent recommended by World Health Organisation (WHO). At present, the insurance coverage is negligible; covering about 15 percent of total population through different forms of health insurance’ poor families. New diseases, lifestyle diseases for example bring enormous challenges to healthcare financing system today. Given the fact that cost

the health ecosystem.

Role of TPAs TPAs perform a varied range of func-

cover story

tions. Right from bringing the providers on-board for creating a network of hospitals to providing cashless service to the insured, TPAs play an important role. TPAs being in the center of provider and payer relationship, their role are very critical for smooth execution of health insurance transactions and keeping the operational hurdles at bay.

Issues and challenges TPA intervention in the health insurance industry seemed to be the right choice during the first few years. The belief that the TPAs would provide unbiased service and will be able to maintain a healthy relationship with all stakeholders seems to be fad. The industry as a whole facing issues in

What’s awaiting the Indian Health Insurance sector Merger of TPAs in order to compete as a bigger force with the prominent players Gradual extinction of TPAs Acquisition of TPAs by insurance companies to leverage the experience they have TPAs would look for alternatives like pre policy checks, public sector units’ claims processing and the like as alternative business models

‘The public sector insurers have plans to set up a joint internal TPA for in-house claims administration.

The joint TPA would serve only the public sector insurers. The market share of the public sector insurers is over 60 percent’ the current model, some of which are as follows:

In-house claims administration During the initial days, almost all insurance companies were associated with one or more TPAs for claims administration, i.e. while the policies were sold by the insurance companies, TPAs used to take care of all administrative aspects of claims management. TPAs were paid for the services provided, usually a fixed percentage of the premium collected from the enrolled members. The fee varies from four to six percent based on the individual negotiations. However, few companies like Bajaj Allianz have been processing the claims on its own (inhouse claims administration) for years now. The stand-alone health insurance companies such as Max Bupa and Star Health Insurance have their own in-

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house claims administration units and they do not rely upon any TPAs. The public sector insurers have plans to set up a joint internal TPA for in-house claims administration. The joint TPA would serve only the public sector insurers. The market share of the public sector insurers is over 60 percent.

Advantages It is expected that insurance companies have better control over the processes when carried out internally.

Currently insurance companies pay around 4-6 percent to TPAs towards administration fee which is perceived as a higher amount by the insurance companies. Insurance companies also believe that the influential providers will have very little say on manipulation of claims thereby preventing fraud. The general perception is the customers do not have to run

around TPAs, the customer service will be more efficient and the insurance companies can bring control over claims ratio. At the same time, since insurance companies will have all the controls, the transparency of the processes still remains a question. Insurance companies may try their best to show case their dominance in the industry.

Industry impact The recent trend of moving towards in-house claims administration by the health insurance companies is going to have huge impact on the existing TPAs. Once the proposed TPA by public insurers appears on the scene, it is going to take away most of the current volume from the existing TPAs. Public sector insurers have over 60 percent market share and many private insurers have their own in-house claims administration units. Thus the move might prove unfavorable on existing TPAs. So what is in store for them?

The TPAs have the vast experience due to their involvement as key stakeholder in the healthcare industry which can be leveraged up on.

Conclusion Over the past decade and half, TPAs have played an important role in health insurance industry. Inspite of the issues and challenges their contribution to growth of the industry cannot be ignored. The industry is still taking baby steps. The TPAs have been influenced by payers which have not given them enough authority to deliver. If the industry loses out TPAs, customers are going to be impacted at large. The growing trend of adopting in-house claims administration practice gives an upper hand to the insurance companies. In the age of consumerism, unless the regulatory authorities take bold initiatives, we may witness unavoidable friction among the stakeholders inviting new hurdles impacting the industry growth.

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A Rapid Response to

Stroke Reduces Damage

Technological advancements have boosted neuroscience. Dr Rajesh Garg, Director and HOD, Neurology, Paras Hospitals, Gurgaon, shares his views with Shahid Akhter Please give an overview of neurology and neurological disorders in India ?

Neurology is growing at a slow pace but certainly the scope has widened and diversified. Today there are around 1,000 qualified neurologists in India.

Advanced imaging, electrodiagnostic investigations, improved blood tests and other technological breakthroughs have paved the way for enhanced diagnostic accuracy ,leading to better understanding and treatment of neurological disorders.

Headaches are so universal and a good many triggers are there.

How do you ascertain the cause and determine the cure?

Headache is very common and it comes in a diverse variety. There are hundreds of diagnostic headache categories. This pain is the outcome of interaction between the brain, blood vessels and the surrounding nerves.

The causes, again, are simply countless. The pain may be due to a simple blow or injury, or may emerge as an outcome of illness, infection or other conditions that may precipitate a pain. Add to this, environmental factors, lifestyle and the maze of chemicals surrounding us.

Once a correct diagnosis is made, the treatment plan is conveniently chalked out. It all begins with the case diary which makes it easier for the

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“The mysteries of the brain continues to elude us. We are still squinting in the primitive ages as far as brain is concerned’’ neurologist to decode the headache and arrive at a conclusion.

What is epilepsy? Are there any statistics on the numbers of Indians suffering from this disorder ?

The prevalence rate of epilepsy is about 5 per 1,000 in India. However, due to lack of neurologists and the stigma attached to it, there are many who prefer to hide it rather than come foward for treatment. Many think it is supernatural and treatment is neither required nor possible. However, these myths need to be dispelled and people who witness successful treatments feel encouraged to seek medical advice.

Epilepsy or seizure disorder is a condition affecting the nervous system. An epileptic seizure results from a sudden electrical outburst in the brain that leads to a changed pattern by way of behaviour, consciousness movement or sensation. Drugs are capable of controlling 70 percent of people with epilepsy. At times, surgery is the solution and some neurologists

combine surgery with medication.

How common is Parkinson’s Disease in India ?

Age related prevalence of Parkinson’s in India is around 70 per 100,000.

Compared to the West, Parkinson’s disease in India is relatively less.

However, in days to come when the aging pattern of the Indian population changes, there may be greater number of those affected.

The symptom begins when more than 50 to 80 percent of dopamine neurons have died. There are a variety of triggers but it is widely accepted that genetics and environmental factors merge to set the disease in motion.

Drugs and surgical procedures (deep brain stimulation)are the two options for Parkinson’s disease. In deep brain stimulation, the neurosurgeons implant electrodes into a specific part of the brain.

What are some of the latest approaches to treating stroke ?

The average stroke rate in India is around 150 per 1,00,000 which is similar to the developed nations. Ischemic strokes account for more than three fourths of the strokes in India.

The worst damage that can happen from a stroke occurs within three to four hours. Fast and early treatment is the need of the hour. First it needs to be ascertained if the stroke is ischemic (blocking an artery) or hemorhagic ( involves bleeding into the brain).

How do you resolve the medical and ethical dilemma in brain death?

According to The Transplantation of Human Organs Act, 1994, ‘Deceased person’ is defined as a person in whom permanent disappearance of all evidence of life occurs, by reason of brainstem death or in a cardio-pulmonary sense at any time after live birth has taken place. Further, it goes on to state that ‘brain-stem death’ suggests the stage at which all functions of the brain stem have permanently ceased.

Once brain-stem death has been diagnosed by an authorised team using specified criteria, the dead person’s organs can be removed for transplantation provided legally valid consent for this is available.

Please tell us about the team of doctors at the Neurosciences in Paras Hospital?

We are a team of five neurologists, each specialising in one aspect of neurology and focused for appropriate approach in his respective field. The highly skilled team of neurosurgeons, neurologists, neuroanesthetists, neuro radiologists, psychiatrists and experts in critical care work in tandem to provide the best possible healthcare services.

How different is the Neuro ICU at Paras Hospital?

The ten-bedded Neuro ICU, stroke unit, is equipped with latest ventilators, monitors & defibrillators and is manned 24x7 by Neurointensivists. There is a facility of continuous monitoring of brain function and vital parameters with the stateof-art equipments.

DR RAJESH GARG

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special specialfocus focus

Bringing Treatment

to the Common Man Though cancer treatment in India is cheapest globally, still Indian patients find it unaffordable. Working on this line, Health Care Global Enterprise (HCG), has opened up new avenues in cancer care. Ajai Kumar, Founder and Chairman, HCG talks to Sruti Ghoshal, ENN Oral cancer is the 6th most common cancer reported globally and India ranks 8th among nations. How is HCG helping in reducing the incidences of oral cancer Oral cancer is prevalent in certain sections of the society. Historically, oral cancer was caused due to smoking and chewing of tobacco. HCG has contributed largely in the anti-smoking campaign. We wrote a lot of petitions pertaining to non-smoking in public places. We have been the forefront for decades in carrying out anti-smoking campaigns. We have conducted many screening camps, where they detect cancer in its earliest stages. We will be shortly starting a bus service in parts of North Karnataka where they will have all the equipments for pre-screening.

The Government of Karnataka has asked us to initiate this bus service in other parts of Karnataka as well. Our ultimate goal is to avoid relapse of cancer once it’s treated.

“We have changed the face of cancer treatment in India with 27 centres and 20 more coming, we are the largest group in cancer care”

Oral cancer is mainly caused due to chewing of tobacco.

Has HCG tied up with Karnataka Anti- tobacco Cell to curb this?

We are working with them and recently we did a campaign. We conducted a rally in Mysore and other places. We believe HCG being largest cancer care

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AJAI KUMAR

group; we can definitely make a great impact on the social aspect.

FACT FILE

What are the steps that HCG has taken to make cancer treatment more affordable?

• Cancer is the second most common disease in India.

• As per Indian population census, the mortality due to cancer is alarmingly high • Cancer prevalence in India is estimated to be around 2.5 million, with over 8,00,000 new cases and 5,50,000 deaths occurring each year

The perspective that people have about cancer treatment is that it is very expensive, but it is how one looks at it. India is the cheapest healthcare provider in the world and cancer care is also among the cheapest in the world.

If you look at technologies, like Linear Accelerator, Cyber Knife, the cost to the customer in Africa is double than that in India. So we have mastered the technique of doing it at a low cost.

Similarly, lot of generic drugs are available at a very low costs and that has made a huge difference. But the problem that we face in India is that majority of people belong to the BPL or lower middle class for whom this cheap treatment is also unaffordable. But there is a ray of hope; We have started working with different governments like the Government of Andhra Pradesh, Karnataka, Tamil Nadu and Maharashtra and have come up with Arogyashree, a scheme for the BPLwhereby we pay for their medical costs, like fooding and lodging. As a foundation we have an excellent system of medicosocial workers. We make sure that no patient is denied treatment because of his/ hereconomic background. On this note Harvard Business School did a study on us, showing that how you can create an enterprise in healthcare which maybe a corporate enterprise for profit, at the same time can take care of all sections of the society. Last year our foundation took up the treatment of 25 children. So we have a great social responsibility and that is why we define ourselves as ‘corporate with a heart’.

Have you set up any hospitals in rural Karnataka for delivering cost-effective treatment for the rural people?

We have set up several hospitals in the

tier II and Tier III cities. Our whole model is based on Hub and Spoke model. The Bangalore centre in the Hub and around this we have many clinics and hospitals which are connected to the Hub hospital through either video conferencing or by other means.

We have built centres in Mysore, Shimoga and other places. We have a big centre coming up in Gulbarga. Around it we create screening centre. We are also working with the government to set up nodal points for screening. We have spread our roots almost all over the country. We have changed the face of cancer treatment in India. With 27 centres and 20 more coming up, we are the largest group in cancer care. So our Hub and Spoke model has enabled our patients to seek treatment at the nearest location and head back home on the same day rather than staying away from home for months.

What are the new technologies introduced in chemotherapy and radiation oncology?

In the field of medical technology we have replaced Cobalt with Linear

Accelerator. In Linear Accelerator we have adopted high-end therapy where the focus is on treating cancer and not the normal tissues. Now we also have Cyber Knife, where we can treat tumours only avoiding all other normal tissue. Another high-end therapy that we are working on is proton therapy where there won’t be any exit or entrance doors. We are planning to launch that in India in another two to three years. In surgeries also we are bringing new innovations and working on complicated surgeries. We are also doing robotic surgery now.

We have also introduced personalised medicines where patients are treated on the basis of molecular diagnostics.

We have also approved for a genetic sequencing machine which is the first time in India. Through this we can sequence and differentiate different chemotherapy for different patients.

This is going to make a huge impact on deciding what should be the right treatment.

Do you think that government hospitals should also work towards bringing ICT in the hospitals?

I have different perspective. The Government should work towards the improvement of the Primary Health Care system, anaemia, malnutrition among women and children. It is very difficult to focus on everything and be a monitoring agent. The government through its different schemes should empower the private enterprises and endow them with the work of helping the poor. So the government’s role has to be clearly defined as a monitoring agency and funding the poor and not actually getting into the actual treatment of these complicated procedures, because the human resources put in to maintain the technology is very difficult. So the government in my view should refrain from being in the business of putting up hospitals.

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expert speak

Healthcare System for All Philips, which ranks third among the health IT companies in the world, strives towards making healthcare more accessible and affordable. In conversation with Sruti Ghosal, Wido Menherdt, CEO, Philips Innovation Campus (PIC) shares his vision on making healthcare affordable for the masses

Do you think the Indian healthcare system is fertile enough for innovations?

What are the challenges you see cropping up limiting the acceptance level of the Indian healthcare fraternity?

Wido Menherdt

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Indian Healthcare is ready for innovation. The biggest issue that Indian healthcare system faces is access.

If you look at the modern healthcare system it still lacks access and we are definitely working towards increasing the access level. The ground is also very fertile for entrepreneurial

development as India is the country of entrepreneurs. So there are a lot of entrepreneurs who are setting up hospital chains which are very innovative in nature.

The main challenge which India faces is cost-expense, which is much more challenging in India than in other countries. But India is a value oriented country so attaining the target is not impossible here.

Do you think the healthcare regulations are not giving a positive environment for growing innovations?

Currently the Indian regulations are not at par with the US regulations. Because of the FDI regulations in India, few people think that India doesn’t want to welcome innovations. But according to me regulations are by and large a good thing. So what the government is doing is the right thing,

A comparative analysis between US and Indian healthcare system US SCENARIO Regulatory environment

INDIAN SCENARIO •

Defined guidelines under JCHAO, advocating stringent care protocols

•

Largely unregulated allowing a fragmented delivery mechanism without any need for IT intervention

•

CMS regulated reimbursement norms facilitated by IT

Quality focus

•

Increasing focus on adequate quality of care

•

Not viewed as a market differentiator due to lack of regulatory support

Comparative spend

•

Larger IT spend (10 to 15 percent budgetary allocation)

•

Mimal IT spend only 1 to 2 percent of budgetary allocation.

•

Increased focus on EHR/ clinical solutions

•

Viewed as a non-core spending with a lower priority

“

The ground is very fertile for entrepreneurial development as India is the country of entrepreneurs. So there are a lot of entrepreneurs who are setting up hospital chains which are very innovative in nature” because we want to give our products which are suited for the Indian market. We want to deliver products which will actually be beneficial to the Indian healthcare system and therefore designing innovations which doesn’t sync with the Indian healthcare system doesn’t hold any good.

cant. But if you see the Indian market at large it is much more affordable than the other developed nations of the world. We are trying to make our products more cost-effective and more affordable.

According to you how costeffective is the Indian health IT market?

The health IT market has limitless opportunity and it is open for innovations. For example the telemedicine service in India has quite proved to be useful. India is a value oriented country and when people saw that making a phone call costs lesser than going

We are trying to make it cost-effective and more affordable. In India, a certain strata of the society can afford high-end healthcare, but the majority

How do you see the growth of the health IT market in India?

and visiting the hospital in person, they started adopting that technology.

So in India there are more opportunities for innovations and Indians are accepting new changes and giving way for innovations.

What are your future plans of expansion?

The range of Philips products is very broad at PIC. From a global perspective we want to bring in more innovations among the local products. Over the time, we want to bring in innovations in almost all the ranges of Philip Healthcare system that is available in the market. We want to bring in more innovations in the home space, where people can stay at home and get the same treatment as they receive at hospital. Unlike US in India people have to stay in hospitals for months to recover and undergo treatment, so Philips is working towards providing solutions which will enable a patient to actually stay at home and undergo treatment at the same time.

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Leaders’ leader speak Speak

‘Our best is yet to come’ Jasdeep Singh, Facility Director, Fortis Hospital, Shalimar Bagh, is upbeat about his ongoing efforts in turning the caring venture into a saga of success.

He discusses his health mantra with Shahid Akhter, ENN We have worked hard to ensure that our level of service remains unmatched. Not just the patient but even the attendants should feel the positive aura and remember us for our high standards of service and excellence that we strive for.

What sort of challenges you faced initially and how did you iron them out?

jasdeep singh

Within a short span of three years Fortis Hospital Shalimar Bagh has carved a niche and established, into a centre of repute. How did you achieve so much in so little a time ?

Fortis is a brand name with a strong recall value, so our task was much easier. We began with community outreach and our focus was to ensure that people in and around should have the best of healthcare facilities by way of infrastructure and a pool of doctors JASDEEP SINGH who are most trusted. Instead of a super specialty with a single entity, we

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opted for one stop shop in all verticals of healthcare.

Fortis Hospital, Shalimar Bagh has done tremendously well ever since it opened its doors. The reasons are multiple and can be clubbed under the following: Brand Power, Clinical talent, Infrastructure, Comprehensive Medical Programmes, Values and Processes.

We ensure that the 7 ½ acre infrastructure, biggest among Fortis hospitals in Delhi, is utilized as best as possible. From the exterior façade to interior lobby and corridors, they reflect our ethos.

Challenges were many fold but we were determined to emerge as a winner. Every new healthcare facility takes time to gain confidence of the population and one of the key reasons why patients come to a hospital is for its clinical talent. At Fortis Shalimar Bagh, we ensured that our medical fraternity was and continues to be par excellence. Another aspect which helped us establish ourselves was the comprehensiveness of the medical programmes the hospital had to offer. A patient always prefers a hospital where the family members are least hassled especially when the ailment is multi-disciplinary.

The hospital also offered great services which were clear differentiators for the patients to choose this hospital every time.

We achieved this gradually and today our customer satisfaction level is impeccably great.

Railway lines running close to the hospital was one sound hindrance which we overcame by introducing innovations system that has cut down the noise level considerably. Double glazed glass panes were introduced to reduce the heat and the landscape was reinforced with lush greenery.

What services and specialties are offered at Fortis, Shalimar Bagh?

We cater to almost all verticals of health. The hospital has been designed strategically to offer almost all specialties which positions it strongly as a community hospital of choice. From common cold to Bariatric (Weight Loss) surgery, general surgery to high end cancer surgeries of the Gastrointestinal tract, Birthing to high end neonatal ICU, Trauma to Joint Replacement, complex neuro-surgery to high-end plastic and reconstructive surgery, pre and post birthing fitness to cosmetic procedures, child health to mental and behavioral sciences.

All clinical specialties at one place makes Fortis, Shalimar Bagh, the first choice in a one stop shop in healthcare.

We want to make everyone feel and experience the high end quality by way of services that we have created. We have Fortis Operating System in place to redress the grievances where we fail to deliver what we promise. We leave no room for dissatisfaction.

Our NABH accreditation is a peer assessment that recognizes, assures and ascertains the high quality of care and patient safety standards.

How good is your emergency and trauma service ?

We offer a comprehensive, round the clock emergency medical services.

It is equipped with state of art emergency equipments and managed by a team of experts who are quite capable of providing all necessary life saving procedures like resuscitation, airway protection, vascular support, cardiac support, cardiac pacing, and multidisciplinary support, Orthopaedic services, Neuro Sciences in case of accidents, falls, and assaults.

To cut down on the wait time we have the charting and triage system, a 24 x 7 clinical laboratory, dedicated CT, MRI, Xrays and ultrasound facilities.

Cardiac ambulances and emergency

Not just the patient but even the attendants should feel the positive aura and remember us for our high standards of excellence and service that we strive for technicians are always at hand. Minor procedure rooms are there to look after trauma and emergency. ‘

Who is your target group and how affordable is Fortis, Shalimar Bagh ?

Nothing can be more rewarding and humane than saving a life. There is an influx of people from all walks of life who pour in from North and West Delhi and even from neighbouring states.

Fortis is affordable to all if you look at the services and infrastructure. In fact, we are the most affordable.

We offer a range of rooms, varying from six beded economy ward to Presidential suite. In between, we offer deluxe rooms, single rooms, twin sharing rooms and four beded wards.

We are keen to cater to all sections of the society.

How do you keep your doctors abreast of the latest medical developments ?

CMEs are de rigueur and we take all steps to ensure that our doctors keep sharing and exchanging ideas.

There are a number of meetings and programmes to ensure that the latest development percolates within the medical fraternity. Cross learning, conferences, specialty seminars, forums are organised as and when required.

Fortis, Shalimar Bagh is reckoned as the first hospital in India to have acquired green building certification. Can you please spell the salient features of this unique certification ?

Green Building Certification is a recognition of patient friendly environment that showcases the inclination towards nature conservation and sustainable development. It fosters the health care facility and ensures the quick healing environment for the patients.

There is overall accountable saving in all energy consumption by way of light, heat and energy. There is enhanced indoor environmental quality which ensures sufficient natural light into the interiors, sufficient fresh air flow, heat ventilation air conditioning, sufficient views of the outdoor, reduced water consumption, etc.

Rain water harvesting is another unique feature that adds to the optimum natural resourses utilisation at our hospital.

How does energy conservation and the greenery impact hospital environment ?

There is accountability in savings in almost all aspects of energy conservation. To begin with, efficient building material allows minimum solar heat gain into the interiors and this greatly reduces the need of air conditioning.

The hospital makes maximum utilization of renewable energy by way of cheaper and cleaner sources of energy as compared to conventional sources.

There is almost 30 percent reduction in running energy consumption bill.

Your future plans of expansion and growth ?

Our vision is to expand it to 550 beded hospital at the earliest. We will be focusing more into transplants, high end radiation oncology and a lot of other things are in process. I can say, �our best is yet to come.�

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news

drugs

Government to Ban Sale of TB Drugs in Open Market

Synriam Developed by Ranbaxy Wins Innovation Ranbaxy has been conferred with the Innovation Excellence Platinum Award at the ASSOCHAM Innovation Awards 2013 in the Science & Technology category for its new anti-malaria drug, SynriamTM. The prestigious award was given by Hon’ble Minister for Science & Technology and Earth Sciences, Shri Jaipal Reddy.

India’s First New Drug, SynriamTM, was launched by Ranbaxy last year on April 25th (World Malaria Day).The drug is used for the treatment of plasmodium falciparum malaria, in adults. As per IMS data, over two million SynriamTM pills have been sold since its launch and over 700,000 patients have been treated in India.

Sale of tuberculosis drugs could be prohibited in open market as part of efforts to ensure calibrated and monitored administration of these medicines which would then only be given on daily basis free of cost by government registered outlets to patients.The Health Ministry is proposing changes in view of irregularity in administration of these drugs to patients and lack of proper monitoring which is hindering efforts to check the disease.

According to the Health Ministry, about 65 per cent of the TB patients avail these drugs under the government’s DOT (Daily Observed Therapy) System while the rest opt for treatment by private practitioners and buy drugs from the chemists based on their prescription.

New Bill Proposes Central Licensing for Some Critical Drugs Licences for manufacturing drugs under 17 critical categories will be given only by the Centre and not by states, a new bill has proposed.Under the new bill, only the Central Drugs Standard Control Organisation will have powers to grant manufacturing licences to 17 critical categories of drugs that includes life-saving drugs, vaccines and DNA products which require specialised manufacturing.

The Drugs and Cosmetics Bill, 2013, a comprehensive legislation for the drugs and cosmetics sector, was cleared by the Union Cabinet.The new legislation proposes a separate set of rules for grant of compensation in case of death or injury during clinical trials and contains penal provisions, including fine or imprisonment, for violation of the law.

Updated Rheumatoid Arthritis Management Recommendations Issued By EULAR The European League Against Rheumatism (EULAR) has released updated recommendations for the management of RA. According to this latest guidance, treatment with diseasemodifying anti-rheumatic drugs (DMARDs) should be initiated as soon as a diagnosis of RA is made, with the aim of reaching a target of remission or low disease activity in every patient.

As first-line treatment, EULAR recommends rheumatologists administer methotrexate (MTX) or combination therapy of MTX with other conventional synthetic DMARDs. Low-dose glucocorticoids should also be considered in combination with DMARDs for up to six months, but should be tapered as soon as clinically feasible.

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news

technology

Computer Model to Give Longer Life to Joint Replacements A computer project just completed at Southampton University in the UK should lead to better performing, longerlasting joint replacements. The project developers are now looking for partners who wish to put the model into practice.

Currently, joint replacement surgeons rely on their experience to decide how best to replace worn out joints with artificial components. But even these artificial components break down, some after only a few years.The MXL computer model developed at Southampton University promises to improve on that.The idea is that with MXL, even less-experienced surgeons will be able to select and carry out a safe surgical route and achieve optimum joint performance for each patient, whether this is surgery to preserve the joint, or complete replacement if it is worn out.

New Technology Could Lead to Fewer Road Accidents Latest advances in capturing data on brain activity and eye movement are being combined to open up a host of ‘mindreading’ possibilities for the future. These include the potential development of a system that can detect when drivers are in danger of falling asleep at the wheel.The research has been undertaken at the University of Leicester with funding from the Engineering and Physical Sciences Research Council (EPSRC), and in collaboration with the University of Buenos Aires in Argentina.

The breakthrough involves bringing two recent developments in the world of technology together: high-speed eye tracking that records eye movements in unprecedented detail using cutting-edge infra-red cameras and high-density electroencephalograph(EEG) technology that measures electrical brain activity with millisecond precision through electrodes placed on the scalp.This could be the first step towards a system that combines brain and eye monitoring to automatically alert drivers who are showing signs of drowsiness.

Researchers Develop Novel Nanoparticle Silencing genes that have malfunctioned is an important approach for treating diseases such as cancer and heart disease. One effective approach is to deliver drugs made from small molecules of ribonucleic acid, or RNA, which are used to inhibit gene expression. The drugs, in essence, mimic a natural process called RNA interference.

In a new paper appearing today online in the journal, ACS Medicinal Chemistry Letters, researchers at Sanford-Burnham Medical Research Institute have developed nanoparticles that appear to solve a big challenge in delivering the RNA molecules, called small interfering RNA, or siRNA, to the cells where they are needed.

By synthesizing a nanoparticle that releases its siRNA cargo only after it enters targeted cells, Dr. Tariq M. Rana and colleagues showed in mice that they could deliver drugs that silenced the genes they wanted.

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NIT-T to Explore Possibilities in Telemedicine A national conference by the National Institute of Technology-Tiruchi (NIT-T), plans to bring together doctors and engineers from across the country to explore expanding healthcare reach to remote sections of the population, by tapping into various possibilities of telemedicine.

The three-day workshop scheduled at NIT-T campus from July 12 to 14, is the first of its kind to be hosted by an academic institution, according to coordinators S. Raghavan, professor, ECE department, and N.Sivakumaran, faculty, ICE department, NIT-T. Super specialists from medical institutions and engineers with expertise in telemedicine will participate.

App to Monitor Blood Pressure Scoops Top Prize at First BMJ Hack Day

A simple smartphone app that makes it easier for GPs to help patients with long terms conditions that require regular monitoring, such as high blood pressure, won “Best in Show” at the first ever BMJ hack day in London which took place on 6 July 2013.

The judges were impressed by its “simplicity and cheapness” and the team will now work with BMJ to take their idea forward.