eHealth Jan 2016

eHEALTH Magazine

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

Issue 01

January 2016

EDITOR-IN-CHIEF: Dr Ravi Gupta EDITORIAL TEAM HEALTH Senior Assistant Editor: Garima Pant Assistant Editor: Prathiba Raju Correspondent: Romiya Das SALES & MARKETING TEAM: eHealth National Sales Manager: Fahim Haq Mobile: +91-8860651632 Senior Executive-Corporate Relationship: Priyanka Singh Mobile: +91-8860651631 SUBSCRIPTION & CIRCULATION TEAM Manager Subscriptions: +91-8860635832; subscription@elets.in DESIGN TEAM Creative Head: Pramod Gupta, Anjan Dey Deputy Art Director: Om Prakash Thakur, Gopal Thakur Senior Web Designer: Shyam Kishore Graphic Designer: Ismat Pal Singh WEB DEVELOPMENT & IT INFRASTRUCTURE Manager-Web Development: Ishvinder Singh ADMINISTRATION Head Administration: Archana Jaiswal EDITORIAL & MARKETING CORRESPONDENCE

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Contents

January 2016 | VOLUME - 11 | ISSUE - 01

10 Corporate Profile

Mercy Hospital Mission with a Vision What started off just as a small clinic 37 years ago has taken the shape of a healthcare conglomerate today, in the eastern region of the country. Sanjay Prasad, President & CEO of Mercy Hospital, Kolkata, in an interaction with Elets News Network (ENN), talks about the past journey, present initiatives and the future roadmap for the Mercy group — a healthcare brand that has earned people’s trust over the years

14 Cover Story

Tech-Enabled Healthcare Transforming Lives Technology convergence with healthcare will play a key role in improving accessibility and meeting the challenge of infrastructure and manpower shortage. With greater deployment of tools such as telemedicine, teleradiology, hospital information systems (HIS)/hospital management information systems (HMIS), online or electronic medical records (EMR) gradually finding their ground in the country and more expected in the times to come, tech transformation will engulf the healthcare sector. Technology enabled care (TEC) in the healthcare domain, using cloud computing and wireless technologies, will enable easy accessibility irrespective of geographical location, fewer errors, quick response in times of emergencies and patient convenience among others. Romiya Das of Elets News Network (ENN) discovers the reach of tech-enabled healthcare in 2015 and the road ahead

40 Focus

Galvanising Healthcare via Insurance Nearly 60 million in the country are burdened by the out- of-the pocket healthcare expenditure. To fill the burgeoning gap, the government’s push for universal health coverage, the government-sponsored health insurance schemes (GSHISs) and the engagement with the private insurance companies are proliferating towards a positive outcome, writes Prathiba Raju for Elets News Network (ENN)

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National and International Collaborations for Trainings

feature

22 Foreseeing Poised Progress Exclusive Interviews

24 Cashing in on IT for

Healthier Karnataka

U T Khader, Minister for Health and Family Welfare, Government of Karnataka and District In-charge Minister for Mangaluru District

Transforming Wellness through Technology Shakthi Nagappan, CEO, BioAsia

Anytime, Anywhere Healthcare

Need for Customised Health Insurance

Dr Archana BM, Founder and Principal Consultant, Health Croniche

Dr Sriharsha A Achar, Chief People Officer & Chief Information Security Officer (CISO), Apollo Munich Health Insurance

Spotlight 28

Medical Devices – Made In India Rajiv Nath, Forum Coordinator, Association of Indian Medical Device Industry (AIMED)

industry speak

On way to Home from Hospital

Richa S Debgupta, Zonal Director, Fortis Healthcare

Product Launch

Anita Seth, Founder & CEO, pinkWhale Healthcare Services Private Limited

Healthcare Goes on Cloud

Kolkata Epicenter of Healthcare in East

A Step Towards Virtual Consultations

Krishnamurthy Ramalingam, CEO & Founder, Galactic Medical Databank Private Limited Chhitiz Kumar, CEO, Philips Capital India and Head, Government Affairs-PPP

Healthcare Leaders Forum Bengal, 2015

Transforming Healthcare Paradigms

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Startup eIndia Healthcare Summit, Maharashtra 2015

IT Works for Health Sector

editorial

A Health(y) Trend The healthcare sector plays a primary role in catering to the medical needs of people at large. And now, with the advent of newer technologies, it’s looking to further widen its scope to reach out to the masses. Going by the trend, tech-enabled healthcare is going to be one of the primary driving factors pushing the entire health market in the coming times. And it’s not just about technological advancements in the field of research, surgery, diagnostics and treatment – the IT revolution has also changed the way our hospitals and clinics function. Computerisation of records, diagnostic results, faster sharing of reports, possibility of sharing case studies and seeking advice from doctors even beyond borders have added a whole new dimension to healthcare practices. Similarly, use of mobile apps and other digital tools have helped take medicare to hitherto unreached population of the country residing in far off places. In 2014, nearly 7,500 startups across the globe looked to develop digital solutions in the healthcare domain, while year 2015 saw around 300 startups focused to the health domain itself. On one end, the Indian startup companies are working to bring medical practitioners and patients closer using technology, on the other, the government’s Digital India initiative is bringing game-changing products and software that have and will be dominating the Indian healthcare IT industry. The dominant rural-urban divide in accessing healthcare is a predominantly worrying factor. The burgeoning need of the hour is to scale up public health services, increase the number of trained health professionals and enhance public healthcare spending to ensure adequate healthcare coverage. Although the Indian health insurance market still lags behind other countries in terms of penetration, the health insurance segment is showing a rising trend. It continues to be one of the most rapidly growing sectors in the Indian insurance industry. We try and bring a holistic view across these burning health concerns in our 11th Anniversary issue. We also look forward to an overwhelming participation by the stakeholders at the upcoming “6th Healthcare Leaders Forum – Technology for Patient Delight”, on 2nd March, 2016, in New Delhi. The Forum will track the growth and envisage the future of IT in the healthcare sector in India, apart from addressing crucial challenges and advancements in the field. It will provide with an networking scope with the industry peers. New opportunities will be explored, strategies will be brainstormed and business relations made to boost the future of the healthcare industry in India. This summit will provide you an opportunity to showcase your services to CIOs, CTOs, CEOs, Public Health Departments, IT decision makers of leading hospitals across the healthcare industry, technology solution providers and vendors. We look forward to your continued support in our quest for quality healthcare in the country.

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

Interview

Mercy Hospital

Mercy Hospital Mission with a Vision What started off as just a small clinic 37 years ago has taken the shape of a healthcare organisation today in the eastern region of the country. Sanjay Prasad, President & CEO of Mercy Hospital, Kolkata, in an interaction with Elets News Network (ENN), talks about the past journey, present initiatives and the future roadmap for the Mercy Group — a healthcare brand that has earned people’s trust over the years. How has been the journey of Mercy Healthcare in the last 37 years of its existence? Over 60 years ago, the late Rev. Dr. Mark Buntain and Rev. Dr. Huldah Buntain, along with their one year old daughter Bonnie, arrived in Calcutta, now rechristened as Kolkata. They saw the needs of the city and started an education and feeding program. When a frail girl fainted at a school that Mark had founded, he rushed her to a city hospital in search of emergency help. Startled by the hospital’s congestion and

inability to meet the medical needs of the city’s poor and sick, Mark vowed that day to medically treat the underserved of Kolkata. His vision began with a small clinic. After several years of strenuous work and multiple miracles, the plans to build a larger medical facility began to take shape. In 1977, Mark opened the doors of Mercy Hospital (formerly AG Hospital & Research Centre), a sevenstory general hospital devoted to serving the medical needs of Kolkata. The Mercy Group has a dedicated team of Doctors and Nurses and partners with long standing well wishers, donors and education based institutions from across the globe. What started as a small

clinic in the back of a building has now expanded to a 173-bedded multi specialty hospital, a school of nursing, diagnostic centre and a footprint of outreach Mercy Clinics serving the outlying areas of Kolkata in the states of West Bengal and Orissa. Over 40,000 needy people receive free healthcare treatment every year through our medical network. As we move into the future, we plan to expand our services to include a College of Nursing and 40 Mercy Clinics to carry on our founder’s original dream of serving the underserved.

How has healthcare in Kolkata and the eastern region evolved? What are the key features of the segment in the region? Once a premier destination for medical care, Kolkata’s reputation as a medical hub suffered major setbacks in the ‘70s. This is a city that had nurtured legendary doctors, like Bharat Ratna Dr. Bidhan Chandra Roy, an accomplished physician and academician, who established the Indian Institute of Mental Health and Infectious Diseases Hospital; Dr. A. K. Basu, who successfully performed the first cardiac surgery in this country at Nil Ratan Sarkar Medical College & Hospital; and Prof. A. K. Saha, who performed his leading experiment on the ‘dislocation of shoulder joint’ at a Sanjay Prasad President & CEO, Mercy Hospital, Kolkata

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city hospital, to name just a few. The city gave the country its first medical college – Medical College & Hospital, Kolkata. The public hospitals in Kolkata, be it SSKM, Kolkata Medical College or Nil Ratan Sarkar Medical College, were a melting pot for the best clinical acumen and a crucible for medical treatment and research, in the heydays of 1960s, which set new benchmarks for other institutes. The city’s healthcare landscape got a second round of boost in the decade beginning 2000 with the establishment of new national and international groups of hospitals. In the last decade though there has been an influx of corporate hospitals albeit not in very large numbers. These are professionally managed groups, bringing in state of the art equipment and infrastructure, and have successfully been able to attract good medical talent from overseas. With a strong focus on Quality and Accreditation this signifies a time of overall upliftment in the services. Today, the momentum has picked up further. The existing hospitals are scaling up their bed strength, setting up multiple units in the city and exploring alternate revenue models for augmenting profitability which in turn is a vindication for those that have been investing in healthcare as an industry. However, there continues to be a glaring gap between the demand and supply in this region. The city does not cater to it’s population alone. The reach is the entire state, neighboring states and neighboring countries like Bangladesh, Nepal and Bhutan. According to a study, Kolkata is projected to face a massive shortage of beds and other healthcare infrastructure in the days ahead, as the city is strategically located and is considered as the gateway to the East. It is also gradually becoming the hub for medical tourism, especially from the countries located near the eastern border.

What are the specific operational areas of Mercy Hospital and where does it see further opportunities for growth?

Mercy Hospital, a multispecialty, tertiary care hospital currently is rationalized to around 170 operational beds. Through the network of Hospital, OPD’s and Outreach Clinics, approximately 100,000 patients are being served every year. The hospital offers a variety of services, including a complete surgical facility (general surgery, orthopedic, obstetrics, gynecology and neurosurgery), a critical care suite including ICCU, ITU, Level II NICU, SICU & HDU, a mother and child centre, an emergency center, and general medical and surgical centers. It offers the entire suite of services offering round-the-clock emergency, trauma care supported by more than 100 consulting doctors, an efficient laboratory and diagnostic facilities, and a 24-hour pharmacy. The West Bengal Government has empanelled Mercy Hospital as a Class-I Medical Service Provider. It is also among the very few private hospitals in Kolkata affiliated to the West Bengal Health University for research activities. In the area of education, Mercy Hospital has collaborated with Christian Medical College, Vellore and is successfully running the Masters in Family Medicine (MFM) program for doctors since 2008. The ongoing efforts have also resulted in Mercy Hospital becoming the only host centre for Certificate Course on Gestational Diabetes Mellitus (CCGDM) in collaboration with Public Health Foundation of India (PHFI) and Dr. Mohan’s Diabetes Education Academy. Mercy Hospital operates a school of nursing that was started in 1979 under the West Bengal Nursing Council and recognized by the Indian Nursing Council. At present, work is underway to develop a College of Nursing. Also, work is in progress to start a Masters in Hospital Administration program from this academic year.

As an established academic institute, what academic collaborations have been made by Mercy School of Nursing? Mercy School of Nursing began operations in 1979 under the West Bengal Nursing Council. The school is recognized by the Indian Nursing Council and thoroughly prepares women for careers in healthcare. Nurses graduating from this program are highly sought after by both public as well as private hospitals due to the high standards of education received. Since its inception, almost 500 students have graduated and are working as registered nurses in India and overseas. The school while providing qualitynursing education also enables its students to have international exposure through it’s partners like Azusa Pacific University, Northwest University, Skbvde Gymnasium School of Nursing, etc.

With a well-established presence in the healthcare segment, what is the future roadmap for Mercy Healthcare? The healthcare system in the country has been developing rapidly and will continue to grow in the next five years. It will increase its reach, services and will witness a significant rise in investments and expenditure in both public and the private sector. As per estimates, it will grow at an average of 14-15 per cent CAGR over the next five

January / 2016 ehealth.eletsonline.com

Interview

Mercy Hospital

years to touch $280 billion by 2020. Mercy Hospital is looking at increasing the number of beds to meet the rising need as well as strengthen the Mercy Clinic network by increasing number as well as facilities in the outreach clinics. Another aim is to achieve excellence in imparting training and education. Towards this, the hospital is looking at strengthening the infrastructure for international structured training for nurses and also hospital management students, which is the need of the hour. The team Mercy Hospital is committed to provide personalised tertiary care, wherein medical outcomes would be the pathway to further build the brand. Focus will be on service quality, patient safety, infection control, antibiotic stewardship and working towards total ‘patient delight’.

How does the group aim to contribute and achieve the aim of ‘Healthcare for All’? For India as a nation, health issues like malnutrition, infant mortality, infection control, overpopulation are real issues and the healthcare system remains overburdened. The Centre and the State governments have realised the importance of spreading healthcare to the remotest parts of the country. Mercy Hospital is also aligned with this responsibility. The ethos and history of the hospital, commitment to provide free and subsidized healthcare to 40 per cent of its patients, and innovative leadership combine to make Mercy Hospital a model healthcare network To realize these objectives, Mercy Hospital has nurtured and sustained a unique healthcare delivery model at three levels: a structured “free care delivery” model through a network of 20 rural clinics, a lower cost and “subsidized treatment” model delivered through partnerships collaborated through six urban community clinics and a competitively ‘marked to market’ priced delivery model for sustainability through the multi-specialty hospital. It has been heartening to note the developments in the healthcare space in

January / 2016 ehealth.eletsonline.com

the state, being spearheaded by the Chief Minister. We wish her and the entire team all success as she puts in place a program for development.

What are the policy interventions that the healthcare sector in the state needs to align with the healthcare objectives at large at the national level? Despite rapid economic growth over the past two decades, the budgetary support to and expenditure on healthcare still remains low. India spends about 1 per cent of its GDP on public health, compared to 3 per cent in China and 8.3 per cent in the United States. But hopes are high that the new government at the Centre would upgrade the basic healthcare infrastructure and make medical services more affordable for the underserved in the coming five years. According to a recent study, the patient aspirations are also fast changing. Invigorated with a rising disposable income and third-party payment mechanisms like health insurance, Indian consumers are growing more aware of their healthcare needs, demand quick response, less waiting time. Patients now demand better quality care but at the same time they do not want to travel long distances. So, these factors will certainly fuel the growth of the healthcare sector in the coming years and the State Government has already started taking care of these by initiating multi-specialty hospitals as well as critical care facilities in the districts with all modern equipment available in the district hospital. We sincerely hope that this will reduce referrals to city hospitals to a great extent in future Breaking the conventional model of business, the coming years will see great out-of-the-box thinking by the strategists in the field of healthcare, beginning with the way healthcare is delivered. To begin with, a rise in retail clinics, single specialty, and secondary and tertiary care centers have started playing a dominant role. The tier II and III cities will become attractive to the

healthcare players, especially because of the tax sops and increasing disposable incomes among Indian families across the country, accentuated by the dearth of quality healthcare infrastructure in these locations. Technology has also played a crucial role in bringing quality in healthcare, be it better nursing communication systems, patient monitoring devices, imaging or telemedicine to provide low cost diagnosis to remote patients, etc.

What steps can be taken to align the objectives of the Group with the national mission of Skill India? The fast-expanding domestic healthcare industry is the third largest employer, but is critically short of manpower. Healthcare in India needs more trained manpower, be it doctors, nurses or paramedics. The private players and the Government need to work hand in hand to strengthen medical education in the country. Our respected Prime Minister Shri Narendra Modi launched the ‘Skill India’ campaign on the occasion of the first-ever World Youth Skills Day, which included the launch of the National Skill Development Mission and unveiling of the new National Policy for Skill Development and Entrepreneurship 2015. As mentioned earlier, one of Mercy Hospital’s aim is to achieve excellence in imparting training and education. Towards this, the hospital is looking at strengthening the infrastructure for world class structured training to nurses and also hospital management students, which is the need of the hour. In conclusion, through the collective wisdom of the Governing Board of Directors, an eminent Advisory Council and a dedicated team of professionals, Mercy Hospital is committed to providing ‘Compassion with Excellence’. The journey over the last four decades has been satisfying for the organisation. The future looks bright. ‘Never doubt that a small group of thoughtful citizens can change the world. Indeed, it’s the only thing that ever has.’ – Margaret Mead

GMDCLOUD

An Integrated Digital Health Platform.. Innovations ReDefined..... "GMDCLOUD", is the next generation integrated Health Conglomeration between the patient, provider, payer, lab & pharmacy

Bringing Disruption in Healthcare

PATIENT PORTAL GMDCLOUD MOBILITY

Patient can manage and view all his/her EMRs. Share your EMRs for second opinion.

Supports Apple, Android and Windows Phone

TELEMEDICINE AND TELE-EDUCATION Tele - Consultation between patient and doctor or specialist. Tele-Education for doctors and nurses as part of CME.

HOSPITAL PORTAL Reception, Doctor, Nursing, Technician, Clinician, eprescription modules are incorporated.

GMDCLOUD SECURITY 1. SSL Secure – 256-bit SSL Secure with built-in messaging system gives you Enterprise grade security for all your data 2. SSAE 16/ISAE 3402 Attestation 3. ISO/IEC 27001:2005 Audit and Certification 4. Secured Cloud-Based EHR 5. HIPAA Business Associate Agreement 6. Enterprise-grade Security 7. Meaningful Use Certification in progress

INSURANCE PORTAL Claim Management System Support of various Insurance Companies Notification of the Claim status through SMS, Messaging and Emails

Other Features.. Microsoft Azure Platform Patentable Universal Medical Record Global Healthcare Compliance and Security enabled Advisors - exports in Management and IT Industry Software as a Service (SaaS) Model and Affordable Cost

INTERNATIONAL CODING STANDARDS ICD9, ICD10, Snomed. CPT4, HCPCS, HL-7, DICOM

GMDCLOUD ANALYTICS Helps in Effective and Efficient Management Chronic and Epidemic Diseases Collaborative Medical Research and Clinical Trials

Company Details: Galactic Medical Data Bank Technologies is a upcoming Global Leader in Consulting, Technology and Outsourcing Solution. We help enterprises through strategic consulting, operational leadership, and the cocreation of breakthrough solutions, including those in Mobility, Sustainability, Big Data, and Cloud Computing. Galactic Medical DataBank Technologies is currently focusing on Patient Engagement with an Innovative Product and Solution codenamed as “GMDCLOUD”, which involved Cloud Computing, Mobility, Big Data & Analytics. Galactic Medical DataBank Technologies is a Member with Healthcare Information Management Systems Society (HIMSS), member of American Health Insurance Plan & active member of Project Management Institute, USA For more details please visit www.gmdbcloud.com SJCE-STEP, JSS Institutions Campus, Manasagangothri, Mysore Email us at: support@gmdbcloud.co.in Contact us @: +91 98804-33750 , +91 72593-76020

Cover Story

Tech-Enabled Healthcare

Transforming Lives Technology convergence in healthcare will play a key role in improving accessibility and meeting the challenges of infrastructure and manpower shortage. With greater deployment of tools, such as telemedicine, teleradiology, Hospital Information Systems (HIS)/Hospital Management Information Systems (HMIS), and Online or Electronic Medical Records (EMR) gradually finding their ground in the country and more expected in the times to come, tech transformation will engulf the healthcare sector. Technology-enabled care (TEC) in the healthcare domain, using cloud computing and wireless technologies, will enable easy accessibility irrespective of geographical location, fewer errors, quick response in times of emergencies and patient convenience among others. Romiya Das of Elets News Network (ENN) discovers the reach of tech-enabled healthcare in 2015 and the road ahead

January / 2016 ehealth.eletsonline.com

reventive, patient-centric and reaching out to the masses – Year 2015 saw technology enabling healthcare with a aim to achieve a wider and deeper presence in the country. The technology enabled care (TEC) – telecare, telehealth, telemedicine, mHealth, digital health and eHealth services have and will be driving the healthcare domain in the times to come. The healthcare industry involuntarily stepped into digital space with the introduction of the term Health 2.0 in the early 2000s. And almost two decades down the line, digital space is redefining the patient-doctor connect with ventures like Doctor Insta Pvt Ltd, which provides healthcare consultation through video conferencing, receiving pre-Series A funding of US$ 500,000 (`3.31 crore) from angel investor Rishi Parti and BrahmaX Ventures, a US-based venture capital firm. The company, which launched its services early in 2015, is also planning to raise an additional funding of up to US$2 million (`13.26 crore). Riding high on the increasing spent in the segment, the healthcare sector is expected to reach the market size of US$ 280 billion by 2020 at CAGR of 16 per cent, predicts an FICCI-KPMG report. Apart from technological advancements in the fields of research, surgery, diagnostics and treatment, the IT revolution has also changed the way our hospitals and clinics function. Computerisation of records, diagnostic results, faster sharing of reports, the possibility of sharing case studies and seeking advice from doctors in distant countries through email have made healthcare reach out to the masses. Mobile apps and the startup ecosystem too have helped the market to expand.

Startups Pushing the Market In 2014, nearly 7,500 startups across the globe looked to develop digital

solutions in the healthcare domain, while year 2015 saw around 300 startups focused in the health domain itself. On one end where Indian startup companies are working to bring medical practitioners and patients closer using technology, government’s Digital India initiative and the startup revolution is bringing game-changing products and software that have dominated the Indian healthcare IT industry. The software and the product driven industry registered a double digit growth (12-14%) in financial year 201516. ICT has spawned new platforms for vendors offering more products, cloudbased services, tech geeks and young entrepreneurs by developing a host of apps for enterprises and diverse industry verticals.

The Digital India initiative will not only benefit the established players but also the startups across the country as the programme envisages investments of `4.5 lakh crore (US$ 68 billion) over the next decade. With ICT connecting devices and people, the industry players are investing substantially in developing new platforms and hiring more tech geeks to serve their clients in India and across the globe. The industry is expected to add US$ 20 billion in 2016 to the exisiting revenues of US$ 146 billion in the year 2015. The new wave of healthcare startups, a blueprint for technology enabled, personalised, participatory, and preventive medicine is required to drive the transformation in healthcare delivery.

Rajiv Nath Forum Coordinator, Association of Indian Medical Device Industry (AIMED) “In medical devices, innovations are incremental and are patentable. But, there is no IP protection and we are recommending that government should introduce it, particularly in a utility model. The Government of India can carry out a study to see that the medical devices, which are innovative and useful in public healthcare, are cost effective and yeild quality result”

january / 2016 ehealth.eletsonline.com

Cover Story

With time, more healthcare providers will be advocating, participating, and driving innovation co-creation to accelerate the flow of ideas and advances in healthcare delivery. The healthcare startup companies are using technology to bridge the supply-demand gap in this sector. The Indian startup sector focuses on healthcare discovery platform connecting patients to hospitals and doctors helping them to book appointments such as Practo and CrediHealth.com; medical equipment and diagnostics where companies use technology to simplify diagnostic procedures such as Perfint Technologies, and Biosense Technologies; startups focusing on specialty care such as MyDentist, and Vasan Eye Care Hospitals; digitising and tracking platforms integrating patient medical records and putting them at one place such as Practo Ray, and eKincare; ecommerce websites that help people to order medicines online or healthcare equipment online such as HealthKart, Medidart and Medist.

Industry Outlook The Indian Healthcare IT market is reported to grow at a CAGR of 14.02 per cent over 2014-2019, as reported by Research and Markets. The market is categorised into three segments –

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Startup Push  Practo and CrediHealth. com - connecting patients to hospitals and doctors to book appointments  Perfint Technologies, Biosense Technologies - medical equipment and diagnostics where companies use technology to simplify diagnostic procedures  MyDentist, Vasan Eye Care Hospitals - startups focusing on specialty care  Practo Ray, eKincare - Digitising and tracking platforms integrating patient medical records and putting them at one place  HealthKart, Medidart and Medist - ecommerce websites that help people order medicines online or healthcare equipment online

hardware, software and IT services. DELL, HCL, HP, TCS and Wipro are among the key vendors in the Indian market. “Healthcare industry is striving to address the ‘triple aim’ of improving the quality of care, enhancing the patient experience and reducing cost. It is focused at making quality care affordable to

patients wherein connected health is a new model: a mix of technology and information, to enable patients and clinicians to make better decisions. A cumulative data collated through multiple initiatives of telemedicine, telehealth, telecare, digital health devices, mHealth, eHealth and remote-monitoring solutions, provides access to the verifiable, real-time patient-generated data enabling physicians to plan progressive care and avoid negative health events to keep patients healthy even when out of the clinical facilities,” says Shakthi Nagappan, CEO, BioAsia. The Gartner study predicts an expenditure of US$ 1.2 billion on IT products and services by Indian healthcare providers (such as hospitals) in 2015, which is a seven per cent rise from 2014. This includes expenditure by healthcare providers (including hospitals, ambulatory service and physician practices) on internal services, software, IT services, data centre, devices and telecom services. The vertical specific software (VSS), which includes hospital information system, electronic health records, health information management, patient financial management etc., is expected to grow six per cent in 2015 to reach US$ 28 million. Rajiv Nath, Forum Coordinator, Association of Indian Medical Device Industry (AIMED) says, “In medical devices, innovations are incremental and are patentable. But, there is no IP protection and we are recommending that government should introduce it, particularly in a utility model. The Government of India can carry out a study to see that the medical devices, which are innovative and useful in public healthcare, are cost effective and yeild quality result”. Looking from a global perspective, marketsandmarkets research predicts that the healthcare IT market globally is poised to reach US$ 228.7 billion by 2020, growing at a CAGR of 13.4 per

cent during 2015 – 2020. Here, the market growth can be attributed to the growing need to adhere to regulatory guidelines, government initiatives for eHealth, high return on investment, and rising needs to curtail escalating healthcare costs. North America is accounted to be the largest regional segment of the global healthcare IT market and is accounted for the maximum share of 45.5 per cent in 2014 followed by Europe, Asia-Pacific, Latin America, Middle-East and Africa. The growth in the largest regional segment is attributed to the stringent legislative and accreditation requirements regarding healthcare, the high adoption rate of HCIT (for reducing high healthcare costs), regulatory requirements regarding patient safety, and the presence of a large number of IT companies. Some of the major global players like McKesson Corporation (US), Allscripts Healthcare Solutions, Inc. (US), Athenahealth, Inc. (US), Epic Systems Corporation (US), GE Healthcare (UK), Siemens Healthcare (Germany), Cerner Corporation (US), and Carestream Health (US). Globally, cloud, analytics and open source technologies are now playing a major role in transforming the way healthcare is delivered.

Smart Technology The rapidly transforming medical technology, change in practice pattern of the doctors, and availability of stateof-the-art diagnostic and therapeutic equipment has revolutionised the present healthcare delivery. IT has simplified the services with error free data registration starting from patient registration till he/she is healed. Technology has eliminated handwritten entries and tags helping to remove duplication and ensuring smooth, seamless flow of qualitative information. The modern technologies have enabled the digitisation of health records and

Dr Dharminder Nagar MD & CEO, Paras Hospital “Today, many doctors advise patients, especially elderly ones, who require regular consultation, to avoid regular visits and stay in touch with them through WhatsApp or email. Doctors are also advising drugs to customers via mobile apps and gadgets, reducing costs of travel and visit charges. Further, electronic records offer many advantages over the conventional paper-based methods of recording patient data. These help in reducing costs, and minimizing human error while improving the efficiency standards. These electronic records can also be equipped with authentication systems and act as a major deterrent against security breaches” accessibility of healthcare to the remotest areas along with making healthcare delivery a seamless task. The recent collaboration between All India Institute of Medical Sciences (AIIMS) and Tata Consultancy Services (TCS) has culminated in a transformed, patient-friendly outpatient department (OPD) process. As a part of the much-needed change, TCS introduced a new technology and streamlined processes that will benefit more than three million patients visiting 21 OPDs in the main hospital each year. IT has revolutionalised the way doctors and patients interact. Leveraging IT products and services, the doctors will have the detailed information about the patient’s health, along with the appropriate

treatment required. Many hospitals have come up with various innovative ways to use technological support to enhance personalised patient-care. Hospitals have come up with unique identification cards that enable the doctors to keep a track of the medical records of their patients. It also helps the patients to present their medical records when seeking a second opinion. “Today, many doctors advise patients, especially elderly ones, who require regular consultation, to avoid regular visits and stay in touch with them through WhatsApp or email. Doctors are also advising drugs to customers via mobile apps and gadgets, reducing costs of travel and visit charges. Further, electronic records offer many advantages over

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Cover Story

the conventional paper-based methods of recording patient data. These help in reducing costs, and minimizing human error while improving the efficiency standards. These electronic records can also be equipped with authentication systems and act as a major deterrent against security breaches,” says Dr Dharminder Nagar, MD & CEO, Paras Hospital.

Mobile Health India will overtake the US as the second largest market for Smartphone by 2016 as smart mobile devices are becoming affordable, according to a global research firm eMarketer. This further implies a critical mass that signifies an immense opportunity for the healthcare sector to leverage the mobile-based tools to provide better care delivery. Mobile connectivity and infrastructure is not only driving the market but is also providing solutions to the industry, especially in chronic disease management. There are various mobile health applications and services platforms providing solutions both to the doctors and the patients. These services include clinical decision support, remote patient monitoring, maintaining patient’s healthcare records, analysing future diseases, treatments and prescriptions etc.

Shakthi Nagappan CEO, BioAsia “Healthcare industry is striving to address the ‘triple aim’ of improving the quality of care, enhancing the patient experience and reducing cost. It is focused at making quality care affordable to patients wherein connected health is a new model: a mix of technology and information, to enable patients and clinicians to make better decisions. A cumulative data collated through multiple initiatives of telemedicine, telehealth, telecare, digital health devices, mHealth, eHealth and remote-monitoring solutions, provides access to the verifiable, real-time patient-generated data enabling physicians to plan progressive care and avoid negative health events to keep patients healthy even when out of the clinical facilities”

IT is playing a leading role in the hospital’s state-of-the-art operation theatres, blood bank services, laboratory and radiology services. The intensive care units of the hospital are equipped with excellent digital monitoring systems and electronic records which are highly beneficial for patients. IT-enabled diagnostic services have reduced time of report sharing and has enabled centralised record keeping which allows multiple departments to share diagnostic results of patients. In developing countries, such as India, mobile technologies have impacted the consumers in a big way by extending their reach to the

remotest locations. There are many healthcare apps catering to various healthcare needs – calling ambulance under 108 Emergency Response Service, medical consultation, app for diabetes patients, managing blood pressure through Smartphone, mobile clinic to treat the economically weaker section, app for cardiac arrest victims, to book appointment with doctors, to find doctors, reading healthcare articles, apps for doctors discussing cases and many more. With the increasing rollout of 3G and 4G along with fibre to support opens up the possibilities using mobiles and internet to address healthcare challenges. Video calling and high speed data transfer with 3G network support can help in telemedicine services, while 4G network would enable superior picture quality with reduced image distortions in the video calls and quicker data transfer.

Connecting the Unreached Healthcare in rural India is still awaiting improvement as the doctors refrain from serving there due to nonavailability of proper infrastructure. Telemedicine is acting as a bridge between the urban and the rural gap. This advancement has allowed the doctors to perform medical diagnosis, consultations, procedures, surgeries and treatments while

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staying miles away from their patients. The potential benefits of telemedicine include reduction of medical costs, expanded access to quality healthcare, and increased specialty knowledge amongst medical professionals. With four major scopes of opportunity — tele-consultation, tele-monitoring, tele-education, and tele-surgery — the growth opportunities are immense. In rural areas, where affording a smart device is not feasible, innovative diagnostic virtual health programmes provide technology services at a nominal fee. Such services have given a boost to the telemedicine effort to connect doctors from urban areas to remote villages through video conferencing. With the access to ICT, people are getting useful health information from the internet and improving their quality of life.

The Game Changer Technology adoption of cloud is transforming the healthcare domain and expanding its reach. In one of the recent initiatives, eClinicalWorks, a USbased firm in healthcare IT solutions, announced a $30 million investment to further digital healthcare in Asia, specifically India and additional countries in the region. This investment will develop talent and cloud-based technology infrastructure, coinciding with the Digital India initiative aimed at ensuring various services, including healthcare-related ones. The cloud computing technology’s potential is helping the healthcare IT infrastructure to adapt and transform into flexible and efficient platforms.

Cloud computing provides infrastructure allowing hospitals, medical practices, insurance companies and research facilities to tap improved computing resources at low capital outlays in initial levels. The healthcare cloud infrastructure will lower the barriers for innovation and modernaisation of HIT systems and applications. “Of course, technology brings more accurate diagnostics, digital images, digital diagnostics are far more specific but I think the key element that we kept missing out is affordability aspect and we need to make technology more affordable,” says Indira Behara, Senior Manager, Strategies, Global Health Strategies Emerging Economies Pvt Ltd. Hospitals and physicians have started having access to cloud based medical records and medical image archiving services. The objective is to lessen the burdensome task from the IT departments of the hospitals and allow them to focus on supporting imperatives such as adoption of

Indira Behara, Senior Manager, Strategies, Global Health Strategies Emerging Economies Pvt Ltd. “Of course, technology brings more accurate diagnostics, digital images, digital diagnostics are far more specific but I think the key element that we kept missing out is affordability aspect and we need to make technology more affordable”

EMR and improving clinical support system. And with the sector gravitating slowly towards private cloud, the avenues seem endless.

Roadblocks While the advantages of technology enabled healthcare are manifold, challenges including accessibility, infrastructure and quality also exist. A lot still needs to be developed in the segment of Healthcare IT. Breach of information security and the inability to trust healthcare service provider with chances of a patient’s health information remaining private through electronic records being negligible are some of the potential technological drawbacks that exist. Further, in adoption of IT, healthcare providers have to face several problems while designing and implementing healthcare management systems as there are no standard systems in place. Most of the hospitals focus on care delivery with a low investment in IT. There has been reluctance of medical, nursing and other staff in adjusting to the change and apprehending the technological failures, as some still see the paper system to be more reliable. While the above challenges do exist, technology-enabled healthcare solutions and disruptive technologies will definitely show the way to improve patient care in the times to come.

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Feature

Foreseeing Poised Progress

iving a whole new makeover to how healthcare is being imparted in India, innovative Technology Enabled Care (TEC) like telemedicine, mHealth, eHealth services and innovative startups enabled an eventful year in the sector. As 2016 is set to unfurl, the health sector is likely grow even stronger, juxtapose with challenges like rising demand, lack of inadequate infrastructure facilities, rising costs and rapidly evolving market conditions. As per PricewaterhouseCoopers (PwC), India requires 600,000 to 700,000 additional beds over the next five to six years, indicative of an investment opportunity of US$ 25-30 billion. Given this demand for capital, the number of transactions in the healthcare space is expected to witness an increase in near future. The healthcare system in the country recognising the need for innovation this year; will be making advances in TEC. This would further help improve reach of healthcare in rural India, which accounts for over

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70 per cent of the population and also emerge as a potential demand source. Progressing towards innovation, the overall Indian healthcare market today is worth US$ 100 billion and is expected to grow to US$ 280 billion by 2020, at a compound annual growth rate (CAGR) of 22.9 per cent. Healthcare delivery, which includes hospitals, nursing homes and diagnostics centers, and pharmaceuticals, constitutes 65 per cent of the overall market. Meanwhile, experts inform that the Indian government has accorded priority in its 2014-2015 budgets to the healthcare sector. Key recommendations that will have a direct impact on enhancing healthcare access include a rise in foreign direct investment (FDI) limit in the medical insurance business to 49 per cent; four more medical institutions of the status of All India Institute of Medical Sciences (AIIMS); 12 more medical colleges in the public sector; and broadband connections in rural areas to expand the reach of telemedicine.

For example, electronic health records can help providers keep track of patient information and can even alert them automatically about possible problems. Electronic prescribing systems eliminate concerns about lost or illegible handwritten prescriptions. Many systems are now able to help providers make decisions about treatment (for instance, using a patientâ&#x20AC;&#x2122;s age and weight to help ensure that the correct dose of a medication is given). On its surface, ICT is a remedy for many of the human flaws that lead to medical errors and inefficiency in healthcare. Startups in the healthcare domain are bridging the gap between healthcare and technology to build a better, safer and more inclusive healthcare experience. Taking the sector to the next level with healthcare records moving online and doctors switching over to mobile based solutions, startups are emerging to help patients to reach the doctors and helping them track their medicine regime or get a diagnosis from who are thousands of miles away. Growing role of ICT in healthcare promises many benefits, including easy access to information, better communication among healthcare providers, and interventions to improve quality and safety of healthcare, the coming year does hold a renewed promise for the Indian healthcare sector.

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Exclusive Interview

Cashing in on IT for Healthier Karnataka Karnataka is implementing ICT initiatives, including e-Hospital software and new business models in the Department of Health and Family Welfare, for offering better health services to the people, says U T Khader, Minister for Health and Family Welfare, Government of Karnataka and District In-charge Minister for Mangaluru District Come May 2016 and you will complete three years in office as Minister. How do you describe your term? Elucidate major initiatives and accomplishments. I am happy about it. I express gratitude to my leaders for choosing me as the Health Minister. Health & Family Welfare is an important portfolio. During my tenure, several people-friendly initiatives have been undertaken. For some, we have received appreciation. When I assumed charge as the Minister in 2013, I was new to the subject. The first few months had been a learning curve. Later period was marked for making health services effective and accountable. All our initiatives and programmes have been designed around the concept of Health for All. Some are preventive and others curative in nature. Major initiatives include ICT initiatives (e-Hospital); establishment of ICUs with ventilators, free supply of essential medicines on demand; linking hospitals with medical colleges through telemedicine; launch of Arogya Sahayavani (104 - Phone Doctor) and establishment of Drug Distribution Centres in health centres. Launching Bike Ambulance, paying highest salaries to doctors (`60,000 PM for MBBS and `80,000 PM for

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the Public Private Partnership mode.

Describe the mandate of the Department of Health and Family Welfare. What were the challenges you faced while implementing health services?

U T Khader, Minister for Health and Family Welfare, Government of Karnataka and District In-charge Minister for Mangaluru District

MD) and 100 per cent free medical treatment for BPL cardholders, 70 per cent free medical treatment for APL cardholders and free dental camps for senior citizens are some of the accomplishments for which we have received positive feedback. Another is receiving a national award from the Ministry of Social Justice and Empowerment for providing Group D jobs to 100 leprosy-cured patients in Karnataka. We have also signed an MoU with the Hindustan Lifecare Ltd, a Government of India enterprise, for setting up ‘Janata Diagnostic Centres’ and ‘Jana Sanjeevini Stores’ under

Health is a State subject under the Constitution of India. Our focus is to reach the goal of Health for All on the lines of the policy directives issued from the Government of India keeping the National Health Policy as a major objective. Today, Karnataka’s network of health centres (8,871 sub-centres, 2,353 PHCs, 206 CHCs, 146 taluk hospitals and 30 district hospitals) caters to people’s needs throughout the State. Each centre has a mandate in attending people’s requirement. Currently, we have 785 ambulances and 17 Bike Ambulances. The department ensures the implementation of various national and state health programmes and also provides comprehensive healthcare services to the people of the State through various types of health and medical institutions.

What is your vision for Health and Family Welfare? How does ICT and e-Health software fit into your objectives? The

primary

objective

the

Anniversary Issue Department of Health and Family Welfare is to provide health service to the people of State. To facilitate the same, several resources have been created and developed under various Central and state programmes. It is a continuous activity and upgradation process. My vision is to facilitate better healthcare facilities by creating resources and infrastructure facilities. I believe that technology will come in handy for facilitating better healthcare services to people. During 2015-16, we undertook ICT initiatives with an objective to strengthen the healthcare network in the State. e-Hospital software is one such initiative being implemented in all the hospitals with a view to document and utilise the health information of every patient visiting the government hospitals. The National Informatics Centre and KIONICS (a Govt of Karnataka enterprise) are supporting the e-Hospital initiative for development and deployment. Similarly, digital software is being deployed in high-frequency X-ray machines of the taluk and district hospitals. By installing this software, action will be taken to get the opinion and advice of the experts by sending the X-ray reports to the higher level

hospitals through tele-radiology ans several others.

Which are the new initiatives in pipeline during 2016? Give details of their status. There are several. Some of those are listed below: Janata Diagnostic Centres: Hightech medical equipment in all district hospitals will support patients for various diagnostic tests. On January 4, 2016, Governor Vajubhai Vala launched the first phase in Bangalore. Under Phase-1, as many as 14 centres will be set up in district hospitals, including at Bengaluru, Mysore and Mangaluru. They will function 24x7

generic drug stores have been set up all over the State. Though they are already running, the official launch is due. In Phase-1, 30 stores will be opened with an objective of having at least one such store in each district. Only drugs manufactured by wellknown companies will be sold here to ensure quality. While 361 generic drugs can be procured under Jan Aushadhi, as many as 748 drugs are available under Jana Sanjeevini. We did not find the Centre’s model feasible, as drugs for critical illnesses, including cancer, aren’t available at a lower cost. E-Kirana: A teleradiology facility named ‘E-Kirana’ is set to open at the Bangalore Medical College and

During 2015-16, we undertook ICT initiatives with an objective to strengthen the healthcare network in the State and are equipped with CT scanners, MRI scanners, high-tech labs for blood tests and other modern medical equipment. The cost will be about 50 to 60 per cent lesser than what is being charged in diagnostic centres. Jana Sanjeevini Stores: To facilitate medicines at reasonable prices, a chain of Jana Sanjeevini

Research Institute (BMCRI). It will connect government hospitals across Karnataka, enabling immediate reading of X-rays, CT scans and ultrasound images from rural areas by experts at the BMCRI. Optical fibres for the project have already been laid and connectivity to hospitals will be achieved in phases starting from the districts and then taluks levels.

E-commerce is an emerging market in India. Why are you against online sale of drugs? In the absence of official guidelines for online sale of drugs, I feel it is not appropriate to take up this matter. We want the Government of India to come out with guidelines in this matter for moving further. My apprehension is drug abuse by the youth if drugs could be purchased via e-commerce. Through e-pharmacy, there was every chance for the youth to purchase drugs that were sedative in nature and leading to its substance dependence. We should not mix enterprise with health.

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Industry Speak

A Step Towards Virtual Consultations Anita Shet, Founder & CEO, pinkWhale Healthcare Services Private Limited

How is IT transforming the healthcare sector in the country? IT is transforming the healthcare in India from a “Pop & Mom” run shop to a more corporate, accountable entity. Unlike the western countries, close to 70 per cent of the healthcare is delivered by private practitioners at small and medium-sized clinics or hospitals. pinkWhale has been working closely with this segment for the last few years and sees a huge opportunity for technology to improve efficiency and productivity. IT in health will help better the quality of care, facilitate preventive care, and reduce risks and mortality apart from streamlining the processes and accountability.

What are the solutions offered by your company? Healthcare in India has been more of a reactive process than a proactive regime. From our experience, we have learned that this is majorly contributed by poor follow-up care and close to NIL patient awareness. pinkWhale is a telehealth company that focuses on enabling and being the backbone of providers to deliver convenient and cost effective follow-up care, and also, to equip them to empower their patients be better aware of their medical conditions, best care options, supportive therapies and nutritional needs. Our Cloud -based virtual

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Virtual platform enables easy communication and information sharing between patients and their doctors, says Anita Shet, Founder & CEO, pinkWhale Healthcare Services Private Limited, in an interview with Elets News Network (ENN) platform enables easy communication and information sharing between patients and their doctors. Our platform also has an integrated OPD management and medical health records built into it.

How do your solutions help in improving healthcare quality, productivity and cost? Healthcare cost is a sum of care, travel, and cost of absence from work. Statistically, more that 40 per cent of the outpatient care does not require physical examination. Patients can benefit from virtual consultations in such situations. This in turn enables doctors to efficiently utilise their OPD hours for the needy patients. pinkWhale’s solution enables patients to address all such health situations with their doctors from their home, telephonically or online. With home diagnostics and virtual consultation a pregnant woman can order a test, upload her reports online and initiate a follow-up with her gynecologist from the comfort of her home. Our solution benefits patients by providing cost-effective, convenient access to their doctors on one side and improves efficiency, quality of care and productivity for doctors.

How do you think healthcare IT has transformed patient care? In

five years from now, what other transformations do you see? Healthcare delivery in the past has been restricted predominantly to outpatient and inpatient care. IT is enhancing care worldwide by enabling virtual and home care. This transformation in care delivery is enabling a 360-degree care to patients. In the next 5-10 years we will see physical care, virtual care and home care functioning together. This will be supported with many diagnosis tools, enhanced with IoT technology. High quality healthcare will be delivered in a convenient and cost effective method in near future. But government’s support is a must.

How IT innovation can bridge rural-urban health divide? Bridging this divide is the biggest challenge for modern India. Traditional telemedicine did not yield the expected results to bridge this divide, as the facilities were restricted to limited bigger care centers. With telemedicine broadening its scope to digital health and technology making it accessible from mobile devices, this divide can be substantially reduced. With the support of the medical fraternity and governance, healthcare IT innovators can do wonders to narrow this divide. pinkWhale hopes to play a significant role in facilitating this effort.

Exclusive Interview

Medical Devices -

Made In India Made-in-India medical devices are a possibility now if the government helps make the sector viable and addresses the adverse duty structure, informs Rajiv Nath, Forum Coordinator, Association of Indian Medical Device Industry (AIMED), in a tete-e-tete with Prathiba Raju of Elets News Network (ENN) How will the upcoming medical device park help the device industry? We should focus on appropriate eco system for import substitution of Rs 22,000 crores of imports, to enable the vision of ‘Make in India’. India is 90 per cent import dependent when it comes to medical products alone. India’s import dependency on high-end medical devices is over 80 per cent. In order to be import independent, we need favorable policies and innovative ideas. For example the two upcoming medical device parks in Andhra Pradesh and Nagpur (Maharashtra) would be of great value as they will reduce the import dependency, increasing export while generating wealth and employment within. If favorable policies are in place we can be a hub of medical device as well. In terms of investment for each industrial park it might be about 200 to 500 crores. The medical device parks aims to create an ecosystem which will be interdependent and create policies which allow local manufacturing to thrive. With such high import dependency, the country needs favorable policies and on the ground ecosystem to allow manufacturing of medical devices which require higher technology, inputs, raw materials and consumables.

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Rajiv Nath, Forum Coordinator, Association of Indian Medical Device Industry (AIMED)

And, how about the medical device park in Andhra Pradesh? The project of medical device park in Andhra Pradesh has been approved by the State cabinet. Once the site project is approved and post discussion among senior bureaucrats in AP government, suggestions will be sought and put into implementation. We expect the project to be operational in two to three years.

Can your share the details of the upcoming Nagpur medical device park? A delegation already visited Nagpur

and reviewed the project. A report and recommendation would be given to the Maharashtra government. AIMED as already suggested not to repeat the same product line of Andhra Pradesh of electronic and software, as AP has that kind of industry around they can cater to them. Nagpur can have more hard technology implants, which are not made in India. The industrial park is practically ready as they have the infrastructure at place. It needs just some additional facilities so it can be ready within a year and it can actually overtake the Andhra Pradesh Park. There are seven product verticals in medical devices the consumables, disposables, electronics, equipments, implants, diagnostic reagents and surgical instruments we have recommended that concentrate on couple of segments, so common eco – friendly system can exist.

What are the exclusive features of these medical device parks? What we have recommended to AP and Maharashtra government is that they need to have a cluster approach around common manufacturing facilitation hub. The hub can have ethane oxide gas sterilisation plant, a hard technology laboratory tool room for doing various kinds of moulds. Both the parks will be spanning across 200 acres.

Anniversary Issue

Can you brief us about the medical device clusters in our country? How the parks will compliment them? Currently five existing clusters of manufacturing device existing in the country – Delhi-NCR belt has more high volume hard technology disposables; Ahmedabad has more of disposables low technology, orthopedic implants and stents, Mumbai –Pune is electronic and diagnostic industry oriented and Bangalore and Chennai are electronic and equipment oriented. We have recommended to the government to build upon the existing clusters and the park can connect all the five clusters. The department of pharmaceuticals has already created a task force for the medical device which came out with a report. The task force has drafted a medical device policy and it’s with the Prime Minister Office (PMO) for a release. In that draft medical device policy has recommendation that such park is necessary. The parks can have a common manufacturing facility and then a cluster of SME can be created around this. For example to come up with a highend technology facility it will be costing Rs 40 crore and small companies can’t invest. So such medical device park can help and benefit the SMEs.

What are the advantages of producing Made-in-India medical devices? If manufacturing happens locally and if the manufacturers are able to give price commitment for two years, it will allow public healthcare to buy large volume goods at competitive prices for over a period of time. Made in India’s medical device demand will grow. Not just domestic products, but if a manufacturer takes steps to meet the local markets requirements like quality, price competitiveness; they

For India to be import-independent, the government should increase the import duty to 10 per cent and keep lower duty on the raw materials. Currently, it’s the other way round where the peak duty is on raw materials and minimal duty is on the finished devices can be automatically competitive in the export market. The current exports in the segment are US $1.2 billion. When compared to China, the medical device in India is able to compete on quality and technology and able to demand a price utilisation nearly 30 per cent higher than China in the international market. Chinese Government has been very aggressive and are giving 17 per cent subsidy to export of medical device and in India what is given differs by just two to three per cent, which is miniscule.

How important is the national policy on medical device? The policy is very important because

if the policy does not take shape, these parks will be green parks. An industrial park cannot sell on its own as this is not real estate asset. For India to be import independent, government should increase the import duty to 10 per cent and keep lower duty on the raw materials. Currently it’s the other way around where the peak duty is on raw materials and minimal duty is on the finished devices. Huge requirements for import substitution then the flood gates will open to start manufacturing in India. We have incorrect and incomplete regulations of Drug and Cosmetics Act and apply only to 22 devices; a proper set of regulations is needed.

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Industry Speak

Healthcare Goes on Cloud Cloud benefits the healthcare industry by providing a quick and accurate access to patient’s EMR at the time of treatment, says Krishnamurthy Ramalingam, CEO & Founder, Galactic Medical Databank Private Limited while speaking with Elets News Network (ENN) What are your views on Healthcare standards in India? India is evolving and we do have customised Indian version of HL7, telemedicine standards and EMR standards, but we still need interoperability standards, health policy for hospitals /doctors to send patient’s medical history within 24 hours upon patient’s request. Patients should be absolute owner of his/her health data (not hospital or insurance company), etc. Many of these standards are already available and implemented in many countries just that we need to adopt it in our country. Singapore

Krishnamurthy Ramalingam CEO & Founder, Galactic Medical Databank Private Limited

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has adopted and implemented healthcare IT across their country within a timeline of 3-4 years where all public (80%) and private (20%) healthcare delivery clinics and hospitals store their entire patient’s health data on their private cloud and every citizen’s health insurance is covered. The cloud computing in healthcare space is developing rapidly.

What according to you should be done to radically change the healthcare service delivery with ICT intervention? What is your company doing in this regard? Our company has developed a disruptive innovative product and global integrated digital health platform – GMDCLOUD, which seamlessly integrates with various stakeholders such as patients, doctors, clinics, hospitals, insurance companies, pharmacy, diagnostics centers, and corporate companies. We have implemented international healthcare standards – ICD9, ICD10, SNOMED, CPT4, HCPCS, HL-7, DICOM, HIPAA, HITECH ACT, Meaningful Use, etc. GMDCLOUD also supports Indian languages. We are already implementing it in few tertiary care centers in India and few enquiries

from Middle East countries too have come. We feel proud to be a part of Make in India and Digital India initiatives of our government and we might also be able to come up with Digital Health for India in five years period.

How important is cloud technology in healthcare? Healthcare on cloud benefits the industry by providing quick and accurate access to patient’s EMR at the time of treatment. It ensures better coordinated care of patients moving across different levels of healthcare delivery primary, secondary and tertiary care and also across different healthcare providers – public, private, clinics, and hospitals. It helps in taking accurate clinical decisions and saves money on repetitive diagnostics procedures. Healthcare analytics can be used for effective and efficient management of chronic diseases, epidemics, collaborative medical research, and collaborative clinical trials on rare diseases – at various levels (state & central). it is helpful in effective and efficient insurance claims settlement. To read the complete article, log on to: http://ehealth.eletsonline.com/

Industry Speak

On Way to Home from Hospital Information technology should be taken as investment not as an expense, opines Chhitiz Kumar, CEO, Philips Capital India, and Head, Govt Affairs-PPP in a tête-à-tête with Romiya Das of Elets News Network (ENN) How do you see information technology changing the healthcare scenario in the country? The biggest change we can see now is that healthcare is headed from hospitals to homes and in the hands of the individuals. That is a big change happening on a macro level. People are not there just for the treatment purpose, wellness is becoming equally important today. Wellness is either carried at home, be in terms of recovery or the preventive side of it. Technology is clearly enabling all of this. If you recollect, earlier people used to visit path labs for tests and then probably go in the evening to collect the reports, some 15 -20 years back. But now, the scenario is entirely different: the pathology labs provide services to collect blood samples from patient’s home. They ask for the email ID of the patient and by evening, one can just visit their email and download the reports. There are lots of changes happening in the healthcare and wellness segment, thanks to an increasing trend to leverage technology. We see the trend getting bigger and bigger in the times to come.

How does IT help in addressing the rising medicare costs, improving productivity and quality in healthcare? IT brings in a lot of efficiency leading to substantial reduction in the cost. The shift in the way one would submit one’s blood sample and obtain the reports digitally could be one of the many such changes. With IT delivering reports digitally to the patients, it saves their visit time and travel cost to and from the labs.

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Anniversary Issue Technology is escalating big time; for instance, it is difficult to get a radiologist in Tier II or Tier III cities. Patients have to travel to metro cities to get their scans done with a reputed radiologist. Here, technology acts as a boon as the patients can get their scan done at their local medical centre, which can be examined by some reputed radiologist in a metro city. The patient is assured of the quality of the report and he/she does not have to travel long distances. In India, nearly 70 per cent of the population lives outside metros. This is why, the healthcare cost becomes a major factor, in case a family member takes ill and others have to accompany him all the time during his treatment period. In such a condition, eICU provides an additional layer of critical care service. These are just a few instances where IT has really helped people save both on time and expenses.

What, according to you, are the challenges a solution provider has to face in this sector? The investments in IT are beneficial for the healthcare sector. But most of the hospitals implementing technology solutions expect quick returns. However, the gestation period for getting the returns could be much longer than what they want it to be. These have to be looked upon as investments and not expenses. These are investments to be made today for reaping benefits in the future. If one wants to scale the healthcare, it simply cannot be done with pen and paper. Clearly, there is a need to make right investments in the right areas. Medicine as a practice is becoming far more integrated now. If we talk about clinical solutions, one would find a lot of diagnostics and therapy coming together, and the investments have to be made from that perspective. Those investments need to be made keeping in mind a larger time frame and not for short-term gains.

Most of the hospitals implementing technology solutions expect quick returns. However, the gestation period for getting the returns could be much longer than what they want it to be Secondly, from the solutions point of view, at times the solution providers do not take into account the crucial factor of change management, which is necessary to deliver a power-packed solution. There is a need to train the staff to help them get into the groove. A lot of handholding is required on those lines, which currently I do not think too many solution providers are doing to help the hospitals deliver better. They just implement the solutions and move out, which shouldnâ&#x20AC;&#x2122;t be the case.

What are the recent technological innovations by Philips Healthcare to scale up rural healthcare? We came up with handheld ECG, which can be remotely connected. It can come very handy for general physicians (GPs) in the field. With numerous centres of excellences in cities, GPs can get the ECG reading done from there to figure out the seriousness of the case. The challenge is that most of the GPs do not know how to read an ECG on this device.

It is a small handheld device, which can be used by GPs apart from their stethoscope. One can use the ECG device on someone complaining of chest pain to gauge the seriousness of his discomfort. As it costs less, it also makes it highly affordable for the masses. There are quite a few other initiatives undertaken by the company. There is an IT platform developed by us to identify the high-risk pregnancies. For example, India gives birth to the largest number of children every year. Now, with shortage of doctors, one cannot expect all the deliveries to be handled by someone single-handedly; there is a need to have solutions enabling midwives to handle low-risk pregnancies, while doctors would probably take care of the high-risk ones. Right now, we are piloting it in a few districts. These solutions have already been tried outside India, and the outcomes have been quite encouraging. Now we need to test it under Indian conditions to see if it works well for us, too.

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Industry Speak

Transforming Wellness through Technology Technology has a significant role to play in the future of prevention, diagnosis and treatment of ailments, says Shakthi Nagappan, CEO, BioAsia, during a conversation with Romiya Das of Elets News Network (ENN) How do you see IT innovation in healthcare market India vis-àvis the global trend? Currently, the healthcare sector is undergoing through a transition phase. While India faces the dearth in basic infrastructure facilities to serve the higher demand of quality care services. Indian healthcare market is expected to grow at a CAGR of 22.9 per cent to US$ 280 billion by 2020 from US$ 100 billion. Indian entrepreneurs have created a number of remarkable success stories. Globally, cloud, analytics and open source technologies are now playing a major role in transforming the way healthcare is delivered. The rise of SMAC (social, mobile, analytics and cloud) solutions have thus led to a convergence of technologies aided by IoT, mobile and web based applications and facilitating remote healthcare services. The healthcare IT market in India is growing rapidly, as many hospitals are opting for digital technologies following reduction in errors and the potential to create a seamless treatment process. The healthcare IT market was valued at US$ 0.83 billion in 2014 and is expected to reach US$ 1.60 billion by 2019.

What is required to improve the existing technology to reinvent care delivery?

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of “cottage applications” which may have served a specific need in the past are increasingly causing bottlenecks in getting a unified view of the patients, payers, suppliers, doctors. This requires an integrated approach to have a 360 degree view of the key stakeholders using data management and analytical techniques which will aid in better decision making and compliance.

How does IT help in tackling rising costs and improving productivity and quality in healthcare industry? Shakthi Nagappan CEO, BioAsia

The healthcare industry is challenged with constantly changing and unpredictable patient volumes, fluctuating supply costs, stringent government compliance and quality requirements, staffing shortages etc. which require the management to make informed decisions using “in the moment” actionable information. With the digitisation of services, vast amount of data about the patients are available from internal and external sources and profiling of this data in order to move away from “cure” to “prevention” requires adoption of new techniques like “big data” analytics. Moreover, mushrooming

There is hype on how ‘Big Data’ can help in fast and efficient discovery of drugs, which otherwise could incur an estimated development cost of about US$ 2-3 billion for testing a single drug successfully. The large clinical trial sizes and higher failure rates for drugs in proving their superiority have led tech giants ponder the use of big data analytics to expedite the drug discovery process. Besides, the recent advances in cloud computing along with big data promise to radically transform healthcare by making the rich data into actionable data.

How can government initiatives like ‘Digital India’ and ‘Make in India’ trigger growth in IT innovations in healthcare?

Anniversary Issue

Technology advancements in healthcare informatics, telemedicine, HIS, EHR, remote diagnostic and therapeutic tools have pivoted the first step towards tech enabled healthcare and can be further leveraged to effect new modalities of healthcare. In countries like India, which has significantly high population, limited healthcare access and healthcare burden, engaging thousands of medical specialists to the remotest corners may not be possible, but one can make their services available through broadband at multi-service centers in every village by leveraging SMAC. That, in essence, is the vision of Digital India initiative. We strongly believe this initiative has a great potential in making India a leader in digitally delivering health.

How IT innovations can bridge rural-urban healthcare divide in India? It is estimated that 15 per cent of Indiaâ&#x20AC;&#x2122;s population still has no access to healthcare services, either due to lack of availability or economic reasons. Around 905 million Indians live in rural

The rise of SMAC (social, mobile, analytics and cloud) solutions have led to a convergence of technologies aided by IoT, mobile and web-based applications facilitating remote healthcare services areas and 6.7 per cent or 61 million, currently use internet on a regular basis. Rural areas are expected to drive the internet growth in India. About 4.4 per cent go online using a smartphone, a significant increase from 0.4 percent in 2012. Indian telemedicine, though in its nascent stage, is showing robust growth at approximately 20 per cent and is projected to grow from US$ eight million in 2012 to approximately US$ 19 million by 2017. Moreover, video interactions with the physicians through digital devices, empowers patients from remote areas to connect with ease.

What are the challenges you see in this domain? There are plenty of challenges, particularly the resistance to adoption

of technology at various levels. Data security and privacy is another major concern as it exposes the highly confidential medical information related to patients. Currently, the IT budget for many Indian hospitals does not exceed 10 per cent of revenues, which is substantially lower than the allocation globally. Moreover, despite the long-term gains in efficiencies and costs that could be achieved, the initial high capital investments are likely to discourage organisations from looking at investing in advanced technology systems right away. In addition to this, lack of in-house IT expertise, lack of standards, reluctance/resistance of staff, inadequate support from IT vendors, etc., are some of the bottlenecks that need to be dealt with.

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Industry Speak

Anytime, Anywhere Healthcare Online prescription and delivery of medicines will reduce medication errors and improve patient care, says Dr Archana BM, Founder and Principal Consultant, Health Corniche, while talking to Elets News Network (ENN)

Dr Archana BM, Founder and Principal Consultant, Health Corniche

How is IT transforming the healthcare sector in the country?

India? What transformations are expected in next five years?

IT is transforming the healthcare sector in the country by transforming the way healthcare Institutions operate by linking everything from patient demographics to clinical data to financial reports and delivers the information wherever and whenever required. It helps to Synchronise to the needs of todayâ&#x20AC;&#x2122;s healthcare enterprise. As the end result, the use of IT would be a decision support system by addressing the needs of multiple healthcare audiences. Use of IT ensures it s a global solution that helps deliver better patient care while simultaneously increasing enterprise efficiency, improving collaboration and reducing costs.

What IT healthcare solutions does your company offer? Health Corniche provides an end-to-end hospital information solution catering to all possible functions in hospitals. Our solution enables the implementation of the latest and advanced software application innovations using plug and play approach. With proven expertise providing support for leading healthcare applications Health Corniche partners with the top vendors for hospital information. Hospital Information System (HIT): It is an integrated cloud solution

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that offers best - of - breed software applications available in a software-asa-service (SaaS) model. The solutions cover all the functional needs of a hospital from an IT solution perspective. PACS (Picture Archiving and Communication System) Solution: This Platform is a versatile solution that can be scaled up or down as Enterprise cloud PACS solutions to hospital chain or centralised PACS solution to single hospital. It integrates with a browser based DICOM viewer giving physician access to your images. Business Intelligence Solution: forms an Integrated Analytics Platform for a Healthcare enterprise, by acquiring data from its ERP and the Ancillary systems. It facilitates an Operational Data Store for the source Systems for OLTP reporting. It cleanses and confirms data for greater accuracy of report metrics. Mobile Health and Telemedicine Solution: Enhance public health through use of m Health and Telemedicine. Mobile devices are making a huge difference in peopleâ&#x20AC;&#x2122;s lives across the globe. Internet enabled smart phones and tablets provide access to information and a channel of communication to the users.

How has healthcare IT transformed the way treatment procedures are carried out in

Information systems currently being used in healthcare environment in India can be broadly categorised into three types. Firstly, composed of systems that are limited in objective and scope for instance Laboratory Information System, Radiology Information System, and Financial Information System. Secondly, information system is composed of HIS; this consists of communication network, a clinical component and a financial/administrative component and this integrates the three major parts into a cohesive information system. Thirdly, information system, enterprise health information system is expanding in health environment. Such system captures and stores comprehensive patient information across the entire continuum of care in health organisations using integrated healthcare delivery model. Five years from now most of the healthcare institutes will adopt cloud based Enterprise Health Information system (EHIS) to create connections between every organisation, entity and department within a healthcare ecosystem, delivering information where and when it is required. To read the complete article, log on to: http://ehealth.eletsonline.com/

Enhancing Well Being Through IT

Health Corniche provides technology based solutions in the field of information technology, delivering adoptable solutions serving the healthcare providers and other sectors. The company operates with business associates in the healthcare domain in India with diverse partnership from international software and local service companies

Healthcare IT Solution Cloud Based Integrated Hospital Information System PACS (Picture Archiving and Communication System)Solution

Business Intelligence Solution Mobile App and Telemedicine Solution

Contact Details: HF 224 , Ittina Neela , H1 Block ,Huskur Gate , Electronic City ,Bangalore 100. Phone :+91 9663531990, email : archana@healthcorniche.com. website: http://healthcorniche.com

Spotlight

Kolkata-Epicenter of Healthcare in East To make PPP successful in Bengal, trust factor between government and private players should be re-established, Richa S Debgupta, Zonal Director, Fortis Healthcare tells Elets News Network (ENN) Fortis is one of the new comers in the eastern healthcare market. How do you analyse the overall scene of the eastern market? Fortis is a relatively new player as compared to corporate groups present in the healthcare market of the east. Over the past few years the group has grown organically and inorganically. We forayed into this market with some strong acquisitions such as Wockhardt hospital which is now a part of Fortis group. We are a people oriented company and the entity of a company remains within the workforce that it possesses. The entire eastern market is glistening with new opportunities and we are trying our best to give to offer our best possible services to our patients.

How do you cater your services to the massive influx of patients which come from Bangladesh and other adjacent north eastern states? The prime challenge that we are facing at this moment while dealing with a gamut of patients coming from different parts of India as well as from neighbouring countries like Bangladesh and Nepal, is that we have dealt with a massive catchment area. We are currently catering our services to a massive population which is coming in from different parts of the country as Kolkata is the epicenter of healthcare in the

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Burma, Nepal, Bangladesh. We are partnering with smaller nursing homes and medical centers in the districts and senior doctors from our end is visiting these areas and conducting OPDs. These small centers are helping us massively. It is helping in diagnosing the diseases in the bud and the patients are getting a post hospital treatment in these health docks.

east. All the major super specialty hospitals are located in the city which is why the pressure on the city based hospitals are soaring day by day. The growth of the market is also affected by the irregular distribution of the healthcare institutions. It is still in a nascent stage in comparison to other states of India. We need to distribute the hospital facilities in different parts to state to bring in parity and reach a state of healthcare equilibrium.

How Fortis is reaching out to the massive population? What is your modus operandi? Fortis has established a lot of healthcare information centers in different parts of the state to cater to the massive population, which is pouring in from northeastern states and also from foreign countries like

The outflow of traffic of patients and doctors from Bengal has reduced considerably over the years. How do you look upon this development? Over the years the healthcare industry in the east has evolved a lot and the entire demography of the eastern health care market has changed. New players plunged into the market which led to the creation of new jobs and that affected the outward traffic of doctors from the state. Many came back to Kolkata and started fresh and also patients gained back the lost reliance on healthcare system in the east and their bent towards the western and southern states for better healthcare system also diminished with time.

With digitisation of healthcare many patients are well informed about a disease. How do you see this transformation? It is great to have patients who are literate and focused on their

Anniversary Issue needs. It makes things easier for the doctors and also for the patients. A proper communication channel is established in between both the parties and this helps in the long run. Digitisation and modernisation are also very important for healthcare at this moment. We keep upgrading our technology and are at par with the global healthcare. We are talking about minimal access surgery in heart and mulling over the idea of minimal access neurosurgery. At the same time we are training our team of doctors and paramedics rigorously who can offer the best possible services to the people of the state. Digitisation is the only way through which we can only change the face of the health care industry of the country.

How can government and private sector work hand in hand towards the development of the state of healthcare system? I believe government run hospitals are doing pretty well and trying their best in meeting the healthcare related needs of the people of Bengal. The excessive pressure of patients in the government hospitals is actually crumbling the existing infrastructure. This is the place where the private players can chip in and can partner the government hospitals in providing best possible services to the citizens. But currently both government and private players are working separately as the trust factor between the two is missing. We need to reestablish faith and we must reach to a consensus, and government must understand that we are not here to make money. If we can create a common platform then we very well work under PPP model.

The healthcare industry is struggling to create skilled manpower, which is affecting the growth of the industry. Where is the problem?

Digitisation is the only way through which we can change the face of healthcare industry in the country Manpower problem has been looming large over the industry for years and that is adversely affecting the growth and the economy of the industry. Presently there is a massive scarcity of skilled hands, which is needed to run the machines and run the show. To increase the inflow of new and skilled manpower we need to increase the population of medical and nursing colleges within the state and government needs to ease its stand on the licensing process and also on their need to unknot the age old regulations which are there within the system. We as private players are constantly sanitising our staffs through on job training and skill development programs. To attract more youths into the nursing profession state and the central government must lay down some progressive plans.

How private hospitals in Bengal are working towards the development of rural healthcare? To establish a proper rural healthcare system we need to build up a proper civic infrastructure, which will help the doctors and the entire medical fraternity who are working in the rural part to get a decent life out of their living. Today Tier II cities in Bengal lacks in proper civic amenities, the government must upgrade them to facilitate modern healthcare.

What are your plans for the eastern region? Fortis will add up the current strength of the beds that we have in our hospitals, we are also keen on acquiring new properties and also eager to start liver transplant facility and also radiation facility in the east soon.

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Focus

Galvanising Healthcare via Insurance Nearly 60 million in the country are burdened by out- of-the pocket healthcare expenditure. To fill the burgeoning gap, the government’s push for universal health coverage, the government-sponsored health insurance schemes (GSHISs) and the engagement with the private insurance companies are proliferating towards a positive outcome, writes Prathiba Raju for Elets News Network (ENN)

n a country where less than 15 per cent of population has some form of health insurance coverage, the potential for the health insurance segment remains high. Hence, there is an urgent need to ramp up the central governments universal healthcare coverage in the country juxtapose to growing private health insurance can address the new public health challenges and inequities in health outcomes, inform health experts. “In India, where most people have dug deep into their pockets to pay doctors, pharmacies and

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diagnostic centers (or ‘out-ofpocket spending’) as the norm for a long time, vulnerability to impoverishment caused by medical expenses remains high. At just about 60 dollars per capita of total health spending available in the country, India now has to pay for a dual burden of disease as the non-communicable diseases are now making up the majority of the country’s disease burden statistics. Universal Health Coverage would be a game changer for the country,” feels Somil Nagpal, Senior Health Specialist, World Bank.

Surging Towards Wellness Although the Indian health insurance market still lags behind other countries in terms of penetration, yet the health insurance segment is rising. It continues to be one of the most rapidly growing sectors in the Indian insurance industry with gross written premiums for health insurance increased by 16 per cent from `13,212 crore in 2011-12 to `15,341 crore in 2012-13. The health insurance premium has registered a compounded annual growth rate (CAGR) of 32 per cent for the past eight financial years.

Anniversary Issue “The increasing awareness about the need for health insurance has been aided by a number of health insurance companies entering India. The double-digit rise in cost of medical treatment at 15 - 25 per cent, also puts a heavy burden on one’s personal resources, which is not readily available all the time. The increasing life expectancy to 72 years in India also puts a burden on the healthcare segment to ensure lifestyle maintenance. The number of companies in this segment has led to the growing number of insurance agents selling health insurance policies,” Dr Sriharsha A Achar, Chief People Officer & Chief Information Security Officer (CISO), Apollo Munich Health Insurance informed Elets News Network (ENN). The private health insurance companies informed that the government backing would accelerate the health insurance segment. “We have several expectations from the upcoming Union Budget 2016-2017. As a prerequisite for health insurance to become an important aspect of one’s financial planning, we look forward to the adoption of the long pending National Health Policy in the upcoming budget announcement. Coupled with the rising costs of healthcare and the Government’s focus on enabling access to all, we believe there could be an announcement for the institution of a regulatory framework to govern the medical industry. Without this, healthcare providers have been found to abuse the system, and charge customers unnecessarily

Somil Nagpal Senior Health Specialist,World Bank “India now has to pay for a dual burden of disease as the non-communicable diseases are now making up the majority of the country’s disease burden statistics. Universal Health Coverage would be a game changer for the country”

95 per cent of middle-class Indians do not have enough health insurance to cover some of the most common procedures and ailments in the country. Consumers above 45 who are at higher risk of health problems and closer to retirement, are least prepared for emergencies as they are under-insured by an average of 69 per cent high rates,” Achar said. Informing that reducing rate for service tax would benefit the health insurance sector, S Prakash, Executive Director, Star Health and Allied Insurance Company, informed Elets New Network that the segment is flourishing as the premium secured under health insurance was registering a significant rise. Even the insurance regulator, which earlier categorised health insurance as one of the components under miscellaneous, has now brought it as a separate category.

Wave of a New Era A new era of health insurance development is seen in India and many multinational companies in

Dr Sriharsha A Achar Chief People Officer & Chief Information Security Officer (CISO), Apollo Munich Health Insurance “We have several expectations from the upcoming Union Budget 2016-2017. Looking forward to the adoption of the long pending National Health Policy in the budget announcement”

collaboration with international insurers are proliferating with innovative products and distribution channels, and the raising of supervisory standards. “Overall, the Indian healthcare market is young right now with many of its sections in a nascent stage. One of these sections is the health insurance market, which is primarily government-driven. I believe the health insurance sector in India will start evolving soon, and the sea change that this sector needs will eventually be brought about,” Robin Raina, CEO, Ebix informed.

Not All Fit and Fine? However, a recent report by BigDecisions.com, a personal finance advice platform, revealed that 95 per cent of middle-class Indians do not have enough health insurance to cover some of the most common procedures and ailments in the country. Surprisingly, consumers above 45 who are at higher risk of health problems and closer to retirement, are least prepared for emergencies as they are under-

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Focus

insured by an average of 69 per cent. The BigDecisions study is based on data obtained from 10,000 consumers across eight major cities, aged 25 to 45+ and in the income bracket ranging from `6 to 36 lakh annually. With more private companies entering the health insurance, which is currently limited to certain treatments, will be extended to various treatment and procedures too. “There are good reasons to expect that the growth momentum can be sustained. In particular, there is a huge untapped potential in various segments of the market. In health insurance, as insurers can play a critical role in bridging demand and supply gaps, major changes in both national economic policies and insurance regulations can help highlight the prospects of these segments going forward,” Achar added.

Govt backing fruitful While the private health insurance companies are slowly making inroads in health insurance, the governmentsponsored schemes helped cover over 300 million people with some form of insurance. A report by World Bank indicates over the last five years, government-

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S Prakash, Executive Director, Star Health and Allied Insurance Company “Health insurance segment is flourishing. Even the insurance regulator, which earlier categorised health insurance as one of the components under miscellaneous, has now brought it as a separate category” sponsored schemes have contributed to a significant increase in the population covered by health insurance in the country, scaling up at a pace possibly unseen elsewhere in the world. Over 300 million people, or more than 25 percent of India’s population, gained access to some form of health insurance by 2010,

Robin Raina CEO, Ebix “Health insurance market is primarily government-driven. I believe the health insurance sector in India will start evolving soon, and the sea change that this sector needs will eventually be brought about”

up from 55 million in 2003-04. More than 180 million of these were people below the poverty line. The report projects that more than 630 million persons, or about half of the country’s population, can be covered with health insurance by 2015. By this time, spending through health insurance is also likely to reach 8.4 percent of total health spending, up from 6.4 percent in 2009–10. “The various central government sponsored schemes, the National Rural Health Mission (NRHM), launched in 2005, expanded to the urban population through the National Urban Health Mission (NUHM) in 2013. To provide financial protection to targeted populations and the Rashtriya Swasthya Bima Yojana (RSBY), covers the cost of secondary-level hospitalisation. In addition to array of state specific insurance schemes, a national framework for UHC is needed informed Dr. Henk Bekedam, WHO representative to India. “A clear vision where India wants to be in 15 years and a roadmap, including a step-by-step process to get there is necessary. This will require an agreed upon process in consultation with all stakeholders with a key role for the state governments,” Bekedam added. The Centre and State government should coherently enable and drive health policies and programmes, which are state specific, and developing a unifying national framework for UHC that carries all of us in India towards the SDG targets and promotes health equity

Anniversary Issue across geographical, gender distinctions.

social

and

Tech enabled workforce Technology-enabled frontline workers are especially needed to increase the outreach. Adoption of IT in our operations will increase the level of customer services and customer relations multifold. In the health insurance domain, IT requires heavy investments, where adoptions take time. Organisations must accelerate their investments and should be ready to embrace the change in the same pace. As customers of the health insurance industry are quite varied, one solution does not suit all customers. “Customisation and made to suit applications and solutions are mandatory today for success. We certainly need assistance from the insurance regulator to consider some more visibility on the adoption of cloud and information security required on cloud. Currently, we cannot use global cloud to store customer data outside Indian boundaries. Adopting cloud technologies can give a health insurance company a cutting edge in terms of technology and delivery of customer facing applications,” Achar informed. With rapidly evolving technology, the need of the hour for companies is to remain ahead of the curve and this puts a tremendous onus on IT teams to turnaround projects quickly. An agile mindset works on leveraging collaboration and engagement in real time to achieve desired outcomes. There is a dearth of IT resources that understand business needs and

Dr Henk Bekedam WHO Representative to India “A national framework for UHC and a clear vision where India wants to be in 15 years and a roadmap, including a step-by-step process, is necessary”

are able to churn out solutions which are apt from the word go. Usually, there are delays, errors and poor quality that is seen which if avoided can be a boon for a company. Shortage in financial budgets is another challenge that limits IT penetration among health insurers. By virtue of the business model constraints of health insurers, large spend are not common, even though they might be fruitful for a company. This needs to be addressed by the IT industry and insurers together in the interest of the customer. “UHC calls for financial protection, to reduce out-of-pocket spending, curb catastrophic health expenditure and prevent healthcare-related impoverishment. While

K Srinath Reddy President, Public Health Foundation of India (PHFI) “UHC calls for financial protection, to reduce out-ofpocket spending, curb catastrophic health expenditure and prevent healthcare-related impoverishment”

it will probably take some years for UHC to evolve to nearly complete levels of population coverage, service coverage and cost coverage, early relief can come through the free provision of essential drugs and diagnostics at strengthened public facilities. The various Central and State insurance schemes too need to be unified to provide an expanded package of services, with an emphasis on primary and secondary health care for all while allowing the poor unimpeded access to essential tertiary ,”said K Srinath Reddy, President, Public Health Foundation of India (PHFI). Meanwhile the union health ministry has informed that the government is committed to advancing Universal Health Coverage in India.”Increasing the public health spending to two per cent of the GDP over the next four to five years will certainly make the health sector more responsive,” said BP Sharma, Secretary, and Ministry of Health & Family Welfare.

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Industry Speak

Need for Customised Health Insurance There is an urgent need to ramp up the health insurance coverage in the country as out-of-pocket payments are still among the highest in the world, informs Dr Sriharsha A Achar, Chief People Officer & Chief Information Security Officer (CISO), Apollo Munich Health Insurance, to Romiya Das of Elets News Network (ENN) How do you find the health insurance market in India vis-Ă vis global scenario? The health insurance segment is exploding, literally. With more than 75 per cent of the population without any form of health insurance cover (whether provided by government or private sector), there is a critical need to improve the infrastructure, which not only h e l p s creation of

innovative insurance products, but also enables easier distribution of the same amongst the large population. In comparison to the mature, global health insurance segment that supports the ever-ending demands of customers, India is still evolving. The segment still remains an unexplored territory in India. Health insurance has become one of the most prominent segments in the insurance space today and is expected to grow significantly in the next few years. As spending on healthcare in India is expected to double in a couple of years, it is believed that health insurance will eventually become the biggest contributor in the non-life segment.

Could you brief us about Apollo Munichâ&#x20AC;&#x2122;s insurance model? Our operations are heavily hinged on our customers. As a company we have made a conscious choice of taking all our decisions, whether on product, distribution, service, based on what our customersâ&#x20AC;&#x2122; expect from us. We invest heavily in customer research to find their latent needs for health insurance, how are they enjoying our services, and exploring newer technology which can help us deliver our promises to the customers.

How has the adoption of IT impacted your operations? At Apollo Munich, we have adopted

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technology across the board in areas such as CAREculator and an underwriting rules engine for easy customer purchase decision processes. To ease customers sourcing process, we have also used technology to offer over the counter policy issuance, tab and mobile based issuance, online buying solutions. We offer automated e-fax, two hour cashless authorisations across the country, and biometrics to ease claims processes. The adoption of technology in all facets of the organisation has helped us to achieve a pan India presence, quadrupling of productivity per employee, enhancement of provider satisfaction, consistent decision making tools and reduction of our carbon footprint.

How does technology adoption help in addressing the challenges in the sector, including fraudulent practices? There are three broad categories of fraud. Policyholder and claims fraud - where the fraud is against insurer by policyholder and/or other parties in the purchase and/or execution of an insurance product; Intermediary fraud by intermediaries against insurer and/or policyholders and Internal fraud against insurer by employee on his/her own volition or in collusion with parties that areinternal or external to insurer.

Anniversary Issue All these three categories of fraud can be addressed using high-end analytics and technology to enable validations using results thrown by analytics. For example, if we have a common ID (like SSN) quoted across financial transactions; it would be easy to check it against past history and similarity. The check for an individual’s transactions can be likened to the Credit Information Bureau (India) Limited (CIBIL) score and an instant alert using modern day communication methods like email, SMS etc, can prevent the fraud from being committed. Also, usage of technology like biometrics can prevent impersonation – one of the biggest frauds faces by health insurers today.

How can IT bridge the gap between health insurance companies, TPAs and hospitals? Today, health insurance companies, TPAs and hospitals work on different platforms, under different coding and reporting regimes. This is the biggest challenge and poses a big gap in servicing of customers. IT can play a vital role in bringing all under the same roof. Adoption of common coding methodology such as WHO’s International Classification of Diseases (ICD) can ensure minimal gaps in understanding and reporting. Standardisation of rates will allow a customer options to choosefrom for a provider, a doctor and can aid in competitive fees for procedures. IT can help build this information repository. The use of Biometrics can help link all entities and aid in the prevention of fraud.

How beneficial are the websites comparing medical insurance for the commoners? Insurance aggregator websites are beneficial to digital media users as they can provide comparative details on health insurance products and their

approximate premiums. However, owing to differentiated products and lack of a common definition on many sub-elements, one often ends up comparing apples to oranges. The credibility of online information is judged differently by different consumer segments. Some value them as they get quotes from health insurance companies, while others find them intrusive for the same reason. For a value seeking Indian customer, it more often than not results in being a premium comparing exercise.

How can IT help in tapping the rural health insurance market? IT has so far piggy backed on the Government’s bio-metric infrastructure to reach out to the rural masses. The approach needs to be widened and the aim should be to utilise the connectivity being offered by the Government via e-choupals, district centers, village key men, mobiles and Internet. Interoperability and reach via common IT platform with payment banks, small banks and institutions like National Bank for Agriculture and Rural Development (NABARD) must be enhanced in near future.

How is cashless health insurance facility benefitting this sector? Cashless insurance claims procedure reduces the stresses of nerve wrecking medical casualty experiences.Cashless settlements offer the customer the feel of having the promise fulfilled by the insurer in terms of offering financial help, when it is needed. This allows the whole process of claims to be turned around in a very quick manner, sometimes in as less as 60 minutes! Today our company settles most of cashless claims within an hour. This also reduces costs for the insurer as cashless claims covers standard procedures, the procedures and likely costing of which is prescribed by word medical bodies which insurers uses to

convince the hospitals to charge at the right levels for the treatment.

How do you see the sector’s growth in the coming years? As health insurance companies adopting newer technologies faster and making use of it in all spheres of business to make life simpler for all stakeholders viz, customer, employees, shareholders, hospitals and vendors. The overall growth of the sector is expected to be in high double digits for next 10 years as per research reports, highlighting the fact of underinsured market in India. We are already seeing foreign partners in health insurance companies agreeing to increase their stakes from 26 per cent to 49 per cent, which means more capital, will be infused in the health insurance sector. This will in turn help improve distribution reach as well as productivity of the health insurance industry. With the advent in technology in the healthcare sector, the rising cost of health care will only spur the need for financial protection at time of medical distress even more pronounced triggering the growth in health insurance businesses. The Government of India is focusing on healthcare and its intention of ensuring it reaches the masses in a standardised form is apparent.

What are Apollo Munich’s business plans for next five years? Apollo Munich continues its path to be a trusted leader in health insurance sector by providing innovative solutions to the citizens of India. We see a huge opportunity before us in terms of the untapped market potential. Our endeavor will be to reach out to all and grow as fast as possible. The sky is the lower limit in my view. And becoming an `8,000 – 10,000 crore company in the next five to seven years is very much achievable.

january / 2016 ehealth.eletsonline.com

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LEADERS FORUM

Transforming Healthcare Paradigms

(L-R) Dr Akun Sabharwal, Upender Jit Singh, Health Minister Chandrima Bhattacharya, Kieran McBrien, Dr NC Borah, and Dr Sujoy Kar launch eHEALTH magazine’s East Special edition

Continuing with its journey in the healthcare domain in the country, ‘5th Healthcare Leaders Forum-Bengal’ organised by Elets Technomedia Pvt Ltd brought together innovators, investors and the eastern region hospitals and healthcare service providers to deliberate and discuss on the need to increase the pace of sectoral reforms and highlight the measures taken by the state government to improve the overall healthcare ecosystem in the State of Bengal. With quality medical services being confined to the urban centres of the region, the rural pockets hold tremendous opportunity for the healthcare service providers to deliver quality care. We bring a snapshot of the key stakeholders views shared at the forum

january / 2016 ehealth.eletsonline.com

Inaugural Session

Healthcare Policy and Initiatives in Bengal The East Indian region is plagued with almost similar ailments as the entire healthcare sector in the country. Paucity of trained and skilled medical manpower, health infrastructure, lack of quality medical education institutes and shortage of funds has been prevalent in the eastern region as much as other parts of the country. Realising the need to bring in the desired change, the state government has been taking policy measures to improve the overall healthcare ecosystem in the state Chandrima Bhattacharya Minister of State, Department of Health and Family Welfare, West Bengal

“Our hona’ble Chief Minister is leading the health department. There is no other state in the country where the CM is handling the health department port folio which is the most important sector of a state government. The new government has really brought revolution in the healthcare sector by making medical treatment free in the Government as well as tertiary hospitals also. In all government hospitals, any sort of treatment has been made free to the people. We have set up 107 fair price medicine shops which has shown a way to the country and was highly appreciated by the Centre. The State government is giving the land, electricity, water to the hospital premises while the private sector is providing medicinal facilities at reasonable prices. In the RSBY, we are leading the country and built up 33 CCUs at a distance of 50 kms and 17 HDUs and this has gone up to the level of sub divisions which has been done in the last four years.”

Upender Jit Singh MD, West Bengal Electronics Industry Development Corporation Limited (WEBEL)

“ICT has been widely used in healthcare industry for last one decade in specific and has played a major role in the healthcare sector. Some technologies used currently include electronic health record, hospital management and information system, picture archiving and communication system generally used as PAX which is used for archiving and retrieval of all the digital imaging system and bar coding. One thing which is of utmost importance is telemedicine and telehealth. Webel is working on these aspects in a big way. As a state nodal agency, we are one of the few states which are implementing the National Optic Fiber Network (NOFN) project and Webel will be the implementing agency. The benefit of this would be once we have rolled out the optic fiber network till the gram panchayat level with huge bandwidth and network available, the possibility of telemedicine would be enormous.”

Kieran McBrien Regional Director, EMEA of Novaerus Ltd, Ireland

“Our vision is that air borne infection at the hospitals is a massive issue across the world. Around 1,500 years ago Arab doctors used to wash their hands from vinegar before carrying out procedures. If you are continuously cleaning your environment or the bio burden on the surface, you are reducing the number of contacts points and the danger of contact points for your hands. Fundamentally the point is people have not been cleaning the air because it has not been possible to do it quickly and effectively at low cost. That is what now changing as technology is becoming cheaper every day. If you apply air quality technology as the first point of your infection control problem effectively, respiratory infections and air borne infections would be gone. It’s important to clean surfaces but if you treat your air consistently you would be able to reduce chances of infections that can take a toll on you.”

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Dr Akun Sabharwal Director, Drugs Control Administration, Telangana

“Telangana is the youngest state in the country but we are the biggest player in pharmaceutical. Our state manufactures almost 40 per cent of the medicines made in India and also export 58 per cent of the medicines. We also regulate quality and prices of medicines and functioning of blood banks. We leveraged technology to try and cut down the trouble the government sometime gives to the hospitals and industry at large. We have grown from the undivided state of Andhra Pradesh. Telengana has inherited almost 85 per cent of manufacturing capacity with 490 manufacturing units and about 27,000 pharmacists which are functioning. We are one of the few drug regulators in the country which has put everything online like licencing procedures, parameters, flow charts etc. Now nobody needs to turn up at my office to get these things done as everything can be done online.”

Dr NC Borah CMD, GNRC Hospital, Assam

“Private healthcare is becoming more expensive everyday and beyond the reach of almost 75-80 per cent people of our country. The recent socio economic survey showed that monthly household income of around 70 per cent people is below `7,000. As a result, about 75-80 per cent of the people do not have access to private hospitals that leads to excessive rush at the government hospitals and pressure on their doctors as well. In an experiment, we have hired 500 people to work in the hospital and another 500 deployed in a community who they take care of poor people and create awareness amongst the masses. Besides, accessibility is a major issue in the hospitals especially in the tertiary care hospitals. A majority of them are located in metropolitan cities and a very few are based at tier two and tier three cities. On an average for a tertiary care facility, a patient has to travel 50-60 kms and sometimes even 100 kms distance.”

Dr Sujoy Kar Director-Medical Services, Apollo Gleneagles Hospitals, Kolkata

“I would like to through some light on four distinct paradigm shifts that you need in healthcare. The first is, change the way the medical education is given. You have five years of MBBS, three years of MS or MD or a certain years of post and then you have a licence to practice that branch for next 40 years. What is that we need to bring in as an innovation that there are constant changes the way the medicine was practiced in 1980s is no more the same way the medicine is practiced today. There are changes and we have to bring along them and how are doctors not only in tertiary or secondary care hospitals but in the community are taking the challenges of technology and information and changing themselves over a period of time.”

Delegates at the registration desk

january / 2016 ehealth.eletsonline.com

Speakers felicitated after the session

Session 2

Healthcare infra in East: Changing paradigms for making healthcare accessible and affordable to all Keeping in line with the Government of India’s vision to make healthcare accessible and affordable to all, the second session at HLF 2015 saw the eastern region healthcare industry leaders discuss and showcase the challenges and the possible solutions ahead of this segment to attain the universal mission

Dilip Patil Managing Director, Trivector Biomed LLP

“We have been using many air filters, sterilizers and ironisors but they are all having inherent drawbacks of being expensive and requiring high maintenance. The top five causes of death in the world are hospital acquired infection causing more deaths than the road mishaps, breast cancer, AIDS and arms conflicts put together. In the USA, over a lakh people die every year due to healthcare associated infections (HAIs) which cost them additional 40 Billion USD annually. More bacteria are developing resistance to commonly used anti biotics which leads to consumption of higher number doses and adding to the expenses. Plasma has been used in medical field for sterilizing medical equipment but sterilizing the air using plasma without affecting the patients is the latest innovation which is being tried by medical institutes. It doesn’t need any maintenance and eradicates up to 99.9 per cent of viruses, fungi, bacteria and odour. This high voltage low current plasma acts on the DNA of the pathogen and it disintegrates in the molecules of the air, leaving no residues.”

Rupak Barua CEO, AMRI Hospitals, Kolkata

“Today’s discussion is affordability and accessibility particularly in eastern Indian but it is not the question of only eastern India but it is a pan India thing. We are facing same kind of challenges across India. In one way Indian healthcare industry is rapidly progressing and is expected to reach to 280 Billion USD by 2020. In the 1980s there was an IT revolution but now in 2015 we are talking about healthcare revolution. Tremendous amount of work is going on in terms of development of the healthcare and in particular it has happened more post the year 2000 when globalization and insurance sector and we started inviting foreign players in the healthcare. It terms of growth of healthcare sector, there is a huge dearth of human resources and infrastructure.”

Participants discuss on how east is putting in efforts to make healthcare accessible and affordable

(L-R) Dr Ravi Shankar Singh, Rupak Barua, Dilip Patil and Joy Chakraborty felicitated with momentos january / 2016 ehealth.eletsonline.com

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Dr Ravi Shankar Singh Zonal Director, Paras HMRI Hospital, Bihar

“In Bihar we have 12 crore population and just three years back there was no organised comprehensive healthcare provider. We had individual small nursing homes but there was no major healthcare service provider. We set up a 350-bedded hospital and tried to make things available. We were targeting the patients going to Mumbai, Delhi and other metropolitan cities to avail medical treatment. We successfully brought good doctors and technology and now it is running efficiently. Two things hold extreme importance— accessibility and affordability. A few years back, private players were apparently apprehensive about the political situation but now this issue no longer prevails and now the players are interested to invest in Bihar.” Joy Chakraborty COO, PD Hinduja Hospital, Mumbai

“At some places in Maharashtra, both private and government setup are one of the best in the country. However in the remote villages the situation is yet to be improved. The new government which has taken over within a year has appointed around 2,000 doctors and 10,000 nurses with lucrative salaries. As a result private hospitals are losing their medical staff to the government setup. Then to make it affordable the government has launched Rajiv Gandhi scheme through which poor patients can avail completely free medical treatment because they are covered through insurance. To incentivize the healthcare provider the government has done grading of those hospitals. Most of us being a private operator, we are not completely out of the healthcare part. According to the Bombay High Court order came in 2006 every private/ trust hospital is bound to give free medical treatment to poor people to an extent of ten per cent completely free treatment and 50 per cent subsidised rate.”

Session 3

Relevance of Make in India for HealthcarePerspective from East Reemphasizing on the clarion call by Prime Minister Narendra Modi to use the ‘Make in India’ campaign to enable quality and far-reaching healthcare to all, key stakeholders shared the perspective from the eastern region. The Make in India campaign aims to have medical equipment manufactured in India itself to bring costs down and make healthcare reach the poorest of the poor all across the country Aloke Mookherjea Director, Woodlands Multi-Speciality Hospital Ltd, Kolkata

“Why Make in India comes in the healthcare discussion for a simple reason that it is a policy of the government to improve healthcare, requiring more medicines at affordable costs being made in India. Healthcare is a focus area in Make in India. The path of medical equipment is only 0.3 per cent and I don’t think it an obstacle, rather it’s an opportunities for investors to invest. The wellness market is going to be around one trillion Indian rupees having the innovation of latest diagnostics as essential part. GE, which is one of the largest engineering conglomerates in the world, had set up a base in India and started exporting equipment to all emerging markets at a very low cost. They have 10-15 per cent of the global market in the next five year.”

january / 2016 ehealth.eletsonline.com

Richa S Debgupta Zonal Director, Fortis Healthcare Ltd, Kolkata

“If we go to the cost structure, it largely encompasses the consumables related to operations. If we talk about setting up a hospital, medical technology constitutes a huge part. Around 40-50 per cent of your cost actually gets into medical technology. Ninety per cent of medical equipment is being imported and that’s where the cost is hidden. Talking about Make in India, if we start to manufacture these medical equipment, the cost can go down significantly to the tune of 40-50 per cent and that can easily be passed on to patients. If we are able to implement it well, it is going to benefit all of us whether it is the providers or the patients.”

Dr Srijon Mukherjee Director, Calcutta Institute of Maxillofacial Surgery, and Chairman, Indian Board of Oral and Maxillofacial Surgery

“We actually have all these products made in India, but their quality is not up to the mark. There is an urgent need to improve the quality and also need for developing medical equipment indigenously. Unfortunately, the quality of equipment are not good enough to use in the operation theatre.”

Subhash C Mandal Vice President and Chairman, Indian Pharmaceutical Association

“The total healthcare cost of the world is 2.8 trillion USD and out of this India’s share is 30 Billion USD which consists of five per cent of the country’s GDP. But one estimate says that it should be 100 Billion USD by 2025 and its share should be 8-10 per cent of the GDP. Medical cost is a major component of the healthcare. Currently, India is producing around 1.26 lakh crore of medicines out of this India is exporting around 65,000 crore medicines to more than 200 countries globally. It is enough to prove that quality of Indian medicines is very good. You may know that 25 per cent of the total export of Indian medicines is to the US market. The US market norms are so stringent that it is really difficult to enter into the market. India has the largest number of US FDI complaint plants outside US and India is also filing maximum number of approval applications every year next to the US. This proves that India is producing quality medicines. That apart, India is manufacturing HIV medicines at minimal cost and supplying to the African countries where HIV is predominant.”

Participants join a round-table at 5th Healthcare Leader’s Forum, Bengal

(L-R) Aloke Mookherjea, Richa S Debgupta, Dr Srijon Mukherjee, Subhash C Mandal and Bhudeb Chakravarti january / 2016 ehealth.eletsonline.com

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Bhudeb Chakravarti Honorary President, Centre for Development of Excellence

“There are three areas where the government and people should focus on. The first being the process. We only talk about technology, outcome and how we can achieve things. But process constitutes a huge part of any healthcare institution. It is not only the process of doctors for OT, investigations, diagnostics, but you also have the process of procurement and how you will utilize the resources or how you are going to treat your patients. We must treat our patients as our clients and let us build them in a proper manner. We have maximum number of human resources in India, they are talented enough but unfortunately they are not available.”

Session 4

Leveraging Technology for Healthcare Transformation ICT can fundamentally transform healthcare and the segment is among the last industries to be completely disrupted by technology. But roadblocks remain on both sides, be it related to information available to consumers or to health practitioners about how technology can help simplify and automate large parts of their workflow, to focus better on the patients Sanjay Prasad, President and CEO, Mission of Mercy Hospital and Research Centre, Kolkata

“Leveraging technology for healthcare transformation – So, two or three premises that we have is that healthcare is already at a state, where the basis has been established. How can we now build up on transforming this is going to be the key of our deliberation. We have touched upon certain extremely important perspective as simple and profound as data security. While, we are getting data from multiple sources and we are trying to do the mix and churn in them I think at some point there are outlets which are emerging how can you and I as hospital administrators responsible for patient confidentiality be able to be that guard so that the data doesn’t not go into the wrong hand. That is what our challenge is. As a group we have clearly emerged from an evidence based practice to an information based practice to an intelligence based practice and now it is all about predictive based practice which we want to get into.”

Indira Behara Senior Manager, Strategies, Global Health Strategies Emerging Economies Pvt Ltd

“What are the goals that we seek from a good high performing health system? It should be efficient, responsive, are it’s accessible. Of course, technology brings more accurate diagnostics, digital images, digital diagnostics are far more specific but I think the key element that we kept missing out is affordability aspect and we need to make technology more affordable. Technology isn’t just restricted to Information Technology. Today we are talking about things like digestible sensors, preventive health, 3D printers. We are actually in an era where people are trying to print organs and tissues. Some of the projects that my organization works with the Revised National Tuberculosis Control Programme (RNTCP) has an excellent platform running in three of its pilot projects. We are talking about supplying chain management, ensuring that private providers and chemists are actually given their money on time, people get calls that they get their medicines on time. We can use technology extensively to improve healthcare sector.”

january / 2016 ehealth.eletsonline.com

INDIA’S PREMIER ICT EVENT

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Joy Chakraborty COO, PD Hinduja Hospital, Mumbai

“In 2008, I remember there was a very popular video clipping of vision for future by Microsoft, in which a lady was going for jogging in the morning, a diabetic and how she manages to store her records of blood sugar. It was mentioned that in 2013 that’s going to be the scenario and it was dreamt that a lot would be changed. But we are far away from that dream what we wanted to see in 2013. However, there is certain progress that we have made. When you talk about technology for healthcare transformation what are those transformations? I am going to talk about patient experience that is driving private operators. Today, by virtue of having PACS along with speech to text conversion of the reports, our report turn out time has been brought down drastically. We have made online payment system so that people need not to stand in long beeline to get their check up done.”

Dr Rana Mukherjee Director, Care Continuum

“When you are talking about transforming healthcare through technology, one should aspire for where we can reach. If we look at healthcare, each of has a different way of segmenting it. I would be segmenting it to training, preventive healthcare, access to healthcare, diagnostic, treatment and finally monitoring. In terms of the technologies that can be used for transformation, one of the first things I mentioned was training because I think that’s where everything starts. For training, the technologies that can make a difference are— remote learning and simulation so technology will come in both these ways for training of healthcare professionals. Next thing is sensors and miniaturization to make a diagnostics and even to investigate patients.”

Niranjan Kumar Ramakrishnan CIO (IT), Sir Ganga Ram Hospital, New Delhi

“The value of whatever we are trying to do in terms of technology should reflect somewhere like in patients experience we all talk about. Are the patients really seeing some difference the way they are getting treated? Another most important thing is keeping medical treatment fee affordable for the patients over a period of time. If we are not increasing the fee, then I think we are really doing a great help to the people seeking treatment. If technology can really keep the cost as it is in the hospital, it can help patients. My approach towards technology is that there should be a proper implementation and real meaningful use out of the technology. Recently a group of people created a WhatsApp group called ‘Chennai Angles’ to extend help to the flood-affected people in Chennai. It helped a lot and supported the flood-stricken people in Chennai. I firmly believe that this is the real technology transformation.”

Panelists discuss how technology can help simplify and automate their work and help them become more patient-centric

january / 2016 ehealth.eletsonline.com

(L-R) Indira Behara, Joy Chakraborty, Sanjay Prasad, Niranjan Kumar Ramakrishnan and Dr Rana Mukherjee

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Session 5

Healthcare Adoption: Innovative Strategies While accessibility of healthcare is a major concern, it can be overcome effectively by using the right mix of technology and innovation. What is also needed is creating specific innovative models catering to the unique needs of a particular segment

Ikram Khan CEO, Rural Healthcare Foundation, Kolkata

We have generated a lot of innovative models in health system and that model has so far been replicated in India and many tertiary care level models came up like Fortis, Apollo and Medica. Unfortunately, we have not achieved that level of a good health system despite having brilliant minds. It requires a lot of willpower to become a super power. However, many states have done a great job. For instance, the Andhra Government has developed a tertiary care model like ‘Arogyashree’ which has got replicated in many states. Similarly, Rajasthan government has taken up fair price medicine shops for the betterment of needy people.

Sandhya Thukaram Director, Marketing and Business Development, Unitus Seed Fund

We are talking about technology, innovation and demand. One thing which is missing is business model innovation which implies how can you bring it all together and create channels of business and then you can reduce costs. I can give an example of one of our portfolio companies Well Care Healthcare System. It’s very expensive to set up an independent centre. In India we have nine ophthalmologists for every million people. So a senior doctor had set up an eye screen device in existing healthcare centres. And there is diabetic retinopathy which is very common so by having it in a diabetic centre, he is already got patients walking in. The device is connected on the internet and one trained professional screens it that senses the image to certified ophthalmologists who sends back the recommendations. So very easily he has combined the technology with business model innovation. He has now 120 centres across India.

Delegates at Q&A session with the panelists

january / 2016 ehealth.eletsonline.com

Speakers falicitated after the session

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a grand success Heartfelt thanks to all our speakers, sponsors & delegates in making HLF BENGAL 2015 a grand success. The Summit would not have been the same without each one of you.

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Event Report

INDIA’S PREMIER ICT EVENT

IT Works for Health Sector With technological interventions becoming order of the day, more and more organisations are embracing IT to improve their operations and making service delivery efficient. Healthcare delivery in India has been a challenge, like rest of the developing world, where infrastructure falls short of the requirement. In this backdrop, leveraging innovations and technology to transform healthcare delivery is the right way to go. With an aim to discuss the present state of healthcare, past initiatives and their outcome, likely future trends and what needs to be done to bridge the gap, a separate “elets Maharashtra Healthcare Summit” was organised as part of the “11th eIndia - Maharashtra”. We present here the views of key speakers in a nutshell here. 58

january / 2016 ehealth.eletsonline.com

Session

Leveraging Technology for Healthcare Transformation Technology has been a game changer in the healthcare sector. The session saw various health sector stakeholders, including hospitals and other medical institutions, sharing their experiences, showcasing their achievements and highlighting the issues they have come across, in the delivery of healthcare. The aspects discussed at the session included interface tools for handicapped, RCTS and telemedicine, among others. Also, the use of technology for better healthcare delivery was deservedly under focus in this session. Several initiatives, like eAushadhi, Blood on Call and MCTS, undertaken by the Government of Maharashtra were also the topics for discussion. ASHA and Janani Suraksha Yojana under the National Health Mission were given major attention, along with other projects, such as eHealth, HIS project, telemedicine and eMamta hogging the limelight.

Principal Secretary – IT, Government of Maharashtra, Vijay Kumar Gautam address the audience during the session

Easing Healthcare

Integrating Sectors Dr Prakash Wakode

V K Gautam

Joint Director, Department of Medical Education & Drugs Government of Maharashtra

Principal Secretary Department of IT Government of Maharashtra

“There are a number of common things between the Health Department and us, like human machine interface tools for handicapped, RCTS, and in particular, telemedicine. We have also formed a group that will help the physicians to be placed in the remote areas to communicate with our experts. Being a teaching institution, we also started using eLibrary for students, and eClass, where people sitting in smaller towns can communicate with large centres and even abroad for various dialogues or seminars.” http://ehealth.eletsonline.com/2015/12/drprakashwakode/

“It is needless to emphasise that if the overall healthcare ecosystem is brought to a digital platform, both public and private sector will have to be integrated at some levels. For this, we need to work out on strategic interventions at the policy and regulation levels without tinkering much with the professional autonomy of these institutions or individuals. We can also get a set of critical data which can provide critical information for an overall statewide management of emergencies in the healthcare system.” http://ehealth.eletsonline.com/2015/12/vkgautam/

january / 2016 ehealth.eletsonline.com

Event Report

INDIA’S PREMIER ICT EVENT

Towards Digitisation

Game Changer

Dr Tarun Chaudhary

Dr Vinod R Rao

Project Director, Maternal Health, National Health Mission Government of Rajasthan

Mission Director National Health Mission Government of Gujarat

“ASHA and Janani Suraksha Yojana (JSY) were the key interventions when the NHM started. However, nobody unfortunately knows what ASHAs are doing in the field. In Rajasthan, there are 48,000 ASHA workers and we have created a structure keeping a detailed record of them. We built this by assembling the existing resources and converted them all into digital. We designed a claim form which made the ASHAs aware of the paid 26 activities that they are entitled to. This helps monitor the work done by ASHAs in every district and the CMO concerned releases the payment with a digital signature after verification. This helps us closely monitor ASHAs, as it’s linked with PCTCS. ASHA Soft is evidence-based and we have created a dedicated ASHA helpline to deal with their queries. For this, we have also paid more than `80 crore to ASHAs this year.”

“Healthcare is one of the sectors that has implications for a common man more than any other sector. There is no other sector that has so much scope of application of technology relevant to a common man than on the health sector. Over the decades, we have experimented with the application of technology and have seen remarkable outcomes. In health mission, the Mother and Child Tracking System (MCTS) has turned out to be a game changer.” http://ehealth.eletsonline.com/2015/12/drvinodrrao/

http://ehealth.eletsonline.com/2015/12/drtarunchaudhary/

Enabling Connectivity Sandeep Khurana Vice President United Health Group

“The way we see healthcare technology and how the percolation of technology can happen at state and population level has two layers - foundational and advanced building blocks on top of that foundation. From foundational standpoint, eHealth and HIS projects, and telemedicine and eMamta are enabling last-mile connectivity for the poorest of the poor. What we have experienced while working in Haryana is that the data we start collecting becomes increasingly important with time. You begin to create disease registries. You are able to plot incidents of communicable diseases and non-communicable diseases on the state’s map and you are able to direct your programmes at district, taluka and block levels. We have done similar work across the world and it is heartening to see that India has left behind many of the advanced countries in deploying these initiatives. Once we have this basic layer ready, we are able to run various programmes and design clinical pathways for patients with advanced morbidities.” http://ehealth.eletsonline.com/2015/12/sandeepkhurana/

january / 2016 ehealth.eletsonline.com

Impacting Well-being I A Kundan Mission Director National Health Mission Government of Maharashtra

“Maharashtra is one of the leading states in terms of healthcare. We have more than 10,500 sub-centres, 1,811 primary health centres, more than 483 hospitals and delivery points up to 1,590 at sub-centre levels. Maharashtra, in all aspects, is going forward and this is an indicator for the same. There has been an exceptional reduction in IMR and MMR, around 87 per cent. We are using information technology solutions in monitoring across offices. For instance, we have got a health management information system. The Government of Maharashtra has its own software eOffice, eTendering, court case management system, eAushadhi, Blood on Call, MCTS and many more. MCTS is one good software to track IMR and MMR. It also creates a unique ID number when a woman first gets pregnant, and accordingly, the flow up plan is generated.” http://ehealth.eletsonline.com/2015/12/iakundan/

Session

Building Infrastructure for Making Healthcare Accessible and Affordable to all - State Perspectives Better technology infrastructure is the first and foremost thing to be kept in mind before talking about providing better healthcare services in remote areas. It’s only after that technology-driven healthcare initiatives, like teleopthalmology for treatment of eyes and telemedicine, can be thought of. And, the session lay due emphasis on the infrastructure aspect. Mobile-based monitoring of mother and child in Chhattisgarh was talked about by Dr Ayyaj Fakirbhai Tamboli, Director, National Health Mission, Government of Chhattisgarh. Facilities like GIS mapping to locate the nearest health facility were listened to by the audience with rapt attention. Apart from that, Dr Akun Sabharwal from the Drugs Control Administration shed light on online licensing, which points to the efficient use of technology.

Dr Akun Sabharwal, Director, Drugs Control Administration, Govt of Telangana, speaks on Building Infrastructure for Making Healthcare Accessible and Affordable to All – State Perspectives

An Eye-opener Dr Sandeep Namdeo Mahatme Mission Director, National Health Mission Government of Tripura

Tripura holds a population of almost 37 lakh, predominantly in rural and tribal areas. However, the state faces the challenge of availability of specialised doctors (eye specialists). With 75 per cent rural population, we have only 20 doctors out of which 10 will be retiring in 2016. We also have two medical colleges with limited capacity and sudden increase in the number of eye surgeons is not possible. Therefore, making use of appropriate technology, we opted for teleophthalmology six years ago. Initially, we started with teleophthalmology services in the blocks, as they had the advantage of the dual connectivity of the blocks — traditional and mobile towers, which were specially erected for the purpose of connectivity. The patients were being screened in the BDO office and the same data was transferred to the referral hospital – IGM Hospital, the only hospital at the state level where ophthalmologists view the records and prescribe medicines online. The patients take the printout of the prescription and purchase the medicines from the chemist. http://ehealth.eletsonline.com/2015/12/drsandeepnamdeomahatme/

january / 2016 ehealth.eletsonline.com

Event Report

INDIA’S PREMIER ICT EVENT

Healthcare on Mobile Dr Ayyaj Fakirbhai Tamboli Director, National Health Mission Government of Chhattisgarh

“Chhattisgarh started with mobile-based monitoring of mother and child in 2012. Earlier, it was a Java-based platform in mobile phones. But now, we are shifting towards Android-based tablet system. We have distributed these to 275 ANMs. It has already been implemented in urban areas and now we are implementing it in rural areas as well. We also created an application to make people aware. It is a GIS mapping-based thing, which captures the photograph of a location and its latitude and longitude. It is pushed into the system and based on that all the public health facilities have been mapped. With this map, people can locate the nearest health facility. Another mobile application provides drug availability information in public health facility, generic name of the drug. Thus, the pharmacists know about the status of the drugs available in the warehouse through a transparent ecosystem.” http://ehealth.eletsonline.com/2015/12/drayyajfakirbhaitamboli/

Tech Efficiency Dr Akun Sabharwal Director, Drugs Control Administration Government of Telangana

“Telangana has 490 big manufactures and around 28,000 pharmaceutical shops. We have shifted to online licensing. It might appear strange to the IT world, but most of the pharmaceutical regulations still happen on paper and pen. We have also done flow charting and time-lining. In Telangana, now we assure that if you want to set up an industry, we will give you the licence in 30 days. There is also a penalty clause – if the file is stuck at any level, there is a penalty of `1,250 per day beyond 30 days, so the employee concerned has to pay from his pocket. We achieve it through barcoding and file tracking system. The entire process is on website now for manufacturers and pharmacy shops. Across the country, regulations happen in terms of areas and we have shifted from that approach to something called the verticals. We have specialised teams looking after cosmetics, vaccines, etc. The US is the only other country that does it.” http://ehealth.eletsonline.com/2015/12/drakunsabharwal/

january / 2016 ehealth.eletsonline.com

February

Share your Startup Story

2016

asia’s first monthly magazine on The Enterprise of Healthcare

Showcase your Services to your Buyers

Startup on the Go- Regulatory Roadblocks in Healthcare Startup Journey

In 2014, nearly 7,500 startup across the globe looked to develop digital solutions in the healthcare domain, while year 2015 saw around 300 startups focused in the health domain itself. At one end where Indian startup companies are working to bring medical practitioners and patients closer using technology, government’s Digital India initiative and the startup revolution is bringing game changing products and software that have dominated the Indian healthcare IT industry. In eHEALTH February edition, we explore the tech-enabled Start up landscape in the health segment and the support extended by Venture Capitalists to the health entrepreneur ecosystem.

Other focus segments CIO Focus : How Healthcare Technology is Transforming Medicare? Tech Focus : Technology in Pharma Research Edu focus : Pharma Institutes Digitally Aided Medical Education

Deadlines for Above: Artwork : 23rd January 2016 Editorial : 21st January 2016

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Product Launch

Anniversary Issue

Mobile Digital X-ray System from Philips P

hilip’s MobileDiagnost Opta is small, fast, and flexible, delivering quality diagnostic images on a managed budget. Based on decades of expertise and innovation, this powerful compact mobile digital X-ray system is designed for allaround performance and fast return on investment. It moves through crowded spaces in the OR, ER, ICU, and general wards with freedom and ease, bringing digital imaging right to the bedside. Optimised for a wide range of diagnostic capabilities, the system helps radiographers carry out a variety of examinations with ease. It has a telescopic arm which allows the system to cover even more applications as it enables free exams at off‐center position. Light in weight and more

compact than motorised systems, MobileDiagnost Opta moves around challenging spaces in ORs, ERs, ICUs, and general wards with freedom and ease. Speed, power, performance, and affordability makes the product a good option for smaller clinics, hospital that require multiple mobile DR systems, or facilities looking for a single system

to cover most application needs. This system uses a UNIQUE image processing for consistent diagnostic image quality. UNIQUE harmonizes contrast levels, highlights faint details, and adapts parameters to provide lots of detail and wide image dynamics, while still maintaining a natural, artifact‐free appearance. Special built-in APR (anatomical programmed radiography) control helps achieve a high level of exposure accuracy by selecting filters based on anatomy and capturing quality images with effective dose management. In addition, to ease your move into digital radiography, we also offer a digital-ready analog configuration. The analog configuration can be easily upgraded to digital whenever you are ready.

Fortis La Femme launches Integrated Child Health Record App F or those experiencing parenthood for the first time, keeping a track of child’s vaccination is a pressing concern. To address this Fortis La Femme has launched Integrated Child Health Record (ICHR) mobile application. This app can be downloaded from the mobile app store on both iOS and Android phones. It is activated as soon as a child is born and is directly linked to the hospital information system (HIS) and stored on cloud till the child is 12 years old. The ICHR app carries the details of a newborn’s vaccination schedules as well as growth chart tracker. This will be particularly beneficial for couples who have premature babies since

Fenton chart (that tracks growth of a premature baby till 40 weeks) can be accessed by mothers while they are at home and the child is admitted in NICU at the facility. Details about the batch and brand of vaccination will also be entered at the time of vaccination. In case of a delay in administering a particular vaccine, subsequent dates will automatically get updated on this App. The ICHR sends reminder messages to registered mobiles (either parent). The reminder message will be sent five days prior to the due date and a reminder appointment message would be sent 24 hours in prior. The concept of ICHR is so novel that not only does it ease the health record

management for the parents; it also facilitates analysis and trend analysis for doctors further leading to better patient management in future. Parents can take a print out of the vaccination record from ICHR which will print with the hospital logo as an authentication and can be submitted by them at the time of school admissions.

january / 2016 ehealth.eletsonline.com

Startup

Accessing Healthcare Live Healthcare IT is transforming as well as enhancing the treatment procedures in India with players like Doctor Insta helping patients access preventive and curative healthcare (physical and mental) on their finger tips

he healthcare domain sees an immense growth with the increasing internet penetration and Smartphone user base combined with innovativeness of healthcare technology players like Doctor Insta. Offering preventive and curative healthcare on the go Doctor Insta is a video medicine company that aims to fix the present problem of accessibility (seeking medical advice at 3 am in the morning or even while travelling to a different city), reliability and consistency in India’s healthcare market. The telehealth app allows the pediatrics, psychology, general medicine, diet and nutrition practitioners to provide a focused care without asking the patient leave their home. The application provides an access to doctors 24x7 with stringent quality control and assurance procedures in place and with doctor selection ratio of only three per cent (only 3 out of 100 applying doctors are selected to practice on the platform). It offers a standard fee with different price

points for health consultations. The app is compatible on iOS, Android and Web platforms. The idea was curated after the co-founder Amit Munjal used a similar service while being on a remote isAmit Munjal Dr Parshant Jain land of Hawaii with Co-Founder & Chief Executive Co-Founder and Chief Health that video consultaOfficer, Doctor Insta Officer, Doctor Insta tion saved his life. The venture ‘Doctor Insta’ founded Dr Parshant Jain carries 16 years of experience in diverse fields including on 30 October 2015 by Amit Munjal Medicine, Management Consulting and (Co-Founder and Chief Executive OfBusiness Development. Also worked as ficer) and Dr Parshant Jain (Co-Founda Management Consultant with Accener and Chief Health Officer) received investment of US$ 500,000 by US ture where he consulted Fortune 500 based venture capital company, BrahTechnology Companies as well as Dot Coms. The company holds an employee maX Ventures and Angel Investor Ristrength of 25 people. shi Parti. Munjal was the ex-CFO and Head (Investments/Divestments) at Citi The company till date has carried Holdings USA, SVP at Bank of Ameriout various strategic alliances with almost all online pharmacies and ca-Merrill Lynch, with prior stints at diagnostic labs to provide one stop Deloitte Consulting (Clients: Yahoo, solution to patients’ healthcare needs. Google, Expedia.com etc.) and Johnson They have associated some of the best Center of Entrepreneurship and Innomedical practitioners and caregivers in vation & Kauffman Foundation. While, the country with the venture. Doc Insta will be expanding their services at a pan-India level through B2C and B2B2C channels and in other developing nations with similar demographics in the coming times. They will also be offering their services by providing second opinion consultations, pre-operation prospecting, and post-operation followups. They also eye to launch alternative medicine platform (AYUSH).

Consult health expert without leaving home

January / 2016 ehealth.eletsonline.com

For further information visit: www.doctorinsta.com