asia’s first monthly magazine on The Enterprise of Healthcare
volume 9 / issue 07 / july 2014 / ` 75 / US $10 / ISSN 0973-8959
Maharashtra
Maharashtra
Gateway to Innovations in Healthcare
ehealth.eletsonline.com
eHealth Magazine
Healthcare Leadership Awards & Summit 2014
Aditya Birla Memorial Hospital Bhaktivedanta Hospital Kokilaben Dhirubhai Ambani Hospital National Institute of Opthalmology Galaxy Care Hospital Oyster and Pearl Hospitals
Bhatia Hospital Bombay Hospital Noble Hospital Global Hospital Qi Spine Clinic Sahyadri Hospital
Meeta Rajivlochan
Secretary, e-governance, Public Health Department, Government of Maharashtra
volume
09
issue
07
ISSN 0973-8959
Contents
Policy
14- Health Sector Trends Augur well for Market Boom
Special Focus
16- Responding to Healthcare Needs Compassionately Rekha Dubey, CEO, Aditya Birla Memorial Hospital
20- Offering Model, Scientific,
Holistic Healthcare Service Dr Ajay P Sankhe, Pediatric Consultant, Bhaktivedanta Hospital
36- Managing Illness with Skill, Compassion and Quality Dr Dileep Mane, MD (Internal Medicine), Noble Hospital
22- Putting Human Touch
38- Caring for Woman and
Before Technology Dr PD Potdar, Medical Superintendent, Bhatia Hospital
Child for 50 Years Dr Amita Phadnis, Medical Director, Oyster and Pearl Hospitals
24- New Centres for Blood on
44- Why No Regulatory Body
Call Service in Mumbai Sanjay Kumar Jadhav, Assistant Director, SBTC
26- Going Beyond Obligations
to Provide Affordable Healthcare Dr Rajkumar V Patil, Joint Director, Medical Services, Bombay Hospital
28- Redefining Laparoscopy
with Galaxy Dr Shailesh Putambekar, Medical Director, Galaxy Care Laparoscopic Institute
30- World Class Healthcare Infrastructure at your Service Manpreet Sohal, CEO, Global Hospitals
32- Bridging Gaps in
Healthcare Services Dr Ram Narain, Executive Director,
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Kokilaben Dhirubhai Ambani Hospital
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for Health Providers? Amit Bhandari, Vice President, ICICI Lombard
46- Making Healthcare
Affordable Through Technology Tarun Katiyar, Principal Consultant, Hospaccx Healthcare Systems
In person
48- Prevent, Diagnose,
Research: Best way to Cure Heart Ailments Dr Ashok Seth, cardiologist
Specialty
52- Arthritis is not Just Old Age Dr Pankaj Bajaj, Chief Orthopedic Surgeon and Medical Director, Cygnus Orthocare Hospital
54- Working with Compassion, Professionalism and Dedication Dr Amit Sachdeva, Director, Axiss Dental
Expert Speak
56- Prevention is Better Than
Control Sankara Sarma, Franchise Director, ASP, Johnson & Johnson
In Focus
58- Time for Intelligent and
Efficient Hospitals Michael Sullivan, Vice President, Schneider Electric
60- OMRON: for Better Life, for
Better World Shinya Tomoda, Managing Director, OMRON Healthcaren
zoom in
62- Being World-Class Through Innovation Dr Prem Kumar, Registrar, RGUHS
In Focus
64- Oracle Bets on Big Data in
Healthcare Sundar Ram, Vice President, Technology Sales Consulting, Oracle Corporation
asia’s first monthly magazine on The Enterprise of Healthcare volume
09
issue
07
july 2014
President: Dr M P Narayanan
Partner publications
Editor-in-Chief: Dr Ravi Gupta
I C E CO ECT Connecting Technologies,Trends & Business
Infrastructure Construction Engineering
Editorial Team
WEB DEVELOPMENT & IT INFRASTRUCTURE Team Lead - Web Development: Ishvinder Singh
Health Sr Assistant Editor: Shahid Akhter Correspondent: Ekta Srivastava
Executive-IT Infrastructure: Zuber Ahmed
governance Sr Correspondent: Kartik Sharma, Nayana Singh, Souvik Goswami Research Associate: Sunil Kumar
Finance & Operations Team
Executive – Information Management: Khabirul Islam
Sr Manager – Finance: Ajit Sinha Legal Officer: Ramesh Prasad Verma
education Sr Correspondent: Mohd. Ujaley Correspondent: Seema Gupta ICE Connect Assistant Editor: Rachita Jha Correspondent: Veena Kurup Sales & Marketing Team West: Douglas Digo Menezes, Mobile: +91-9821580403 North: Vinay Shil Gautam, Mobile: +91-9910998066 South: Vishukumar Hichkad, Mobile: +91-9886404680 Subscription & Circulation Team Manager Subscriptions: Mobile: +91-8860635832; subscription@elets.in Design Team Sr Graphic Designer: Om Prakash Thakur Sr Graphic Designer: Shyam Kishore Editorial & Marketing Correspondence eHEALTH - Elets Technomedia Pvt Ltd Stellar IT Park, Office No: 7A/7B, 5th Floor, Annexe Tower, C-25 , Sector 62, Noida, Uttar Pradesh 201309, email: info@ehealthonline.org Phone: +91-120-4812600 Fax: +91-120-4812660
ehealth does not neccesarily subscribe to the views expressed in this publication. All views expressed in the magazine are those of the contributors. The magazine is not responsible or accountable for any loss incurred, directly or indirectly as a result of the information provided. ehealth is published by Elets Technomedia Pvt. Ltd in technical collaboration with Centre for Science, Development and Media Studies (CSDMS) Owner, Publisher, Printer - Dr Ravi Gupta, Printed at Vinayak Print Media A-29, Sector-8, Noida, UP, INDIA & published from 710 Vasto Mahagun Manor, F-30, Sector - 50, Noida, UP, Editor: Dr Ravi Gupta © All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic and mechanical, including photocopy, or any information storage or retrieval system, without publisher’s permission.
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editorial
Maharashtra – A Microcosm of India Since taking charge, Union Health Minister Dr Harsh Vardhan has unfurled his vision to transform Indian healthcare. He made his Vision 2020 statement, which envisioned healthcare for all. The Union Health Minister’s vision found resonance with the Prime Minister Narendra Modi, who is committed to serving every mother and child, young and old, with free and clean hospitals, generic medicines, rational drug policy, healthy lifestyles and most importantly, doctors. The honourable Minister’s vision is well served by the expanding healthcare sector. Rising incomes and easier access to high-quality healthcare facilities have pushed the demand for healthcare in India. From `3,500 in 2011, the per capita expenditure on healthcare to is expected to touch `5,400 in 2015. The Indian healthcare sector is expected to grow at a CAGR of 15 percent and be worth `9,51,414 crores by 2017. With such a bright future ahead, eHealth proudly presents you the July 2014 issue, which throws the spotlight on noteworthy hospitals in Maharashtra, particularly in Mumbai and Pune. Why just Maharashtra, you may ask. Maharashtra is one of India’s and most economically developed states. In addition to being a financial capital, it also India’s second most populous state, with a large population of people from other states, especially in Mumbai. This makes it a microcosm of India. Cities like Mumbai and Pune have seen many multi super-speciality hospitals coming up in the last ten years. Add to that, Maharashtra has traditionally had social healthcare movements, and many functioning charitable hospitals too. Mumbai, with its dense population provides a fascinating study on how to make healthcare available to all. Pune, once a small town, is coming up as a major IT hub, and its growth is a reflection of the rise of Indian affluence. By looking at these two cities, we can study the promises and challenges for Indian healthcare. Through a series of interactions, we have evaluated the work done by the hospitals. Further, to highlight the emerging models of secondary and tertiary healthcare and the growth of health industry, we are pleased to present the Maharashtra Healthcare Leadership Awards and Summit 2014. Its aim is to create a vibrant platform for hospitals, government, corporates and academia to share success stories, challenges and opportunities in Maharashtra. The summit is a part of our effort to appreciate and recognize the achievers, innovators and suppliers who have significantly contributed towards the growth and development of health sector in the state of Maharashtra.
Dr Ravi Gupta ravi.gupta@elets.in
july / 2014 ehealth.eletsonline.com
7
news
Health collaboration on priority for BRICS nations
Collaboration in the field of healthcare is one of the priorities to strengthen the bonds among the BRICS nations, an Indian government official said. “We have declared health collaboration as a priority to collectively enhance our partnerships among each other and other countries we are engaged with through bilateral and multilateral mechanisms,” said Additional Secretary, Health, C.K. Mishra. Speaking after the World Health Organisation (WHO) released a bulletin devoted to the theme of “BRICS and Global Health” – a joint initiative of WHO Representatives in BRICS countries, he noted that the production of high-quality, affordable medicines, vaccines, diagnostics and other health technologies by the BRICS is improving access in resource-poor countries. Brazil, Russia, India, China and South Africa (the countries known as the “BRICS”) involve nearly 40 percent of the world’s population. After having achieved remarkable economic growth over the last two decades, they have taken important steps towards improving their health systems and the health of their citizens.
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US doctors to train Kolkata doctors on emergency medical care Kolkata’s Peerless Hospital has tied up with a US-based university to train the doctors specialising in emergency medical care. The Peerless Hospital has tied up with the Ronald Reagan Institute of Emergency Medicine at the George Washington University to conduct a three-year full-time Masters in Emergency Medicine Programme. The first batch of 16 students will pass out next month, said the hospital’s managing director Dilip Samadar. The hospital also launched The Peerless Institute of Emergency Medicine and Trauma Care. While motor vehicle crashes account for the majority of all trauma-related injuries and deaths in India (22.8 percent), injuries related toAsuicidal and homicidal incidents are also prominent, said hospital chairman S
K Roy. The newly-inaugurated unit provides a four-tiered emergency service right from initial field care to recovery. India loses approximately 2-2.5 percent of its GDP to only road traffic injuries. Annually, more than 330,000 injuries occur in India. Half of these require medical treatment while as many as 80,000 lives are lost.
GNRC receives US$ 150,000 WBG grant The World Bank Group (WBG), through its India Development Marketplace (IDM) initiative, has chosen GNRC (formerly known as Guwahati Neurological Research Centre) to receive a grant of US$150,000. The grant was announced by Onno Ruhl, Country Director, India, World Bank and Anil Sinha, Regional Head, South Asia Inclusive Business Models, International Finance Corporation (IFC) during a conference and workshop on development marketplace in Guwahati. IFC, a member of World Bank Group, is the largest global development institution focused exclusively on the private sector. The event was organised from June 19-22, 2014 at the NEDFi Convention Centre, Guwahati. The award was presented by Ruhl and Jitesh Khosla, Chief Secretary, Government of Assam to Dr Nomal Chandra Borah, Chairman, GNRC. Through its India Development Marketplace initiative, the World Bank Group (World Bank and the International Finance Corporation) identifies and supports scalable, replicable and financially sustainable projects that offer solutions to the most pressing social, environmental and economic problems. The social enterprises which were recognised for India Development Marketplace 2014 awards, went through an extensive due diligence and evaluation/meticulously evaluated for their demonstrated projects.
Punjab to have its own AIIMS to boost healthcare Punjab would soon have its own All India Institute of Medical Sciences (AIIMS) to give a boost to healthcare in the state, an official release said. The AIIMS would be set up in the Doaba region, near Jalandhar. The decision was taken by Health Minister Harsh Vardhan during a meeting with Punjab Chief Minister Parkash Singh Badal, who
called on him at Nirman Bhawan here Thursday, the release said. Underscoring the need for setting up an AIIMS in the state during the meeting, Badal said the hospital would provide an easy access to patients from across the state to avail quality treatment at the shortest possible time. He said that the state government would provide
Urgent need to provide communitybased services for de-addiction: Pranab There is an urgent need to provide community-based services for the identification, counselling and de-addiction of drug addicts along with their after-care and rehabilitation, President Prabnab Mukherjee said. At an award ceremony to recognise outstanding services in the field of prevention of alcohol and substance abuse, Mukherjee said alcoholism and drug abuse were psycho-social-medical problems requiring a holistic approach. “The aim of the comprehensive treatment programme should not merely be to get the addicted individuals off alcohol or drugs. Focused attention on making the addicts productive members of the society by making them drug-free, crimefree and gainfully employed is what is required,” he said.
200 acres of land free of cost to the centre for the project. The chief minister also flagged the issue of
drug menace in the state and sought the support of the union health ministry in tackling the grave problem.
Telangana Govt to double budget allocation for healthcare Telangana Government is keen to double budget allocations for healthcare from the present less than 2 per cent, state Minister for IT and Panchayat Raj K Taraka Rama Rao said. “I would discuss with the state Health Minister to ensure that there are better budget allocations for health care which is now less than 2 per cent of the budget allocation. Our government would set a target of at least doubling the present allocation to start with,” he said. Development of public health sector is crucial as nearly 85 per cent of the state’s population depends on it, he said. As announced earlier, a super speciality hospital will be set up in each district of the state which would be on the lines of Nizam’s Institute of Medical Sciences. Further, PHCs and Area Hospitals would be set up in every mandal and taluqa, he said.
NDMC hospitals to provide birth, death certificates free Birth and death certificates will henceforth be provided to the public in New Delhi Municipal Council (NDMC) areas free of cost, according to civic council chairman Jalaj Shrivastava. The NDMC, which functions under the administrative control of the union home ministry, is effecting certain amendments in the current Birth & Death Software and it will provide a printing option to all the hospitals within its jurisdiction to facilitate issuance of first free copy of birth and death certificate to the public before discharge from the hospital, Shrivastava said. The civic body will implement the system in all government hospitals in the NDMC area as soon as hospitals nominate officers who will be designated subregistrar by the Chief Registrar’s Office to sign the first free copy of Birth and Death Certificates, said an official spokesperson.
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special focus
Quality is
All About Attitude Says Meeta Rajivlochan, Secretary, Department of Public Health, Government of Maharashtra in conversation with Rachita Jha, ENN, as she talks about the state government’s effort to introduce quality standards in close to 400 hospitals, both in the public and private sector, which have been empanelled under the Rajiv Gandhi Jeevandayee Arogya Yojna
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Please help us with the genesis of the concept of introduction of quality standards for hospitals in Maharashtra. We are the first state in the country to launch such comprehensive endto-end quality standards that are also built-in with our health insurance scheme called the Rajiv Gandhi Jeevandayee Arogya Yojana. It was our quest for improvement in patient care services that got us started on the issuance of quality standards in Maharashtra. The objective of these standards is to see that patients get adequate information about their own treatment plans and about pricing and also that hospitals follow standard operating protocols and provide a high quality of service. These standards were issued last year and since then we have trained more than 300 people from various hospitals. We believe that it is possible to have low cost healthcare without compromising on the quality of care. The essence of quality in healthcare is maintenance of patient care records and improving hospitalprocesses. What is needed is an attitude which says quality is important. We decided to lay down certain Standard Operating Procedures (SOPs) that restore the faith of the patients in healthcare systems, encourage physicians to follow good clinical practices and provide templates for hospitals to bring-in efficiencies by making documentation a practice. The introduction of quality standards is a low cost intervention for the government wherein simple operational lacunae can be addressed and the outcomes will be much better for all the stakeholders in the community – be it physicians, administrators and patients at large in Maharashtra. We have tried to summarise best practices in medicine and to incorporate these in the standards. We believe that hospitals are willing to improve and the response has been very encouraging.
We have tried to summarise best practices in medicine and to incorporate these in the standards. We believe that hospitals are willing to improve and the response has been very encouraging Tell us more on some of the key aspects of the Quality Standards. There are nine different chapters in these standards: Human Resources, Facilities Management, Infection Control, Monitoring Medication, Patient Medical Records, Standard Operating Protocols, Quality in Patient Care, Transparency in Pricing and Patient Satisfaction Indices. For instance we have mentioned that for a 50 bed hospital it is mandatory to have two doctors per shift and the nurse patient ratio should be 1:1 for ventilated beds and 1:3 for non-ventilated beds. It is mandatory to have ambulance services for all hospitals whether in house or on call. ICU should have life saving equipments such as ventilator, defibrillator and pulse oxymeter and all equipments should be in working condition. We have also mentioned that it is necessary to have uninterrupted power and water supply at least in critical areas such as ICU, OT and labour ward. We have also emphasized on infection control parameters that include maintenance of
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special focus
a central registry for hospital acquired infections and ventilator associated pneumonias. This would facilitate hospitals in taking corrective action. Then our medication monitoring standards makes it mandatory for hospitals to have storage of medicines with FDA approval. It is important that we track and document patients at the hospitals to get information and intelligence on the disease and treatment patterns, so we have made it mandatory for every patient to have a unique ID which must be recorded on all patient documents.
Please share the details on the SOP guidelines for Standard Operating Protocols (SOPs) and Patient Care specifically by the state government. The SOPs should be developed for admission and discharge, medicine storage and dispensing, OT work flow, ICU admissions, the discharge process, emergency services, laboratory services and radio-diagnostic services. The use of such SOPs would go a long way to improving services in casualty and patient service in general. In terms of quality of patient care, the indicators include use of surgical safety checklists, documentation of post-operative complications, pre-anesthesia check conducted before surgery to give some examples. The list also prescribes the documentation of average door-to-needle or door-to-balloon time in treating heart attack patients in an effort to improve outcomes. The left internal mammary artery graft is a standard indicator for heart surgery and we encourage hospitals to record the incidence of such grafts. We have a separate set of standards for patient satisfaction that detail on appointment scheduling, informed consent before surgery or a procedure. We encourage hospitals to provide a feedback form to patients at the time of discharge in the local language, as many times the patients are
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Rajiv Gandhi Jivandayee Aarogya Yojana Card Distribution
The audits of hospitals have already started showing results and many hospitals have improved their infrastructure and overall score of their hospitals not well versed with English. We have also made it mandatory to have a citizen’s charter, suggestion box under the indices.
Tell us more on the success of Rajiv Gandhi Jeevandayee Arogya Yojana- a unique initiative by the state. We have empanelled hospitals under the scheme in September last year, and conducted the first round of basic audit in November last year. The scheme has been successful in reaching out to patients and offering them services at a low cost. The majority of feedback received is very positive. However, there have been some complaints of hospital administration not
being prompt in addressing the patients needs and charging money for services that are expected to be completely cashless. We have a call center for recording all such grievances which are then communicated to the hospitals and our efforts have been to see that the grievances are redressed at the earliest possible. The Patient Satisfaction Indices that we have introduced and Transparency in pricing standards encourage hospitals to improve services so that such complaints could be reduced. The audits of hospitals have already started showing results and many hospitals have improved their infrastructure and overall score of their hospitals.
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Health Sector Trends Augur well for Market Boom I
ndia is a country with a billion plus population. Providing affordable healthcare to a huge population is a big challenge for the medical sector. The healthcare sector has been growing by leaps and bounds and will continue to do so over the next decade. With new government at the centre, healthcare industry is expected to boom alongside new milestones which are to be achieved over the next few years. The latest trends in the medical health sector portend huge growth potential.
Market Size The future of the health industry seems to be bright and can be one of the drivers for growth of the Indian economy. The Indian healthcare industry, growing at a CAGR of 15 percent, is expected to touch US$ 250 billion by 2020. The domestic healthcare sector is poised to touch US$ 100 billion by 2015 and US$ 275.6 billion by 2020, according to industry estimates. There is an immense scope for enhancing healthcare services penetration in India, which presents ample opportu-
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Citizens form the backbone of a country’s economy. A developed nation is characterised by its healthy citizens. Therefore, healthcare should be a major thrust area in India’s fiveyear plan. Nitika Narvekar, ENN, explores the healthcare opportunities in the country nity for development of the healthcare industry. Of the total healthcare revenues in the country, hospitals account for 71 percent, pharmaceuticals for 13 per cent and medical equipment and supplies for 9 percent. The private sector has emerged as a vibrant force in India’s healthcare industry. Its share in healthcare delivery is expected to increase from 66 percent in 2005 to 81 percent by 2015. In 2013, healthcare and life sciences emerged as the second favourite destination for venture capital after technology, attracting 27 investments worth US$ 181 million, according to research firm Venture Intelligence. The hospital and diagnostics centre in India received foreign direct investment (FDI) worth US$ 2,191.91
million, while drugs & pharmaceutical and medical & surgical appliances industry registered FDI worth US$ 11,583.69 million and US$ 741.80 million, respectively during April 2000 to December 2013, according to data provided by the Department of Industrial Policy and Promotion (DIPP). The metro cities are strengthening quality healthcare whereas the smaller towns are also emerging as potential destinations in the health sector. Government ideologies are playing a major role in deciding the country’s health policies. Public-private partnerships are adding to the development of health sector.
Medical Tourism Medical tourism is a booming phenomenon in countries like India.
Of the total healthcare revenues in the country, hospitals account for 71 percent, pharmaceuticals for 13 percent and medical equipment and supplies for nine percent
Medical tourists choose India as their favourable destination because of the key opportunities in Indian healthcare sector in the form of efficient infrastructure and technology. Medical tourism also referred as medical travel, health tourism or global healthcare is a term used to describe the rapidly-growing practice of travelling across international borders to seek healthcare services. Health tourism includes segments such as multi-specialty hospitals, Ayurveda, holistic medicine centres and health spas -- adventure tourism and eco-tourism providers. Services typically sought by travellers include elective procedures as well as complex surgeries, etc. Majority of these tourists come to Indian shores seeking liver transplant, heart surgeries like bypass or pacemaker, bone marrow transplant, hip replacement, knee replacement, eye surgeries, etc. Indian expertise in conducting these surgeries with most advanced technology is at par or sometimes even beyond comparison with its American or European counterparts.
Medical tourists visiting India are anticipated to touch 3,200,000 by 2015 and medical tourism is expected to grow at an annual rate of 30 percent till 2015.
Government’s initiatives The government has also taken up several initiatives like the Rajiv Gandhi Jeevandaye Yojna, National Rural Health Mission (NHRM) and National Urban Health Mission (NUHM) to improve the healthcare delivery in the country. Our Prime Minister Narendra Modi in one of his speeches said that we should focus on health rather than focusing on sickness. Not only did he mention about providing healthcare to everyone but also emphasized on the increasing role of technology and innovation in the health sector.
Drivers of growth The health sector is growing because of increasing life expectancy, new innovations and research, high-disposable income, greater penetration of insurance and also life style changes. There has been a flood of medical tourism and medical education in the country.
India is a land full of opportunities for players in the medical devices industry. The country has also become one of the leading destinations for high-end diagnostic services with tremendous capital investment for advanced diagnostic facilities, thus catering to a greater proportion of population. Besides, Indian medical service consumers have become more conscious towards their healthcare upkeep. Most Indian metros have hospitals with world-class infrastructure, processes and outcomes. However, 70 percent of the healthcare infrastructure is confined to the top 20 cities of India. In order to reach the remaining population, innovations both in healthcare products and delivery are required. The surge of new players and the further penetration of stalwarts into the industry have created a galaxy of leaders in the healthcare industry. As a series of special focus section, this issue of eHealth explores the new models of healthcare emerging across the country from the point of view of the stalwarts of the healthcare sector. We have through a series of interactions, evaluated the work done by various sectors of this industry. An outcome of the urge to look at the emerging models of secondary and tertiary healthcare and the 360 degree growth of health industry, we were obliged to come up with an occasion like ‘Maharashtra Healthcare Leadership Awards and Summit’, so that we can create a vibrant platform for hospitals, government, corporate and academia to share success stories, challenges and opportunities in Maharashtra. The summit is a part of our effort to appreciate and recognize the achievers, innovators and suppliers who have significantly contributed towards the growth and development of health sector in the state of Maharashtra.
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Responding to
Healtcare Needs, Compassionately Aditya Birla Memorial Hospital is a multi-speciality tertiary hospital located in Pimpri-Chinchwad, Pune in the western Indian state of Maharashtra. The hospital is a homage and tribute to late Shri Aditya Vikram Birla. ENN’s Nikita Narvekar interacts with Rekha Dubey, Chief Executive Officer, Aditya Birla Memorial Hospital to explore more about this word-class multi-specialty hospital talents in the medical industry as fulltime consultants since its inception. The hospital’s mission is ‘Compassionate Quality Healthcare’. Today, we have around 95 full timers. Most of our doctors come from AIIMS, KEM Mumbai and many other good colleges. It is beneficial for the patients as doctors are availabe 24X7. If a patient comes in with a blockage, we have one consultant who will be free to check the patient immediately. If a patient is in the hospital for more than 10 days, then there has to be an explanation as to why there is a delay in his recuperation. Since our inception, we have focused on technology. We are one of the best in terms of technology and also infrastructure wise.
What is the next exciting phase for Aditya Birla in 2014-15? Please tell us something about Aditya Birla Memorial Hospital. Spread across 30 acres, Aditya Birla Memorial Hospital has 500 beds out of which 350 are fully functional. We have all the specialities apart from
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heart and kidney transplants. We did not have nuclear and radio therapy but now we will start both in the next two months. So, now we will become a completely tertiary care hospital. The hospital has employed finest
We are eagerly waiting to start the radio-therapy wing. After that, we will have a total built-up area of about 75,000 sq ft where we will have two floors for radio therapy, one for consultancy, one complete floor for chemotherapy.
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We will also have the nuclear medicine and iodine therapy. This is what we are waiting for. Also, we will be starting a new 150bed hospital in Ujjain. So, as a group, we have 18 hospitals in total from where we cater to all kinds of people. Our next move would be to connect as a hub-and-spoke hospital. Our main focus is to move to Tier-II cities now.
How is healthcare industry doing in Tier II and Tier III cities? There is a huge need in these cities and we need to proceed towards such areas so that the people there have better facilities.
What are your initiatives in medical education and training? In medical education, we are running the DNB courses. We have also designed our own dialysis technician course. We have a different set-up for this. We also have nursing courses. We need to produce our own manpower.
What are the latest medical equipment you have deployed in your hospital for the diagnosis and treatment ? As I told you, since our beginning, we have been the pioneers of almost all the medical equipments. We were the first ones to have hydrotherapy in the hospital.
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We were the first ones in almost every area. Also, the machine that we have brought for radiotherapy is the world’s second machine and the PETScan that we got is the Asia’s first machine.
Could you tell us about any collaborations and accreditation strategies? It is Maharashtra’s First Joint Commission International (JCI) and National Accreditation Board for Hospi-
What are your expectations from the new government? They need to pay attention towards the poor and their health. Everybody is ready to work with the government to achieve the goal of health for all. Nobody wants to go to a government hospital. Most prefer private hospitals because they have no choice. Government hospitals give free treatment, but the quality of treatment is poor. Unless and until there is a very
Everyone prefers private hospitals because they have no choice. Government hospitals give free treatment, but the quality of treatment is poor tal (NABH) accredited hospital, and also India’s First HACCP and ISO: 22000:2005 certified hospital.
What are the IT initiatives undertaken in the hospital? We were the first ones to have collaborative software to save the back-up of all the documents. When we did that, none of the hospitals here had that IT change. Our clients can see their report sitting in the comforts of their homes, they can have their appointments, check their reports, payments, everything online. Our doctors can also do the same.
strong scheme that is designed, which is bereft of corruption, people will not be ready to affiliate with such schemes. Public Private Partnership is a very good model but only if it is free of corruption. Health and education is the primary job of the government. The whole system is screwed up. They have stranger laws for healthcare in our state. We can expect that with the new government at the centre, things will change. We are not lacking ideas, we are lacking will.
special focus
Offering Modern,
Scientific, Holistic Healthcare Service Dr Ajay P Sankhe has been working as a Pediatric Consultant in Bhaktivedanta Hospital since its inception. In an interaction with Nikita Narvekar, Dr Sankhe, Director, Bhaktivedanta talks about the mission, present and future plans of the hospital
Could you tell us about Bhaktivedanta in brief? Bhaktivedanta was established in January 1986. We started as a non-profit organisation and that time Mira Road was a very small place, so we started with focus on critical care and emergency services. We began with basic specialities like physicians, pediatricians, gynaecologists, orthopaedics, etc. with core focus on Emergency Medical Services (EMS). Right now, we are a 170-bed hospital with six operation theatres and almost all speciality treatments, a Path lab and the state-of-the-art radiology centre. Apart from the treatments, our major thrust is the services that we offer to people. We have various outreach programmes. This hospital is run by a trust who are into a lot of community service programmes in areas like Thane, Vasai, Virar, almost all the outskirt areas and tribal belt. Our focus has been on eradicating blindness. We work towards cataract treatments and diseases like cancer in the tribal areas and offer free treatments to tribals. We have one rural centre in Wada, Maharashtra and will be setting up another in Talasari which is a tribal region. Many patients from there die on their way to hospital, after being stabilised in a Primary Health Centre, since it takes half an hour to two hours to get to a hospital. So, we plan to start an acute care receiv-
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ing unit, probably in Manor given its proximity to areas like Wada, Talsari, Vikramgad, etc. to receive patients on their way to be checked, monitored and stabilised again, and sent to the hospital in an ambulance. We are focussing on Talasari because it is a tribal area and the people there are very poor and need medical attention. We have already appointed people to take care of their needs and once the hospital is functional, they will be taken care of.
What is exciting that is coming up for Bhaktivedanta in 2014-2015? If the government approves our paper for additional FSI, we will build one more building. The present hospital is full, and we don’t have space to expand. The new building will be of similar size.
What are your initiatives on medical education and training?
What about accreditation and collaboration strategies of the Hospital?
We have an in-house CME for all our departments. They undergo rigorous training so our manpower is highly skilled. We have weekly CMEs for all departments and monthly CMEs for outsider or visiting doctors. We have recently been recognised as a Laparoscopy training centre by the Maharashtra University of Health Sciences as well. Since we are focussing on emergency medical services (EMS), we are adopting an EMS model from the United States for training the paramedics to handle the golden hour during a heart attack. In addition to all this, we also run a medical college.
We have applied for NABH accreditation, and hopefully by this year, we should be certified. Also, we have collaborated with SL Phadke Lab for pathology .
We stress more on spiritual care. In fact, spiritual care in itself is a new treatment modality. We have a spiritual care department What multi-speciality services have you introduced for your patients recently?
Any initiatives that you have taken in treatment modality or infrastructure ?
In the last two months, we have introduced two new services, a Cath lab and Cardiac services. The state-of-theart Cath lab has minimal radiation issues. We have a cardiac theatre which focuses on preventing cardio diseases. It is a lifestyle disease so patients are taught how to avoid cardiac arrests, or how to save themselves from another angioplasty or a bypass surgery. We conduct these lifestyle modification workshops for our patients every two months, where the focus is on yoga and meditation. In fact, we have a dedicated therapeutic yoga department. Another new department is urology, and we have a urologist and latest equipments for the same.
We are looking at integrating our services. We have integrated Ayurveda, Allopathy and Homeopathy for treating asthma, especially in children. Also, we have integrated spiritual health and cancer treatments to help cancer patients cope with their illness. We are researching on how to integrate cancer and spiritual health and how spirituality affects depression and anxiety. We stress more on spiritual care. In fact, spiritual care in itself is a new treatment modality. We have a spiritual care department and we are focussing on generic spiritual care, and not a religious one. So, I would say, this is a unique feature of Bhaktivedanta.
How do you look at the opportunities in Tier II and Tier III cities? Healthcare opportunities in India are tremendous, particularly for organisations like us who are focused more on community health. We are a corporate hospital, no doubt, but before that we are a Trust hospital. Our main focus is to fulfill the goals of the trust and to look after the social needs and reach out to the public. Cities are expanding as rural population shrinks and with urbanisation, a lot of diseases have sprung up, the top two being cancer and heart attacks. So, the stress in these cities will be so huge that you will need to have huge hospitals in these areas to suffice the medical needs.
What are your expectations from the new government? India needs a lot of healthcare infrastructure. We need to have good roads and EMS for the state in practice, not just paper. The gap of skilled manpower needs to be filled. The country faces a shortage of doctors and nurses. We cannot blame the people who go abroad, because that is a very small percentage. We need many more doctors than what we are producing now. We also have to utilize the workforce and resources that already exist. The Rajiv Gandhi scheme that we have is an excellent programme, but is doomed for failure as it has not been implemented well. If implemented properly, it will prove to be a boon. Also, the Public Private Partnership models have to be good and friendly.
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Starting out as a maternity home, Bhatia Hospital has today grown into a multi-speciality hospital that offers treatments in many branches of medicines. ENN’s Nikita Narvekar talks to Dr PD Potdar, Medical Superintendent, about the hospital’s road ahead
Putting Human
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Please tell us something about Bhatia Hospital. Bhatia Hospital was started in 1932 as a maternity home of 25 beds in one of the heritage buildings donated by a member of the Bhatia community. With the efforts of everyone’s team work we have now grown in to a 209-bedded super speciality, tertiary care hospital. We provide healthcare to people from all strata of society irrespective of their caste, creed, and financial status. We believe in human touch more than technology or infrastructure, so it is important for the staff and patients to relate to each other so that the patient feels that he is a part of the hospital.
What are Bhatia Hospital’s plans for 2014-2015? We are coming up with a nine-storey building which will have a state-ofthe-art cath lab. This lab is not only pertaining to the heart but to the investigation of the entire body. Also we will be shifting the entire administration department in the new building so that this building can be developed for total patient services. We will also be having a skin bank. This will be useful for the burns patients.
What are the latest multispeciality services that you have introduced for you patients? Orthopaedics is our prime focus. We have started knee joint replacements where the patient can even sit on the floor folding his legs without any difficulty. We have eliminated open abdominal surgeries and replaced it with Laparoscopic surgeries. We have state-of-the-art operation theatres which match international standards. There are multiple cameras in there. We have got laser in urology which can destroy any tone without any difficulty.
We believe in human touch more than technology or infrastructure, so it is important for the staff and patients to relate to each other so that the patient feels that he is a part of the hospital Also we are advanced in other specialities also. We have a specialised burns care unit which meets the international standards and can treat people even with 70 percent burns.
taking 50 exposures from different angles.
What are you initiatives on medical education and training?
We have applied for NABH accreditation and we are already on that job. We will also look into medical tourism. How do you look at the opportunities in Tier II and Tier III cities? We haven’t thought about moving into these cities.
We always stress on a type of medical education called Continuous Medical Education (CME). We have CME programmes for university, DNB students. We also have certain topics for public awareness. We have well experienced consultants who lecture people on various topics.
Any initiatives that you have taken in treatment modality or infrastructure? Our motto is to give tender care to the patient as a mother gives to the child. So our passion is to look after the patient first. We have an X-ray machine where even the minutest details can be picked up. We have the latest CT scan machine which has the capacity of
What about accreditation and collaboration strategies of the hospital?
How do you look at IT opportunities in healthcare industry? We have a website which is very informative. So we are incorporating IT into our working. What do you expect from the new government that has ushered in? There is a need for more hospitals. So the government should provide land at reduced prices. Also, there is a need for reduction in taxes for health establishments and medicines. They have to reduce the burden of schemes on the private and trust hospitals by improving the standards of public hospitals.
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New Centres for
Blood on Call Service in Mumbai The ‘Blood on Call’ scheme also known as ‘Jeevan Amrut Service’ will soon have nine new blood centres in Mumbai. Sanjay Kumar Jadhav, Assistant Director, State Blood Transfusion Council (SBTC), elaborates on the scheme and the blood transfusion scenario in Maharashtra. In conversation with Nikita Narvekar, Elets News Network (ENN) Could you please tell us more about the ‘Blood on Call’ service? The scheme aims to provide blood and blood components on phone call by transporting blood by motorcycle through cold chain box from district hospital to the nursing homes and dispensaries within the reach of one hour. The pilot project was launched at District Hospital, Satara in 2013 followed by the second project in Sindhudurga district. Following the success of both, the scheme was
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launched in Mumbai on January 7 this year and is being implemented successfully. A toll free number 104 has been provided and the call is received at a call centre set up in Pune and then diverted to respective blood bank. After, the availability of blood is checked, due checks are held and the blood sample is cross matched by technicians and only then the blood is transported to the required place. The nursing homes or hospitals
have to register their names with the District Hospitals for availing the facility.
What was the thought process behind the scheme? Whenever there is a need of transfusion on blood or blood component to the patients, the relatives have to search the addresses of blood banks and face a lot of inconvenience in getting the blood. It was to overcome this difficulty, that the scheme was started.
What is the next phase for blood transfusion in the state? Based on the success story of Sir JJ Mahanagar Blood center, the State Government has initiated measures to replicate a similar model at 10 Public Sector Regional Blood Banks at Thane, Ahmednagar, Pune, Nashik, Jalgaon, Nagpur, Chandranagar, Amravati, Parbhani and Satara. Also, at present, New Mumbai does not have efficient blood bank to cater the need of the region. Hence we intend to establish a State of the Art blood centre with residential training facility. Also, blood bank activities will be monitored by an online process called Haemovigilance. The data will comprise of details of blood from point of collection to transfusion to a patient and a pilot project execution for the same is under process at Mumbai.
What has been the response to this scheme? We have had tremendous response to the scheme. It has been implemented successfully and is gaining popularity. So far, 7572 calls have been received and a total 4774 blood bags have been issued. 870 hospitals and nursing homes have registered with us so far.
Are there any expansion plans for the scheme? We will soon have nine blood centres- Dahanu, Vasai, ESIC Hospital Mulund, Bhabha Hospital Kurla, Shatabdi Hospital Kandivali, Railway Hospital Byculla, Bombay Port Trust Hospital, V N Desai Hospital Santacruz and SDH Malwani. This will cover maximum areas in Mumbai.
What were the challenges faced while implementing the scheme? Every initiative has its own hurdles. We did not have any difficulty as such and if there were any problems we
overcame them all. Setting up agencies was difficult so we tied up with NGO’s to make the scheme happen. We recruited additional staff solely for the scheme. There are about 110 posts for doctors, technicians, social workers, etc.
What is the scenario for blood transfusion like in Maharastra? Our state is much better in terms of blood transfusion. In 2013, 21,141 camps were held in state and 14.75 lakh units of blood were collected. At present there are 309 registered and licensed blood banks in Maharashtra out of which 225 banks have component preparation facility and 88 blood banks have Apheresis facility. In this facility, specific blood component is collected from the donor with the help of Automatic Machine. Sir JJ Mahanagar Blood center has prepared and distributed 3.48 lakh components to needy patients in last four years at a mere cost of `450.
Please tell us about technology implementations for Blood on Call. We have a technology for rapid detection of haemoglobin called as micro haemoque. Then we have initiated a technology to lessen the difficulties and time in grouping. Then the manual process for blood banking has a scope for manual error. To eliminate that we have automation in blood banking, then we have started mobile blood donation so that a person does not have to go to distant camps to donate blood. Then all our data is web enabled. So we have a lot of technologies being used for all our processes. The Union Ministry of Health and Family Welfare felicitated the state on June 14 on the occasion of the world blood donor day for providing excellent blood donation facilities. State Blood Transfusion Council (SBTC) is the only body in India which met the mandated target of one per cent of a state’s population donating blood.
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Going Beyond Obligations to Provide Affordable Healthcare In its thrust to provide affordable healthcare, Bombay Hospital has gone beyond its obligations and ventured into other cities a well. ENN’s Nikita Narvekar charts this journey in a conversation with Dr Rajkumar V Patil, Joint Director, Medical Services, Bombay Hospital
Please tell us something in brief about the hospital. Bombay Hospital Trust was constituted in the year 1952 as Public Charitable Trust. It has been aimed at providing the same medical care which a rich person gets, to the poor patient. Rameshwardas Birla was the person who initiated the thought and since then our philosophy has been the same- to provide same quality of treatment to every one, irrespective of whether they can afford it nor not. Bombay Hospital has a unique proposition. It is a self-generated revenue model as there are no grants received from the government and donations have dried out over the years. We generate our own revenues from patients and this money is later used for subsidizing the treatment for the poor and the one s who cannot afford high medical expenses.
You mentioned community services, what does Bombay Hospital do to provide such services? We have 720 beds which are fully operational. Out of these, 300 beds are in the general ward. In the general ward, there are no bed or doctor charges. Also, the Nursing Service, Resident Doctors, paramedic services are provided to the patients for free. Even the food is free. The patient only pays for investigation - which is heavily subsidized - and the material and medicines.
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What is the next phase for Bombay Hospital? Bombay Hospital as a trust did not have an obligation to expand, but we still endeavoured in expansion to provide better healthcare services to other cities. So we started Bombay Hospital Indore in 2003 and within a short span of 10 years, it has become a referral centre for central India. It is the only hospital in Madhya Pradesh to have NABH accreditation. We are now constructing a hospital at Jaipur which will be called Bombay Hospital Jaipur. This should be completed in three to four years time. As a trust, our philosophy is to provide affordable health care to all. Since all patients cannot travel to Mumbai for treatment, we provide the same level of treatment in other cities as well.
Tell us about the latest equipments that you deployed for treatment of patients in the hospital. The latest equipment that we have bought is the PET CT Scan which is an expensive equipment to detect cancer at an early stage. As demand for imaging is increasing, we have also added two, 3 Tesla MRI machines which are available in very few hospitals, and their images are of the highest quality. Also we are very focused on technology and hence constantly upgrade the machines and equipments used in the hospital.
What are the initiatives Bombay Hospital has taken for medical training and education? Our core activity is patient health and patient care but we do emphasize on medical education as well. The Bombay Hospital Institute of Medical Sciences started in 1988 and has completed 25 years. We offer superspeciality courses such as DM and MCH and Post Graduate courses like MD, MS and DNB. Bombay Hospital Institute of Medical Sciences (BHIMS)
With the advent of IT, how do you look at the use of IT in the healthcare sector?
We do not believe in franchise models. We want to carry forward the crux of our hospital which was formed in 1952. We want to extend to other cities and states but only on the basis of our model is affiliated to Maharashtra University of Health Sciences (MUHS) and recognized by the Medical Council of India (MCI), and all admissions are purely on merit.
What are your initiatives on accreditation and collaboration strategies? Apart from accreditation, we follow its norms for all departments like facilities, infrastructure, protocols and procedures, etc. We seek every minute detail. We do not want to follow the norms just for the sake of accreditation and certification, but for gearing and training every person who works in Bombay Hospital. When our people are trained, they will be able to deliver better services to the patient and this is what we emphasize on.
How do you look at the opportunities in Tier II and Tier III cities in healthcare? Ours is a totally different model. We aim to build institutions; that is, we want to have multi-speciality hospitals with training facilities for doctors, nurses etc. We are not looking at expansions in terms of small hospitals, nursing homes and such collaborations.
There is no doubt that technology has advanced in the medical field. It has developed to such an extent that perhaps medical practitioners have not been able to match the pace. We ourselves have been trying to catch up with the technology because today there are techniques which can do wonders. Today, you have imaging on smart phones from wherever you are. We are taking steps to advance technologically. We are taking efforts to train every person associated with the hospital, but there is a lot to do to keep up pace with the technology.
Now that the new government has ushered in, what are your expectations for the health industry? I hope that the government provides some relief to hospitals in terms of subsidies on the charges of electricity, water and such other facilities. These are the basic requirements and since hospitals contribute towards the society, a little help in these sectors would be great. We do not want things for free, but at least at a subsidized rate.
What are your views on the existing government schemes? Rajiv Gandhi Yojana (RGY) is good, no doubt, we have other schemes as well, but what we need is a common scheme for all the hospitals. For example, there is a scheme for poor patients which provides completely free treatment to those with an annual income of less than `50,000 and also for people belonging to the weaker sections.
How do you look at the emergence of medical tourism? It has emerged considerably. I had predicted this a few years ago and I believe that medical tourism will be the answer for quality and affordable health care for everyone.
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Redefining
Laparoscopy with Galaxy Dr Shailesh Puntambekar, MD, Galaxy Care Laparoscopic Institute, in conversation with Nikita Narvekar, ENN, talks about his recent initiatives, future plans for the hospital and shares his pearls of wisdom for the new government
Please tell us something about Galaxy Care Laparoscopic Institute. Galaxy Care Group of Hospitals was started by ten professionals in 2005. This was started with an idea of doing all types of minimal access cancer surgeries together. In 2005, we were about ten specialists and we started doing almost all cancer surgeries. We were the first ones in the country to treat cancer through keyhole surgeries. In 2009, we realised that it is important to have a corporate name and also business cannot be run singlehandedly. So, in 2009, we joined the KL Group of Hospitals, and that was the time when we acquired our robot. We were the first ones in the country to have robotic cancer surgeries. Initially, at All India Institute of Medical Sciences, robotic surgeries were done only for prostate cancer. However, we have been using this technique for all types of cancers. Galaxy Care is now known for doing all kinds of organ removal. So, this is considered as a centre of excellence for minimal access and robotic surgeries.
What is the next exciting phase for the hospital in 2014-2015? The next exciting phase is that we are expanding. Right now, we are a 56-bed hospital but we still do 150 surgeries a month. The turnover rate is very high because our average hospitalisation is less than 24 hours.
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We are now expanding to become a 120-bed hospital and the expansion plans have been submitted and by the end of the year we will be a full-fledged corporate hospital with a centre of excellence for robotics surgery.
What is the latest speciality service that you have started for the patients? The new services that we will start are high-risk obstetrics services. We are also starting with a very high obesity surgery programme, and thirdly we are also starting with a new fully-equipped ICU facility.
What are your initiatives in medical education and training? We are academically-oriented. We have three fellowship programmes, DLB fellowship programme in minimal access surgeries, second is Maharashtra University of Sciences Fellowship for one year and Gynac Fellowship programme.
What are the latest modern equipments that you have deployed for diagnostics and treatment of patients? We have deployed 3D cameras. Like robotic surgeries, we have 3D cameras. All over the country, usually 2D cameras are used but we are the first ones to use 3D cameras for doing laparoscopic surgeries. Secondly, we have started doing surgeries through natural orifices. We put the holes through these orifices rather than making holes in the abdomen. These are the two latest technologies we have deployed as of now.
Any landmark initiatives that you have taken in medical treatment or infrastructure? In terms of departments, we have taken an initiative that all the revenues that we get through the surgeries are added as the departmental fund and they are used not only for the welfare
of our doctors but also for the welfare of our employees. Secondly, we give loans to our employees at zero percent interest rates so that they can use these funds as and when needed. Thirdly, every individual working here is fully insured including his family. Lastly, we are teaching English literature and language to all our employees. We conduct classes to teach them English so that they can understand, read and write English.
What about your initiatives on collaboration and accreditation strategies? Right now, we have not been able to have any accreditation, simply, because of our hospital size. Once we are
It should be made compulsory for every individual in the country to have a medical insurance since the age of 18 a 120-bed hospital, we will go for the NABH accreditation. We will use all the other accreditations also.
How do you look at healthcare opportunities in Tier II and Tier III cities? The healthcare opportunities are tremendous. The reason for this is very simple. The cost of the treatment is almost 1/20th of the total cost taken anywhere outside the country. In the metro cities, the cost will remain on the lower side. At the same time, in terms of facilities and expertise, Tier II and Tier III cities are much bet-
ter but since the government is not doing much in the public healthcare sector, the private sector has good opportunities because the patient load is always there. Now all they need is better infrastructure and facilities, expertise in their own city so that they do not have to travel all the way to other cities.
What are your expectations from the new government for the healthcare sector? We expect that medical treatment should be given to the poor and the middle-class people because one sector that costs a lot of money to any family, it is healthcare. So, only looking at the old people and doling out free treatment is not the way to go about. It should be made compulsory for every individual in the country to have a medical insurance since the age of 18. I think that will help us grow in a better way because the insurance will have more clients and hence the packages will also be better as the rates will go down, and everyone will be covered under healthcare insurance. Right now only 30 percent or less population is covered under any insurance.
What are the IT initiatives that you have undertaken? I think we are very savvy about the IT initiatives. May be we are the only organisation among all the 15 Care Group Hospitals to have transmitted live from here to 25 countries. We are taking these initiatives of telemedicine and telementoring not only in India, but all over the world. Secondly, we are trying to get our educational films loaded on the mobile as apps. We have initiated something called ‘Pune technique’ for the treatment of cervical cancer. We have published more than 100 papers and written 5 books which have been translated into Spanish, German and English.
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World-Class
Healthcare Infrastructure
at your Service Manpreet Sohal, CEO, Global Hospitals, in conversation with Nikita Narvekar, ENN, talks about the state-of-the-art medical facilities, landmark initiatives and mission of the hospitals
What is the next exciting phase for Global Hospital in 2014-15? Global Hospitals, Mumbai is a stateof-the-art tertiary care multi-super specialty and multi-organ transplant facility. We are committed to continuous quality improvement and adopt industry leading practices in safety. As a hospital, we meet and exceed international healthcare standards through our integrated model of healthcare quality systems and evidence-based medicine. We believe in surpassing patient expectations by delivering healthcare service that is caring and compassionate.
What are the latest super/multispecialty services that you have introduced for patients? As a tertiary care, multi-super specialty hospital, we have introduced many new advances in the field of medicine. We offer single-port laparoscopic surgeries which reduce the number of incisions and thus result in faster healing. Additionally, we have expert doctors who have pioneered the twostage Hepatectomy - Associating Liver Partition and Portal Vein Ligation for Stage Hepatectomy (ALPPS), for Liver transplant. It is used to induce an increased and rapid growth of the
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future remnant liver, thus increasing the chances for the recipient.
What are your initiatives in medical education and training? As a multi-super-specialty tertiary care and multi-organ transplant facility, we understand the needs of training doctors to take forth our legacy of caring and compassionate care. We offer fellowship and certificate courses in various super-specialty subjects. We also conduct regular CME for doctors and CNE for the nursing staff. Additionally, we encourage our doctors to regularly have interdisciplinary clinical meetings to enhance the care given to each patient.
What is the latest modern equipment you have deployed in diagnosis and treatment at the hospital? We are equipped with the state-of-theart diagnostic and therapeutic equipments. We have GE’s latest Discovery MR750w3.0T, MRI machine which is a 64 slice scanner with 50 cm usable Field of View (FOV) with 70 cm Patient Bore which provides bright inner bore lighting and a flared gantry leading to a comfortable, open experience for the patient.
The GE Discovery 750HD Freedom edition is the World’s First Cardiac Spectral CT which has features like Smart Dose with kV Assist to provide automated kV and mA recommendations allowing users to tailor protocols to each patient, clinical indication and each scan area. Also, ASiR* (Adaptive Statistical Iterative Reconstruction) dose reduction technology enables reduction in pixel noise standard deviation. It also allows for reduced mA in the acquisition of diagnostic images, thereby reducing the dose required. It can be used for Neuro Imaging as well. Samsung XGEO GU60 is the first DR machine installed in Mumbai. The U-Arm design is universal arm-type equipment that can easily be adjusted to scan various parts of the patient from +120 degrees to -30 degrees. It requires 30 percent less dose than conventional X-Ray. GE Innova IGS 530 is GE’s first Cathlab X-Ray system installed in Mumbai. It is an advanced cardiovascular and vascular X-Ray system which provides excellent imaging performance for a full range of interventional X-Ray. It is equipped with intravascular ultrasound (IVUS) and fractional flow reserve (FFR), it will help our experts in better identification of coronary blockages and to
avoid unwanted angioplasty. It helps in viewing anatomy more clearly, making it suitable for cardiac, electrophysiology, neurology, angiography, peripheral angiography and intervention. The Innova IGS 530 is designed from the ground to provide the image clarity you need while helping you keep dose as low as possible. It includes features like Dose Personalization, which gives you the tools to choose from up to five automatic exposure preferences for your system.
Kindly update us on any of your landmark initiative on any treatment modality/department infrastructure. We offer ABO Incompatible Kidney Transplants for CKD patients. It permits more efficient use of available organs regardless of ABO blood type, which would otherwise be unavailable due to hyperacute rejection.
Tell us about your initiatives on collaborations and partnerships, also accreditation strategies. In keeping with our mission statement, quality and innovation are the pillars that we build on. We are NABH and other international accreditation standards compliant in all our processes and will be undertaking the NABH accreditation shortly.
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Bridging Gaps
in Healthcare Services Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital (KDAH), shares his insights on the latest developments in KDAH and their focus on bridging the gaps that exist in the health service sector. In conversation with Nikita Narvekar, Elets News Network (ENN)
Please share with us something about Kokilaben Dhirubhai Ambani Hospital. We are now five years old and since inception, we have positioned ourselves as a hospital which has a fulltime specialists system. We went down this path with a belief that if you want to build an institution, you need to have doctors who would be available full time. You need to have a central principle of full-time system because there is a thought process that when a physician is attached to a single institute, the physician and the institute grow together. The entire model is patient centric. The patient can meet the doctor at one place at any time. Also, since there is no time wasted in going from place to place, the physician can spend more time in research and academics, the capability to establish and conduct research and academics is what distinguishes a hospital and an institute. The transition from a hospital to an institute is based on academics, research and succession planning.
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Over the years, you have to build a department so that you are not centred to one person, so when this one person phases out, you have the second and third level to take up. You are not dependent on a single person, but you become a team. So this was the ethos we started our hospital with and we have the best professional consultants for various departments. Past five years, each of
our department has grown and we are counting more. We strongly believe that the shell of the hospital should be strong which includes good infrastructure, technology, great people & doctors. So, we went about picking great people, who had excellent training, qualifications, credentials and this has got us way beyond today. Initially there was scepticism that in a city where medical facility thrives on big names, how you will get the patients, because generally people say, if XYZ is not attached to your hospital, I will not come to your hospital. In a way we were able to debunk that myth, because if you have great talent supported by technology, quality will come. Physicians will come and go, but you have to build models around individuals. That is the salient feature. With technology becoming the backbone for many, it is no doubt constantly upgrading. If you do not have the latest technology, you will fall behind. You have to be prepared to relook at the technology every three to four years, at your consultant skills. The consultants have to learn new things constantly so that we adhere to the patient recovery and the patient safety. Today the patients want to know about newer things. People are coming with questions regarding latest services, technologies, equipments; level of awareness has gone up. So you have to constantly keep up with these queries. People look at health care as an industry and compare it with other industries when it comes to experience and services. The medical sector has become more consumer-centric. People are paying for it and hence they have expectations. We are adapting to it. Now, it is not about what the matter with the patient is but as to what matters to the patient. As a strategy to become an institute, the first principle we looked at was to fill the gaps in the system that
exist in the city as well as the entire west zone.
When you speak about bridging gaps, how did you go about filling in the needed spaces? When we started, there was no Comprehensive Paediatric Cardiology Programme or Cardiac Surgery in Mumbai or at least in Western India. So we set up the first truly Comprehensive Cardiology Centre for Children which deals with all the cardiology problems. Today, we are among the top 2-3 centres for cardiology in the entire country. We do about 600-700 open heart surgeries for children every year. We do 300 procedures of interventional, non-surgical every year. Our NICU has carried about 60 percent of surgeries done on babies less than 30 days. Also, there was no Comprehensive Rehabilitation Programme in the West Zone. So we set up a Comprehensive Rehabilitation programme and Centre for Sports Medicine where we have the best of the specialist teams. While exploring and catering to newer requirements in the domain, we set up a Robotic Surgery programme in Mumbai. We have now completed two years from the launch and have successfully done 425 cases. Uro oncology is the most common that we do. In 2012, Mumbai did only 18 liver transplants in comparison to 850 transplants in Delhi in a year. So there was a huge gap as there was no living donor transplant done here. We got an entire team from Delhi and set up living donor transplantation programme in Mumbai last year. We will be touching 50 transplants a year soon, but yes as we look at every minute detail there is a long way to go ahead. For the next five years, we will continue to look at programmes that are not there in our city and get them here. And to support all this we have a large infrastructure including 22 operation theatres, 182 ICU beds both for
adults and paediatrics. So we see this as a reasonably good start and we believe in delivering good quality.
Now that you are focusing on technology, what are the IT initiatives that KDAH has taken? When you talk about technology the whole thing boils down to whether you can create a paperless institute. I would say that it is easy to say but difficult to implement. You need the IT backbone. But the gap in all hospitals is the case paper. Also due to medico-legal issues, having e-records is difficult. But everything is changing. E-records are accepted at various places. We are slowly migrating to it. But
detail, gender reassignment surgeries, and many more that needs that are sensitive segments. We will probably be starting new cutting-edge services in Neurology. Continuing to stick to our philosophy, we will be getting into areas where there are gaps.
What are the latest medical equipments that you have deployed for the diagnosis and treatment of patients? In this coming year, we will be acquiring new specialised machinery which is mainly used for the Angiography of the Arteries. Probably we will also acquire technology to do Advanced Epilepsy Sur-
The medical sector has become more consumer-centric. People are paying for it and hence they have expectations what is needed is the mindset of doctors and nurses to migrate towards paperless systems. This will change when you start step by step. The ideal way is to begin at educational institutes as well. IT has huge benefits but today there is no single paperless hospital in India, because it takes time to change a mindset. People have not completely adapted to it. It will take time to move from papers and files to electronic and online medium.
What is the next exciting phase for KDAH? We will certainly be looking at new services, in Urology particularly; we will be focusing on what we call as Urinary Incontinence. It is a big problem but people usually do not talk about it because it is a social stigma. We will be focusing on burning issues which are not discussed much in
gery. In services programme we will probably begin with ECHMO services.
Are there any collaborations or accreditation strategies that KDAH has taken or is looking forward to? We are clearly on our way to NABH accreditation and will be going for JCI accreditation which will be coming up this year. But as a philosophy存 we believe that collaborations should be extremely focused. You should collaborate with a good institute which is excellent at something and together you can raise the bar of your services. So our philosophy is not to collaborate with one big name but with multiple people who are good in their own sectors so that we can exchange our ideas and services and get the best in here. So if this is the case, we definitely would like to have multiple collaborations.
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Rendering
Quality Eye Care at Affordable Charges With clinical expertise and sophistication of diagnostic and treatment procedures, NIO (National Institute of Opthalmology) serves the needs of its patients across a wide spectrum of eye disorders related to Cornea, Retina, Pediatric Ophthalmology, Neuro Ophthalmology and Oculoplasty. Dr Aditya Kelkar, Additional Medical Director, National Institute of Ophthalmology, in conversation with Nikita Narvekar, ENN, holds forth on landmark initiatives that have turned NIO into a hospital of choice for eye patients in and around Pune What is the next exciting phase for NIO in 2014-15? NIO has been providing complete eye care since its inception in 1992. It has always been a challenge to live up to the reputation that NIO has. We also now have a new centre at Baner which was opened few months back. It’s benefiting the patients as the tertiary care will be available to more patients.
What are the latest superspecialty services that you have started? One of the super-specialty services is the advancement in refractive surgery. IntraLase is a new state-of-theart laser treatment that prepares the LASIK corneal flap by using a femtosecond laser. Normal LASIK treatments use a mechanical device called a microkeratome which uses a blade to produce the LASIK flap. This “No Blade” procedure produces a flap that is much more precise in depth, is cleaner, more accurate and is thinner. This results in many benefits to the LASIK patient.
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NIO is one of the very few hospitals in Pune which offers special unit for Pediatric Ophthalmology.
What are your initiatives in medical education and training? We have always been ahead in research and teaching programmes.
NIO has been home to many clinical trials in the past. It is recognised by the National Board of Examinations for DNB post-graduate course in Opthalmology. Academic meets and conferences conducted every month, benefit not only students from our institute, but also students from other institutes.
Kindly update us on any of your landmark initiative on any treatment modality/department infrastructure. We initiated a mobile diabetic retinopathy screening programme which involves a fully-equipped hi-tech van having retinal camera for mass screening programmes.
Tell us about your initiatives on collaborations and partnerships, also accreditation strategies.
Many cities in our country are developing at a very fast pace. Pune being one of them is growing in all terms What is the latest modern equipment you have deployed in diagnosis and treatment at the hospital? All equipments at NIO are based on modern technology and they meet the international standards. The latest therapeutic procedure, as mentioned earlier, Intralase--for refractive surgery. Also, the equipments used for vitreo-retinal surgeries are the most
advanced ones. As far as diagnostic equipments are concerned , the Spectral 3D OCT and fundus photo machine are one of the best in its class, providing excellent resolution, clarity and image quality, which helps us to pick up signs which would have been missed on the conventional machines. NIO also has its own international standard modular operation theatre with laminar air-flow.
NIO is affiliated with the University of Pune, the National Board of Examination and the College of Physician and Surgeon. NIO is Pune’s first NABH accredited super-specialty eye hospital. NABH (National Accreditation Board for Hospitals and Healthcare Providers) is a constituent board of Quality Council of India, set up to establish and operate accreditation programme for healthcare organizations. There are many benefits of accreditation such as better quality care, patient safety, credentialed staff, regular evaluation of quality standards etc. Apart from this, the hospital is also authorized for treatment under Central Government Health Scheme (CGHS), Central Service Medical Attendance (CSMA) and State Government Employees.
What are the new opportunities in Tier-II and II cities across India? Many cities in our country are developing at a very fast pace. Pune being one of them is growing in all terms. Corporate culture has also set in. It has become an educational hub. This definitely increases the opportunities as more and more people are becoming aware of various eye conditions. Also, the compliance is better where the awareness is more.
What are your expansion plans? More Satellite centres to come up in the next five years to extend the quality eye care to all.
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One of the important specialties of Noble Hospital is that it is led and managed by a team of specialized doctors. Dr Dileep Mane, an MD in Internal Medicine, has adopted several strategies to achieve the goal of quality healthcare for all. Dr Mane, in conversation with Nikita Narvekar, ENN
Managing
Illness with Skill, Compassion and Quality What is the next exciting phase for Noble Hospital in 2014-15? Noble hospital is situated at the entry gate of Pune city. Our aim is to provide tertiary healthcare services to the patients at an affordable cost. Critical Care Burns unit is the need of the hour for Maharashtra state, with only few hospitals in the state having this set-up to cater burns patients. We are coming up with a 100-bed hospital set-up, Nobel Annex, where we are planning to have a Critical Care Burns Unit.
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What are the latest super/multi specialty services you have introduced for patients?
What are your initiatives in medical education and training?
We will use computerized navigation system for doing joint replacement and brain tumor surgeries. It uses the computer technology for guiding surgical interventions. Specialised instruments, connected to the navigation system, on touching the anatomical position on the patient, takes images from this patient. This enables the surgeon to ‘navigate’ the images of the patient by moving the instrument.
We are currently accredited by the National Board of Examinations (NBE) for conducting the Diplomate of National Board (DNB) programmes in specialties of General Medicine, Family Medicine, Pediatrics, Obstetrics and Gynecology, and Anaesthesiology. We are also preparing to apply for accreditation by College of Physicians and Surgeons. Apart from this, we also conduct fortnightly CMEs (Continuous
Medical Education) for the general medical practitioners and consultants in the vicinity on topics that are relevant to their professional practice.
What are the modern equipments you have deployed in diagnosis and treatment at the hospital? We have an automated analyzer in our laboratory to measure different chemicals and other characteristics in a number of biological samples, with minimal human assistance. The automation of laboratory testing does not remove the need for human expertise, but it does ease concerns about error reduction, staffing concerns, and safety. We also have a state-of-the-art Blood Bank with all the modern technology including TRIMA cell separator for single donor platelet (SDP).
Kindly update us about your landmark initiatives on any treatment modality/ infrastructure. The orthopedic team at the Noble hospital, Pune has been providing the latest in orthopedic treatment and surgical techniques, which are at par with international standards. We have all specialty services developed in Noble hospital. Few super specialty services are unique. Foot and ankle is unique super specialty developed in our hospital. Foot and Ankle centre is the first of its kind in Maharashtra, and only one of the few in India. Foot and Ankle specialty is not yet developed in India and there is no formal training in this field. Our Expert Dr Sampat Dumbre Patil has received fellowship training in USA (Duke University, Durham and Columbus, Ohio), Switzerland (Basel University), and Germany (Heidelberg). At Foot and Ankle center, we are offering the following unique services: • Sports injuries in foot and ankle • Bunion surgeries • Diabetic foot problems
Critical Care Burns unit is the need of the hour for Maharashtra state, with only few hospitals in the state having this set-up to cater burns patients • Flat foot treatment • Deformity correction of foot • Fractures in foot and ankle These unique features in the department are well supported by wellequipped Orthotics and Prosthetic department which is one of its kind in Pune. Orthotics and Prosthetic department provides treatment for all foot pathologies through conservative means using imported Podo technology from France which works on the latest dilatancy principle of impression taking, digital foot scan & neuropathic & proprioception examination and helps us to correctly diagnose the problem. The treatment can be undertaken for diabetic foot, arthritic
foot, flat foot, collapsed foot, pronated foot, sports injured foot or pain from any kind of foot problems. We provide relief from foot problem by means of a totally-customized foot orthoses, footwear modification or customized footwear. The design of the insole is completely custom made as per each individual’s foot pathology, weight bearing pattern, activity level. We provide Artificial Limbs for every level of amputation. We fit artificial limbs of various categories, starting from basic category such as Jaipur Foot to the most advanced Bionic Limb both for lower and upper extremity amputation. Our prices for artificial limbs are most competitive for best available quality.
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Caring for
Woman and Child for 50 Years From a clinic to three 100-bed hospitals, Oyster and Pearl Hospitals’ journey has been inspiring. As it looks to venture into smaller towns, Dr Amita Phadnis, MD, Oyster and Pearl, talks to ENN’s Nikita Narvekar about the journey so far Please tell us in brief about Oyster and Pearl. Oyster and Pearl Hospital was founded in September 2008, as a specialty hospital for woman and child. We have been practising in the woman and child health segment for over 50 years – since 1960. My father-inlaw, Dr HN Phadnis was a gynaecologist and ran a clinic in Pune named Shree Clinic. My husband Dr Avinash and I took over in 1991, strengthened its infertility and high risk obstetrics and established the first IVF unit in Pune and western Maharashtra in 1995. We later established two other facilities in Pune – Neo Clinic (tertiary level neonatal and paediatric care) and Sumati Health (women’s wellness and Corporate Health). Oyster and Pearl Hospital, a 100 bed boutique hospital, was a culmination of the practices established at our three units. Our logo signifies mother and child or parent and child. So, we began with woman and child and then added on other specialties, such as orthopaedics, specialty joint replacement, advanced spine surgery, onco surgery, bariatric surgery and many others. This helped in enhancing pa-
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tient services and achieving good growth. In 2010, we established another 100 bed facility in Pune, the ONP Tulip Hospital that again focussed on woman and child health.
How will ONP expand in 20142015? ONP Hospitals had launch another 100-bed hospital this year in June, the ONP Life Point Multispecialty Hospital at Wakad, with a dynamic, dedicated and devoted team of doctors. This will increase our bed strength to 300 in Pune. In the next phase, ONP Hospitals looks to expand in two directions – towards smaller towns, such as Osmanabad and Ratnagiri, and towards larger cities, such as Mumbai, hence targeting 500 beds by late 2015. We would plan to go asset light at all other facilities.
What are the initiatives you have taken in medical education and training? We have not entered the medical education sector and as of now have no plans.
What latest equipment you have accquired for diagnostics and treatment? We invest in equipments that enhance patient safety and continue to better our results. For example, we have recently started using Home NST machines to monitor high risk pregnancies. We will be adding an embryoscope in order to further improve IVF results. Bone scalpels used in spine surgery improves patient safety, since the bone is cut with extreme precision and reduces the chances of nerve injuries. Keyhole surgeries or minimally invasive surgeries involve the use of endoscope and lasers in spine surgery. Hand reconstruction for congenital defects is being done at ONP with use of micro vascular reconstruction and nerve surgery – example toe transfer for absent thumb. In joint surgery, ACI (autologous chondrocyte implantation) is being done, as well as a large number of routine/complicated revisions joint replacements. In neonatal care, we will soon be adding a body-cooling equipment, which will help achieve hypothermia in neonates with brain related injuries. This will help improve the long term outcome for these babies.
Do you have any collaboration and accreditation strategies? Now that we are well established, we have initiated the accreditation processes. In terms of collaboration, we will be outsourcing our Dialysis sector very soon. We had a charitable joint venture with the Pune Municipal Corporation for 7 years, providing maternity services on a completely charitable basis.
What are your expectations from the new government? All of us are aware that there is a huge gap in providing healthcare service to the masses in India. The doctor- pa-
ONP Hospitals looks to expand in two directions – towards smaller towns, such as Osmanabad and Ratnagiri, and towards larger cities, such as Mumbai, hence targeting 500 beds by late 2015 tient ratios in the urban and rural sectors are dismal. Healthcare should be treated on urgent and priority basis in both public and private sectors. Healthcare budget in the public health sector should be increased. Needless to say that only increasing expenditure on healthcare is useless unless appropriate utilization of funds to truly provide healthcare is ensured at the micro level. That is the key. In the private health sector, the biggest cost is real estate and infrastructure maintenance. The private sector hospitals should be given a higher FSI and lower electricity and water tariffs and health care should be given a reduced tax structure. This will allow the private sector to provide cheaper healthcare. If the private health sector is given an economic boost, it will go a long way in increasing the reach of health care to the lower socio-economic sections. Health Insurance is creeping in slowly, but surely and government policies on the same should be fine tuned. Insurance companies will soon rule the economics of the private sector health care and unless the financials of the same are regulated, the private
sector will find viability difficult because the margins of the insurance packages are very low.
How do you look upon the opportunities in Tier II and Tier III cities? The scope is tremendous, but offering low cost health care is the key. The challenge is to manage an enterprise from a distance and to be successful with that. Local deployment of the entire team of doctors, nurses and other manpower is the key with, superspecialty support provided periodically. Healthcare sector establishment and break even takes at least three years and when we set out, it is important to make the financial plan accordingly. Equity investors in healthcare need to keep a long term horizon in mind. Short term yields are poor and then there is disappointment.
What are your initiatives in terms of IT into health industry? Over 10 years ago, we developed our own healthcare software labelled LeelaMed. Initial versions were developed for infertility; but, now it has evolved into complete health care software.
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?????????? Special Focus
Qi Spine
for Right Diagnosis, Every Time Please tell us something about ‘Qi Spine’. ‘Qi Spine’ is India’s first clinic which specialises in treating spine ailments and injuries. Back pain is the most common complaint. So, there can be specific spine disorders like slip disc and also a lot of conditions are non-specific. About 85 percent of back pains fall into the latter category where diagnosing the root issue through X-Ray is difficult. Also, in the Western countries, back pain is the second reason for sick leave after common influenza, but you do not find specific diagnosis for it. So, we deal with diagnosis and treatment of spine disorders.
What is the next exciting phase for Qi Lifecare in 2014-15? Due to increasing patient load and capacity utilization at our existing seven clinics across Delhi and Mumbai, the company has decided to rapidly expand its footprint of clinics to meet the needs of back- and neck-pain patients across major cities in India. As part of this expansion strategy in 2014-15, we plan to open specialty spine clinics for diagnosis and treatment of back pain for the first time in the cities of Bangalore and Pune, besides opening more clinics in Delhi and Mumbai.
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Navinder Dullat, Chief Operating Officer, Qi Lifecare, in conversation with Nikita Narvekar, talks through the advanced diagnosis and treatment protocol at Qi Spine Clinic which has proven extremely effective for the treatment of back and neck pain What are the latest specialty services that you have introduced for patients? We have opened India’s first specialty clinics for diagnosis and treatment of back pain and spine disorders called ‘Qi Spine Clinic’. We address the need for a specialized solution for the increasing incidence of back pain in the general population due to sedentary lifestyles. Qi Spine Clinic offers specialized diagnostic consultation services which help identify deficiencies in the patient’s spine, which cannot be identified by standard tests like X-Ray and MRI exams. This diagnosis protocol is used to develop individualized treatment plans to eliminate the root cause of the patient’s back pain. Treatment plans are evidence-based and non-invasive, conservative in nature, with the goal of avoiding surgery and dependence
on painkillers, or other symptom-management methods.
What are your latest initiatives in medical education and training? As India’s first specialty spine clinic chain, we have developed an intensive six-month Clinical Training Programme (CTP) to provide our in-house team of Spine Consultants with deeper understanding of diagnosis and treatment of various spine disorders. This Clinical Training Programme has been designed by our Head-Clinical Operations, in collaboration with leading European experts in the field of spinal rehabilitation. The CTP comprises a mixture of theory classes, supervised practice, and clinical role-play exercises. It provides spine consultants with exposure to the latest evidence-based methods of diagnosing and treatment of spine disorders, including Digital Spine
Analysis, Machine-based exercise therapy, Functional testing of the Spine and specialised manual therapy techniques such as MDT, Mulligan technique, etc. More than 65 spine consultants have successfully undertaken the CTP in the last two years.
What latest modern equipments you have deployed in diagnosis and treatment? We are the first healthcare company in India to deploy the Digital Spine Analysis (DSA) – the world’s first accurate test to measure Spine function. The DSA uses a combination of specialised computer-controlled devices that can isolate, test and measure the functional ability of every element of the spine’s supporting musculature in a safe and accurate manner. This test of the spine, which is non-invasive and takes 45 minutes to complete, provides the doctor with an accurate and complete picture of the functional health of the patient’s spine – clearly identifying deficiencies which cannot be detected by imaging tests like X-Rays and MRIs. The DSA is the equivalent of the ‘stress test’ which a standard function test used to detect cardiac disorders. Qi Spine Clinic is the only facility in India which has the DSA technology and know-how. This diagnostic protocol using Digital Spine Analysis has ensured a success rate of 93 percent in eliminating back pain for over 2,000 patients in the last two years. Kindly update us on any of your landmark initiative on any treatment modality and department infrastructure. We have recently opened doors in Delhi-NCR by opening two clinics – one each in West Delhi (Punjabi Bagh) and South Delhi (Greater Kailash).
Tell us about your initiatives on collaborations and partnerships, also accreditation strategies. We have partnered with Dr Gautam Shetty, Co-Founder of the Indian Or-
thopedic Research Society, to start our medical research wing, ‘Qi Spine Research Division’, to conduct and publish original research on the prevalence of back and neck pain in the general population and specific population groups, and on the efficacy of treatment protocols and approaches for back pain cases. We have partnered with health insurance companies like Bajaj Allianz and Future Generali to offer specialised services for diagnosis and treatment of back and neck pain to health insurance customers.
What are the new opportunities in Tier-II and -III cities across India? We see tremendous opportunity for Spine Clinic in Tier-II and Tier-III cities,
both metros and Tier-I cities like Delhi-NCR, Mumbai, Chennai, Bangalore, Kolkata, Pune, Ahmedabad, and TierII and -III towns like Chandigarh, Lucknow, Ludhiana. As part of this plan, we plan to start ten new clinics in the current financial year across Mumbai, Delhi-NCR, Bangalore and Pune.
How do you look at the use of IT in healthcare sector? When we talk about healthcare, there are a lot of applications and aspects of healthcare where IT can set up starting from the mere basics like recordkeeping. It is very important to keep the patient data in an organised way, and this is where most of the practices in India are lacking. So, IT gives you the tools to start doing all this very efficiently, but then
We are the first healthcare company in India to deploy the Digital Spine Analysis (DSA) – the world’s first accurate test to measure Spine function primarily due to the latent unfulfilled demand for a specialised and effective solution for back pain across urban markets in India. (We have estimated that upwards of five million urban Indians seek treatment for back pain across India every year, and this is not limited to the top metro cities alone. The poor state of healthcare infrastructure in Tier-II and Tier-III towns means that patients in these cities often have to travel to the nearest large metro city to avail themselves of specialised diagnostic/treatment services. These patients would prefer to save money and time, if these services were made available in their own cities.
What are your expansion plans? As part of our five-year expansion strategy in the next two years, we plan to expand our presence to 30 clinics across ten cities of India including
it is up to particular hospital and clinics. The type of data they keep will help determine as to how much of IT is being used. On the front end, when it comes to the customer service element, there is a lot of IT support available today, which was not there ten years back. Also, there are applications to track the consumer from end-to-end basis, controlling the outcome, where IT helps you largely.
What are your expectations from the new government? The past governments have kept service taxes applicable on many small players, and temporarily healthcare has been kept out of this net. So, what I expect is that the present government should permanently take it off as it only adds a burden on the patient’s pockets. When it comes to allied medical services, there is a lot to be done.
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Neurology,
A Victim of Neglect Sahyadri is the brainchild of Dr Charudutt Apte, a Neurosurgeon, CMD of the group. Today Sahyadri is the largest chain of hospitals in the state of Maharashtra. Dr Apte in conversation with Rachita Jha, ENN talks about the hospital & shares his insight on neurology in India To begin with, please tell us something about your journey so far‌ From a humble beginning to the largest chain of hospitals in the state, the journey has been challenging as to be expected. When we started with a small neurosciences unit in Pune 20 years ago, there were hardly any hospitals in the private sphere, which were interested in developing Neurosciences as a major specialty. Apart from Cardiac related services, most of the hospitals were not interested in any other specialty but over last two decades, things have changed so much that one sees specialty hospitals of almost all specialties developing all over the country. This is a very healthy sign of emerging confidence in the Health Care providers about the need & viability of different health care models. We started with a small Neurosciences unit in rented premises in Pune in 1994. A small group of neuro consultants came together & the beginning was truly humble with around 15 dedicated beds. But we ensured that we equipped the unit with all the state of art facilities available at that time & I must say that the response we received from the medical community, as well as from the society at large was very encouraging. Within a matter of two years, we started think-
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ing about expansion & that was the time, many of our friends from various specialties approached us with the idea of joining hands, to start a larger set up with focus of super specialties. In just about 5 years, our Neurosciences unit got recognition across the state & we could summon
enough courage & resources to plan a bigger project. We all belonged to the erstwhile middle class & our group as a whole lacked the comfort of strong financial backing but what we lacked here was made up by the enthusiasm & commitment of our comrades. Our dream of a focused specialty
hospital came into existence in 2004 & since then we have not looked back. We developed the Hub & Spoke model in Pune by adding 7 community hospitals which apart from offering the local community emergency & higher secondary care, serve as feeders for the Hub & also developed couple of hospitals in the Western part of Maharashtra over last ten years.
Why only in Pune & was it difficult to start a specialty in Neurology as your first venture ? I & our original group members are from Pune, so the choice was obvious. Starting the unit was not difficult but there was a lot of skepticism in the minds of our well wishers as regards the viability of a Neurosciences Unit. But within a matter of few months, it became obvious that there was a huge need for such a facility, which was not appreciated by doctors & honestly even by us. None of us belonged to management branch & we had not done any market survey or any viability study. At that time, having a chain of hospitals was not even on our radar!!
When we talk about Neuro in terms of emergency services of critical care, what are the aspects that are different from the others? The basic infrastructure & competencies are the same but Availability of a Neuro Physician & Surgeon is the Key Factor. Be it a Stroke or Head Injury, every major decision about diagnosis & treatment from the moment of admission needs them. Critical Care Physicians are important members of the team but not the decision makers. When one compares this with a Cardiac Emergency, the Physician is well versed with it & is capable of managing the medical part well, till the actual intervention, when Cardiologist is necessary. In polytrauma, it is the Critical Care Physician, who manages the show, till actual surgical intervention is needed.
Coming to Sahyadri & the group, where do you see it in the next financial year ? Next three years is the consolidation phase & we have no plans for any expansion. Since last few years, we have grown inorganically as the opportunities kept of coming & we did not feel like loosing them. The only new venture would be addition of Radiation Oncology in our first hospital.
What are your plans for medical education? We are accredited for the post graduate courses like many hospitals in the country & are running these courses in various specialties since a few
most logical way to proceed & I understand that various state governments have started the exercise of entering into PPP arrangements for Radiology & Laboratory Services
But when you look at Tier 2 or 3 cities, especially Tier 2 cities like Nashik & Kolhapur, where people are venturing, do you think it is up to the mark? These are expanding cities & more over, population around are recognizing these as reliable medical centers. 25 years ago, people from Pune would go to Mumbai for any major medical care, in spite of fairly good availability in Pune. So it is not only the question of making a good facility
Within five to 10 years, it will be a known thing that medical education is no longer going to be a lucrative business, going by the way it is today years. We believe that this is a very important activity, which adds hugely to the professional & academic outlook of the hospital & benefits the patients greatly.
In terms of medical tourism, do the hospitals attract a lot of foreign patients & are you prioritizing it? We have been getting patients from the Pacific Islands, mainly Fiji but the number is small & due to very many reasons, that is not our priority for the present either. We have a PPP with Govt of Fiji, whereby our teams go there to perform specialty surgical procedures.
What are the different ways do you think that the government can come up with? For the yawning gap between the need for these services & the availability, I firmly believe that PPP is the
available but for its viability, people’s perception has to be favorable & this takes time. We were the first to give tertiary care facilities & started Neuro & Cardiac facilities, including surgeries in Karad. But it has taken us almost five years to settle. This becomes a serious issue for the viability of the hospital & we have learnt this lesson a very hard way. Lastly the issue about a large sized corporate set up being considered as competition to the existing nursing homes is also a major hurdle. Though the fact remains that such hospitals are actually working in a Complementary fashion & not competing with them, most nursing home owners do not view us that way. So the challenges in smaller cities are much different than bigger cities & before venturing, it is very essential that all these factors are taken into account.
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Given the current situations, what are the opportunities in the health insurance sector? In spite of recession, the healthcare sector has continued to grow. The lifestyle is changing and so there are lifestyle related diseases. Also, there is a higher disposable income, so people today want to go to good hospitals in search of quality treatment. The population is ageing and also the life expectancy is increasing leading to a rise in the senior citizen population. So on account of this, health insurance has continued to grow even in recessionary times. Thirdly, the cost of treatment is also increasing. Hence, people want to be sure that they are insured; hence we are seeing more than 20 percent growth in the retail health insurance sector. We are seeing a trend where the onset of disease has started happening even for people who are in their 30’s and 40’s. This is the reason that people are buying health insurance and this will continue to grow. The other factor is the increasing focus of the government on this sector. The previous government also talked about bottom of the pyramid population’s health insurance and this government is also keen on providing universal health care coverage to the entire population.
Amit Bhandari, Vice President, Health Underwriting and Claims, ICICI Lombard, talks about the growth in health insurance sector and the need for regulating health providers. In conversation with Nikita Narvekar, Elets News Network (ENN) 44
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The government is also spending money in this sector and they are looking at the insurance sector as a route to provide healthcare to people.
What are the challenges that you face in the health insurance industry? It is a challenging business and each stake holder has huge expectations. The biggest challenge would be the distribution. Few years back, awareness could have been a big challenge.
But today people are aware that there is a need for health insurance. In spite of that, people who develop disease conditions like hypertension and diabetes only look for insurance, but the younger population is not looking at the option. A person who starts working, say at the age of 22, will want to buy a car or a house but not insurance. Once the priority list is fulfilled, the person is already above 30 and his health also starts deteriorating, then he starts thinking about health insurance.
Why No Regulatory
Body for
Health Providers?
But things are changing now, young people are suffering from diseases and hence there is an increasing awareness. Yet people are not buying insurance and hence distribution has to reach that level. From the insurance perspective, we do not have data on morbidity. That is the second challenge. The third is the regulation on the health care provider industry is missing. There is no standard guideline for treatment. The government is working on this and hopefully that should be implemented. Health is a state subject. As an insurer we are not able to get one view of the providers across the country. There has to be some registry which will solve one of the challenges.
What other steps can be taken to boost the health insurance sector? There are various stakeholders in the Health insurance sector- customer, provider, government and the insurer. The government is very clear on their front. The insurer can come up with new products which are simple and transparent products covering entire continuum of health right from primary to secondary to tertiary care. This will help the buyers opt in for insurance. Insurers have to be involved with the customer right from the beginning, not only intervene when the customer is sick but also help prevent him from falling sick. All the stakeholders have to play their individual parts.
How do you look at the idea of foreign participation in the health insurance sector? Health insurance is not lacking capital. The area where we are lacking as country is the expertise that a foreign player brings. Foreign participation will help only in bringing the strategic expertise in the sector.
What are the features that one should look at while deciding on medical insurance? There are three things that an insurance buyer has to keep in mind- the product features, the suitability of the product for the family and the claim settlement process including the turnaround time for the claims. The product feature involves everything what suits the customer and also what suits his family requirement. The buyer should look at the things that are covered in the product, suitability of the product for his family, the kind of hospitals he goes to for treatment.
IRDA regulates the entire insurance sector, but there is no single regulatory body for the providers. So the government has to look into this as well Insurance now offers various products for various strata of customers. So a person should opt for a product that suits him. The good part today is that the regulator publishes the claim settlement ratios and other things very often. So a buyer only has to look at it and opt for the company that he wants to go for. After looking at all this, he should have a look at the premium also.
Many a times the policy buyers are misled. What safeguards do you think can be put to prevent mis-selling? The biggest disconnect that we ob-
serve is that people do not declare their pre-existing conditions, biggest examples being hypertension and diabetes. People believe that these are life-style problems, but this is the biggest misconception. For an insurer these are material non disclosure issues. The second problem is disconnect between what the customer declares to the advisor and what is further disclosed to the insurer. Many times there is a mis-communication between the buyer, advisor and the company. So this can be avoided once the buyer checks the policy. The health regulation effective from October 1, 2013 provides a free look period of 15 days. So the customer can return the policy within 15 day, if he is not satisfied with it and the company has to return the entire money.
What changes do you think need to be made when it comes to the regulation of the health insurance industry? If we look at the new regulations effective from October 2013, there are many positives that the regulator has taken into account from the customer’s point of view. So, no insurer cannot deny renewal of policy due to a claim in the policy. They are bound to give lifetime renewal guarantee to the customer. We would still like the regulator to do things. Since there is no provider regulator, the insurance regulator can create a registry. If a hospital indulges in malpractice, the industry can ban that hospital. This will minimize fraud at hospital level.
Is there any product that you have launched recently? We launched a product a year and half ago, which says ICICI Lombard Complete Health Insurance. It is applicable for any strata of the society, where the buyer can look for things he wants and we are receiving tremendous response for the same.
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special focus
Making Healthcare
Affordable Through Technology Tarun Katiyar, Principal Consultant, has been advising hospitals on how to reduce their infrastructure costs and make their buildings go green. Nikita Narvekar of ENN talks to him about how going green can be beneficial for hospitals in the long run Please tell us something about the mission and vision of Hospaccx Healthcare Systems. We are basically into hospital and architecture. Our aim is to make affordable infrastructure for hospitals. We try to reduce the infrastructure cost for hospitals so that it leads to decrease in billing cost for the patients. So we try to make affordable buildings. It can be through different modes like using dry walls so that the building is constructed faster. We try to construct green or intelligent buildings so that it can breathe by itself, so that the electricity or water cost or the overall operational cost for the hospital goes down. In the last six years, we have built around 90 hospitals ranging from small nursing homes to big medical colleges. These buildings have been built across the country starting right from Uttaranchal in the north to the tip of the country down south in Nagarcoil which is 60 kms away from Kanyakumari.
How do you visualise and evaluate the IT transformation? Traditionally we built infrastructure for
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hospitals, but now we have to build infrastructural systems for them so that there is a transformation in the dayto-day operations of the hospital. The integration of different departments as well as different integrations- medical, communication or building integration has to be done with the help of IT. So I can say that IT has helped in the growth of paperless hospitals which is very useful for HIS and MHIS as well as they try to reduce the operational cost for the building. The integrations of different medical equipments with IT is also very important. We do a lot of It integration for medical infrastructures.
How do you perceive the market for HIS and HMIS in India? These are still to be developed and there are big numbers of infrastructure coming in this sector. But there are various mobile applications which are useful in two ways, one is for the treatment and the other is for the prevention of patients. So there are n number of mobile apps that are coming up which is actually transforming the entire healthcare scenario. We do have 100 bedded hospitals but the healthcare sector is going to old school ways for example we have spring health which is coming up with small women’s polyclinic so that they can take care of the preventive aspect. So there is transformation into preventive healthcare from treatment healthcare. IT is playing a major role in terms of mobile apps, day to day websites which manage the patient health.
What are the latest technology developments in this field? For us, we try to make budgeted hospitals. There is a reason for this. Most of our hospitals are based in Tier II and Tier III cities, where the manpower cost is very high. So the hospitals
want to reduce manpower as much as possible. So what we do is involve various applications where we try implement lot of IT integration which reduces the manpower. Also, it increases the monitoring of finance and clinical aspect of patients so basically it cuts down on the human interference and error.
Now that you are talking about your presence in smaller cities, how do you look at the opportunities in Tier II and Tier III cities? If you look at the present healthcare scenario, 80 percent of is unorganised and majority of it is based in these smaller cities.
For example, six years back when we built our first hospital 16 slices was the highest for an MRI Scan but today it has gone up to 164 slices. So, the change in technology is drastic. We believe that you should provide healthcare to more number of people than affordable patients and hence we see tremendous scope in smaller cities.
What is your roadmap ahead? Firstly, we have to upgrade our knowledge. Secondly, the government has to support us. Unfortunately right now, the electricity cost of the hospitals is very equivalent to the electricity cost of malls. There has to be some subsidy
Most of our hospitals are based in Tier II and Tier III cities, where the manpower cost is very high. So the hospitals want to reduce manpower as much as possible But now the competition is rising as the so called big daddy’s are getting into Tier II and Tier III cities and the existing doctors are fighting to prove their existence and hence building larger infrastructures. So this is the potential in such smaller cities.
What were the challenges that you faced when you got into this service? The biggest challenge is that the wishlist for doctors in the smaller cities is not very clear. By the time, they build facility, the technology and the wish list of the person changes drastically. But this can be solved by coping up with the technology and infrastructure. You have to keep in mind long term views that when you are building an infrastructure it has to be built for the next thirty years. So you have to give yourself that window period.
provision, as spending electricity for watching movie in a mall is definitely not equal to spending electricity for a surgery in a hospital. The government supports the builders more than health care providers though the healthcare sector is a major economy provider.
What are your expectations from the new government in healthcare? There is a need for more healthcare infrastructure in the form of medical colleges. We can easily build hospitals but having qualified man power is difficult. Building a machine is easy but training the man behind that machine is very difficult. Skilled and qualified man power will come in only with more medical colleges. We are way behind the smaller countries in terms of availability of doctors. This gap has to be bridged.
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in person
Prevent, Diagnose, Research:
Best way to Cure Heart Ailments Dr Ashok Seth is a world-renowned cardiologist, known for introducing pioneering techniques in curing heart ailments. He has contributed extensively to the growth, development and scientific progress of Cardiology especially Interventional Cardiology in India and across the world. For his exemplary contribution and achievements in the field of medicine, he was honoured with Padma Shri, one of the nation’s highest civilian awards, in 2003. Dr Seth, in an exclusive chit-chat with Ekta Srivastava, ENN, shares his insights on an era of cardiac science
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You have contributed extensively to the growth, development and scientific progress of Cardiology especially Interventional Cardiology in India and across the world. How has your journey been? I started in the year 1984, when Interventional Cardiology was basic and devices were crude. The start of Interventional cardiology was in the year 1977. There were very few centres across the globe during 1980-1981 who were experimenting with interventional cardiology. I was in England at Birmingham University Teaching Hospital, one of the first centres to start Angioplasty. We lived in an era where we did not know where science could take us. In those days 50 percent patients would be diagnosed with recurrent blockages, 5 percent of people would have problems within the hospital like heart attacks were salvaged. A key breakthrough in Angioplasty was the advent of stents. Between 1980 and 1994, we tried a lot of techniques and I pioneered many of those techniques for the Asia-Pacific region. We realized if the balloon can’t hold on things, then we should cut these blockages out from within the arteries, and that was called ‘directional atherectomy’, a technique of actually cutting the blockages within the coronary arteries. This technique was slightly better than the balloon, but again not dramatically better. In the early 90s, we brought out a drill. I was one of the biggest proponents of this drill-like device. We were looking for ways of removing the blockages rather than blowing them up. The efforts were towards finding that magic bullet that can treat these blockages. By 1994, we had metallic stents, stainless steel ring-like tubes, and which actually transformed Interventional Cardiology and increased the safety measures for angioplasty. At that time, everyone used to think
that Angioplasty was temporary, while surgery was permanent. This transformed in 2002, this was the third era of Angioplasty when medical stents called ‘drug-eluting stents’ came in. The same stainless-steel device coated with a drug was explored, that not only saved but also prevented the re-occurrence of the blockages. The technique worked in a manner where the drug reached till the arteries and stopped the reoccurrence. The re-occurrence of the blockages came down from 25 percent to 5 percent which lead to making Angioplasty as the first choice of patients. This was the third era of Angioplasty, because it became the treatment of choice. It actually relegated surgery by 25 percent. Now, it’s the fourth era of Interventional Cardiology with the
which could implant valves without surgery, the procedure was called ‘percutaneous treatment’. We pioneered this technology and therefore formed the most robust set-up of percutaneous valves in India. What we do today is so different from what I did 20 years ago. There has been a huge transformation. Now, it has become a routine — changing valve through a cath-lab method. Most importantly, safety, durability and expertise in Angioplasty —all have evolved over the years.
What is the present scenario of cardiac diseases in India? Cardiac diseases have gone through a radical transformation over the years. It is the biggest killer. It is feared that 50 percent of deaths in
In China, 90 percent of the stent market is indigenous, in a similar manner we should also encourage indigenous manufacturing of stents ‘dissolvable stents’, which dissolve after a few months of its placement into the body. Angioplasty has transformed from being a crude technique with re-occurrence and complications to extremely safe durable and a robust technique which can be applied literally to 75 percent of the patients suffering with coronary artery diseases. The second era of Interventional Cardiology has been what we call structural heart diseases—Non-invasive technology. We have always felt that the only way to treat valves was performing an open-heart surgery—open the heart, take the valve out, put a new valve, stitch it and there you have it. It was a complex technique but was the only one to be able to change valves till early 2000’s. In 2004, at Fortis Escorts Heart Institute we were the first inventors of the device
India will happen due to heart diseases. It is reoccurring both in urban and rural population. There has been an increase in heart diseases where women are concerned. Over, last 15 years there has also been a rise in younger population. The worry is that 50 percent of our population is youth. Over thirty years down the line the extent of heart diseases would be so enormous that everybody will have somebody who will be suffering from a heart disease. These are the reasons we have to look into every aspect of this disease and do a vigorous research and diagnosis. Most importantly, we need to look at the prevention aspect of the disease. Working in the area of prevention is most important. The treatment processes are getting expensive by day and the disease proportion is getting more rampant.
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How Fortis Escorts Heart Institute is planning to provide sustainable healthcare in rural sector? This is possible through good publicprivate partnership. Actually, there are four stake holders in the process—the Government, the private sector, the industry (the device and the medicine manufacturers) and the doctors. We talk about treatment options. We talk about expensive stents. Only 5 percent of Indian population can afford them. We are still not giving enough emphasis on micro insurances. We are still not creating a scope for manufacturing low-cost. To have a solution, we can increase the manufacturing of these devices in zones where they are tax-free and we can save ourselves from the expenses of importing these devices. In China, 90 percent of the stent market is indigenous, in a similar manner we should also encourage indigenous manufacturing of stents. We have to create a milieu for encouraging innovation, as innovation can create intravenous therapy and make it affordable at a low cost. These things can happen only through partnership of all four stake holders. We will offer a low-cost model to serve the people in rural markets. We can provide services to more and more people in these areas, with prevention being at the core
What would be the role of interventional cardiologist in the next 10 years? Interventional cardiology has become the cornerstone of treatment of heart diseases. In future, I believe more interventional cardiologist and surgeons would come together to treat patients. Interventional cardiology will continue to increase, but in close collaboration with cardio-surgeons. There will be innovations of new devices and new techniques. The way
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We have transformed the landscape of healthcare delivery in India. Now, we are expanding our reach by providing critical-care facilities to the patients in a manner where we are not only providing critical care to the patients but also following a low cost model. In this sphere, even England started a year after us.
What is needed today is common sense and ethics amongst physicians, so that they do the right thing for the right patient at the right time forward is through minimally invasive techniques and make future surgeries less invasive.
Do you think technology is helping in giving best care to the patients? Yes, technology is helping in a tremendous way—technology is the future. Telemedicine should be more widespread. We were pioneers in ICT for-
mat. In India, we do not have enough critical-care centres. So, we created a concept of providing critical care through our e-facilities. We are monitoring 400 beds remotely. We are able to see patients directly in Raipur, Bareilly by being here. We have specialists and we are able to monitor every patient of our 400 remote facilities. We are not only able to look at them, but also advice treatment.
specialty
Arthritis is not Just Old Age Dr Pankaj Bajaj, Chief Orthopedic Surgeon and Medical Director, Cygnus Orthocare Hospital, discusses the emerging spurt in arthritis and the advances in technology that ensures comfort for the knees. In conversation with Shahid Akhter, ENN, he shares his ortho experience How widespread is arthritis in India? Arthritis refers to joint inflammation and there are more than 100 diseases that affect the joints. Broadly, it can be divided into osteoarthritis — arthritis due to wear and tear of muscles that comes with age — and the inflammatory arthritis. According to WHO reports, one in six people and one in three families suffer from arthritis in India. In other words, Arthritis affects 15 percent of the Indian population. It is alarming to see the patients emerging in the lower age group as well. Almost 40 percent patients are in the age bracket of 34 to 40 years.
What reasons you attribute to this alarming trend? A joint is a meeting place of two bones and to facilitate the movement, the bones surfaces are covered with cartilage to protect them from actually rubbing against each other. Ligaments hold the bones, while the muscles relax or contract and the synovial fluid nourishes the joint and the cartilage. Any short circuit in this mechanism may trigger pain and discomfort. Arthritis is an umbrella term for over hundred types of musculoskeletal disorders that can affect people of all ages. It is not just about joint pains associated with
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old age. For hundreds of conditions, it is almost impossible to pin point the precise cause. The cause or causes may be hidden in factors like genetics, lifestyle, environment, inflammation, etc. Scientists are still studying these aspect. Besides sedentary life style and high obesity level, there are various other factors associated with arthritis. Lack of awareness, poor exercise, junk food and similar issues pile up to the problems of arthritis. Even injury and infection can spark off arthritis. Diminishing level or excess of fluid, wear and tear of the cartilage are some of the other common factors.
When is knee replacement recommended? Is it associated with old age? Ideally, if your day to day activity is compromised due to knee pain, it is
usual discomfort associated with daily tasks will come to a halt. In India we have a tendency to shift or postpone surgery as far as possible and this delay leads to further aggravation of the problem. Knee replacement surgery performed before severe stiffness and pain set in is associated with better outcomes. For many, it may lead to freedom from depression.
What factors do you take into account before deciding a knee replacement surgery? The magnitude of pain and stiffness is one factor. Next we need to ascertain if the symptoms seriously undermine the patient’s ability to carry out everyday tasks and activities, like walking, going upstairs, getting in and out of cars, getting up from a chair, etc. Is the pain persistent and does it continue while in
While the trend of younger people getting arthritis is worrying, we are happy that advances in technology has made it possible to seek the right medical intervention to ensure a hassle-free future life for such patients time to consult the doctor. Knee surgery is mostly for older people, although age is not a deciding factor today. Consideration of surgery is based on the severity of pain and the degree of disability of the patient. A healthy joint bends easily and allows pain free movements. Once this is compromised, the joint deserves an examination to ascertain the cause. The doctors then decide if joint replacement is required.
What are the benefits of such a surgery? The quality of life receives a new lease. There will be substantial reduction in joint pain. One will be able to accomplish more activities like pain free walking, lifting, exercise, etc. The
sleep or rest? Have medications failed? The extent of knee deformity is there a noticeable arch in the inside or outside of the knee, besides other factors.
Who decides the need for the knee replacement? It is not just the patient or the doctor but even the family members are required to be at the discussion side to evaluate and understand the knee replacement surgery. The decision is based on individual’s disability, extent of pain, health report and other factors.
Why should one consider Cygnus Orthocare Hospital? We have a team of experienced surgeons with latest technologies at our
disposal. We use computer assisted surgery (CAS) by navigation system and I-assist. Shortly we will be NABH accredited. Our reputation is not confined to patients in India alone. Almost 25 percent of our patients come from Afghanistan, Iran, Iraq and other CIS nations. Mostly, they are here during winter time when the temperature is more pleasing for them. Lack of good treatment compels many to come to us. This brings in a new lease of life for many of them. Also it breaks the notion that joint replacement can only be accessed by the affluent, by providing option to poor patients at affordable prices. Our rates are very affordable when compared to other corporate Hospitals.
Your foray into research and academic studies ? We have CMEs in place. As part of the Knowledge Exchange Programme initiated by Cygnus Orthocare Hospital, last week we had Dr David H Gibson, a renowned orthopedic expert from USA. He was of the opinion that deskbound lifestyle is causing knee arthritis among younger people in India. He also highlighted advances in technologies which have made treatment of knee arthritis easier, and cheaper. He felt the need to innovate technologies and solutions which suit people in Indian conditions.
What technological innovations have improved life in othrocare? In India robotics have net yet reached the ortho clinic but other technological advances are in place. Presently available implants are designed keeping in mind US and European population. Hence most of the time they don’t match our patient profile. In Europe, the most common size in use is 4-5-6 while in India it is 2-3 and sometime 4. We have moved rapidly with technologies and today we have a newly designed prosthesis for the Indians and Caucasian population.
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specialty
Working with
Compassion, Professionalism
and Dedication Axiss Dental is the brainchild of two practicing dentists, namely Dr Amit Sachdeva and Dr (Capt) Sandeep Sharma. With a common vision to streamline and standardise dental treatment in India and diligent effort, they have built the largest network of multi-specialty dental clinics in the country. Axiss Dental, today, is India’s leading multispceialty chain of dental clinics. Dr Amit Sachdeva, Director, Axiss Dental, in conversation with Dr Ravi Gupta, CEO, Elets Techonmedia Pvt Ltd, shares his insights on branded healthcare and how Axiss Dental achieved the pinnacle of success 54
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Please throw some light on the origin of Axiss Dental. How was it started, what was the idea? Axiss Dental was founded by Dr (Capt) Sandeep Sharma and myself Dr Amit Sachdeva. It came into being in 2004. During that time, there was a huge gap in patents’ accessibility to doctors. People used to travel from far off suburbs to parent centres. We realized the need for setting up of a multi-specialty industry housing dentists and who could be moved to different areas, at different periods of time. The idea was to set up infrastructure in various suburbs of town or different locations. In 2007, we formalized the whole structure of the company. Since 2007 through 2012, we had been moving along with certain hospitals where we had been outsourcing the department in totality. We partnered with various hospitals like Apollo, Colombia Asia, Fortis, for the simple reason that we wanted to enhance our network across India. By 2012, we mastered all the processes to run an organization of that level. We went into a major kind of branding effort and standalones – growing organically and simultaneously partnering with lots of existing mom and pop stores to see where they are deficient in and how they could actually benefit under the Axiss Umbrella. Today, we have 65 networks across 12 cities in India.
Branded Healthcare is a new idea in India. How is it being accepted by the end-users, customers? The main advantage of branded healthcare is predominantly based on the fact that one can use a lot of economies of scale not in just relation to good manpower, but also technology at a much cheaper rate. Acceptance of branded healthcare – approx. six years back – the whole concentration on branded healthcare was only a percentage of the whole market share. However, a recent report in 2013 has shown that
the branded healthcare has increased to about six percent of the total market size. Going by the worldwide trend, people over a period of time have started realising that branded healthcare is a concept which involves a lot of aspects and which are taken care of by the management. This includes a certain level of transparency in relation to work, availability of doctors, accessibility to adjust your appointments and standardisation in relation to protocol and procedure rates. These are the aspects which help individuals to take a holistic view of the dental market. That is why, Axiss Dental, predominantly, believes in prevention and not just cure. Our growth story is as such that the adaptation is much better now since the brand is much more visible and more established. It was definitely a challenge
work and grading him for his quality of work. If he is doing a good work, he is rewarded. Everybody is monitored by the other person.
Which are the cities you are in? We are basically in three regions where Delhi-NCR is one of regions which include Noida, Gurgaon, Faridabad. In Punjab we are in Patiala, Chandigarh, Ludhiana and Jalandhar. We have a centre in Indore in central part of India. We are also in Bangalore and in and around Bangalore area. So, these are the areas where we have been predominantly focussing on.
What are the expansion plans for the Axiss Dental? Currently, we are looking at close to about 150 to 200 centres in the next
Axiss Dental has its own USP. Its USP lies in the fact that it has been born and brought up by the dentists about four years back, but today market itself is overcoming the challenge.
How are you going to ensure quality in the branded healthcare? That’s one of the USPs of the Axiss Dental. We actually look for a dentist who is already in-charge of a particular clinic and is responsible not only for the profitability, but also for the productivity and quality of that centre. We have regional heads who, on a daily basis, are monitoring every single work happening at the centre. We have an IT process which is basically guiding us to know every patient’s diagnosis -- what work has been done for him, what treatments were prescribed for him, how the treatments were done, etc. Everything is digitalised today. We got a dentist who is looking into another dentist’s
two years and covering India in totality. Axiss recently has also launched an annual dental plan which is an innovative method of insurance but it’s something which a customer chooses on a yearly basis. This plan is accompanied with prevention programmes which basically include check-ups, diagnosis and X-Rays. We believe in a cycle in which we can prevent, treat and what you can carry home. So, it’s a kind of prevention cycle for your lifestyle completely. We have individual plans in which we are able to guide the patients in various manners. So, rather than binding someone with an insurance policy, it is better that he/she chooses his/her kind of plans. If you are spending within our plan, you can actually avail yourself of some points which you can use to buy the same plan again next year at a much more lower cost.
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expert Speak
Prevention is Better Than Control The Advanced Sterilization Products (ASP) division of Johnson & Johnson is pioneer in the area of preventing Hospital Acquired Infections (HAIs). Sankara Sarma, Director, ASP in an interaction with ENN’s Ekta Srivastava explains why this approach is better at fighting HAIs
Is infection control a bigger issue than it used to be? Why? To start with, we believe that infection prevention is a better approach than infection control. Having said that, Hospital Acquired Infections (HAI) is getting higher visibility for a variety of reasons in India as well – firstly, we
are getting to see some Indian publications on HAI rates. These rates are both very high and at the same time there is a high variability across various healthcare settings. Secondly, hospitals are focusing on preventing HAIs in order to improve patient outcomes and reduce the length of
patient stay at the hospital. This is particularly important given the disturbing trend of heightened antibiotic resistance and new Multi-drug resistant organisms. Consequently, there is a lot of interest among healthcare providers for hospital accreditations either NABH or JCI, where there is a lot of importance given to infection prevention processes and metrics. Lastly, with awareness levels going up generally, there is an increased sensitivity across the board to certainly prevent the infections that are preventable.
Infection Control today has emerged as the major concern in the hospitals. What special measures are you taking to control the spread of infections? ASP (Advanced Sterilization Products) division of J&J has been a pioneer in the area of offering infection prevention products, technologies and solutions. We are focused on critical areas which are prone to high infections such as OR, ICU (including transplant areas, dialysis units, etc), CSSD and Endoscopy. We collaborate with the healthcare providers with customized solutions to benchmark with the standards, improve the processes, impart trainings and implement tools, etc. This is a knowledge
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based approach on top of the world class products and technologies. This Care Area based approach is guiding us to assist hospitals in a focused manner by customizing the solutions. To this end, we have invested in trained infection prevention specialists in our organization.
How did that affect the way you approached patient safety? It is easy to see the connection between infection prevention and patient safety and hence the quality of outcomes. At Johnson and Johnson, our aspiration is by caring, one person at a time, we help billions of people around the world live longer, healthier and happier lives. By working with the hospital providers in the four care areas mentioned above, we believe that we are assisting the hospitals in improving the patient safety and living our aspiration.
What are the major challenges that you have faced? Some significant hurdles include lack of regulations to monitor patient safety, scarcity of dedicated infection prevention specialists such as Infection Control Nurses and Infection Control Officers, insufficient budgets and investments around infection prevention. Many of these hurdles are resolved in other countries where the infections rates are lower than one to two percent, where as in India the published reports show the infections at five percent to twenty five percent and more.
Even after booming technology and luxurious facility provided by the multi-specialty hospitals, HAI has emerged as one of the main reason for patient’s death in hospitals. Where do you think is the main loophole in the management? It is true that hospital acquired infections is one of the top contributors of deaths even in western countries. Given that critical surgeries and in-
patient admissions are growing at high double digits, if the protocols and processes do not keep pace, one could imagine the adverse impact of infections. Infection prevention is a strategically important subject that requires dedicated and priority investments since this impacts patient safety and quality of patient outcomes across the care areas in a hospital. There are publications that show that infection prevention reduces average length of stay. Some of the other
government has recently released a working paper on sterilization. NABH has been a front runner in hospital quality and the accreditation is finding a lot of takers. Accreditation becoming a requirement for empanelment with Insurers is also a key step.
What role do (or should) patients play? Is it reasonable to expect patients to ask their caregivers to wash hands? Absolutely, patients need to take re-
Infection prevention is a strategically important subject that requires dedicated and priority investments since this impacts patient safety and quality of patient outcomes across the care areas in a hospital benefits include improvements in the operational metrics such as OR utilization, inventory management, etc.
What is being done by regulators at the state and national level to address infection control? Healthcare has started getting attention recently, even though a lot needs to be done. On the infection front, the
sponsibility. My mother recently had a knee replacement surgery and one of the criteria I used to select the care giver is whether the hospital has any quality accreditations. Accreditations assure that there are protocols and monitoring in place. In countries like Australia, hospitals display infection rates and in the USA, there are penalties for hospital acquired infections.
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focus in focus
Time for Intelligent and
Efficient Hospitals
Michael Sullivan,Vice President, Healthcare Solutions, Schneider Electric, is dedicated to energy management and patient safety in healthcare. In conversation with Shahid Akhter, ENN he discusses the infrastructural challenges and the need for hospitals to innovate and integrate technology With almost two decades of experience in healthcare facilities, how would you describe the most vital challenges facing hospitals today? Not just in India but around the world, hospitals and health care organizations are faced with identical issues of conflicting priorities.Let me focus on some of the basic issues that tend to
derail the healthcare infrastructure. Hospitals today, are the second most energy-intensive buildings followed by restaurants, and they are on the rise. This financial burden — in addition to an aging world population and increasing energy costs— add to the mounting pressure on healthcare organizations to do more with less without compromising quality of care.
In US alone, almost 20,000 people die of hospital infections acquired while in the hospital. Reducing the risk of hospital acquired infection, as well as other potential risks, like power failures, is crucial in ensuring a high quality of patient care and maintaining the organization’s reputation. Noncompliance with regulatory standards is a stepping stone to disruption in operations, poor quality of care, safety issues, and substantial fines. With the increase in energy demand, many countries are requiring healthcare facilities to focus on carbon output and meet mandates for energy reductions. Hospitals are open round the clock and those visiting are often under a great stress when life and health are at stake. Violence, infant abductions, patient wanderings, and theft of drugs and hospital assets are major concerns. Finally, patients’ satisfaction matters and it needs to prevail. The wellbeing of patients is a key to reducing length of stay and preventing readmissions. According to the American Society for Healthcare Engineering (ASHE), in green hospitals, patients are discharged an average of 2.5 days earlier compared to traditional hospitals.
How would you address these challenges ? Lets take an example. There is an attempt to abduct an infant from a hos-
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pital ward. A hospital that has an integrated security system with real-time location system tracking can thwart the move. Specific sequences can be implemented to protect the child. For instance, Staff would receive alerts so they can respond according to their standard operating procedures. Alarms would sound; access control systems would lock designated perimeters and internal doors to push the abductor to a staircase, where he or she can be apprehended. Video cameras can scan the area and send live camera feeds to security staff, as well as provide identification for police. Similarly, information can be harnessed from designated sections of the hospital by installing meters and sensors. Intelligent control, management and analytics can improve infrastructure efficiency and allow maintenance to be scheduled to reduce system downtime. Rising energy costs and consumption can be intelligently monitored and controlled.
How about hospital’s energy waste that may add to the burden on operating costs? Hospitals are great guzzlers of energy. I recently attended Australian Healthcare Week and discovered that in Australia, hospitals were the number one consumers of energy in buildings and accounted for more than half of the emissions from Australian government buildings. The result was transformation and now one can see a glaring example in Royal Children’s Hospital in Melbourne. It was built with both patients and the environment in mind, earning the hospital recognition as Australia’s first 5-star Green Star hospital. We find that our customers find the greatest benefit and maximized savings when they implement a comprehensive energy management programs that address the following questions: What is my hospital’s energy manage-
ment strategy, how do I buy energy, how do I control energy, how do I optimize energy and finally how is my hospital performing against energy goals and benchmarks? Schneider Electric’s experience with hospital energy management shows that a comprehensive program can save more than 12 percent more energy when compared to just implementing.
How does one monitor the hospital data and analytics in a big hospital ? One of the biggest challenges to improving operational efficiency is the sheer complexity of the systems it takes to run their buildings. Almost all hospital executives and managers are working across multiple systems – patient room management, security, utilities management, energy management, and IT, to name a few. These systems operate independently and
grates a hospital’s systems that can help healthcare organizations transform from the status quo into a facility of the future. New South Glasgow Hospital, for instance, is the largest critical care complex in Scotland. This new worldclass hospital is already using components of StruxureWare for Healthcare to integrate its systems, including HVAC, lighting, fire, security, video surveillance and more, creating an intelligent hospital infrastructure. This integration and intelligence is fundamental to achieving efficient and sustainable hospital energy management, but also holds the potential to optimize overall operations through data transparency, ultimately improving patient care.
What makes Schneider Electric’s StruxureWare so special ? Schneider Electric’s Schneider Electric’s StruxureWare for Healthcare
Schneider Electric’s experience with hospital energy management shows that a comprehensive program can save more than 12 percent energy it is difficult to have a holistic view of of the entire scenario but now things have changed. Today, hospitals have tools to dramatically elevate how they measure, understand, and manage resources, the quality of care they deliver. An eagle’s eye view of the hospital with graphical user interfaces and mobile applications can help hospital managers and executives to view the data they need while sitting behind a desk or on the go.
Schneider’s response to the emerging problems in hospitals ? Tools such as Schneider Electric’s StruxureWare for Healthcare inte-
enables hospitals and healthcare facilities to see, measure and manage their entire hospital infrastructure. With our global experience, healthcare expertise, advance technology and dedication, we help hospitals improve their environment of care and the financial health through energy savings and improved infrastructure efficiency. StruxureWare for Healthcare includes software that monitors power to maintain 99.9 per cent availability, tests back up power systems, alerts maintenance staff to potential facility issues, and optimizes environment conditions to reduce the threat of HAIs.
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in focus
Omron:
For better Life, For better World Shinya Tomoda, Managing Director, OMRON Healthcare, India, is keen to strengthen the market network with a turover of 110 crores. In conversation with Shahid Akhter, ENN, he discusses his vision and views When was Omron established and how did it gets its name? Omron was established in 1933 as Tateisi Electric Manufacturing Co. The origin of the name “OMRON” can be found in “Omuro,” the district where Tateisi (our founder) first set up shop in Kyoto city. The company name symbolizes a corporate culture focused on innovation and creativity and is now a brand that is synonymous with quality throughout the world.
How has been the journey so far? OMRON has completed 81 years of its existence in 2014. Today, it is a multi-billion-dollar, diversified company operating in healthcare, industrial automation, electronic components, social systems, and environment fields. It has presence in 35 countries and more than 30,000 employee base. In many of the countries, we are one of the leading providers of many home healthcare monitoring devices, for example, we have the highest market share in digital BP monitors in India as well as across the globe.
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When did OMRON foray into healthcare products and devices in India? OMRON healthcare products were made available in India in 1997. Today, we are a key player in the health care segment providing innovative medical devices for monitoring and therapy – for health monitoring at home. The home monitoring portfolio comprises of home healthcare products such as blood pressure monitors, body fat analysers, pedometers, digital thermometers, respiratory therapy devices, etc. We have more recently forayed into medical devices sector to be used at hospitals / clinics by doctors and professionals with the products such as BP monitors to name just a few.
What product category is driving business in India for OMRON? It is the home use digital BP monitors. OMRON healthcare has the highest market share (approximately 70 percent) in the country. Our range of digital BP monitors aim to promote the healthy practice of BP monitoring at home with its best of user-friendly features based on advanced technology.
How do you visualise the blood pressure monitor market in India? In India there are more than 130 million people suffering from hypertension and the penetration level of home usage of BP monitors is just 2.8 percent. As compared to other countries such as China (15 percent) and Japan (33 percent), this percentage is too low. This indicates that there is a huge need to promote the practice of home
price varies from `1900 to `4000. Our strategy is not to beat the competitors but to expand the market.
The company aims to clock in a turnover of `110 crore in this FY (2014-15) which indicates a growth of around 54 per cent over the previous FY BP monitoring in the country which is one of the best and the most desirable and easy steps to protect oneself from life threatening disorders.
What is OMRON’s health care vision? Omron Healthcare’s vision is “Healthcare @ Home”. It is based on the idea of helping people to utilize their own health data at home so that they, and their medical professionals, can utilize this valuable information to prevent, treat, and manage lifestyle-related diseases. We continually challenge ourselves to achieve a society where people can enjoy healthy and comfortable lives.
Why should a consumer choose OMRON over other available products ? OMRON products are noted for their accuracy. Also, we have a wide range of products to suit various budgets. There are many different OMRON blood pressure monitors sold in India and the
Omron promises to bring to India newer technologies to facilitate care for the rising chronic disease scare amidst billions of people
Your business plan and road map for the next fiscal year ? The company aims to clock in a turnover of Rs 110 crore in this FY which indicates a growth of around 54 percent over the previous FY. Strong product portfolio and robust partner network have been instrumental in propelling OMRON’s healthcare business in the country. We strive to expand our reach by entering new distribution channels .
Your efforts in pan India coverage? We are intensifying our pan India marketing efforts to give a boost to the brand awareness and penetration. One of the major initiatives in this regard is a TV commercial campaign which shall be rolled out in August (till September, 2014) The company also aims to further spread the network of its traditional channel (pharmacies/ chemists) by covering 45,000 Tier 1 and 2 cities in this FY through 100 distributors across the country. This FY, the company has also charted out strategies to scale up further in the home glucometer segment the way it has done in the home BP monitoring domain.
What new products are being launched by OMRON in near future? Omron promises to bring to India newer technologies to facilitate care for the rising chronic disease scare amidst her billions of people. For this purpose OMRON uses its latest proprietary biometric sensing technology in all its home-use healthcare devices, health management services, and testing devices for medical institutions at a price that’s more economic than competition.
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Being World-Class Through Innovation Formed with a mission to create healthcare professionals across all disciplines, the Rajiv Gandhi University of Health Sciences (RGUHS), Bangalore is now looking to becoming a world-class university. Dr D Prem Kumar, the Registrar of RGUHS explains the steps that the university has taken to make the university world class without compromising on its ideals of producing committed world class professionals
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ajiv Gandhi University of Health Sciences came into existence in the year 1996 when the Karnataka legislature merged the Health Professions’ Education into a Health Sciences’ University. The Rajiv Gandhi University of Health Sciences Act aimed to meet the demand for healthcare professionals across the globe. The University’s motto, ‘Right for Rightful Health Education’, summarises its founders’ aim to create healthcare professionals across all medical disciplines from medical to dental, traditional medical systems to pharmacy, nursing to allied health sciences. The University founders aimed to take advantage of the globalisation and liberalisation in the education academic sector and created programs that matched well with international standards. The University offered courses in Undergraduate, Postgraduate, PhD, Fellowship and Certification programs.
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Universities have evolved from being places where students go to study, gain knowledge, take exams and get degrees. They now set the agenda for change. Universities are the portals through which the success of the socie-
Research Teaching
Figure-1 Outreach
ties emerges. Health universities have a greater responsibility due to their impact on the society. To become a world-class university, Rajiv Gandhi University of Health Sciences (RGUHS) plans to improve its rating by becoming a globally engaged, research-intensive university that responds to social, economic and environmental challenges. For this, it is changing its policy and do research in multiple healthcare disciplines for encouraging, enabling and supporting research collaborations and partnerships. To promote more research, the curriculum at RGUHS will offer courses that align research methodology as a matter of curricular standard, while conforming to the stipulations by various apex bodies. This will provide an outstanding student experience, encourage and reward excellence and creativity in learning and teaching practice, while making the graduates will emerge as professionals sensitive to social development. RGUHS plans to create an infrastructure that blends the strengths of existing capacity with the potential of emerging technology. Its programs adhere to the regulatory norms, butare quick to adapt to changes. It will build user friendly and economically viable delivery mechanisms for the teachers and students. Teachers will be trained as educational leaders that inspire the young minds to embrace the future. It will transform the examination system to test the relevant professional skills of the students rather than test their capacity for rote learning.
Organizational innovation For achieving its grand targets, the University plans to adopt a collegial atmosphere of governance. Its large number of affiliated institutions, their collective infrastructure and human resources will be leveraged to design a collaborative network of academic excellence. A cluster of institutions thus created can share their libraries, museums, digital resources, etc. RGUHS will also create opportunities for inter-professional and crosssectoral learning at various levels and with graded priorities. Undergraduate students will be encouraged to participate in inter-professional teamwork; there would be short term postings for the internees to experience inter-professional team performance; research based projects to assess the effect, efficiency and economy of inter-profes-
Organisation Academic Research Research
Research Output Industry-Academia Research Output Linkage Research temperament
X
RGUHS plans to put in place an accountability framework to ensure that it delivers on its promises on time and with reasonable quality of services. The framework will work as a benchmark for its performance and stakeholder satisfaction. Every service that the university provides will be listed on a public domain like the university’s website and also on the notice boards of all its affiliated institutions. Each service will be time bound and the upper time limit will be adhered to. For affecting the changes, RGUHS feels innovation needs to take place at the university to usher in new ideas and methodologies. The innovation has to be at an organizational, academic, research and co-curricular level.
Health Products PG Studies= Research output
sional concepts in the postgraduate courses.
Research innovation The research policy at RGUHS will only focus on clinical research, fundamental biological research and their translational impacts as well as medical humanities like medical sociology, medical anthropology, health psychology, health economics, etc. This will create centres of excellence that will be aided in upgrading their facilities. These institutions will then share 30 percent of their resources with other less endowed institutions and mentor them. The university will also form alliances with other institutes of note, both national as well as international. It will also form alliances with universities in developing and under developed countries to mentor and support health science education, research and extension as part of its social responsibility.
Academic innovation RGUHS plans to start a Continuing Professional Development Program, a series of skill-based workshops and short term courses for working professionals. These programs will be accredited under various professional registration bodies. The student evaluation system at RGUHS will also undergo a change to infuse transparency in student assessment and a time bound system of
2 Figure-
announcing examination results. Use of Information and Communication Technology (ICT) will add speed and accuracy to the assessments. Options like open-book-examination, online synchronised evaluation are also being considered. Webcasting of lectures, demonstrations, group discussions, etc, will further the university’s reach. Making them available on RGUHS Learning management System will enable students to study them as times as necessary to hone their skills.
Co-curricular innovation Rajiv Gandhi University of Health Sciences has always promoted sports and developing a healthy and all-round lifestyle. RGUHS also combines its health studies with social work. Its volunteer base of 15000 students will be trained to be socially committed healthcare professionals. They will be encouraged to partner with state’s health systems to provide a strong volunteer force. As Rajiv Gandhi University of Health Studies starts to upgrade it’s services, it has its work cut out. To become truly world class, the university will need to internalize the ideals of transparency, research, community building and sharing etc. it will have to be a self-sufficient organization, so that it can have the financial freedom to take its own decisions. With stellar record of imparting education and producing good talent, the university’s attempt at achieving a world-class status does not seem so far fetched.
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Oracle Bets on
Big Data in Healthcare Business giant Oracle looks to increase its presence in healthcare by offering Big Data solutions that can help usher in personalized medicine. Sundar Ram, Vice President, Technology Sales Consulting, Oracle Corporation explains
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echnology giant Oracle Corporation, a big name in the business world with their award winning Oracle suite of software, has had a limited presence in healthcare space. This is because traditionally, healthcare has been about the relationship between a doctor and patient. Big hospitals that cater to a large number of patients gave Oracle the opportunity it needed to enter this domain. Its database powers the HIMS/HIS solutions that the corporate hospitals use to manage their disparate services and patients. Oracle’s database programs also help in the back office operations like supply chains for production and transportation of drugs. Oracle’s involvement in the health-
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care industry is set to undergo a seismic change as it goes after Big Data in healthcare. Sundar Ram, Vice President, Technology Sales Consulting Oracle Corporation, Asia Pacific explains, “There are different ways that healthcare can benefit from IT, and Oracle wants to be in all those spaces. It has its own solutions in some areas like the Healthcare Transaction Base, an Oracle application that provides a single view of a patient across multiple touch points he has had from a healthcare perspective. We also have solutions for healthcare analytics and clinical trials. But we want to use IT in ways it has not been used in this sector. We feel the next big wave of benefits will come from Big Data,
where it could be about personalized data collection about individuals, innovative research mechanisms, innovative disease tracking mechanism for personalizing medicine etc.” He feels there is a lot of saving to be had in terms of outcome and treatment and as well as the cost of healthcare. Explaining the relevance of Big Data, Mr Ram talks of a study done by McKenzie Global Institute in the US where it found that one of the biggest beneficiaries of Big Data was healthcare. Mr Ram says that while a ton of patient data is available, it is not connected. Big Data solutions, he says, can be referenced, connected and the most effective treatments for the patient can be determined, thus heralding personalized medicines. In absence of a meaningful data, he says, patients undergo numerous tests that are time and cost consuming. Also, the treatment given to the patient may not be ideal since it has not been personalized. But stringing together disparate but related data will yield useful information towards treating a patient. Ram says Oracle foresees a lot of innovation happening in this space, and is collaborating with many organizations for the same. He says Oracle’s intention is to be of benefit to both the end users - the patient as well as the healthcare companies. It is closely working with hospital chains and insurance companies to identify patterns in claims so that they can price their policies according to the individual user. While expounding about the promise of this new field, Mr Ram says that Oracle will not be ignoring the back and front office solutions that it already provides and will continue to innovate and push the envelopes in those fields.
Patient Feedback Management System American Megatrends
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Philips Brings Pain Therapy at Home Philips India launches pain therapy devices for home use
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s India urbanizes, it faces a new challenge in healthcare that may turn epidemic – body aches. The increasingly urban lifestyle means that people are doing less strenuous work and spending more time sitting, whether it is in offices, cars or at homes. At the other end, people hitting the gym or playing a sport tend to over exert themselves, causing wear and tear. In both cases, the resultant body aches can be unbearable. Prevalence of chronic pain in India is estimated to be approximately 30% and the number of musculoskeletal cases which are a result of unhealthy lifestyle, stress, poor posture, physical exertion, ageing and degenerative osteoarthritis are increasing. India’s pain management industry, which includes pain killers, medical and alternative therapies etc, is worth more than Rs 2,500 crores annually and is growing at 15 percent. A popular home remedy for aches and swellings has been pressing the affected parts with a hot cloth. In fact, this treatment is prescribed even by medical practitioners. But the drawback with it is that while it does provide relief, the hot cloth is sometimes too hot or it cools down too fast. Philips India, a leading health and wellness company, has been addressing the issue of pain management in India for a long time, but on a business-to-business level. Its products are used by sports doctors and
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physiotherapists for providing relief. But now, Philips India is venturing into the home segment category with two new pain management devices. Its InfraPhil and InfraCare devices are designed for home use. They use infra red rays to provide relief to the affected part of the body similar to a hot press by colth, but unlike the cloth, they maintain a steady temperature and are neither hot nor cold. Commenting on the products, Jayati Singh, Head, New Businesses, Consumer Lifestyle, Philips India says, “People are realizing that popping pills is not a solution the pains; it is just a temporary relief. They are either making changes in their lifestyles or are looking at solutions which don’t have too many side effects. That is where this product lands – it does not have any known side effects and can be used at home.” Unlike painkillers or using gels balms that affect only the top layer of the skin do not permeate deeply, in-
fra red therapy permeates to at least five millimeters beneath the skin and dilates the blood vessels and enhances the blood circulations. Philips is targeting the products at men and women between 35-65 years. It is confident that the product will sell despite being costlier than its competitors. Ms Singh says, “When it comes to health, cost becomes secondary. We noticed that even in Tier II cities, there is a lot of traction for our product.” The market for infra red lamps is currently populated by products that are not reliable and are prone to malfunctions. In this field, the InfraPhil and InfraCare devices by Philips promise a long life and reliability. With these two products, Philips sees a merging of its three departments healthcare, consumer lifestyle and lighting. The bulbs for the lamps are made by the lighting division, it is a healthcare device and consumer lifestyle will be selling it.
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Dräger India is now in your city with a Clever, Compact and Comfortable Ventilation Solution An initiative to provide optimum ventilation solution
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umbai - Dräger, an international leader in Medical and Safety technology, extends its reach beyond the metro cities of India with the compact and mobile ventilator Carina. Carina comprehensively fits the needs of hospitals in smaller cities and towns in India. It optimizes workflow and workspace usage. It offers a range of ventilation modes for spontaneous and mandatory ventilation. Its light weight and compact size brings in mobility within the hospital. Although the healthcare industry in India has shown significant progress over the last few years, interior towns of India continue to be deprived of the ventilation technologies optimized for their needs. Carina intends to address the challenges of specialist owned hospitals
and facilitate them with quality and economical ventilation. Carina, along with its original accessories such as Novastar and Classicstar masks, provides also high performance non-invasive ventilation, including synchronizations and leakage compensation. It supports spontaneous breathing attempts with the “Room to Breathe” concept during all invasive ventilation modes and is easily transported between departments. Further elaborating on this initiative, Mr Nikil Rao, Country Manager, Dräger India Pvt. Ltd says. “We identified the requirements of our customers in interior towns of India for a multi-purpose and economical ventilation solution. We created an offering of Carina along with its accessories to connect to the needs of our customers.” Dräger Medical GmbH is the manufacturer of Carina.
Dräger. Technology for Life
Dräger is an international leader in the fields of medical and safety technology. Our products protect, support and save lives. Founded in 1889, Dräger generated revenues of around EUR 2.37 billion in 2013. The Dräger Group is currently present in more than 190 countries and has about 13,500 employees worldwide. Please visit www. draeger.com for more information july / 2014 ehealth.eletsonline.com
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Nuclear Medicine is Safe
and Effective R
adiation Medicine Centre (RMC) of BARC recently held a two-day seminar on ‘Radiation Medicine Centre in the Service of the Nation’ where the effectiveness and positive benefits of nuclear medicine diagnostics and therapy were demonstrated. RMC has been promoting the use of radioisotopes in medicine for research, clinical investigation and therapy since 1963. RMC also provides clinical researchers with pharmaceuticals labeled with suitable radioisotopes (radiopharmaceuticals) to use as tracers for their studies. Nuclear medicine is considered to be one of the most classic examples of the peaceful application of nuclear energy in the welfare of mankind. Dr M G R Rajan, Head, Radiation Medicine Centre, said, “There are a lot of myths revolving around the practice of nuclear medicine, that is unsafe and harmful, but it is not. In fact, it is safer with better patient compliance than other modalities. The choice of the appropriate radiopharmaceutical makes the diagnosis very organic and disease specific, so there is no way that it can go wrong.” He added that RMC conducts over 9,000 SPECT and PET scans on patients, about 800 patients are given therapies with radioactive iodine and other isotopes, and 1,400 patients are referred for thyroid function tests. Dr Ramesh V Asopa, Head, Clinical Nuclear Medicine Section, RMC said, “Nuclear medicine is different from X-Ray, MRI or other scans,
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because it gives a functional picture of the organ, whether the organ is functioning normally or sub-normally which helps diagnosis greatly. We are also conducting some rarest scans which are either not available anywhere else or are very expensive to carry out.” He further added, “It is a misconception that radioactivity causes or aggravates cancer. The medicine administered in proper quantities for therapy causes no harm to the patients. Also, the patients are kept in total isolation and all necessary safety measures are taken so that the radioactivity is not passed on to anyone else.” Dr Sunita Sonavane, Nuclear Medicine Consultant said, “The staff here is provided with adequate safety measures. The RMC has been working for 50 years and nobody has ever been harmed. So, this is enough to prove that nuclear medicine is abso-
lutely safe. Nuclear medicine procedures are used safely in young children including babies who are a few days old.” RMC has also been researching on new innovations and diagnosis for various other illnesses. Dr Savita Kulkarni, Senior Scientific Officer at RMC said, “There are 35 million deaths in India due to TB and the death rate is two deaths per three minutes. This is very alarming, particularly with the emergence of multi-drug resistant tuberculosis. Hence, we are identifying the virulence of different strains of Mycobacterium tuberculosis in the context of their interaction with the patients’ immunity. We also carry out anti-TB drug testing service.” RMC provides Fluorine-18 labelled radiopharmaceuticals to several hospitals across Mumbai including the Tata Memorial Hospital.
Supported by
Ministry of Tourism
Government of India
MEDICAL AND WELLNESS TOURISM SUMMIT – 2014 July 25th, 2014; “Silver Oak” Habitat World, at IHC, Lodhi Road, New Delhi-110003 Registration Starts: 9.30 am onwards
Chief Guest
Mr. Parvez Dewan, IAS
Secretary, Ministry of Tourism, Government of India THE PROBABLE ISSUES OF DISCUSSION • Branding India as a better destination for Health Tourism.
• Legal remedies for medical malpractice.
• Innovative strategies to promote Health Tourism.
• Highly unorganized Health Tourism sector.
• Proper marketing for Health Tourism.
• Inequities embedded in the health care system.
• Inadequate Grievances Redressal policy.
• Combining Health Tourism with Spiritual Tourism.
TARGET PARTICIPANTS Captains of Health Tourism Industry / International & National Health Tourism Experts / Corporate Groups with investments in Medical infrastructure / Health Projects / Indian and Foreign Tour Operators / Health vacation Planners / Institutes imparting Health Tourism related Education / State Tourism Boards / Airlines / Healthcare professionals / Doctors / Medical Equipment Companies / Pharmaceuticals / Biotechnology Companies / Hotels / Spa Wellness / Travel Companies / Insurance Companies / Medical Students / Non-Profit Organizations etc.
SPONSORSHIP OPPORTUNITIES ARE ALSO AVAILABLE
PARTICIPATION FEE – NIL
FOR FURTHER ENQUIRES PLEASE CONTACT :
Manisha Singh – 011 – 49545423 Ext 123 manisha.singh@phdcci.in / Varun Gogia – 9871098716 varun.gogia@phdcci.in / Aditi Sood – 8800169977 aditi@phdcci.in PHD CHAMBER OF COMMERCE & INDUSTRY : PHD House, 4/2 Siri Institutional Area, August Kranti Marg, New Delhi – 110016
Ph: 011-26863801-04, 49545454, 49545400, Fax: 011-26855450, 49545451 E-mail: Phdcci@phdcci.in Website: www.phdcci.in
launch pad
Full Body Vibration Exerciser
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SIM India introduces uShape, a full-body vibration exerciser that helps to burn off calories efficiently. The uShape, also known as whole body exercise vibration training, is designed to achieve a whole body workout with little effort and time, making it perfect for the time-poor urban dwellers. The uShape provides strong vibrations to the whole body with stand, sit or hold. Varying positions such as squat, push up, lunge are also possible. These strong vibrations cause rapid contractions to all muscles that are being exercised, making it an easier and more effective way to get a full-body workout. This results in increased muscle strength, improved flexibility and improved blood circulation which encourage the body to burn upto 136 Calories in 10 minutes, resulting in an increased metabolism. Moreover, it helps to reduce the appearance of cellulite and also helps in achieving effective shaping and toning of the whole body.
The Total Power – Hydraulic
fitness machine
A complete body work out from legs to abs to shoulders is what you get while working out on exerKING that too in just 15 - 20 mins. This machine features hydraulic cylinders that can automatically and continuously adjust itself to the strength, power, speed, output and the need of the person using it. Opposing muscle groups, therefore, are alternately exercised during both flexion and extension without injury, damage or soreness as the user is not tied down to a pre-set speed of movement and never meets more resistance than he/she can handle. As muscle fatigue sets in the exerKING, the total power machine accommodates the resistance to the user’s force potential totally unlike other fixed speed controlled isokinetic machines. To make fitness easier, eye-level read out gauges in a panel allows the individual to see precisely how much force he/she is exerting exactly where in the body and at what point of the exercise. This machine can also be used by people having back problems without any fear of having any complications and it’s one of the most comfortable sitting positions for workout. Resistance is variable by the twist of a control knob provided on the left side of the seat. Also, a seat belt is provided for getting proper body hold on the machine.
Butterfly Needle SRL Diagnostics has come up with an inventory notion of Butterfly Needle that along with providing diagnosis, curbs the syringe phobia in the patients. Accidental needle stick injuries are a quiet crisis in healthcare systems around the globe. Safer blood drawing devices are needed that mitigate the dangerous and costly aspects of needle stick injuries during routine blood draws. Butterfly needles technology is an indispensable tool for collecting blood from all patient demographics, particularly paediatric, geriatric, patients with difficult veins or dorsal hand veins. How does it work? When the needle is inserted into the vein, a ‘flash’ can be seen. The ‘flash’ is a small amount of blood that flows into the hub connected to the needle when the needle enters a vein.
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