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July 2017 | Volume 12 | Issue 07
industry perspective
10
COVER STORY
The Evolution of Public Healthcare in India Policymaker’s perspective 14 National Urban Health Mission An integrated mission for urban healthcare Dr K Rajeswara Rao Joint Secretary, Ministry of Health and Family Welfare Government of India 18 Bolstering Growth of AYUSH Through Quality & Sustainability Padmapriya Balakrishnan Deputy Chief Executive Officer, National Medicinal Plants Board 22 AYUSH: Helping India Achieve its Health Goals Dr DC Katoch Advisor (Ayurveda), Ministry of AYUSH, Government of India
36 PSRI Hospital Where Quality Health Services is Way of Life Dr Dipak Shukla CEO, PSRI 40 Healthcare Delivery Undergoing Changes at All Levels Chander Shekhar Sibal Executive Vice President Fujifilm India 42 Manipal Hospitals Dwarka: Seeking Excellence in Healthcare Prof Dr Sanjeev Bagai Director and Dean, Manipal Hospitals-Dwarka, New Delhi 44 NABH: Ensuring Quality Health Services in India Dr BK Rana Director, NABH Quality Council of India 46 IVH Enabling an Integrated Tertiary Care Ecosystem Swadeep Srivastava Managing Partner India Virtual Hospital 48 Indogulf Hospital Closing the Quality Gaps in Global Healthcare Dr S Kumar Managing Director Indogulf Hospital
24 Revamping Public Health Services in India Dr Jagdish Prasad Director General Health Services, Directorate of Health Services 28 Aiming to Correct Imbalances In Quality Tertiary Healthcare Prof (Dr) Nitin Madhusudan Nagarkar Director, AIIMS Raipur and AIIMS Bhopal
32
HEALTHCARE INNOVATIONS
e-Hospital: Infusing Efficiency in Public Health System
50 New Horizons of Growth for Indian Health Startups Krishnamurthy Ramalingam CEO & MD, Galactic Medical DataBank Private Limited 54 Axio Biosolutions Saving Lives Through Innovations Leo S Mavely Chairman of the Board and CEO of Axio Biosolutions 57 Universal Hospitals Where Quality Matters Dr Shabeer Nellikode Managing Director Universal Hospitals, Abu Dhabi
Plot No. 424, CMR Building, Near Govt. School, Metro Pillar No-138, Ghitorni, New Delhi-110030
8
Editorial India Gearing up for Affordable, Inclusive Healthcare Public health service in India is undergoing a major transformation. Driving this change are the fresh policy initiatives by the government and technological innovations that are touching every aspect of our lives. There is an urgent need to bolster our efforts to make healthcare more affordable and inclusive by strengthening the existing infrastructure and bridging the boundaries to enable smooth flow of information. Our cover story -- ‘The Evolution of Public Healthcare in India’ -- delves into the impact of policy change and technology on the healthcare sector, while it also tries to find solutions to some very pertinent challenges that have been pestering the healthcare sector in India for long. Our feature on Healthcare Innovations, ‘e-Hospital: Infusing Efficiency in Public Health System’, highlights how the country’s most populous state of Uttar Pradesh has taken a big leap by adopting Information and Communications Technology (ICT) to infuse a new vitality into the government hospital network. It underscores the immense potential of the e-Hospital project in transforming the healthcare delivery in the State which has to grapple with a multitude of problems, owing to its sheer size and diversity of population. This Healthcare Leaders Forum (HLF) special issue of eHealth magazine contains interviews of policy makers like Dr K Rajeswara Rao, Joint Secretary, Ministry of Health and Family Welfare, Government of India; Dr Jagdish Prasad, Director General (Health Services), Directorate General of Health Services; Dr DC Katoch, Advisor (Ayurveda), Ministry of AYUSH, Government of India; and leading industry captains to help our readers get first-hand information on various issues, challenges as well as innovations that are pushing the Indian healthcare sector to reach new heights. A special focus area of HLF, now in its seventh edition, is to deliberate on the scope of New Healthcare Policy-2017. Eminent speakers at HLF-2017 will delve deeply into the nitty-gritty of how this policy with private sector as strategic partners seeks to enable universal health coverage and deliver quality healthcare services to all at affordable cost. Looking forward to our readers’ invaluable feedback.
Dr Ravi Gupta Editior - in - Chief Elets Technomedia Pvt. Ltd ravi.gupta@elets.in
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COVER STORY
The Evolution of Public Healthcare in India Policy interventions by the government, coupled with technological innovations and increasing integration of modern health services with age-old proven systems are effectively addressing the pain points of the Indian Healthcare system, writes Vivek Ratnakar of Elets News Network (ENN).
JUly 2017 | ehealth.eletsonline.com
12
COVER STORY
The year 2014 marked a watershed moment in the history of Indian public healthcare system. The World Health Organisation (WHO) on March 27 that year declared India a polio-free nation -- the fourth WHO region globally to have achieved this feat after Americas (1994), the Western Pacific Region (2000) and the European Region (2002). This achievement was made possible by technological innovations, close monitoring and relentless efforts of some 2.3 million polio volunteers, who worked day and night to reach every child across the country for immunisation. “The government has played a vital role in the eradication of small pox, polio, yaws and kidney worm infestation. This all has been made possible by a robust public health system. Even malaria, which was among the most threatening endemic diseases in India, is now on the verge of being eliminated in the country. We are also trying to eliminate leprosy at the district and block levels by 2018-2020,” says Dr Jagdish Prasad, the Director General-Health Services, Directorate of Public Health Services, Ministry of Health and Family Welfare. The public health sector in India is undergoing a tremendous change driven by forward looking policy initiatives, technological revolution that is fast closing the gaps in healthcare delivery system and increasing integration of traditional systems of medicine with modern healthcare to deliver affordable and inclusive healthcare for all. Policy Push to Make Healthcare Affordable for Masses The National Health Mission (NHM), India’s flagship health sector programme with an
JUly 2017 | ehealth.eletsonline.com
“healthi.in plans to empower 1.5 million users to make smart choices about their health by 2018. To do so, healthi intends to continue to invest in improving the efficacy of our AI (Artificial Intelligence) based predictive analytics engine, and to empower better connectivity and communication between the healthcare provider and the customer through technology.” Krishna Ulagaratchagan Co-Founder and CEO healthi.in
allocation of Rs 26,690 crores for 2017-18, is gradually revitalising rural and urban health sectors by providing flexible finances to State governments. The mission has four components -- the National Rural Health Mission, the National Urban Health Mission, tertiary care programmes and human resources for health and medical education. “The National Rural Health Mission has brought down the maternal and infant mortality rate tremendously. It provides incentives to women to get their delivery done in government institutions free of cost,” states Dr Prasad. The Ministry of Health and Family Welfare has also added two new programmes to its basket under NHM -- Mission Indradhanush, which improved immunisation coverage by over 5 per cent in the just one year, and the Kayakalp initiative, which was launched in 2016 to inculcate the practice of hygiene, sanitation, effective waste management and infection control in public health facilities.
India has also deployed nearly 100,00,00 Accredited Social Health Care (ASHA) workers, who are playing a transformational role in the change happening in Indian healthcare system. They act as mobilisers for institutional deliveries, focus on integrated management of neonatal and childhood illness and advise on home based neo-natal care. The National Health Policy, 2017, which has the stated vision of enabling universal health coverage and delivering quality healthcare services to all at affordable cost, looks at problems and solutions holistically with private sector as strategic partners. The policy marks a major shift from the past in terms of raising public health expenditure on health to an unprecedented 2.5 per cent of the Gross Domestic Product (GDP) in a time-bound manner. The policy also recommends mainstreaming the traditional health systems by leveraging the potential of AYUSH through co-location in public facilities. Technology as a Change Agent “Two significant transformations are currently underway in the Indian healthcare sector: the increasing adoption of technology in clinical practice and a systematic effort to prevent chronic diseases. However, both these efforts are in their infancy,” says Krishna Ulagaratchagan, Co-Founder and CEO of healthi.in. For technology, its use in clinical practice is primarily limited to the front office with practices such as appointment scheduling and billing. For the latter in India, it is mostly limited to health checks. Though
13
As per Nilesh Aggarwal, CoFounder, eMediNexus and COO, IJCP Group, technology has touched every aspect of human life. “This is true of the healthcare sector as well. Even till a few years back, India’s healthcare sector was lagging behind in terms of technology adoption. However, the recent times have brought in some muchneeded development. The union of technology and healthcare has opened up new avenues to address a multitude of issues. From storing medical records to diagnostic and therapeutic methodologies, technology is revolutionising the healthcare delivery system in the country,” he observes. The growth and change in India’s healthcare industry is being driven
“Grow Fit intends to become a comprehensive daily health companion for its consumers. We recently raised Series A funding of $ 4.5 million from MEMG (Manipal Education and Medical Group), the PE arm of the Manipal Group. The SAR Group and The Grover Trust, Grow Fit’s seed investors, also participated in this round. With this, we will now focus on introducing new product lines and invest more in data science and Artificial Intelligence.” Jyotsna Pattabiraman Founder & CEO Grow Fit
by increasing population, rising incomes, changing lifestyle, easier access to high-quality healthcare facilities, and greater awareness of personal health and hygiene, adds Jyotsna Pattabiraman, Founder and CEO, Grow Fit. “The private sector has been another driving force behind the growth in the Indian healthcare sector. Indian healthcare providers are increasingly adopting new technologies to offer better healthcare services, reach inaccessible regions, and improve operational efficiency. Medical experts are opting for telemedicine as a way to reach rural India and create a network of health service providers. There is rapid growth in telemedicine and mobilebased healthcare as well,” says Pattabiraman. Overcoming Challenges for a Healthy Future While India is doing well in terms of tertiary healthcare with rising medical tourism and establishment of large hospital chains, primary healthcare still remains a matter of concern, says Pattabiraman of Grow Fit. “In the future, healthcare will be delivered through small, connected devices which can communicate with mobile phones. The union of technology and healthcare has opened up new avenues to address a multitude of issues. From storing medical records to diagnostic and therapeutic methodologies, technology is revolutionising the healthcare delivery system in the country,” says Nilesh Aggarwal. According to Ulagaratchagan of healthi.in, a healthcare scenario where wellness behavioural data and historical health data is accurately
“eMediNexus is a contentfocused appthathelpsin keeping doctors updated with the latest advancements and clinical cases in medicine so that they can improve their knowledge, diagnose, and treat patients more efficiently and with more precision. It also gives the doctors an option to take second opinions from other practitioners on the go thereby reducing the need for the patient to be referred to an already overburdened doctor.” Nilesh Aggarwal Co-Founder, eMediNexus and COO, IJCP Group
recorded, owned, and managed by the patient and shared with the healthcare professionals is the need of the hour. “There is a need to make the process of identifying the right preventive health exercise unintimidating; provide choices that factor in the user’s unique needs; and present easy-to-understand results that answer three simple questions: how healthy am I? What do I continue/ change in order to get and stay healthy? And who can help?” “A combination of scientifically validated predictive analytics, machine learning technology, user-friendly design, strong partnerships with healthcare majors and cutting-edge research can make the preventive health journey personalised and ‘one-size-fits-one’, and thereby insightful, engaging, and effective,” he adds.
ehealth.eletsonline.com | JUly 2017
COVER STORY
people are more aware and go for regular health checkups, there is still a bit of disconnect, according to Ulagaratchagan.
14
POLICYMAKER’S perspective
National Urban Health Mission
An integrated mission for urban healthcare The National Urban Health Mission has made a considerable progress since its inception and currently employs more than 24,000 personnel. Besides, more than 4,000 urban Primary Health Centres are delivering comprehensive healthcare in urban areas, says Dr K Rajeswara Rao, Joint Secretary, Ministry of Health and Family Welfare, Government of India, in conversation with Gautam Debroy of Elets News Network (ENN). Excerpts:
Dr K Rajeswara Rao
Joint Secretary, Ministry of Health and Family Welfare, Government of India
Q
and district and State headquarters with more than 30,000 population.
The National Urban Health Mission (NUHM) was launched in 2013, covering all the cities and towns with more than 50,000 population
Since its launch, the mission has made considerable progress and we currently have more than 24,000 personnel consisting of medical, paramedical and programme management resources. Under NUHM, more than 4,000 urban primary health centres are delivering
You are leading the National Urban Health Mission (NUHM). Tell us about the key initiatives launched by the Ministry of Health and Family Welfare under the mission.
JUly 2017 | ehealth.eletsonline.com
comprehensive healthcare in urban areas across the country. Community involvement is being ensured through 54,000 ASHAs (Accredited Social Health Activists) and more than 59,000 Mahila Arogya Samities have already begun operations. Guidelines and brochures for various thematic areas like vulnerability mapping, capacity
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POLICYMAKER’S perspective
building framework, quality assurance, Auxiliary Nurse Midwifery guidebook, medical college collaborations, community process, Information Education Communication (IEC) and Behaviour Change Communication (BCC) have been issued to all the States and the Union Territories (UTs). Joint meetings and video conferences with all the 35 States and UTs ware held in February this year to focus on convergence with other programmes and departments like National Urban Livelihoods Mission (NULM), Housing and Urban Poverty Alleviation (HUPA), Swachh Bharat Mission (SBM) and Ministry of Urban Development (MoUD) to address issues linked to the social determinants of health. National and State-level workshops for municipal corporations, urban local bodies, on community processes, quality assurance, public private partnership, orientation of State Institutes of Health and Family Welfare (SIHFW) and State Health System Resource Centres (SHSRC) have been organised from time to time to facilitate the implementation process of the programme across the country. To focus on the quality parameters, Kayakalp Award Scheme is to be implemented in all the urban health facilities. NUHM has also organised sensitisation workshops with medical colleges to leverage the existing provisions of Medical Council of India (MCI) guidelines, wherein they are mandated to run urban health training centres. These centres can be utilised for providing training, curative and referral services. Involvement of Nursing Council under NUHM by deploying nursing students for six-eight weeks in urban health facilities is also encouraged. In this regard, a Demi Official (DO)
JUly 2017 | ehealth.eletsonline.com
letter has already been issued to the state principal secretaries (health and family welfare).
Q
Which is the nodal agency for implementation of NUHM in States and cities?
Flexibility has been given to the states for implementation of NUHM either through the Health Department or urban local bodies, except for the seven metro cities where implementation will be through the urban local bodies only. A bipartite MoU regarding the implementation of the NUHM will be entered between the SHS (State Health Society) and urban local body with the provision of periodical reporting and review of the progress.
Q
What are the challenges for National Urban Health Mission?
The National Urban Health Mission envisages addressing healthcare needs of the urban population, with focus on the urban poor and special emphasis on slum population, by making available to
them essential primary healthcare services and reducing their out-ofpocket expenses for treatment. This will be achieved by strengthening the existing healthcare service delivery system, targeting the people living in slums and converging various schemes relating to wider determinants of health like drinking water, sanitation, school education, etc. implemented by the Ministries of Urban Development, Housing and Urban Poverty Alleviation, Human Resource Development and Women and Child Development. As NUHM programme has multiple stakeholders, particularly in the metros where implementation is through urban local bodies, often coordination and collaboration becomes a challenge. To address some of these challenges, NUHM is undertaking a series of training programmes for senior and mid-level officers of Health Department and sensitisation workshops of elected representatives of urban local bodies and their functionaries. These are being organised through premier institutes like Indian Institute of
17
Letters have been sent by the Minister for Health and Family Welfare, Government of India to Chief Ministers and Urban Development Ministers of the States. The Joint Secretary (UH) has also written/communicated to Mayors of all major cities or towns regarding the key thrust areas (mapping of urban vulnerable population, HR augmentation, service delivery through proximal UPHC/ UCHC, convergence, community participation outreach activities, financial strengthening, etc.) for accelerating the implementation NUHM. Capacity building of human resources under NUHM, and especially service delivery functionaries in soft skills, communicable and non communicable diseases, dealing with social and psychological issues, is also being undertaken.
Q
The Government of India is coming up with a National Health Protection Scheme. Give us a brief idea about it. The National Health Protection Scheme was announced by the Prime Minister on 15th August to provide coverage to the poor and vulnerable section. The contours of proposed National Health Protections Scheme (NHPS) are under consideration of the Cabinet and approval on the same is awaited.
Q
What is the success rate of Rashtriya Swasthya Bima Yojana (RSBY)?
RSBY is a cashless health insurance scheme which provides annual coverage of Rs 30,000 to a family of
five through a biometric smart card. It targets Below Poverty Line (BPL) households and 11 other defined categories of unorganised workers. An add-on health insurance cover for senior citizens as a top up over the existing RSBY scheme is being implemented since 1st April last year. The scheme covers every senior citizen, providing additional coverage of Rs 30,000 per senior citizen in the RSBY enrolled families. During 2016-17, RSBY is being implemented in 15 states, while SCHIS is being implemented in eight states. More than 3.63 crore families with more than 12.6 crore persons are covered under RSBY. More than 1.5 crore beneficiaries have availed hospitalisation benefits since inception of the scheme.
Flexibility has been given to the states for implementation of NUHM either through the Health Department or urban local bodies, except for the seven metro cities where implementation will be through the urban local bodies only.
Q
What are Ministry of Health and Family Welfare’s plans to develop the health sector in North-Eastern States? An outlay of Rs 752.05 crore has been earmarked for the current financial year 2017-18 under NUHM. The funds will be transferred to the states through the treasury route to the state health societies on the basis of the Programme Implementation Plans (PIPs) approved by the Government of India. Both RSBY and NUHM are centrallysponsored programmes with majority of funding from Government of India. The premium of RSBY is being shared between the Centre and the states in the ratio of 60:40, while in case of north-eastern states and three Himalayan states the premium is shared between the Centre and the States in the ratio of 90:10 respectively. In case of Union Territories, the premium is fully borne by the Government of India.
Special support has been provided to the states of Assam, Nagaland and Tripura through technical experts to enhance the capacity of the state machinery by this ministry with the support of German Development Cooperation, GIZ. Ministry officials are doing regular interactions for discussion on NUHM issues, such as finance and other operational issues. Orientation workshop on NHM/NUHM PIP Guidelines was conducted in January 2017 at Guwahati. NUHM workshop will be conducted shortly for sensitising state officials and urban local bodies. The Government of India always encourages the north-eastern states by extending support and hand holding for better implementation of the programmes.
ehealth.eletsonline.com | JUly 2017
POLICYMAKER’S perspective
Management (Ahmedabad) and The Advertising Standards Council of India (ASCI) with the support of Asian Development Bank (ADB).
18
POLICYMAKER’S perspective
Bolstering Growth of AYUSH Through Quality & Sustainability
Established in the year 2000 to look into the demand and supply of medicinal plants, policy making and conservation, the National Medicinal Plants Board under the Ministry of AYUSH has been playing a leading role in making India a global hub for traditional medicines by ensuring sustainable, quality and optimum quantity supply of the raw material to the burgeoning AYUSH industry, says Padmapriya Balakrishnan, Deputy Chief Executive Officer, National Medicinal Plants Board, in conversation with Gautam Debroy of Elets News Network (ENN).
Padmapriya Balakrishnan Deputy Chief Executive Officer National Medicinal Plants Board
Q
What are the key objectives of the National Medicinal Plants Board?
The main purpose of the National Medicinal Plants Board is to look after all the issues related to medicinal plants in the country. The board was set up under the Ministry of AYUSH (Ayurveda, Unani, Siddha and Homeopathy) with the objective to ensure that there is a sustainable, quality and optimum quantity supply
JUly 2017 | ehealth.eletsonline.com
of the raw material to the AYUSH industry. The board was set up in the year 2000 to look into the demand and supply of the medicinal plants, policy making and conservation of the medicinal plants, which are available in wild conditions. We also support cultivation of medicinal plants by offering subsidy to farmers with forward as well as backward linkages. We also undertake research activities related to the medicinal plants.
Q
With the government laying stress on AYUSH, what kind of promotional activities have you undertaken to increase popularity of medicinal plants in the country? Medicinal plants have been used in the treatment of many diseases since time immemorial. Even in modern medicine, we do not have cure for many of the illnesses like cancer or diabetes. Medicinal plants can be used effectively to cure
20
POLICYMAKER’S perspective
lifestyle diseases. Therefore, people need to be made aware about what kind of medicinal plants they can use in their day to day life to keep away many diseases. We have been doing promotional activities through seminars, workshops and training. Under the advice of Prime Minister’s Office, we started a 365 day campaign throughout the country in August last year. It includes special campaigns, seminars, workshops, trainings, etc.
Q
How do you encourage states to promote medicinal plants?
We have two schemes through which we promote medicinal plants. The first one is the central sector scheme and the second one is related to the cultivation of medicinal plants as a component under the National AYUSH Mission. Under the central sector scheme, we allocate projects for conservation of medicinal plants and research and development. We also provide funds to organise various activities at the state level to promote medicinal plants. We offer fund to state governments, research organisations, departments of the state government and NGOs to promote medicinal plants.
conservation) reserve inside the forest area. That particular patch of land will have high potential of medicinal plant diversity. For many species under extinction, we also promote tissue culture and propagate them on a large scale. We augment them in the forest area by carrying out plantation activities so that instead of one or two species we have more number of plants of that species in the forest.
Q
Since the Northeast India has huge potential for medicinal plants, is there any specific focus on this region to promote the same?
For cultivation of medicinal plants, we give subsidy to farmers. We have provided around 140 new species which are highly in demand and need to be cultivated on a large scale. We also give funds for nursery, marketing linkages, processing, storage, etc.
Around 10 per cent of our budget is dedicated for northeast. We spend specifically in northeast and also allocate funds over and above the budget for northeast. In partnership with the Ministry of Development of North Eastern Region, we have organised conferences and workshops to explore the potential of the northeast region. A lot of medicinal plants are naturally available in Northeast India and are being exploited in unsustainable way. So, we have to ensure that plants are exploited in a sustainable manner and people living in and around forest areas should be benefitted. Therefore, we have asked our state medicinal plant boards in the region to send us suitable project proposals that focus on livelihood of the people and ensure that the rich resources of Northeast India are utilised for the betterment of the people.
Q
Q
There are 60 to 70 ‘red-listed’ species of medicinal plants. These fall under the rare, endangered or threatened categories of species. To ensure that they are protected, we undertake surveys and create a 200-hectare of MPC (medicinal plant
In medicinal plants, there are many challenges because medicinal plants in itself is a big subject. There are 42,000 plant species available in our country of which 9,000 have medicinal value. When we assess the demand and supply, we find that there are more than 1,000
How do you ensure protection of endangered species of medicinal plants?
JUly 2017 | ehealth.eletsonline.com
What kind of challenges you face?
species that are being traded, of which more than 200 are traded in large quantities. Managing all these varieties is no mean task. Currently, the supply is majorly coming from forest areas. However, with the advent of Forest Dwellers Act [Scheduled Tribes and Other Traditional Forest Dwellers (Recognition of Forest Rights) Act, 2006], it has become difficult to control the produce that is being extracted from forests by the locals. Besides, we have also lost the opportunity to document that how much is being extracted from the forest. On the cultivation side, marketing, availability of quality planting material and grey market of medicinal plants pose a challenge. There are many varieties available to farmers, but since the market price of some of the species is very high majority of the farmers often cultivate only those species and then suddenly the prices of those species come crashing down. There are many ‘red species’ that are governed by various laws and regulations and their extraction is considered a crime. So, because of those particular species medicinal plants are secretly traded. We are trying to overcome these challenges.
Q
What potential do you see for AYUSH medicines in the current scenario?
AYUSH medicines have immense potential. The Central Council for Research in Ayurvedic Sciences (CCRAS) has recently come up with many prescriptions for diabetes, migrane, etc. It is part of our rich tradition that we need to reinvent. AYUSH medicines have been documented 5,000 years back. But for making people to accept the traditional healing techniques we need to conduct clinical trials to prove their efficacy.
22
POLICYMAKER’S perspective
AYUSH
Helping India Achieve its Health Goals With the government policy initiatives giving the AYUSH (Ayurveda, Unani, Siddha and Homeopathy) a shot in the arm, the traditional systems of medicine are set to be fully integrated with the healthcare service delivery system in India. Dr DC Katoch, Advisor (Ayurveda), Ministry of AYUSH, Government of India, in conversation with Gautam Debroy of Elets News Network (ENN), talks about the various efforts being made to further push the growth of traditional methods of healing and increase their acceptance in public at large.
Dr DC
Katoch
Advisor (Ayurveda) Ministry of AYUSH Government of India
Q
Of late the Ministry of AYUSH is getting a lot of attention not only in India but also abroad. What initiatives have you taken to promote the traditional methods of healing? In November 2014, the Department of AYUSH was upgraded to the status of a full-fledged ministry. The big programme that has been launched by the government for the promotion of Indian systems of medicine is the National AYUSH Mission. Under this mission, we have launched various programmes related to the development of AYUSH sector, particularly for four
JUly 2017 | ehealth.eletsonline.com
things -- for vertical and horizontal strengthening of AYUSH services; to strengthen the drug quality control mechanism; development of AYUSH teaching institutions; and cultivation of the medicinal plants. These are the core activities that are supported through the National Ayush Mission to be implemented by the various states. This programme is aimed at the overall development of the AYUSH sector. Another important initiative that has been undertaken is to set up tertiary care apex institutions of AYUSH, like the All India Institute
of Ayurveda (AIIA). This project was under consideration for long and now it has been implemented and the institute has come up near the Apollo Hospital in Delhi. Although it is not fully operationalised yet, this will be the apex institute for referral of patients and also for the post graduate and post-doctoral research in the field of Ayurveda. It will also develop collaborations with foreign institutions. Similarly, we are also considering setting up All India Institute of Unani Medicine, yoga and All India Institute of Homeopathy. We already have the national institutions for these, but these institutions will have more focused approach towards developing the traditional systems of medicine. In the area of international cooperation, we are supporting establishment of AYUSH chairs in foreign universities. Since AYUSH has gone to different parts of the world, but there is the need of some scientific activity, creating awareness
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Recently, one Ayurveda chair was declared for a Russian university. A Unani chair has been established in the University of Western Cape in South Africa. Apart from that we have institute to institute MoUs at the international level. Because lot of people want to know about AYUSH, institutions associated with it, the courses being offered and treatment options for treatment of diseases, so for this purpose we have set up around 22 AYUSH information cells in our international missions. The hardcore scientific activities undertaken include development of AYUSH drugs for diseases like diabetes and other noncommunicable diseases, viral diseases like chikungunya, dengue, etc. Focus has also been on developing scientific base of AYUSH through institutions like Indian Council of Medical Research and All India Institute of Medical Sciences.
Q
How the domestic market for AYUSH is developing in India?
If you see the healthcare delivery infrastructure in the country, I think AYUSH has become an integral part of the system. We have more than 7,50,000 registered AYUSH practitioners in the country, around 26,000 government dispensaries, around 36,000 government AYUSH hospitals, 565 AYUSH colleges, and from these colleges more than 30,000 AYUSH doctors and around 3,000 post-graduate AYUSH doctors pass out every year.
If we look at the industry, around 8,867 licensed manufacturing units of AYUSH drugs are operational in the country.
Q
How is infrastructure being developed in the country to leverage AYUSH in delivering healthcare services? Earlier, we were working in isolation. But now we have started working in collaboration with the entire health sector. Under the National Health Mission, there is a strong strategy for mainstreaming of AYUSH. It means making the optimum use of AYUSH in the healthcare services. The AYUSH doctors are also being utilised for the implementation of the National Health Mission programmes to help achieve the health goals of the country, as also providing health services to the people. Around 60-65 per cent of the district hospitals in the country now also have AYUSH facilities. Around 18,000 Primary Health Centres and Community Health Centres also have AYUSH facilities. The vision is to grow the number of such facilities so that the patients have the option to get the treatment of their choice.
Q
What are the key challenges for mainstreaming of AYUSH?
The main challenge is to gain the acceptance of traditional systems of medicine among the people through evidence of efficacy and quality. We are seriously working on these issues. Now we have the Pharmacopoeia Commission of Indian Medicines and Homeopathy. These bodies are responsible for the development of standards of AYUSH drugs. More thrust has been given in this area. I think in near future, we will have the standards for all the drugs and ingredients which are used in
preparing the medicines. Quality control is also an important aspect because we cannot leave the drugs untested. So, for drug testing we now have laboratories in most of the states and we are supporting the states to strengthen their testing facilities. Even private laboratories can be recognised under the Drugs and Cosmetic Rules. Around 45 drug testing private labs have been included under the Drugs and Cosmetic Rules and they are acting just like public labs. To prove the safety of AYUSH drugs, lot of scientific work is being done through our schemes. We are providing support to the scientific institutions for validation of AYUSH drug safety and efficacy. This is the biggest task, as in our country despite 8,800 AYUSH drug manufacturing units the problem is that more than 80 per cent of these units are of medium and small scale. They don’t have the wherewithal to invest in R&D.
Q
What role the private players are playing in the development of AYUSH sector?
Through various schemes, we are providing support to private players. For example, we have a scheme for developing industry clusters. Under this scheme, 20-30 players can come together and set up enterprises with common facilities for drug storage, production, testing, certification etc. In the last few years, around 6-7 industry clusters have been developed in the country, such as in Amritsar, Bengaluru, Jaipur, Kerala, etc. Some more are coming up in various other parts of the country. We also have a scheme for developing AYUSH interventions in public health.
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POLICYMAKER’S perspective
about AYUSH, undertake R&D and help other countries to develop regulations, standards and put in place quality control mechanisms. We have established Ayurveda chairs in the University of West Indies, University of Debrecen, Hungary.
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POLICYMAKER’S perspective
Revamping Public Health
Services in India
Health services are witnessing a paradigm shift in India with the government making tremendous efforts to close the existing gaps in healthcare delivery. The Directorate of Health Services under the Ministry of Health and Family Welfare is at the forefront of this revolutionary change by making health services more inclusive and affordable for the poor through a number of initiatives, says Dr Jagdish Prasad, Director General Health Services, Directorate of Health Services, in conversation with Shivani Tyagi of Elets News Network (ENN).
Dr Jagdish Prasad
Director General Health Services Directorate of Health Services
Q
How is the Directorate of Health Services impacting the healthcare delivery in India?
The Directorate of Health Services is deeply impacting the healthcare delivery in the country. The directorate has played a vital role in the eradication of small pox, polio, yaws and kidney worm infestation. This all has been made possible by a robust health system. Even malaria, which was among the most threatening endemic diseases in India, is now on the verge of being eliminated in the country. We are also trying to eliminate leprosy at the
JUly 2017 | ehealth.eletsonline.com
district and block levels by 20182020. The Directorate not only implements health programmes, but also does the surveillance to find out the gaps, which can be filled by putting in place workforce and a proper monitoring system.
Q
What steps have been taken up by the government to provide affordable health services to citizens? Affordable healthcare can be provided in many ways. One of the
ways was the National Rural Health Mission started by the Government of India in 2005. It has brought down the maternal and infant mortality rate tremendously. It provides incentives to women to get their delivery done in government institutions free of cost. Other positive step in this direction is the provision of essential medicines. Under this programme, whatever money is required to purchase medicines by Primary Health Centres (PHCs) and district level hospitals to provide free drugs to the patients will be contributed by the Government of
26
POLICYMAKER’S perspective
India, so that the patients in public hospitals can get the essential drugs free of cost. Another initiative we have taken is the opening of affordable medicine outlets under the AMRIT (Affordable Medicines and Reliable Implants for Treatment) scheme in all the public hospitals. Recently, the National Health Insurance Policy has been launched for more than 40 million families. Under this policy, every family will be given Rs 1 lakh of insurance for getting treatments done. For elderly people, Rs 30,000 more will be given as insurance and they can get their treatment done in any hospitals either private or government. The package is fixed by the government so that it becomes affordable for the poorest of the poor people to receive treatment.
Q
Which initiatives by you are directed towards addressing the growing burden of noncommunicable diseases in India?
JUly 2017 | ehealth.eletsonline.com
Non-communicable diseases– especially cardio vascular diseases, diabetes, stroke and respiratory diseases—are causing more deaths than communicable diseases in India. Initially, we started a pilot project in 10 districts of the country to develop cardiac ICUs, scalding/cascading for blood sugar and hypertension. Then we started the project in 100 districts cascading for diabetes and hypertension. So far, we have screened about 60 million people including those above 30 years, pregnant women and those who have family history of coronary diseases, diabetes or hypertension. Recently, the Government of India has also launched screening for three cancers – the cervical cancer, breast cancer and ovarian cancer. The training of ASHA and ANMs has been started so that they can do the screening. Once any of the three most common cancers is suspected, the patients can be referred to a particular district hospital for diagnosis and treatment.
Another initiative we have taken is to eliminate rheumatic heart disease that is very common in our country. The Government of India has allocated Rs 120 crore to develop 20 state cancer hospitals in the country. The government has also provided Rs 45 crore to upgrade these hospitals. Rs 120 to 180 crore has been given to medical colleges to develop super specialties so that chronic noncommunicable diseases can be treated locally.
Q
What are the technical aspects of Generic Medicine Code and its implementation?
Generic is a chemical name, like crocine is a brand name and paracetamol is a genric drug. We need to understand that before any drug acts on the body, the chemical has to undergo a process so that it can become effective. It means that to reach the target cells, its concentration in the blood should reach a particular level for it to be effective. But presently, the generic
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Q
What is your vision to make healthcare more accessible and affordable for the citizens?
Availability of doctors is a big challenge, especially in rural areas. To ensure the availability of doctors, the government needs to develop infrastructure in Primary Health Centres (PHCs) and Community Health Centres (CHCs) in rural areas. Presently, the infrastructure of health centres is in a very bad shape. Although a lot of fund has been given to states under the National Rural Health Mission to strengthen the structure of health system public hospital, still it hasn’t come up to the level where it can be compared to any corporate facility. So, the important challenge is to develop
good infrastructure for quality health services. The second area we want to focus on is medical education. Anybody who wants to start a new medical college, they should first run a 300-bedded hospital and at least for the first three years the facility should be evaluated on the quality of services being offered.
Q
What are the technical challenges for implementation of the Clinical Establishment Act? How can these challenges be addressed? The idea is to regulate the whole system of hospitals. We don’t want to control corporate hospitals, but we want to regulate the system of treatment. The cost of treatment should be defined. Today, it is very hard to know how much a hospital is going to charge when a patient is discharged. So, it needs to be regulated. The Clinical Establishment Act will allow us to have standardisation for healthcare facilities. For example, after its implementation if a hospital boasts of a neuro clinic it will have to ensure that it has all the basic facilities in place. The act will not allow a hospital to display a board of neuro research centre when it does not have the facilities of research.
Affordable healthcare can be provided in many ways. One of the ways was the National Rural Health Mission started by the Government of India in 2005. It has brought down the maternal and infant mortality rate tremendously. It provides incentives to women to get their delivery done in government institutions free of cost.
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POLICYMAKER’S perspective
drugs made in the country are not doing the bio metric and bio efficacy tests which is a must. That is the reason why the Government of India has taken the decision that whosoever wants to manufacture generic drugs in the country they have to take bio metric and bio efficacy certification then only the generic drugs made by them can be accepted. We have this in our agenda that even retrospectively every generic drug manufacturer will have to have bio metric and bio efficacy certification and have to develop the system in three years otherwise they have to close their manufacturing unit.
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POLICYMAKER’S perspective
Aiming to Correct Imbalances In Quality Tertiary Healthcare AIIMS Raipur and AIIMS Bhopal have been established with an aim to correct regional imbalances in providing quality tertiary level healthcare in central India and impart medical education and training in under-served areas. Prof (Dr) Nitin Madhusudan Nagarkar, Director, AIIMS Raipur, with additional charge as the Director, AIIMS Bhopal, in conversation with Arpit Gupta of Elets News Network (ENN), highlights the key steps taken so far to improve the health delivery system and future growth plans.
Prof (Dr) Nitin M Nagarkar Director AIIMS Raipur & AIIMS Bhopal
Q
What are the key healthcare services offered by AIIMS Raipur and AIIMS Bhopal? How do you ensure quality of these services? AIIMS Raipur and AIIMS Bhopal are among the six All India Institutes of Medical Sciences established by the Ministry of Health and Family Welfare, Government of India, under the Pradhan Mantri Swasthya Suraksha
JUly 2017 | ehealth.eletsonline.com
Yojna (PMSSY). The initiative aims to correct regional imbalances in providing quality tertiary level healthcare in the country and attain self-sufficiency in graduate and postgraduate medical education and training in under-served areas of the country. AIIMS Raipur and AIIMS Bhopal offer healthcare services pertaining to all the broad specialities, both medical and surgical.
The hospital attached to the AIIMS Raipur has a multi-speciality OPD. The hospital’s current capacity is 400 beds, which is projected to expand to 960 in the near future. It also has functional state-of-the-art Operation Theatres (OTs). With the commissioning of all blocks of the hospital, the number of OTs is planned to be increased to 30. Surgeries – both major and minor –
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POLICYMAKER’S perspective
are being performed in the hospital on a routine basis. In fact, AIIMS Raipur also boasts of the first open heart surgery having been done among the six new AIIMS. The institute offers diagnostic services in pathology, microbiology, biochemistry and radiology. AIIMS Raipur has digital radiology unit, a mammography unit, an OPG (orthopantomogram)Â set-up, CT (computed tomography) scan and DSA (digital subtraction angiography). MRI (magnetic resonance imaging) is in the process of being installed and will be functional soon. Similarly, AIIMS Bhopal has the latest CT and MRI machines. All the laboratories have the latest and the best equipment. Patients coming to AIIMS Raipur and Bhopal can purchase medicines at a discounted price from the AMRIT (Affordable Medicines and Reliable Implants for Treatment) pharmacy located within the campus near the hospital building. The institutes also offer services in AYUSH systems of medicine. These services will complement the allopathic system of medicine offered to the patients.
Raipur includes excellence in medical education, training and research. The institute has an excellent central library spread over three floors covering about 15,000 sq ft floor area. The top floor of the library houses the state-of-the-art e-library and journal section. Around 5,000 medical and nursing books and about 500 books of general reading are available in the library. The institute subscribes to around 400 journals. The Wi-Fi internet facility is available on all three floors of the library. AIIMS Bhopal has an excellent library housed in a separate building. AIIMS Raipur provides robust infrastructure and a conducive atmosphere to facilitate research. Both institutes already have received permission for starting MD (Doctor of Medicine) and MS (Master of Surgery) courses in few specialities. More seats will be added with induction of faculty and expansion of infrastructure and services. MD/MS students will have mandatory hands on training in research methodology. The institutions will have their own PhD courses. Intramural seed grants are being given to faculty members on competitive basis.
Monitoring mechanisms are in place in every department and facility to ensure that quality is maintained in delivering healthcare services. Faculty members are encouraged to visit other places within the country and abroad so that the best facilities can be replicated and offered to the public of central India.
Q
AIIMS Delhi has emerged as the centre of excellence for medical learning and healthcare research in India, how do you plan to have high quality medical care and teachings along with focus on research? The mission statement of AIIMS
JUly 2017 | ehealth.eletsonline.com
AIIMS Raipur
Senior faculty members monitor these activities. Faculty research presentations are planned to be held once a month on rotational basis. Extra-mural research grants will be solicited and cross country research promoted. The institutes already have institute ethics committees to monitor and facilitate research. A Department of Biostatistics, Clinical Epidemiology and Clinical Research Secretariat will be established to facilitate all round research in all the departments. This department will proactively help the faculty and researchers to design research projects, research proformas, data analyses, maturation of research hypotheses, assistance in clinical and field trials and collaborations.
Q
Which innovations you seek to introduce in AIIMS Raipur and Bhopal to improve healthcare delivery? How is information technology bringing efficiency to your operations? AIIMS Raipur and Bhopal have introduced online registration and appointment facility for the benefit of patients. Patients can take appointments as per their convenience and spare themselves
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Telemedicine OPD services were started by AIIMS Raipur in collaboration with the CRPF on April 2, 2013. The services are being provided twice a week on every Monday and Thursday. This service specifically caters to the population in remote and inaccessible areas of Chhattisgarh, especially LWE (Left Wing Extremists) affected areas. Both these institutes have focussed on public health issues relevant to their geographic regions like malnutrition, sickle cell anaemia and head and neck cancers. The institutes strive to make all relevant information available to the general public on their websites. Plans are underway to introduce public lectures. Eminent speakers will be invited to talk on topics of public interest pertaining to health.
Q
Since its establishment in 2012, AIIMS Raipur’s bed strength has increased to almost 400 now, and by the end of this year it is expected to reach 960 beds. What are your future plans? The Standing Finance Committee (SFC) of the Institute has approved the setting up of a School of Public Health (SPH) under AIIMS, Raipur. Centres of Excellence for cardiac care, neurosciences, nephrology and oncology have already been approved by the Government of India to be developed in the hospital complex in Tatibandh. A Tribal Health Research Centre and a School of Tropical Medicine are also planned to be started in the future. With increasing infrastructure and induction of more staff the institute will require to add the available housing units in its residential campus at Kabir Nagar, Raipur. HSCC (India) Ltd. has been nominated to prepare DPR (detailed project report) for this housing project (phase – II) for 191 units for Rs 100 crore.
The Standing Finance Committee (SFC) of the Institute has approved the setting up of a School of Public Health (SPH) under AIIMS, Raipur. Centres of Excellence for cardiac care, neurosciences, nephrology and oncology have already been approved by the Government of India to be developed in the hospital complex in Tatibandh.
Q
Where is Indian healthcare system headed in view of the recent initiatives by the government and the industry?
AIIMS Bhopal
In the Union Budget 2017-18, the overall health budget has been increased to 2.27 per cent of the total Budget. In addition, the Government of India has brought down the prices of various implants and is pushing for prescription of generic drugs. The government is also encouraging the healthcare industry to produce equipment, infrastructure, implants, etc. locally under its ‘Make in India’ campaign. These and other initiatives of the government ensure that the rising cost does not become a stumbling block for availing quality healthcare services by the common man.
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POLICYMAKER’S perspective
the difficulty of having to stand in long queues. The institutes have also started preparing and maintaining electronic health records of the patients, thus making retrieval and referral just a few clicks away.
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Healthcare Innovations
e-Hospital:
Infusing Efficiency in Public
Health System Uttar Pradesh’s healthcare system has taken a big leap by using Information and Communications (ICT) technology to infuse a new vigour into the government hospital network across the state. The e-Hospital project developed by the National Informatics Centre is set to take the service delivery in the state-run hospitals to a completely new level, writes Arpit Gupta of Elets News Network (ENN).
U
ttar Pradesh is in the process of developing an Integrated Health Information Platform (IHIP) under the guidance of Ministry of Health and Family Welfare, Government of India. Electronic Health Record (EHR) is the key to develop IHIP. The National Informatics Centre has developed e-Hospital which is being implemented in 30 district level hospitals of the state in two phases. In the first phase, three hospitals of Lucknow were selected for the e-Hospital project implementation. E-hospital has been functional at Ram Manohar Lohia Hospital since April 17, 2017 and at Shyama Prasad Mukherji (Civil) Hospital since May 1, 2017. The Balrampur Hospital in the state capital is also likely to start using e-Hospital very shortly. Initially the online registration system, out-patient department, in-patient department, billing
July 2017 | ehealth.eletsonline.com
and e-blood bank modules of the e-Hospital project have been operationalised. The State has requested the Government of India to add diagnostic and clinical modules too in the software so that complete information of patient is captured in the EHR. It is expected that by the end of July 2017 all modules will be fully operational. Apart from the three Lucknow
hospitals, the process of integration of 27 hospitals of UP on e-Hospital portal has been initiated. It is expected that by the end of October 2017, these hospitals will start using e-Hospital software. The 27 hospitals of the State that have been included in the project include district hospitals of Agra, Azamgarh, Bareilly, Basti, Faizabad, Gonda, Gorakhpur, Jhansi, Mirzapur, Banda, Etawah, Moradabad and TB Sapru Hospital-
34
Healthcare Innovations
(Left) Alok Kumar, Secretary, Health and Family Welfare Department, and Mission Director, National Health Mission, Uttar Pradesh, being falicitated for his achievements by Peeyush Kumar, Joint Secretary, DBT, Government of India, at the Smart City Summit Uttar Pradesh.
Allahabad, UHM Hospital-Kanpur Nagar, PL Sharma Hospital-Meerut, SBD District Hospital Saharanpur, Pt. Deen Dayal Upadhyaya District Combined Hospital-Aligarh, Pt. Malkhan Singh District HospitalAligarh, Manyavar Kanshi Ram Hospital-Kanpur Nagar, SSPG Division and District HospitalVaranasi, LBS Ramnagar HospitalVaranasi, Moti Lal Nehru District Hospital-Allahabad and LBRN Combined Hospital in Lucknow.
the e-Hospital system. Using the ‘MeraAspataal’ dash board, one can see what kind of services are being rendered by hospitals and if the patients are satisfied with the quality of services given by the hospitals.
Alok Kumar, Secretary, Health and Family Welfare Department, and Mission Director, National Health Mission, Uttar Pradesh said that ‘MeraAspataal’, which is a unique system to capture the patient feedback, will also be linked to the hospitals which will start using
Kumar also informed that Aadhaar number has been linked with the online registration system and now the facility of online registration is also available in RML and Civil hospitals. Separate counters have been provided for patients registered using ORS.
He added that the Ram Manohar Lohia Hospital and Shyama Prasad Mukherji Hospital have been linked with ‘MeraAspataal’ and very soon all hospitals will be linked to ‘MeraAspataal’.
As mobile phones have emerged as an affordable and convenient interface between the patient and the doctor, the government has decided to facilitate booking of doctors’ appointments on mobile phones in around 100 state-run hospitals in Uttar Pradesh. According to Union Minister of Law and Justice and Electronics and Information Technology Ravi Shankar Prasad, this and other facilities will soon be brought on the e-Hospital platform. “Uttar Pradesh, with the Centre’s help, will link 100 hospitals under the ‘e-Hospital’ scheme within the next six months,” he said recently. “The e-Hospital services will be made available, under which people can seek an appointment with doctors using their mobile phones. Around 100 government hospitals in the state will be brought on the platform of e-Hospital in the next six months,” Prasad said. This will prove to be a game changer as given the deep penetration of mobile phones in the state, healthcare will be easily accessible for millions of people across the state and the health delivery can be made more efficient.
July 2017 | ehealth.eletsonline.com
36
industry perspective
PSRI Hospital
Where Quality Health Services is Way of Life Pushpawati Singhania Hospital and Research Institute (PSRI) in Delhi is known for its state-of-the-art facilities in medical and surgical disciplines. Ethics in clinical practice and patientfriendly work culture are high on the agenda of the institute in all its plannings and activities, which makes it a preferred choice for patients and employees, says Dr Dipak Shukla, CEO, PSRI.
Dr Dipak Shukla
CEO, PSRI Hospital
P
SRI Hospital is a nationally and internationally reputed tertiary healthcare institution promoted by JK Organisation. The institute started functioning in 1996 with the super specialities of gastroenterology, GI surgery, nephrology and urology including kidney transplant surgeries. In due course of time, specialities of general medicine, general surgery, gynaecology, ENT, psychiatry and clinical psychology, etc., were added. Recently, institute has added
JUly 2017 | ehealth.eletsonline.com
cardiac sciences, neurosciences, orthopaedic and joint replacement and liver transplant programme as the new four super specialities to the institute. With this addition, PSRI has grown to become a 204bed capacity hospital, including 42 beds for critical care and eight beds for emergency. As such, institute is known for its state-of-the-art facilities in medical and surgical disciplines and is situated in the serene ambience of South Delhi. It has a lot of lush-
green surroundings for soothing and early repercussion of patients. Ethics in clinical practice and patient-friendly work culture are high on the agenda of PSRI in all its plannings and activities. The institute is also known for exceptional employee-friendly work culture. Many employee welfare activities are an integral part of the activity calendar of the institute. There is a structured system for periodical assessment of work performance of employees at all levels and to
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industry perspective
develop purposeful class leadership. Best employees are identified and awarded on quarterly basis at all levels. This approach has been very effective in employee motivation, employee retention and minimum employee turnover in all the categories, including nurses. Since inception of the institute, there has been a thrust on regular professional and academic activities as a whole and for the doctors as well as the nurses in all the departments in particular. PSRI has a wonderful well-equipped library to aid teaching and training programmes for post-doctoral teaching, for which the institute is recognised by the National Board of Examination. PSRI is fortunate to have internationally known clinicians and teachers in the chosen specialities of the institute, who have been the driving force behind the high quality academic activities and research at the institute. The institute has a provision of financial grants for the exceptional performers in their research activities and that too if they have publication of their research work in international journals of their speciality.
To promote research, a wellstructured research department headed by director research is in place. There is an advisory committee of the institute which is responsible to monitor and drive original research as well as clinical research in all the clinical departments of the institute. The institute has a proper and well defined ethics committee to approve and monitor various research projects which are presented before it from time to time. This research ethics committee has been constituted as per the ICMR guidelines. The institute also has a focus for the environment protection and energy conservation. Well planned water harvesting system, highly advanced and sophisticated sewage treatment plant and effluent treatment plant. Solar panels for hot water provision and the latest technology for energy conservation is an integral part of the hospital and support services. Patient satisfaction levels are quantified by 100 per cent confidential feedback of in-patients admitted to various categories of beds from time to time. Very focused
PSRI has a wonderful wellequipped library to aid teaching and training programmes for post-doctoral teaching, for which the institute is recognised by the National Board of Examination.
and personalised attention is given to the patients’ feedback for improving hospital services and enhancing patient satisfaction. On account of very high patient satisfaction levels, patients come from far and wide to PSRI. The institute has also been very sensitive for the health promotion of the nearby population through free health camps, health talks and various health awareness activities. In nutshell, it may be said that PSRI has been unique in developing highly ethical, professional and patient-friendly work culture as a tool for driving changes in the health care sector of Delhi and India as a whole. PSRI doctors and employees feel proud to be members of the PSRI family.
JUly 2017 | ehealth.eletsonline.com
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industry perspective
Healthcare Delivery
Undergoing Changes at All Levels The healthcare industry in India is gathering momentum with focus shifting on improving healthcare infrastructure, digitalisation of hospitals and policy interventions, leading to increase in efficiency of service delivery, writes Chander Shekhar Sibal, Executive Vice President, Fujifilm India.
Chander
Shekhar Sibal Executive Vice President, Fujifilm India
T
he healthcare market in India is growing at a rapid pace and the government hospitals and State governments through Private Public Partnerships (PPP) are trying to improve the healthcare infrastructure, including digitalisation of X-ray. Teleradiology and Picture Archiving and Communication System (PACS) are becoming necessity due to huge patient load and less number of doctors.
JUly 2017 | ehealth.eletsonline.com
The Goods and Services Tax (GST) is going to be a key enabler of making ‘one India one tax’ and this would lead to increase in efficiency and reduce wastage in supply chain management. Healthcare delivery in India is now uniquely composed to undergo a change at all its stages -- prevention, diagnosis, and treatment. Government is taking many steps towards improvement of healthcare sector by promoting routine and proper screening health education programmes in tier 2 and 3 cities. Our focus is on tier 2 and tier 3 cities and in the process of digitisation happening in the medical industry. Most of the time, the government projects are delayed which is a hurdle for us as we are going through PublicPrivate Partnerships. But I believe, with the help of GST we can be in a better position like transporting products within the country. This would also help in reducing the warehouse and transportation cost. Buyer wants faster services and new
technologies which give exceptional image quality at lower dose and enhancing efficiency of point of care x-rays. In this era of digitisation, the quality of workflow is getting better; and the efficiency of people is increasing in the hospitals. With the help of technological advancement, doctors are able to manage workflow systems and are able to treat more patients. Healthcare is reaching to tier 3 cities and capturing villages where various screening programmes are being initiated by the government for healthy India. Recently, the government has also come up with a new policy where preventive healthcare is very important. It’s better to be healthier than falling sick as that expenditure is huge. We need to focus on hospitals expenditure to be more equipped with better technology. Digitisation is the trend and it will go further, better quality equipment would bring more work flow, which will bring better quality, workflow.
www.skydomedesigns.com
42
industry perspective
Manipal Hospitals Dwarka: Seeking Excellence in Healthcare
Guided by the belief and triad of core values of clinical excellence, patient centricity and ethical practices, Manipal Hospitals-Dwarka in Delhi, which is due to launch and go live by October 2017, seeks to become one of the best and most trusted healthcare providers in the country, says Prof Dr Sanjeev Bagai, Director and Dean, Manipal Hospitals-Dwarka, New Delhi.
Prof Dr Sanjeev Bagai
Director and Dean Manipal Hospitals-Dwarka, New Delhi
Q
What are the key healthcare services offered by your hospital? How do you ensure quality? Manipal Hospitals-Dwarka is part of the Manipal Education and Medical Group (MEMG), a pioneer in the field of education and healthcare delivery in India. The 480-bed hospital with as many as 40 specialities and 75 superspecialities, is due to launch and go live by October 2017. The hospital will have centres of excellence in all major departments including cardiac sciences, orthopedics and joints, neurology sciences, critical care, gastroentrology, GI surgery , oncology medicine, radiation oncology, onco surgery, general surgery, minimal invasive lap surgery, renal sciences, urology, renal transplant, liver transplant, plastic surgery, ENT, ophthalmology, reconstructive surgery, women and
JUly 2017 | ehealth.eletsonline.com
children care, pediatric intensive care unit, neonatal intensive care unit, etc. We seek to achieve clinical excellence through an excellent team of doctors, medical specialists who are well versed with the latest advancements in their respective field of medical expertise.
Q
How is Information Technology bringing efficiency to your operations?
We have a sharp focus on digital smart technology in order to achieve excellence in patient care, ensure best clinical outcomes, operative excellence, invasive smart marketing, building management systems, etc. Clearly, this institution is years ahead of its time when it comes to adopting technology, artificial intelligence, VT, tracking, electronic medical records, real time data analytics, digital operation theatres, etc.
Q
Which innovations you seek to introduce in your hospital to improve healthcare delivery to patients? Clinical real-time technology, data analytics, digital online registration systems etc, are some of the key innovations we plan to introduce in Manipal Hospital-Dwarka.
Q
Where is Indian healthcare system headed in view of the recent initiatives by the government and the industry? These are exciting times for Indian healthcare. Collaborations, telemedicine, international medical tourism, etc are all unifying our world. In near future, I see e-health becoming the real focus for attaining excellence in healthcare delivery and making it more affordable and inclusive.
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44
POLICYMAKER’S perspective
NABH
Ensuring Quality Health Services in India Entrusted with maintaining the basic level of quality of services in hospitals, the National Accreditation Board for Hospitals and Healthcare has come up with a number of new initiatives to develop a robust healthcare delivery system in the country. Dr BK Rana, Director, NABH Quality Council of India, highlights the quality standards and various compliance related challenges for hospitals in conversation with Elets News Network (ENN).
Dr BK Rana
Director, NABH Quality Council of India
Q
What are the new initiatives National Accreditation Board for Hospitals and Healthcare (NABH) has undertaken to ensure quality health services get delivered? Currently, NABH offers 15 different accreditation/certification programmes for a range of healthcare facilities. Under the new initiatives, pre-accreditation entry level certification programme was started to ensure a basic
JUly 2017 | ehealth.eletsonline.com
level of quality in hospitals. This programme is being used by those private hospitals offering cashless treatments for empanelment purpose. Insurance regulator IRDA (Insurance Regulatory and Development Authority) has mandated it. In addition, NABH has started an empanelment programme for medical value travel facilitators to ensure good services to patients coming from abroad. This programme is endorsed by the Ministry of Commerce,
Ministry of Tourism and Services Export Promotion Council. In the AYUSH (Ayurveda, Unani, Siddha and Homeopathy) sector, we have started accreditation programme for ‘Panchakarma’ daycare centres.
Q
What are the key accreditation standards have you fixed for AYUSH hospitals and wellness centres? We have five different set of standards under AYUSH to cover all the five streams. The second edition of these standards has put more focus on clinical care aspects. Structural requirement, which used to be a separate book in first edition, has been incorporated in second edition at appropriate places. The requirements of the standards shall have to be identified; evidenced by data gathered, analysed and interpreted with the aim of improving the quality system of a hospital. Wherever the word should is used, it is imperative that the organisation implement the same. Where the phrase can/
45
In general, the organisation will need to establish clear evidence backed by robust systems and data collection to prove that they are complying with the intent of the standards. These systems are as we say, defined, implemented, owned by the staff and finally provide objective evidence of compliance. Some of the key issues include: 1. Patient-related: Monitoring safety, treatment standards and quality of care. This would mean to effectively meet the expectation of patients and their families and associates. 2. Employee-related: Monitoring competence, on-going training, awareness of patient requirements and monitoring employee satisfaction. 3. Regulatory-related: Identifying, complying with and monitoring the effective implementation of legal, statutory and regulatory requirements which affect patient safety. 4. Organisation policies-related: Defining, promoting awareness of and ensuring implementation of the policies and procedures laid down by the organisation, amongst staff, patients and interested parties including visiting medical consultants. 5. NABH Standards-related: Identification of how the organisation meets the NABH standards and the objective elements. Where a part of an element, an element or a standard cannot be applied (for example,
related to emergency, surgical proceudres, laboratory services, radiological services, etc) in a particular organisation, adequate explanation and justification must be provided to NABH and its team of assessors to enable exclusion of applicability. In particular, it must be ensured that the intent of each chapter of standards is understood and applied.
Q
How do you ensure compliance by hospitals? What are the key challenges?
NABH accreditation is based on continuous improvement and monitoring. Certificate is valid for three years and there is a surveillance assessment in 15-17 months. In addition, there is a surprise check of one facility every month. Further, there may be additional surprise visits based on feedback from stakeholders. Continuous monitoring to ensure compliance and making hospitals to improve is a great challenge. Therefore, providing education and training opportunities are important for hospitals to excel.
Q
POLICYMAKER’S perspective
could/preferably is used the organisation would use its discretion and implement it according to the practicability of the proposed guidance.
How do you help hospitals to attain various quality standards set by NABH?
NABH accreditation is based on continuous improvement and monitoring. Certificate is valid for three years and there is a surveillance assessment in 15-17 months. In addition, there is a surprise check of one facility every month.
We organise various training programmes from time to time. These may include training on standards interpretation and implementation, medication management, infection prevention and control, documentation requirements, continuous quality improvement, etc. In addition, we also organise conclaves for accredited hospitals and awareness programmes for potential applicants.
ehealth.eletsonline.com | JUly 2017
46
industry perspective
IVH Enabling
an Integrated Tertiary Care Ecosystem India Virtual Hospital (IVH) is a tech-enabled integrated tertiary care ecosystem addressing the needs of Medical Travellers (domestic and international) looking for quality medical treatments in Indian hospitals and healthcare centres. A professional organisation with doctors, healthcare professionals, patient guides on board, IVH team is trained to support and help patients to manage their medical and surgical care away from home, says Swadeep Srivastava, Managing Partner & Founder, India Virtual Hospital, in an interview with Elets News Network (ENN).
Q
What are the challenges faced by Patients going for Tertiary Care Treatment?
There are numerous challenges faced by patients especially medical travellers (travelling to other city) when they are advised for procedures/ operations. They are not aware of the right treatment, right doctor, right hospital and right cost. Most of these queries are to get the right and credible information due to acute lack of trust on the existing referral system or any credible system to help them choose best of medical care. Every month, several patients go back home unsatisfied because of bad experience in their patient journey.
Q
How India Virtual Hospital is making a difference?
A medical traveller or his family member has to just call us at our health line number: 09999668-222, or visit our website www. IndiaVirtualHospital.com, to inform about their tertiary care treatment requirement. Thereafter, the IVH team takes over either through tele-consultation or the Patient
JUly 2017 | ehealth.eletsonline.com
“Information is power. IVH Patient Education Series strive to create an organised and professional process of ‘decision-making’ by empowering patients with right and relevant information in an unbiased and neutral way and facilitating them at every step for smooth and seamless patient care experience.” Rai Umraopati Ray Co-Founder & Lead, Patient Education, India Virtual Hospital “There are glaring gaps in the patient care services that leave patients & their care at a disadvantage leading to sub optimal services and low patient satisfaction level. The services of India Virtual Hospital are game changer in the healthcare industry of India as it empowers patients at every stage of the patient’s journey. The whole objective of IVH is to provide seamless and smooth experience to patient and its family members, right from the diagnosis to treatment to follow-up stage.” Dr Ravi Prakash Medical Advisor, India Virtual Hospital “IVH has a robust technology along with a state-of-art specially designed Hybrid Mobile App which comes with Dual Interface, one for the Channel Partners/ IVH Patient Care Partners and the second one for the Patients & their Families.” Gaurav Pandey Co-Founder & Lead, IT & Technology, India Virtual Hospital
Swadeep
Srivastava
Managing Partner & Founder India Virtual Hospital
Care Champion (PCC) enrolled under our Expanded Patient Care Programme who works as a caregiver to patients in their city. IVH PCP is backed by our robust module of ‘patient education’ and counselling programme run by our in-house doctors and patient counsellors.
Q
How do you decide on the treatment cost and quality of services to be offered to a patient? IVH has a policy to negotiate best with the tertiary care super-specialist hospitals of all categories and offer transparent costing to its consumers. Since, our module is neutral so the patients can make their own choice to select what suits them the best. IVH only plays the role of an expert advisor.
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48
industry perspective
Indogulf Hospital
Closing the Quality Gaps in Global Healthcare With an aim to serve the needy, Dr S Kumar is building 200-bedded hospital with all diagnostic services including catheterisation laboratory, blood bank and paramedical teaching institute in Conakry, the capital and largest city of Guinea in West Africa. He is also planning to have diagnostic and nursing homes in the surrounding countries. In a conversation with Gautam Debroy of Elets News Networks (ENN), the Managing Director of the Indogulf Hospital, tells about his future plans and ongoing projects. Excerpts:
Dr S Kumar Managing Director Indogulf Hospital
Q
The Indogulf Hospital is recognised as one of the best hospitals in the National Capital Region (NCR), what are your key specialties? The Indogulf Hospital started diagnostic services in the year 2002 and was the first one to start diagnostics in Noida, Uttar Pradesh. Seven years ago, the hospital started
JUly 2017 | ehealth.eletsonline.com
the indoor facility. We are providing quality healthcare services and ours is the best rated medium sized hospital in the region. We are providing specialised services in neurology, obstetrics and gynecology and orthopedics.
Q
The hospital has made its presence globally with a centre in Guinea. Tell us more about it.
Most of the countries in Africa are still under developed. The quality of medical facilities being offered is very poor and the patients have to travel to other countries for quality medical treatment. I am building a 200-bedded hospital in Conakry with all the diagnostic services including catheterisation laboratory, blood bank and paramedical teaching institute. It is one of a kind hospital in
49
Q
The First Lady of Sierra Leone, Sia Nyama Koroma, recently visited your hospital in Noida. What was the result of her visit? The First Lady of Sierra Leone, Sia Nyama Koroma, visited the Indogulf Hospital in Noida on our invitation. She is very keen to develop a chain of maternity centres and schools in her country. The First Lady was accompanied by Madam Rahman Madina, Deputy Health Minister of Sierra Leone and other delegates. They came here to have first hand information on developing medical and educational
institutes. The aim of her visit was also to meet prospective investors for Sierra Leone particularly in sectors like health, education, agriculture and hospitality services. She visited Indogulf Hospital, as it has developed its brand identity as the provider of quality medical services to the rich as well as poor of the society.
Q
What are the future plans of Indogulf Hospital?
Yes, in the times to come I do plan diagnostic and nursing homes in the countries surrounding Guinea. But for now, I am concentrating on Sierra Leone. Sierra Leone is one of the Commonwealth countries. Dr Ernest Bai Koroma is the President
of Republic of Sierra Leone and he has initiated the country on the path of development. His vision and mission is to work for the upliftment of his country with the help of international support. Sierra Leone needs serious medical attention. The country has already successfully put up a fight against Ebola virus. Building hospital in Sierra Leone will definitely serve the people of neighbouring countries as well.
Q
What do you think about the present healthcare system in India?
The healthcare system in India is rated as one of the best in the world. There is a tremendous medical tourism potential in India because of affordable cost of treatment and quality services almost at par with developed countries.
ehealth.eletsonline.com | JUly 2017
industry perspective
Guinea and other nearby countries. I am grateful to Prof Alpha Conde, President, Republic of Guinea, who helped me to implement the project.
The First Lady of Sierra Leone, Sia Nyama Koroma, visited the Indogulf Hospital in Noida on our invitation. She is very keen to develop a chain of maternity centres and schools in her country.
50
industry perspective
New Horizons of Growth for Indian Health Startups
The National Health Policy 2017 is a positive step towards the overall growth of the healthcare sector. With the government planning to spend 2.5 per cent of the GDP on healthcare, Indian health startups are set to reap huge benefits from this policy initiative, says Krishnamurthy Ramalingam, CEO & MD, Galactic Medical DataBank Private Limited, in conversation with Elets News Network (ENN).
Krishnamurthy Ramalingam CEO & MD Galactic Medical DataBank Private Limited
Q
How has been the Indian startup ecosystem evolving recently? What are the key challenges for its growth?
colleges, startup innovation cells at management colleges, and private players providing startup ecosystems at nominal costs, etc.
The Indian startup ecosystem is growing faster than in any other country, thanks to the encouragement by the government (both Central and State), their policies, technology business incubations in engineering
The key challenges for the startups are:
JUly 2017 | ehealth.eletsonline.com
• Government’s policies should be focused on job generation rather than innovations to facilitate
emergence of startups that can provide more employment opportunities. Startup India Portal (startupindia.gov.in) is a very good initiative. But startups are struggling to get registered on it and get approval due to stringent process of getting Innovation certificate, Funding certificate, etc. It should be simple like “Make in Germany” initiative that allows
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Company Details: Galactic Medical Data Bank Technologies is a upcoming Global Leader in Consulting, Technology and Outsourcing Solution. We help enterprises through strategic consulting, operational leadership, and the cocreation of breakthrough solutions, including those in Mobility, Sustainability, Big Data, and Cloud Computing. Galactic Medical DataBank Technologies is currently focusing on Patient Engagement with an Innovative Product and Solution codenamed as “GMDCLOUD”, which involved Cloud Computing, Mobility, Big Data & Analytics. Galactic Medical DataBank Technologies is a Member with Healthcare Information Management Systems Society (HIMSS), member of American Health Insurance Plan & active member of Project Management Institute, USA For more details please visit www.gmdbcloud.com SJCE-STEP, JSS Campus, Manasagangothri, Reg Office - 80, 2ndInstitutions Cross, Mahadeshwara Layout, VijayanagarMysore 2nd Stage, Mysore - 570016 Corp 131/B, 1st Cross, SBM Main Road, Vanivilas Layout, Vijayanagar 2nd Stage, Mysore - 570017 EmailOffice us at:- rkmurthy318@gmdbcloud.co.in Contact us @: +91 98804-33750 , +91 72593-76020 Email : rkmurthy318@gmdbcloud.co.in website: www.gmdbcloud.com
52
industry perspective
•
•
•
•
•
anyone to start a company and get the benefits as long as it generates jobs. Startups should be given grants to implement their solutions at government institutions as proof of concept so that the latest technologies are available at government institutions. Government can facilitate strategic partnerships between startups and multinational companies in all government projects. Government procurement policy should include startups in strategic partnership with MNCs. Government should encourage startups in conferences and exhibitions by providing 100 per cent discount for space, delegate passes, and to pitch their products at national and international level. Policy makers should involve startup representatives in their decision making processes so that their problems are addressed.
Q
How recent policy initiatives like National Health Policy are impacting healthcare startups in India? The National Health Policy 2017 is a very positive step with progressive goals set across all areas of healthcare sector. As the government plans to spend 2.5 per cent of the GDP on healthcare, health startups are set to reap benefits from it, provided they are supported in these ways: • Private players, NGOs and nonprofit organisations are encouraged to run primary, secondary and tertiary health centres so that remote areas in north-eastern states and Union Territories like Andaman and Nicobar and Lakshadweep develop quality healthcare delivery system. • Free ecosystems are provided to startups to develop bio-medical devices, healthcare IT solutions,
JUly 2017 | ehealth.eletsonline.com
bio-pharma, organic farming, etc. • To offer health insurance to every citizen, like in Singapore, so that in case of emergencies the patients and their families do not go bankrupt due to financial constraint. • Yoga and meditation centres are run by non-profit organisations at every hospital, school, college, workplace, etc. • Government makes it mandatory for all hospitals and clinics – both private and public – to go digital by 2020 by providing incentives like the way it was done in the US. • Policy to ensure that all government officials including MLAs, MPs, and ministers receive treatment from government hospitals only. • Making it mandatory that within 12 hours of receiving request from the patient, the healthcare provider should provide the entire medical history present with them to the patient. • Electronic medical record is made a legal record to boost digital health. • Telemedicine and tele-consultation encouraged at all levels. • Tele-education and CME credits should be made mandatory for yearly renewal of licenses of both nurses and physicians.
Q
What role is Information Technology (IT) playing in the growth of startups in healthcare space? Healthcare IT startups are trying to solve the problems faced by healthcare organisations using latest technologies and innovations. Efficiency and proficiency of healthcare providers are improved with the healthcare IT solutions by startups. Innovative, cost effective, qualitative and disruptive solutions are replacing the old legacy systems. Physical storage spaces
Healthcare IT startups are trying to solve the problems faced by healthcare organisations using latest technologies and innovations. Efficiency and proficiency of healthcare providers are improved with the healthcare IT solutions by startups.
for maintaining medical records are saved because of electronic medical record. Insurance claims and reimbursements have been made faster and convenient for claimants. Patients are able to get medicines at their doorsteps using e-medicine portals. Assisted health professionals services can be made available at home through portals which are really transforming the healthcare sector for elderly and palliative patients.
Q
Which areas in healthcare sector hold the potential for growth?
Health IT software and services, affordable medical devices, bio-pharma, medical insurance, healthcare services, pharmacy chains, diagnostics centres, homecare, etc are some of the areas for potential growth in India.
54
industry perspective
Axio Biosolutions Saving Lives Through Innovations
Axio Biosolutions Pvt Ltd is an ISO 13485 certified company with an experienced team focused on bringing high-impact medical products to market. Funded by Accel Partners, IDG Ventures India and Gujarat Venture Finance Ltd, Axio is currently present in 12 countries and is the only company in India to produce this kind of products. Chairman of the Board and CEO of Axio Biosolutions Leo S Mavely, shares his company’s USP, the market experience and future plans, in conversation with T. Radhakrishna of Elets News Network (ENN).
interventional cardiology/radiology) and Dental (dental dressing – stop oral bleeding, protect wound). The excerpts of the interview with its CEO:
Leo S Mavely
Chairman of the Board and CEO of Axio Biosolutions
A
xio Biosolutions Pvt Ltd is the first medi-tech company from India to design, develop and commercialise products for Emergency (emergency bleeding control, stop haemorrhage), Military (chitosan sponge for quick clot – haemostatic dressing), Vascular (vascular haemostatic dressing for
JUly 2017 | ehealth.eletsonline.com
Q
What is your USP and your promise to users?
Wounds cause suffering, pain, long hospital stays, morbidity and even death. Our promise to users is: Axio Products help stop bleeding for first 24 hours from the time applied. Our focus is stop bleeding Saves lives. We started on the premise that most of these are preventable. We demonstrated that it is possible. We believe in solving such primal issues through innovative use of technology. We invent and create such tech. We do not follow. We lead.
Q
Would you share about your products and organisation’s vision?
Axio Biosolutions currently offers four unique products catering to emergency, military, vascular and dental markets Emergency: Axiostat is a sterile, single-use, non-absorbable haemostatic dressing intended to be used for temporary control of bleeding wounds. It stops moderate to severe bleeding due to cuts, abrasions, lacerations, venous or arterial bleeding. The product can stop haemorrhage from actively bleeding vessels within minutes. It is ready to use and can be cut to suit different wound sizes. They can be delivered through a pool of blood and is simple to apply and remove by a non- medical first responder. Military: Axiostat Military variant MIL88 is designed to be used in battlefield conditions and comes in camouflaged, rugged metal pouch packing for easy carrying. It is
55
industry perspective
currently used by Defense Forces, Paramilitary Forces and Army across India, Middle East and Europe. MIL88 is capable of being folded and stuffed into deep wounds. MIL88 uses a.c.t. which is battlefield proven technology to achieve hemostasis in a easier and quicker way. The product and technology assists fprces to stop profuse bleeding caused due to on field calamities. Vascular: Cardiac patients are often at high-risk of uncontrolled bleeding due to the blood thinners that are administered prior to catheterisation procedures. Not any more. Axiostat Vascular dressing is proven to be a very effective and efficient means of stopping bleeding during Vascular procedures when compared to traditional compression methods that can take upto 30 minutes. Axiostat also eliminates the chances of rebleeding after achieving haemostasis in vascular procedures available in multiple sizes. V55, especially designed with measured thickness to stop heavy volume of blood during the interventional procedures. Dental: Axiostat Dental variant, specially designed to control severe bleeding during dental procedures. Often difficult to reach, dental bleeding can quickly become uncontrolled and unmanageable. Our smallest offering designed to optimally fit into the bleeding cavity.
Effective on oral mucosal tissue wounds. Fast action to control bleeding. Active on all sides. Protects wound area. Easy removal using water/saline. Vision of Axio is to develop affordable, high impact medical products that can solve unmet healthcare needs of emerging markets. Controlling life-threatening bleeding continues to be the major cause of death from traumatic injuries.
Q
Highlight your technologies used for making unique products?
Axiostat uses a.c.t (axio clotting technology) to control severe haemorrhage within minutes. a.c.t is based on a biopolymer platform that utilises cationic properties for medical applications. Process Innovation: Chitosan has been in use for medical application since beginning of 21st century. However, major challenges associated with chitosan based products are lack of consistency and presence of impurities. Axio uses a proprietary technology to filter, purify chitosan and result is end products without any variation in performance or safety features. Particularly Axio technology uses low polydispersity, high molecular weight raw material with a very pure, 100% chitosan,
quick-acting Haemostat. Axio products are constantly benchmarked with global harmonised standards and starting material, chitosan complies with the ASTM standard and are made in ISO 13485 approved facilities. Characterstics of Chitosan are Biocompatible; Bioadhesive; 100% Natural; 0% Protein; No exothermic reaction; and Easily broken down to glucosamine.
Q
How significant are your R&D, Manufacturing and Quality resources and practices?
R&D: Axio Biosolutions envisages a future where contemporary knowledge of biomaterials, medicine and engineering will be integrated in designing novel solutions to address the huge unmet need in management of trauma and chronicinfectious wounds. We are a deep science med-tech company with extensive R&D expertise in biomaterials. Our platform-based approach enables us to develop medical products that are engineered to enhance its efficacy even at higher scale. With such a vision, we introduced our first line of haemostatic products that are probably one of the best available trauma heamostats in the market today.
ehealth.eletsonline.com | JUly 2017
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industry perspective
Axio’s research philosophy is to translate the biomaterials research into real-world products and bring them to patients’ bedside at an affordable cost. Here, innovation is a daily practice as we explore unchartered territories in novel materials and technologies. The research & development team at Axio is developing novel solutions that are smarter, friendlier and quicker than the conventional products. Manufacturing Facility: Axio products are manufactured in ISO 13845 certified facility owned and operated by Axio. • State of the art manufacturing facility is located in Pharma Tech Park at Ahmedabad, Gujarat. • Custom built imported machinery with 75-80% automated processing. Minimal human intervention reducing handling errors. • 5,000 sq.ft cleanroom area built according to cGMP, FDA guidelines under Class 10000 manufacturing area. • Gamma sterilisation done terminally. Full traceability from finished product to raw material source. • All 3rd party vendors audited and qualified by EU notifying body. Axio is an equal opportunity employer with commitment to equal treatment of all employees without regard to race, origin, religion, gender, age, sexual orientation, physical or mental disability or other basis protected by law. Axio ensures and complies with environmental policies for manufacturing facility of medical devices. No hazardous, polluting effluents are discharged into the environment. Proper handling and disposal of industrial waste is in compliance with local law.
JUly 2017 | ehealth.eletsonline.com
Quality: We, at Axio, benchmark ourselves to global standards and follow appropriate regulatory guidelines in respective countries of operation. We follow a process that is based on a strong foundation of manufacturing quality standards, mutually beneficial relations with our customers, dealers and all professionals associated with us. • Audited and certified by European Notifying Body – Det Norske Veritas (DNV), Norway. • Dedicated In-house Quality R&D with specialized equipments for testing. • Expert QA and QC team who has undergone rigorous ISO 13485 internal auditor training programmes
Q
What promoted you to the idea of Axio Biosolutions in you?
In 2006, I came across an incident in which a bus badly injured a motorbiker in Delhi. He was profusely bleeding and I felt helpless to stop his bleeding. But I managed to take him to the hospital in time and he survived. I strongly felt the need of a product to stop high bleeding and save lives. I failed to come across something that could stop such a bleeding instantly. First responders only used gauze with high pressure, which is not enough for severe accident victims. Axio’s flagship product Axiostat is a ‘Smart Bandage’ that helps stop profuse bleeding within minutes. It is manufactured in their plant in Ahmedabad. I started Axio Biosolutions in Nirma Labs in 2008. It’s a start-up incubator to develop a product that can immediately stop bleeding and give a patient a few more hours and a chance to survive.
Funded by Accel Partners, IDG Ventures India and Gujarat Venture Finance Ltd, Axio Biosolutions is currently present in 12 countries and is the only company in India to produce this kind of unique products.
It is manufactured on a novel biomaterial platform, based on 100% chitosan — a natural biomaterial modied for medical application. The technology works on charge interactions between negatively charged blood components and positively charged Axiostat.
Q
What has been your market experience? What about your future plans?
Since our inception in 2008, our experience with Indian market is extremly encouraging. Today, we work with Indian Defence Units and we have presence in 12 International markets through country sales partners. We also work with top 100 hospital groups in India. We are focusing on increasing manufacturing capacity to 800,000 and 10,00,000 capacity units. Our future plans include: to bring out a next level of advanced first aid kits for automotive companies in India and globally where our products are part of the kits; expand our foot print globally; and bring out new products;
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Universal Hospitals Where Quality Matters
Accredited by Joint Commission International, the gold standard in global quality healthcare, and the winner of prestigious Sheikh Khalifa Excellence Award 2016 (SKEA), Universal Hospitals follows the principles of total quality management and continuous quality improvement, says Dr Shabeer Nellikode, Managing Director, Universal Hospitals, Abu Dhabi, in an interview with Elets News Network (ENN).
Dr Shabeer Nellikode
Managing Director Universal Hospitals, Abu Dhabi
Q
What are the key healthcare services offered by your hospital? How do you ensure quality?Â
Universal Hospitals offers multispecialty tertiary care with medical expertise and technological capabilities at its core. The key healthcare services being offered include minimal access surgery, aeronautical and aerospace medicine, specialty clinics, treatment for high risk and critical cases, complex surgeries, recurrent, reconstructive and revision surgeries, non-invasive treatment for RF Ablation of thyroid tumours, liver tumours, kidney tumours, beningn thyroid nodules, lung tumours, etc. The hospital also offers 24-hour emergency services, robotic pharmacy and advanced radiology services. We have a state-of-the-art laboratory and over 18 multispecialty departments with state-of-the-art facilities. Universal Hospital is accredited by Joint
Commission International, the gold standard in global quality healthcare and has also won the prestigious Sheikh Khalifa Excellence Award 2016 (SKEA 2016) for continuous improvement aimed at enhancing the competitiveness of the business sector in Abu Dhabi and the UAE. We work on the principles of total quality management and continuous quality improvement. We also empower patients and make them aware of their rights giving them a voice through complaints systems or patient satisfaction surveys, as well as publicising what patients can expect.
Q
How is Information Technology bringing efficiency to your operations?
Much like in any modern industry Information Technology is the critical back bone of the service delivery process. More so in the Healthcare space because no clinical decision can be made in real time if the right information is not available to the right care provider for the right patient in real time. Considering the importance of this we have taken the dual challenge of not only developing healthcare infrastructure but also developing Healthcare IT platform in house. Our EMR has been created from scratch by an internal team and
continues to get updated to current HIMSS standards on a daily basis. This has given us tremendous flexibility in modifying, shaping up business processes to meet changing regulatory needs. The recent announcement of shrinking the claim submission window to 24 hrs is such a regulatory shift. Because of our in house IT system we were able to meet this target without any major shift in business. Further this gives us the flexibility to evolve to accommodate newer diagnostic modalities, newer care processes with seamless flexibility. We have also gone ahead and developed our own ERP back bone with helps in business process restructuring to bring in lean principles in procurement and continuous quality improvement.
Q
Which innovations you seek to introduce in your hospital to improve healthcare delivery to patients? Dedicating beds for end-of-life patients within a hospice inpatient unit, smart rehabilitation at home before and after surgery, post-operative pathways to meet individual need, patient centric approach to health and social care integration and adoption of robotic technology to improve patient car are some of the areas we are working on to improve healthcare delivery to patients.
ehealth.eletsonline.com | JUly 2017
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Complete IT Solution for Healthcare Industry Miracle healthcare solutions provides you the most advanced and powerful solution that makes the working of your Healthcare institutions seamless. This gives you the power of automation which enhances the operational eďŹƒciency, Patient satisfaction and serves you the beneďŹ ts in diverse ways.
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Posting Date: 20 & 25