eHealth Magazine July Issue 2018

ehealth.eletsonline.com the LARGEST PORTAL ON HEALTHCARE INNOVATIONS in Asia and the Middle East

the premier monthly magazine on the enterprise of healthcare in asia & the middle east volume 13 / issue 07 / JULY 2018 / ` 100 / US $10 / ISSN 0973-8959

Special Feature

INTERVIEWS

EHRs Key to Transform Healthcare Delivery in India

Conference Report ANDHRA PRADESH

HEALTH Visakhapatnam - 18-21 JUNE 2018

Dr Kevichusa Medikhru Mission Director National Health Mission, Nagaland

Vikram Thaploo

CEO Apollo Telehealth Services

DSN Murthy

MD & CEO Dhanush Infotech

Raju Venkatraman MD & CEO Medall Healthcare

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JUly 2018 | Volume 13 | Issue 07

COVER STORY

Emerging Technology Catapulting Healthcare Industry to Reach Extra Mile special feature

EHRs Key to Transform Healthcare Delivery in India

industry perspective 18 DSN Murthy

MD and CEO Dhanush Infotech Pvt Ltd

20 Vivek Tiwari

Founder and CEO Medikabazaar

22 Raju Venkatraman

12 state Perspective 14 Dr Kevichusa Medikhru

Mission Director National Health Mission (NHM), Nagaland

Hospital Perspective

Managing Director and CEO Medall Healthcare

24 Srinivasa Rao Paturi

Chairman & Managing Director eVaidya

34 Atantra Das Gupta

Director, Head-Health and Medical Equipments (CE) Samsung India

conference report

16 Shuvankar Pramanick

Chief Information Officer Sir Ganga Ram Hospital

Technology Perspective 26 Vikram Thaploo CEO Apollo Telehealth Services

30 Dr Kamal Verma

Director, Neurosurgery Asian Institute of Medical Sciences

32 Aravindan Selvaraj

Director, Sales and Marketing Aosta Software Technologies India Ltd

ANDHRA PRADESH

HEALTH 18-21, June 2018

Editorial Technology: A catalyst improving patient care Technology is fast influencing almost every aspect of our daily life. Healthcare being one of the most important aspects of life seems consistently deriving its benefit. What used to take days to be properly diagnosed, accessing it today could be just a video call away. Our latest issue of eHealth magazine thus focuses on emerging technologies and changing face of healthcare in India. These hold significance as they are helping the Government and the private sector to take health facilities to every nook and corner of the country. Our cover story ‘Emerging Technology Catapulting Healthcare Industry to Reach Extra Mile’ also highlights role of technology in healthcare industry. It mentions how technology has facilitated diagnostics, treatment, prevention, research, education and analytics. Our feature story ‘EHRs Key to Transform Healthcare Delivery in India’ examines how maintaining history of health records hold the potential to make a huge difference in setting up a proper model for healthcare services’ delivery. The magazine also carries interview of Dr Kevichusa Medikhru, Mission Director, National Health Mission (NHM), Nagaland, who talks about various healthcare initiatives in the State. We have insightful interviews of important industry leaders including Srinivasa Rao Paturi, Chairman and Managing Director, eVaidya; Raju Venkatraman, MD & CEO, Medall Healthcare; DSN Murthy, MD & CEO, Dhanush Infotech Pvt Ltd and Atantra Das Gupta, Director, Head-Health and Medical Equipments (CE), Samsung India. The latest edition also contains interview of Vikram Thaploo, CEO - Apollo Telehealth Services, where he shares information about telemedicine and its various applications to facilitate diagnosis process in rural areas. We have also carried a report of Andhra Pradesh Health Festival held from 18-21 June, 2018 in Visakhapatnam. Organised by Elets Technomedia along with Health Medical and Family Welfare Department, Government of Andhra Pradesh and Andhra Pradesh Medtech Zone, it comprised Health Datathon and Health Hackathon competition and a conference. The occasion was participated by various eminent personalities including Andhra Pradesh Chief Minister Nara Chandrababu Naidu, and the State’s Special Chief Secretary, Health Medical and Family Welfare Department Dr Poonam Malakondaiah; Advisor(Health) Dr Jitendar Sharma; Additional Secretary, Health (GoI) Arun Singhal; Ayushman Bharat CEO Indu Bhushanm and NITI Aayog’ Member Prof Vinod Paul. Representatives of International agencies including World Bank, World Health Organisation (WHO) and United Nations Development Programme (UNDP), also attended the Health Festival. With such a bouquet of articles, interview and feature story, we hope this edition will evoke an invaluable response from our esteemed readers.

Dr Ravi Gupta Editor-in-Chief, eHEALTH magazine & CEO, Elets Technomedia Pvt Ltd ravi.gupta@elets.in

cover Story

Emerging Technology Catapulting Healthcare Industry to Reach Extra Mile Technology has emerged as a major enabling force behind almost every sector’s development in the present times. When it comes to healthcare, the emerging technologies are proving to be a remarkable factor in benefitting the most sections of society or left out places, observes Mukul Kumar Mishra of Elets News Network (ENN).

oday, entire healthcare ecosystem seems embracing new technologies and is looking forward to modern technologies like automation, which is looked upon for leading to scalability, value based care and better medical outcomes. “Technology has always been a catalyst in healthcare service delivery and facilitated diagnostics, treatment, prevention, research, education and analytics,” says Raj Sehgal, Vice President International Sales, Dr Lal PathLabs Ltd. “In laboratory industry, be it new investigations launched, advances in equipment used, testing techniques, genomics, oncology or service delivery, everywhere the technological revolution is bringing better

july 2018

efficiencies, reduction in errors, improved quality and reduction in TAT(turnaround time).” “In international domain with regard to laboratory testing, the entire esoteric test outsourcing business is backed by I.T giving instant access to advance laboratories, patient registration, data transfers and quick reports,” he added. . Continuous technological developments in healthcare have saved countless lives and improved the quality of life. Not only has technology changed patients’ experiences and their families, but it also had a huge impact on medical processes and the practices of healthcare professionals. Technologies including Electronic Health Records (EHRs), telemedicine, cloud computing, IoT (Internet of

Things), artificial intelligence, and block chain, have played a pivotal role in improving the healthcare delivery. Nipun Goyal, Co-founder, Curofy says, “Internet of Things (IoT) and Artificial Intelligence (AI)-enabled technologies are some of the digital development in the healthcare sector and are truly making a difference in this sector.” “These technologies have the potential to radically revolutionise the entire healthcare industry. Collecting the data from various IoT devices and processing it to come up with automated solutions is where AI can truly change the way to look at healthcare today.” “The unprecedented increase in the number of patients and the serious dearth in the number of caregivers

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further the growth of telehealth and mHealth services, with more clinics and hospitals depending on technology to create new efficiencies, prevent readmissions, improve care coordination, and make care more convenient for patients. Cloud technology, that was instrumental in getting remote access to patients’ health records and information last year, will pick up pace in the coming years as well,” Pathak said. It is believed that the care delivery model in India is expected to shift focus from hospitals, clinics and a doctor-centric approach to a more patient satisfaction approach. “The influx of new tools and technology will continue to disrupt the healthcare space, and work towards improving patients’ safety while delivering the best health outcomes, in the near future,” he added. A look at some of the emerging healthcare technology trends help us to understand the kind of transformation that the healthcare sector is embracing or in the process of introducing in various facets of the healthcare delivery. Modern technologies tranforming healthcare landscape Cloud Technology Cloud is simply a new computing paradigm which makes it possible to access photos, videos or documents from any computer with an Internet connection. The internetbased computing technology uses a secure network of remote servers hosted online to store, manage, and process data which can be easily accessed by anyone sitting across the globe. The Cloud is an invaluable tool for medical research, as well as for sharing medical information. With the help of this web based computing technology entire healthcare system can be synchronised. Cloud helps every

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stakeholders of healthcare Industry including patients, hospitals, clinics, dispensaries, laboratories, doctors, pharmacist, medical consultants and counsellors to become part of a system and manage workflow. Information can be disseminated in easy manner and data can be analyzed in effective way with the help of this internet based technology. Experts believe this technology will play significant role in transforming healthcare Industry in coming years.

cover Story

have left the healthcare industry with no other option to come up with fast and effective digital solutions. Smart devices and robotics are making inroads to the healthcare sector and helping to drive the change, prevent illness and reshape healthcare,” Goyal added. He also said that these technology trends would continue to sweep the global healthcare industry by offering a range of innovative solutions to improve the patient care. Also, there is an observation that the vision of digital healthcare is changing consumer expectation and helping doctors and patients connect in a better and innovative ways. Some believe from providing medicine at the doorstep to data security to better access to knowledge and easy patient engagement tools, the IoT and AI are helping patients/ researches to move the big data hoards from repositories to real results. Amidst rise in non-communicable disease and people seeking quality medical care, health-tech market has grown many notches in recent years. Experts believe that latest technological solutions have potential to expand the horizon of healthcare ecosystem and these technologies will prove its worth in coming days. “With one in 20 searches on Google related to health, there is a growing awareness about health among people today. And they are not afraid to use digital channels to get answers to their health-related questions, feels Vipin Pathak, Cofounder and CEO of Care24 – a leading home healthcare player. “It is only logical, therefore, to expect the demand for trends such as tele-consultations or video consultations with medical experts to increase in the coming years.” The digital health market is also likely to grow, reaching an expected value worth $206 billion by 2020, with wireless and mobile solutions contributing the most. This will

Artificial Intelligence AI algorithms are able to bring out medical records, design treatment plans or create drugs way faster than any current actor on the healthcare palette including any medical professional. AI-enabled medical care plays the role of an informative assistant that enables doctors to gain an understanding of meaningful patterns from data collection and eventually can save a lot of time, effort and costs through easy access to unbiased, consistent, good-quality diagnosis and treatment. “The healthcare sector is slowly but gradually shifting to the use Artificial Intelligence or AI, because it promises to enhance disease management and patient outcomes through data analytics. The advent of chat bots, decision support systems and connected biosensors allows patients to share more data upfront, and systems to analyse data near instantaneously based on their meals, blood sugar or weight, Abhishek Shah, CEO, Wellthy Therapeutics believes. IoT Internet of Things has immense potential to give a new high to healthcare sector. It has numerous applications in healthcare, from remote monitoring to smart sensors and medical device integration. It has the potential to not only keep patients safe and healthy, but to improve how physicians deliver care

eHEALTH Magazine

July 2018

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as well. Healthcare IoT can also boost patient engagement and satisfaction by allowing patients to spend more time interacting with their doctors. Telemedicine The terms ‘telemedicine’ and ‘telehealth’ can be used to refer to two-way video consultations, or the transmission of healthcare data like electrocardiograms (ECGs). Telemedicine can be used in many fields, such as cardiovascular healthcare. Telehealth is improving allied healthcare jobs, including some of the top-paying roles in the field, such as medical assistants. The implementation of these telemedicine options mean less crowded waiting rooms and easing the pressure on front desk teams. Other benefits include shorter waiting times for patients, improved access for rural areas and improved efficiency leading to savings. “Telemedicine is very effective in removing distances gap across geographies and bringing primary healthcare and wellness services to doorstep of each individual which is the basis for Universal Health Coverage. It not only provides quality health services like tele-consultations of renowned doctors but also aids in health analytics and data management,” Vikram Thaploo, CEO-

july 2018

Telehealth, Apollo Hospitals said. mHealth Mobile health or ‘mhealth’ is the term used to refer to healthcare and medical information supported by mobile technology. Smartphones allow practitioners to complete tasks in remote locations. A physician can use their smartphone or tablet to access a patient’s Electronic Health records (EHRs), review medical histories, send follow-up emails, and even complete prescriptions. Improved communication aids the role of medical billers, allowing them to send text message alerts about payment schedules and outstanding bills. Mobile communication can also cut down on snail mail, paper use, and time spent on phone calls. There are many mobile apps which provide more high-quality services, and – at the same time – are cheaper for patients to access. mhealth apps are very useful in chronic care management, medication management, fitness and weight-loss, and managing personal health records. Healthcare trackers, wearables and sensors These are great devices to get to know more about ourselves and retake control over our own lives. Whether

influx of new tools and technology continue to disrupt the healthcare space, and work towards improving patients’ safety while delivering the best health outcomes, in the near future.

one wants to manage weight, stress level or keep tab on diseases like diabetes, these smart devices help a lot. People are eagerly adopting wearable technology such as FitBits to track fitness activities, blood pressure, sleep patterns and calories. Clinical and academic researchers studying diabetes, cardiovascular disease and sleep disorders are using wearables to monitor subjects and collect data. Though technology is playing a pivotal role in driving healthcare industry to extra mile, there are many shortcoming associated with the same. Over-dependence on the cloud introduces the risk of important information being unavailable in emergencies. If everything one needs is online (and there are connectivity or bandwidth problems), there could serious repercussions. The main concern rising from Cloud computing technology and increased mobile use is security and data protection. We lack trained manpower to handle these sophisticated equipment and medical devices. In addition, we need to improve infrastructure to leverage these technologies enabling better patient care. In nutshell, it can be said that if technology is harnessed prudently, it will prove to be a big boon to healthcare industry.

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eHEALTH Magazine

July 2018

Feature Story

EHRs Key to Transform Healthcare Delivery in India

As the country is expected to turn the most populated place on earth in a few years, the healthcare sector holds big significance. One of the most crucial things in this scenario can be Electronic Health Records (EHRs), writes Shashank Nautiyal of Elets News Network (ENN).

ooking at the existing state of affairs where a lot of innovations are happening across the country, especially in healthcare ecosystem, existence of a national EHR can make a big difference in healthcare services’ delivery It seems such a move is likely to take Indian healthcare many notches up by facilitating reliable, continuous and lifelong health record for every citizen and will help in realising the dream of Universal Health Coverage (UHC). Electronic Health Records market in India The healthcare industry in India has gone through a lot of transitions in terms of improvements and innovations in the last decade. The

july 2018

trend is expected to continue, as lots of new upgradations are still taking place in the industry. With this the patients’ requirements and expectations have also surged. It is so because of various reasons like better awareness and facility to approach and consult a number of medical experts with the help Internet or phone. Thus, a solution is required on both fronts to expedite healthcare process and delivery system. Of the various models or methodologies adopted to facilitate things on both fronts, the HER holds big promise for the Indian healthcare system. Understanding EHR EHR, a digital medical record of

a patients’ health information, contains all the medical information like medical history, progress reports, allergies or imaging reports. Sometimes, it may also contain data of demographics, insurance information, and related things. It also helps in hospital management and facilitates tackling of clients in an organised manner. EHR assists in achieving flawless coordination between everyone in the healthcare ecosystem and eases the healthcare process in reducing costs and increases the revenue margin. EHR in India’s Perspective With a population of over 130 crore people, India is facing a challenge to make healthcare facility accessible to all sections of society. The technology

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Significance at a glance Big healthcare facilities which have implemented and integrated the EHR in the core processes of the hospitals are taking deriving various benefits from it. The EHR process, thus streamlined, blocks the revenue leaks across the entire chain. And the advantage of data accuracy and cost reduction also helps in administrative expenditure. With the integration of EHR, doctors are also able to treat patients with better care, precision and get

With the integration of EHR, doctors are also able to treat patients with better care, precision and get accurate data accessibility.

accurate data accessibility. The collection of clinical data at the point of care enhances the efficiency and improves the data quality. From the industrial point of view, the pharmaceutical companies and regulatory authorities use the collected data to improve the post-marketing surveillance (PMS) of drugs. As insurance companies can also get accurate data of patients through EHR, so the patients also receive better and timely reimbursements. In short, EHR reduces revenue leaks, increases patient satisfaction and increases the efficiency of the process through technology. Advantages As EHR contains the patients’ medical and treatment histories, an EHR system serves in going beyond standard clinical data collected in a provider’s office. It can be inclusive of a broader view of a patient’s care as well. What do EHRs contain? EHRs contain a patient’s medical history, diagnoses, medications, treatment plans, immunisation dates, allergies, radiology images, and laboratory and test results. The EHRs enable access to evidence-based tools that could be used by providers in taking decision about a patient’s care The EHRs can also automate and streamline provider workflow. Market Barriers for EHR Though EHR has positive outcomes, the adoption rate has been low. Only a few established brands in metro cities of India are using it. The various reasons behind this drastically low adoption rate include: • Lack of awareness of about the attributes of EHR is the largest barrier. This lack of awareness is existed from small to medium scale healthcare service providers. • Lack of urge among traditional doctors and healthcare facilities to become technologically smart. • Lack of urge in acceptance of the

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new product and acquaintance of information technology. • Lack of compatible technology in the market. • High implementation cost and which is beyond the reach of small and medium healthcare service providers. It would an additional burden on their financials and effect their other processes. • The process of implementation takes time, as EHR is being implemented in various modules, which can impede other workflows in hospital.

feature Story

is expected to help in a big way and make health facilities available to all in relatively easier and more accurate way. Also, with the help of huge task force of IT professionals, the healthcare sector can benefit a lot in various ways. They can play their part for the integration of technology in healthcare to solve the challenges of moving ahead in a comprehensive manner. In this light, EHR makes Recording, documenting, tracking and sharing of healthcare records easy and this data will help Insurance Providers, Researchers, and Pharmaceutical Industries. The fragmentation of records can easily be addressed by linking Aadhar’s UID numbers to patient’s EHRs.

EHR’s Scope in India While most of the developed countries have already integrated the model of EHR in their healthcare ecosystem, a section of healthcare brands have also shown interest and embraced it. In India also, many corporate healthcare brands have already integrated with EHR or have plans to integrate in immediate future for using it capturing patient’s data. Still, there is rarely an exchange of EHRs with the patients, as most of the times, it remains with the hospitals and only used for reference when the same patients visit again. In terms of numbers, there are many players have developed EHRs in India, still they have some sort of limitations, apart from advantages. In Indian context, there is need to accept some ground realities, like a limited number of people out of over 1 billion population is digitally literate. A large population resides in rural areas, where despite the vast presence of mobile phones, much needs to be done for spreading digital literacy to popularise it as an instrument of accessing healthcare services as well. In this view, India requires an EHR model that is user-friendly, easy to learn, can establish a safe interface and cost-affordable, so that all the healthcare facilities can integrate it with their processes.

eHEALTH Magazine

July 2018

State Perspective 14

Nagaland Making Concerted Efforts to Boost Healthcare Delivery A slew of measures have been taken in Nagaland under the National Health Mission (NHM) to make healthcare facilities more accessible and affordable to every single citizen of the State, says Dr Kevichusa Medikhru, Mission Director, National Health Mission (NHM), Nagaland, in conversation with Elets News Network (ENN).

How do you perceive healthcare scenario in Nagaland in terms of affordability and accessibility? Nagaland is the 16th State of India. However, due to limited resources, it is lagging behind other States of the country in most of the dimensions, including health. Despite the resource constrain, the State is trying its best to capitalise on the available resources which received a boost after National Health Mission (NHM) was implemented in the State in 2006. Through NHM, the gaps in the infrastructure, HR, equipment, etc., have all been rooted out to a certain extent. Still, in terms of affordability and accessibility, it is one of the States with high OOPE (out of pocket expenditure), which can be attributed to various factors like shortage of medicines, absenteeism of healthcare facilitators including nurses and doctors, delay in healthseeking behaviour, shortage of referral transport vehicle, high transportation cost due to difficult terrain and so on. Recently, to make healthcare more accessible, many health sub-centers have been set-up to deliver health services at the doorsteps. Existing health facilities have also been strengthened so that more people could access healthcare services in and

july 2018

around the area where they reside.

Tell us about the latest initiatives by the National Health Mission, Health & Family Welfare Department, Nagaland, to improve healthcare services delivery in the State. New initiatives which have been initiated in the State under NHM during the past few years are as follows: • Jan Aushadhi stores • Pradhan Mantri National Free Dialysis Programme and Free Diagnostic Services Initiatives • Electronic Vaccine Intelligence Network (eVIN) in collaboration with UNDP • Universal health checkup/Screening and management of NCDs and referrals • District hospital strengthening through the provision of specialists, equipment and other technical HR as per requirement • Provision of nutritional support to TB patients • Ayushman Bharat-wherein Health & Wellness Centres are being set-up in the sub centers and PHC (Primary Healthcare) • NHPM (National Health Protection Mission) which is now called

Dr Kevichusa Medikhru

Mission Director National Health Mission (NHM), Nagaland

PMRSSM (Pradhan Mantri Rashtriya Swasthya Suraksha Mission) will be rolled-out in the State very soon

Nagaland fares not so good in terms of key maternal and child healthcare indicators. What steps are being undertaken to improve the situation? It is true that Nagaland is faring badly in most of the key reproductive, maternal, newborn, child, and adolescent health (RMNCHA) plus indicators. However, if the indicators of the last 10 years are analysed, it will be observed that improvement and progress have been made in terms of most of the indicators, though much more needs to be done. Some of the steps undertaken to improve the scenario are as follows: 1. Adequate operational delivery points and FRUs (First

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comprehensive services. • Strengthening Referral Transport System to bridge the demand gap with expected outcome in reducing OOPE by beneficiaries. • Ensure and strengthen delivery of home-based care through quality training and orientation. • Initiate NCD screening activity for a comprehensive service delivery. • Honing skills of service providers through rollout and implementation of Dakshata programme and LaQshya. • Expanding the service package including locally endemic problems viz: HIV affected children. • Strengthening of MCTS, MDR, tracking of Anaemic Pregnant Women and introduction of CDR. • Expansion of service delivery through regular implementation of Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA).

What kind of challenges are you facing to implement Centre’s Ayushman Bharat National Health Protection Mission? The NHPM is now renamed as

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PMRSSM. Right now, enrollment process as per SECC data is going on. A few challenges that are being faced at the moment on the implementation front include poor internet connectivity wherein the data has to be downloaded from the portal. There are reports from the grassroots level that SECC data does not cover the entire BPL population of the State and for which genuine beneficiaries may be even left out.

State Perspective

Referral Unit): Initiating measures for starting institutional/safe delivery in strategically located health units, so that 100 per cent of DHCs, CHCs and all 24X7 PHCs and at least 20 per cent of SCs conducts institutional delivery to mitigate the problem of high home delivery. Operationalisation of 50 per cent of the existing health units conducting institutional delivery into fully functional delivery points conforming the Government of India criteria of delivery points. 2. Strengthen Village Health Nutrition Day and outreach activities for optimum service delivery with quality; coupled with comprehensive IEC/BCC activities: • Intensifying Village Health and Nutrition Day (VHND) so that every Village/Town/Habitat without a doctor will be accessible to comprehensive services under the supervision of a doctor at least once in a month. • Integrated approach of Mobile Medical Units (MMU) and Mobile ICTCs for delivery of

North Eastern states including Nagaland are facing a shortage of trained medical manpower. What is being planned on this front? To resolve the issues relating to shortage of trained medical manpower, the State has initiated the following strategies: • Optimising the efficiency of the available workforce by further integration and multi-tasking. • Positioning adequate human resource by rational deployment and creation of adequate critical posts. • Expedite the establishment of medical college to address the issue of acute manpower shortage and delivery of tertiary care. • Strengthening of nursing schools for quality skill development. • Upgrading PMTI to provide critical paramedical courses. • Expedite the functioning of the existing SHFWTC. • In-service skill development. • Selection of local resident candidate, particularly for undergoing ANM/ Paramedical Courses. • Incentive Schemes; facility-based group incentives. • Additional remuneration based on difficulty of health units across districts/blocks. • Provisioning PG study based on length of service and rural posting. • Vocation incentive for practicing multi-skilled doctors on LSAS and EmOC.

eHEALTH Magazine

July 2018

Hospital Perspective 16

At Sir Ganga Ram ― Latest Technology Augmenting Healthcare Delivery With the help of latest innovative solutions, we are providing affordable and cost efficient healthcare facilities to people. Out of huge number of people treated in OPD on a daily basis, 20-25 per cent are being provided the service free of cost, says Shuvankar Pramanick, Chief Information Officer, Sir Ganga Ram Hospital, in conversation with Elets News Network (ENN).

How has the hospital evolved in terms of technology and innovative solutions to become a leading healthcare provider? Our hospital is one of the top most hospitals in the private category and all the doctors and consultants have been working here from 30 to 32 years. They are eminent experts of the medical field. They always strive for innovative technology in terms of clinical procedures. Here, Information Technology (IT) is not only to facilitate the non-clinic operations, finance, back office, billing, inventory , but to help all the clinical modules like robotic surgery and telemedicine to enhance patient care. We have one of the best IT set-ups in India.

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Tell us something significant about your services in terms of quality, accessibility, and cost efficiency. Our healthcare facility is a very much affordable. In terms of our contribution to create healthy society, we extend our minimum cost healthcare facility to low income groups. Out of 6,000 people who are treated in OPD on a daily basis, 2,000 are being provided the services free of cost. Cost-affordability is always there in our hospital.

Digital tools like Artificial Intelligence driven devices and wearables/apps could be a game-changer for Indian healthcare industry. But we don’t have trained

Shuvankar Pramanick

Chief Information Officer Sir Ganga Ram Hospital

manpower to handle these devices. Being an expert, how do you analyse this? Artificial Intelligence (AI) has two parts, first one is hardcore clinical decision-making and the second is related with patients only. As far as clinical decision-making is concerned, it can be easily handled since experts are always available for the regular treatments. There are many applications on the AI part as well. It is also used extensively at Sir Ganga Ram in Radio Technology. For patients, we haven’t used AI directly yet, but it has been introduced through smart OPD. With availability of such kind of disruptive technology, patients can have all their digital data in their pocket.

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Hospital Perspective

As patients are more concerned about their health and want to be in constant touch with their consultants, we should implement AI for them.

How distinctly your hospital is catering healthcare services to the people at large vis-a-vis the market? From the cost perspective, we are charging quite low in comparison to other private healthcare providers. We are already an established player in terms of latest technology and catering patients very efficiently.

A few years ago a Smart OPD project was launched at Sir Ganga Ram hospital, tell us how is it helping you to manage the patients’ data? Smart OPD was launched two years back at Sir Ganga Ram. To get patients’ demographic data into their card, a basic structure of smart OPD was implemented at that time. Now it is helping us to incorporate all the patients’ records into the card. Through QR code, patients’ record can be accessed on a consultant’s phone. In a true manner, the Smart OPD has

So our data is secure and there is not even a remote possibility of data leak.

Information Technology (IT) is not only to facilitate the non-clinic operations, finance, back office, billing, inventory here, but also to help all the clinical modules like -- Robotic Surgery and Telemedicine.

been implemented from this year only.

Amidst growing cyber threats in the healthcare sector, what steps have been taken to ensure data security at your healthcare facility? The threat is always there but we have taken many internal measures to contain this. We are trying to handle patients’ data with much compliance.

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How do you rate Indian healthcare ecosystem in terms of technological advancement and innovations? Technology advancements have enriched Indian healthcare industry. With initiatives from the Government side, healthcare delivery has improved in an unprecedented manner. One can notice a lot of technological advancements at every stage of treatment, enhancing patient care.

Having smart OPD option and lots of data at the hospital, are you planning to implement EMR? We are basically following policy directed by National Accreditation Board for Hospitals (NABH), an accredited government body. It has certain rules and regulation on how to handle patients’ data. EMR is the most sensitive data, so obviously there are certain rules and regulation how to use it. We are focusing on Health Insurance Portability and Accountability Act (HIPAA) compliances as well.

eHEALTH Magazine

July 2018

Industry Perspective

Dhanush: Leveraging Telemedicine To Boost Primary Healthcare Dhanush has been focussing towards making innovations in public primary healthcare so that the vast majority of semi-urban and rural poor could access the benefits of the Government healthcare programmes, says DSN Murthy, MD and CEO, Dhanush Infotech Pvt Ltd in conversation with Gopi Krishna Arora of Elets News Network (ENN).

Dhanush InfoTech has been serving clients with its innovative healthcare solutions. How has been the journey? Dhanush’s journey of serving its customers with innovative and worldclass healthcare solutions started 10 years ago. We first experimented in the developing economies like Uganda, Kenya, Nigeria and entered in the Indian market six years back. Our focus has been towards making innovation in public primary healthcare so that the vast majority of semi-urban and rural poor will be able to access the benefits of the Government healthcare programmes. Our journey has been successful so far and the main reasons are: • Focus on Innovation • Passion towards service delivery • Adherence to the healthcare standards and process

You were primarily IT service provider which have recently changed track and focused more on technology-driven healthcare solutions. How did this transformation take place? Dhanush is a premium IT service provider with the two important verticals which were focused by Dhanush in the global market are—

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• Telecom • Healthcare Dhanush has foreseen the gap of medical doctors’ availability in the rural and semi-urban regions and invested in building the telemedicine solutions which bridges this gap successfully. Our innovative healthcare solutions leveraging telemedicine have been successfully adapted in emerging economies across the world, as our solutions have taken the practical constraints of those markets, like – • Restricted availability of Network / Bandwidth • Lack of trained manpower • Lack of power As solutions are designed by taking above constraints into consideration, thus Dhanush healthcare solutions are immensely successful in the regions of our operation including India.

What are the hallmarks of your services in terms of quality, technological advancement, and cost efficiency? Dhanush’s hallmark for service quality is based on achieving customer delight. Our efforts on technological advancement are focussed on improving the efficiency of the

DSN Murthy

MD and CEO, Dhanush Infotech Pvt Ltd

business operations. In terms of cost efficiency, we provide better process controls, improved insights into the data that can help to drive actionable decision-making. Our healthcare solutions are primarily working towards linking up patients’ data from various sources in public and private domain and building a longitudinal health record for citizens.

Tell us about Hospital Management Software solution, a Kit (a Digital Doc) and Anmol (a tablet for health workers). How do these facilitate patient care?

Hospital Management Software Solution Hospital Information Management System (HIMS) is innovative hospital operations management system

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A Kit (a Digital Doc) Telemedicine Kit (TM Kit) is an innovative solution designed especially for people in Uganda, where the operational and infrastructure issues, like lack of power and network connectivity along with unavailability of doctors for consultation have existed. The design of the Telemedicine Kit has been guided by UN agency and was built as per their stringent specifications and testing processes. Telemedicine kit carries various diagnostic devices like Digital Stethoscope, ECG, Digital Thermometer, Glucometer, Fetal Monitor, etc. By using the Telemedicine kit, a nurse will carry this equipment in a robustly built kit to the patient and connects the patient to the doctor through Telemedicine. The doctor can view, talk and review the vital parameters of the patient with the help of the nurse at the patient’s end. A doctor can issue an e-prescription and the entire transaction is recorded electronically. ANMOL ANMOL stands for Auxiliary Nurse Midwives Online, who do the fieldwork and are expected to carry manual records for data entry of beneficiaries who are pregnant/ expected/delivered mothers and infants. ANMOL comes with the full lifecycle of the RMNCH (reproductive, maternal, newborn, child, and adolescent health services)

like eligible couple, family planning, antenatal care (ANC), postnatal care (PNC) and child care. ANMOL is being extended for medical officer module, which can facilitate tele-consultation of the beneficiary at home with a medical doctor to address any emergency scenarios related to high-risk pregnancies.

Shed some light over your services like PACS (Picture Archiving and Communication System) and Radiology Information System (RIS). Please explain about these solutions. PACS and RIS is the latest technology model that enables radiology images to be reviewed by suitable Radiology experts remotely and provide annotations, comments, and diagnosis details.

Dhanush has been working to improve healthcare infrastructures in rural areas through primary healthcare centers and telemedicine services. What kind of challenges do you face? The challenges which are being faced by Dhanush with regards to healthcare infrastructure in rural areas are— • Network connectivity • Availability of power

How do you analyse Indian healthcare IT market in terms of opportunity and challenges? Healthcare IT market is immensely growing and it is interesting to see that Public and Private Sectors are competing for healthcare IT investments. Since last four years, the initiatives and technology adaption, promoted by the Government of India and other progressive States is very encouraging for the players in this market.

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Apart from IT solutions, what other domains of healthcare are you working upon?

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Our innovative healthcare solutions leveraging Telemedicine have been successfully adapted in emerging economies across the world.

Industry Perspective

software which takes care of end-toend services right from the registration to the patient discharge. It has various speciality modules like Ophthalmology, Cardiology, Gynecology, Orthopaedics, etc. The Solution has comprehensive coverage of Operation Theater (OT) management and pharmacy module and it is well appreciated by our customers globally for its wide range of features. Our HIMS is available both “On-premises” and “Software as a Service (SAAS) “models.

We are working on provisioning of primary healthcare services, which constitute doctor consultation, specialist doctor tele-consultation, diagnostic services and healthcare screening services along with ICT solutions in the healthcare field. Our focus is on innovations in primary healthcare segment to improve quality, affordability and accessibility.

Tell us about your expansion plan in coming years to cater people with new innovative solutions. Dhanush is planning to invest in new technologies which can help in conducting various diagnostic tests at an affordable cost. It is also investing in Telemedicine solutions which can operate at much lower bandwidths (At 2G). With its innovative solutions, the organisation plans to expand to all over India and working closely with Central Government and various State Governments. We are working with the African Government to extend the primary healthcare solutions to various emerging economies of Africa.

eHEALTH Magazine

July 2018

Industry Perspective 20

Why Hospitals and Medical Institutions Should Adopt eProcurement System? eProcurement, known as an online procurement system makes the procurement of supplies more flexible, transparent and a timely process. Online procurement sites are giving the customers an array of products to choose from along with a facility of viewing previous orders and the purchases, writes Vivek Tiwari, Founder and CEO, Medikabazaar.

ospitals, just like any other organisation, have different categories of costs and expenses. It ranges from paying the staff and doctors their salaries to their debt expenses. One of the biggest expenses which hospitals and medical institutions incur is procurement of medical supplies. In order to provide best possible medical services to patient at the most affordable prices, the hospitals need to purchase best equipment at such a price which doesnâ&#x20AC;&#x2122;t lead to high operational costs and indirectly results in high medical expenditure. Offline methods of procuring medical supplies, which are still in use, do not lead to the above results. There are massive limitations in this

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type of a supply process which neither benefit hospitals nor the patients. In an offline system, one of the pivotal problems, faced by the customers is the lack of information regarding products. In this system, customer (hospitals and medical institutions) has very limited options of gaining a deep and appropriate knowledge of the product before they make an informed decision about what to order and when to order. The customer also does not have any option to compare different brands of a similar product. A particular product is not only sold by one seller (manufacturer) in India. There are multiple vendors who are providing same product in different prices. An offline system makes it difficult for the customer to compare the

Vivek Tiwari

Founder and CEO, Medikabazaar

features, prices and other categories of the product and then choose which one to order. As hospitals mainly order their supplies in bulk, it is imperative that they compare prices of the supplies and then place their order in accordance with their budget. Geographical reach is another aspect where an offline procurement system does not work efficiently. In India, Tier-2, 3 cities and rural areas are in need of urgent and proper medical care. Hence, it is important that appropriate medical supplies reach the hospitals and that too on time. Due to an offline system, medical supplies, at times, takes an indefinite amount of time to reach the destination leading to unwanted occurrences in hospitals and healthcare centers. eProcurement, also known as an online procurement system can cut

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Industry Perspective

across all the above discrepancies and can make the procurement of supplies more flexible, transparent and a timely process. The Indian market has moved towards a more technological framework. Different types of businesses are moving towards an online platform to offer their services. They are no longer banking on the customer to come to them. On the contrary, they are trying to gain access to their customers on a more personal front by placing themselves on the screens of consumersâ&#x20AC;&#x2122; phones and laptops. The medical procurement industry is also gradually taking a similar road towards placing itself in the large and unending space of the internet. Online medical procurement sites like Medikabazaar has taken a massive leap towards the same and has become a pioneer in bridging the gap between medical supply manufacturers and the hospitals. Online procurement sites are giving the customers an array of products to choose from along with a facility of viewing previous orders and

the purchases which are already being processed. Such a facility allows the customer to take informed decisions and use their finances accordingly. As there are so many products available in the catalogue in online procurement sites, they provide the option of product comparison unlike the offline systems. The customer can see different brands of a particular product and again take a more knowledgeable decision. Unlike offline systems, the internet can cover vast distances and overcome geographical boundaries which can lead to successful and timely deliveries of medical supplies in Tier-2, 3 cities and rural areas. Online sites also have very powerful search engines where the customer can search for their required products. Orders placed through an online platform also lead to a reduced turnaround time with regards to any requested product and services. Most importantly, an online system allows the customer to place an order where the transactions are carried out securely and communications are

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made in easy manner. The whole supply chain process becomes more transparent. There is more efficiency and less disruption. The healthcare industry has adopted technology with a positive mindset. Both doctors and the patients are benefitting from this changing dynamics of the industry and there is no reason why the medical supply procurement industry should not take a piece of the pie. Companies like Medikabazaar have already made in roads in that direction. As technology is becoming more widespread among hospitals and medical institutions, their product and delivery expectations are also changing. They require more supplies in shorter delivery time. The medical procurement industry must transform with the changing times otherwise hospitals will keep on incurring massive operational costs and patient will continue to pay higher medical bills. (The writer is Founder and CEO, Medikabazaar. The views expressed are personal opinion.)

eHEALTH Magazine

July 2018

Industry Perspective 22

Innovative Solutions Helping Medall to Carve Niche Some of the challenges that the Indian diagnostics market is facing include a highly fragmented diagnostics market with over one lakh labs, limited availability of trained resources (pathologists and technicians), and non-adherence to quality standards (while government is keen to enforce standards like NABL & ISO certifications), says Raju Venkatraman, MD and CEO, Medall Healthcare, in conversation with Gopi Krishna Arora of Elets News Network (ENN).

Medall Healthcare, which is South India’s largest chain of medical diagnostic services, provides people best and costefficient diagnostic facilities. What distinguishes you from other stakeholders of this field? As Medall, we differentiate ourselves on multiple parameters as compared to other stakeholders. Some of them are: • Customer reach and ease of access: › Wide geographical presence in 8 states and 63 districts › 7,000+ customer touch points across India hence making it more accessible to the customers › Serve over 10 million customers performing 30 million tests • Integrated Diagnostics: Medall is the largest integrated diagnostics service provider and is also the fourth largest diagnostics player in India providing radiology and pathology services under one roof. Using the state-of-the-art technology, affordable services provide high level of clinical confidence to doctors and patients. • Strong clinical and experienced management team bring in years of rich experience in operations, process excellence, quality, IT and supply chain management. This empowers Medall to carry out large projects in a record time without compromising the quality.

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• Strong focus on quality: We have 8+ NABL accredited and 100+ ISO certified labs across India.

In the era of internet and technology, people usually have all the information about solutions and services. How do you strategise to cater people with best services in a cost efficient manner? To serve customers of all types, Medall has developed many clinical and technological innovations. Some of them are: • Online real-time portal to monitor the quality on a daily basis of all 175+ labs. • Web-enabled real-time digital dashboards for monitoring project performance metrics to customers. • Operations monitoring dashboard • Deployment of CMS to streamline the supply chain for all consumables and reagents • Digital reporting center helps us to centrally monitor and approve the reports on time • Mobile app for customers to access and monitor patients and their family’s health across the world

How do you analyse Indian diagnostic market in terms of opportunity and challenges? Indian diagnostic market is the fastest growing industry, also known as a

Raju Venkatraman

Managing Director and CEO Medall Healthcare

sunrise industry growing at 17-18 per cent every year. The industry size was approximately Rs 6,000 crore in 2017 and will touch Rs 1.35 lakh crore by 2025. Growing health awareness, rising income level and changing attitude towards preventive healthcare is expected to give a boost to healthcare industry in future. Highly fragmented diagnostics market with over one lakh labs, limited availability of trained resources (pathologists & technicians), non-adherence to quality standards (while government is keen to enforce standards like NABL & ISO certifications)are some of the industry challenges forcing the common man to compromise in terms of quality or price or sometimes even both.

Shed some light on latest innovative products introduced to enhance patient care? We believe the future of healthcare is in preventive care. With the increasing awareness, people have

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How do you anaylse Medall’s contribution to strengthen healthcare delivery process in India? Medall strongly believes that partnering with the Government is essential to reach out to poorer sections of the society. In accordance with this strategy, Medall is the first company to successfully execute two large PPPs in laboratory services across the states of Andhra Pradesh and Jharkhand, covering 25 districts in a record time of 90 days. This has helped us to serve over six crore people with the best of technology, quality and speed, which in-turn is reducing about Rs 700 crore of out-of-pocket expenses for the poor customers. This was possible also because of the support

and continuous feedback from the governments of the respective states. Our contribution to strengthen the healthcare delivery process through the district approach, covering 1,400+ hospitals in Andhra Pradesh and 110 hospitals in Jharkhand has made healthcare easily accessible and affordable.

How has been your association with the Government of Andhra Pradesh in healthcare domain? What kind of projects are you working on? Our association with the Andhra Pradesh government started in 2011 and continues till date. We implemented the radiology PPP in a record time of 30 days after winning the bid in association with IFC and GE. Through this project, we made high quality diagnostics available 24 x 7 at an affordable cost in teaching hospitals, also reducing the waiting time from two to three weeks to two to three hours. In 2015, we won the bid for Lab PPP across 13 districts of AP and the same was also executed in a record 90-day time period. Through this project we covered 40 area / district hospitals, 192 CHCs (Community Health Centres) and 1150 PHCs (Primary Health Centres). 105 labs were set-up and over 2,000 qualified

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professionals were deployed across the State. We have served over 1.2 crore people in last 28 months. Under the leadership of the Chief Minister, Special Chief Secretary, Advisor and other officials of Health Ministry, AP’s NTR VaidyaPariksha stands out as one of the most structured, well managed and implemented PPP projects in India. Through these projects, Medall has now become a trusted partner with the Government of Andhra Pradesh (AP) in healthcare diagnostics and we are proud to be associated with the Government of Andhra Pradesh.

Industry Perspective

become more proactive in getting a health check-up done for themselves and their families at least once in six months. One of the recent products Medall launched – SASH (Stay Aware Stay Healthy) caters to this section of the society, wherein an individual can know his/her Health Score. SASH is first of its kind health screening in the industry covering eight major systems including the vitals with 57 parameters at just Rs 640. It empowers healthy individuals to take proactive steps and lead a healthy life.

How do you rate Indian healthcare industry in terms of technology, innovations, accessibility and affordability? We feel that there is still a huge scope when it comes to technology, innovation and accessibility. With the use of automated analysers which can improve the Turn Around Time (TAT), Digital Reporting, Maintenance of Online Customer Health Records, Artificial Intelligence and Machine Learning and Data Mining in the healthcare industry, we see a great opportunity to increase availability, accessibility and affordability for the customers.

Tell us about your association with other State governments and future aspects? Apart from Andhra Pradesh (AP), Medall has been associated with the states of Karnataka, Tamil Nadu and Jharkhand for diagnostic services and we see that the governments have become more open to collaborate with different private partners. Increased allocation to the NRHM scheme and the National Health Policy of 2017 reinforces the point that both the central and state governments are focussing on various healthcare needs of the people. Healthcare has become a priority.

eHEALTH Magazine

July 2018

Industry Perspective 24

eVaidya: Improvising Rural Healthcare Delivery With eUPHCs like projects, eVaidya is leaving no stone unturned to provide affordable healthcare to rural population. The digital PHCs have ensured full time coverage of out-patient (OP) consultation, basic Lab tests and relevant medicines to be available at the vicinity, says Srinivasa Rao Paturi, Chairman and Managing Director, eVaidya, in conversation with Gopi Krishna Arora of Elets News Network (ENN).

eVaidya has taken a slew of initiatives to strengthen rural healthcare to the unreachables. Kindly share some of them. eVaidya aims at providing healthcare to all and thereby reduces distance and time to healthcare delivery. It began with setting up a virtual clinic in Kannagi Nagar, Chennai, which was widely affected by tsunami in 2014. The clinic used to be operated digitally by healthcare professionals stationed in Hyderabad. The initiative gathered a loud appreciation by IIT Chennai and municipal authorities of Chennai. The feather in the cap was the pilot project in collaboration with the Andhra Pradesh Government. Named as eUPHC, it was implemented in Vijaywada and Visakhapatnam. The project received lots of appreciation within the country and across the world as one of the best telemedicine models to be implemented so far. The Andhra Government further took a step ahead and converted all the UPHCs into eUPHCs and currently it runs these with the name of Mukhyamantri Arogya Kendramulu.

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We have bagged two similar projects in the State of Telangana too and it has been successfully running. NUHM (National Urban Health Mission) is looking forward for the similar clinics to be established in the State of Karnataka by us.

How have you harnessed technology to create best innovative healthcare solutions? The organisation is led by enthusiastic entrepreneurs with huge work experience in IT and technology. Moreover, our group of directors and advisors have engineers, doctors and administrators. With such diverse minds at work, we could visualise the healthcare necessity in 360 degrees. The IT solutions developed were validated with repeated testing in the field. The whip of medical validations helped to develop current medical advances in the Electronic Medical Records (EMRs). A user friendly software has ensured paperless environment. The data recordings are HIPAA compliant secure architecture.

Srinivasa Rao Paturi

Chairman & Managing Director, eVaidya

How electronic primary healthcare center and urban healthcare center have improved patient care? Telemedicine has overcome the unavailability of qualified medical professional in rural setup. The digital PHCs under our governance have ensured full time coverage of Out-Patient (OP) consultation, Basic Lab tests and relevant medicines to be available at the vicinity.

Despite technological advancements and various schemes, the healthcare facilities in rural areas have not improved much. How do you analyse this? Medical practices involve abundance

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Tell us about your service like â&#x20AC;&#x2DC;Dial a Doctorâ&#x20AC;&#x2122;. How does it work? This is how whole process works:

Shed some light over your association with the Government of Andhra Pradesh in healthcare domain. What kind of projects are you working on? We are working very closely with the Government of Andhra Pradesh for a long time. One of our large initiatives is the Mukhyamantri Arogya Kendramulu in the districts of Visakhapatnam and Srikakulam. We also work with the department of health and NUHM very closely to advise and support on better healthcare practices for the rural population.

How do you rate Indian healthcare industry in terms of technology, innovations, accessibility and affordability? Definitely Indian healthcare sector is fast progressing, with both Central and State Governments putting lots of emphasis on quality and accessible healthcare facilities. Several schemes on the front of preventive health practices, easy to use facilities,

Industry Perspective

of empathy. A healing touch to a patient by the healthcare providers results better outcome in diseases. To add to it, the preventive healthcare initiatives have latent period during their execution which takes considerably long time to reflect results. At certain extent, these factors have worked adversely in showing the improvement on healthcare front in rural sector. With Governments like Andhra Pradesh and Telangana extending hands in developing technologically advanced healthcare facilities under PPP models which have added a brick to the technological wall of healthcare delivery. We require more Government partnerships to popularise the digital health. It will make healthcare accessible and acceptable to the population.

We require more government partnerships to popularise the digital health. It will make healthcare accessible and acceptable to the population

digitisation of health records reflect true intent of the Government. India, by far, is rated best in terms of adopting new technologies. The usage of mobile phones, apps and internet are maximum in India and hence can be perceived as best used tool in healthcare as well. However, India is a vast country with huge population, high illiteracy and age-old beliefs in quacks and local practitioners. So it takes more time to bring awareness and confidence in the system. Also, there are many rural and backward areas which are not even reachable with proper transport and power. The Government must put more emphasis again through a PPP approach to equipped those areas with better healthcare facilities.

Tell us your plans about expansion. What kind of innovative solutions are you contemplating to launch? We are planning to develop effective programmes in terms of preventive measures of NCDs (noncommunicable diseases).

Tell us about your association with other State Governments. We look forward to partner with other states like UP and Karnataka in providing primary healthcare services.

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eHEALTH Magazine

July 2018

Technology Perspective 26

‘Telemedicine Need of the Hour for Universal Health Coverage’ Telemedicine is very effective in removing distance gap across geographies and bringing primary healthcare and wellness services to doorstep of each individual which is the basis for Universal Health Coverage. It not only provides quality health services like teleconsultations of renowned doctors but also aids in health analytics and data management, says Vikram Thaploo, CEO - Apollo Telehealth Services, in conversation with Elets News Network (ENN).

Can model of tele-health services become the most important component in achieving Universal Health Coverage in India in near future since this model has no geographical constraints? Absolutely! Despite an improvement in the doctor-to-patient ratio in India, which currently stands at 1:1,596 (considering only allopathy doctors), WHO prescribes the ratio to be 1:1,000. Moreover, the division and concentration of these doctors are exclusively in urban areas, secluding the rural masses. In about six lakh villages, where 70 per cent of India’s population lives, the number of doctors is only a fourth of those in urban areas. The problem is not limited to human resources alone. There are severe infrastructural challenges as well like accessibility to high-end devices, technological advancement, data management, electricity, etc. With such diversified needs, assisted telemedicine can play a significant role in bridging the gap. Telemedicine platform holds much promise as about 70 per cent of OPD (out-patient department) cases do not need in-person visits as indicated by independent researches. Further, statistics show that only 15-16 per cent of the patients treated by way of telemedicine have to visit a hospital for further treatment. Telemedicine is very effective in bridging the gap across geographies and it is bringing primary healthcare and wellness services to the

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doorstep of each individual which is the basis for Universal Health Coverage. It not only provides quality health services like tele-consultations of renowned doctors but also aids in health analytics and data management. Telemedicine is indeed the need of the hour for Universal Health Coverage.

With Indian telemedicine market expected to more than double by 2020 as per a survey, what are your future plans to harness this growing market? Apollo Remote Healthcare is currently serving in more than 50 prominent cities in India and has a widespread network with services in 22 countries as well. We also have our presence in 60,000 villages under Digital India initiative helping us to reach closer to our vision of touching billion lives and making an impact in the healthcare industry. We are working on next generation of remote healthcare platform which is aiming at providing “Continuum of Care” with holistic approach. Such technological advancements will help us set new benchmarks in healthcare industry as well as stay ahead in the industry. This will also help us leveraging latest technologies in Machine Learning (ML) and Artificial Intelligence (AI) making the services more accurate, cost effective and easily adoptable. We believe in providing patient centric care to our consumers. Today, the vision for “patient centricity” is

that of a more empowered, active, participatory consumer. This implies that patients should have access to their data – on-demand and at-will. It also implies a more collaborative and participatory relationship between patients and healthcare providers (the doctor, the hospital etc). With this patient centric approach and new innovations in technology, we wish to reach every nook and corner where access to quality healthcare is a challenge. Since Apollo Telehealth is an offshoot of an integrated healthcare delivery system of Apollo hospitals we have advantage of being the clinical leaders and are providing critical services like Tele- Emergency, Tele-ICU, Tele-Condition Management along with regular services like Tele-Consults, Tele-Radiology, Tele-Cardiology etc. This capability enables us to stay on top of digital healthcare delivery system and consequently helping us harness the growing market.

How do you view the role of ICT in Indian tele-health markets and how initiatives like Digital India will help you in achieving your targets? ICT is the backbone of telehealth and any such technology-driven market service delivery cannot exist in the absence of advanced ICT. Information

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What awareness strategy you have for India where common citizens are yet to be acquainted with such concept? True, not many people are acquainted with such concept but we have examples where people rely more on traditional delivery systems e.g. people visit PHC’s and tertiary care hospitals for healthcare. We’ve augmented traditional healthcare delivery with telehealth, enabling people to avail techdriven healthcare from home. To put it in perspective, the functioning of PHC’s in one of the progressive Indian states is the best example of effective service delivery to citizens augmented with telehealth. The PHC’s are staffed with individuals having specific roles and responsibilities, at the same

time specialists’ consultations are provided over telemedicine, entire PHC’s is paper-less and the entire data repository is electronic. The common citizen entering PHC’s is able to understand the difference right from the registration through every step that the entire service delivery is ICT-enabled. The local staff take this opportunity to familiarise patients with digital healthcare. Services being provided at these centers are costeffective, helping in early adoption. We also, promote local dialect in the centers so that patient feel connected not only with the staff but also with remote doctors and unhesitatingly share problems. This motivates patients to not only avail these services frequently but also spread a word about healthcare facilities being provided at these centers, helping us to deliver services to a larger populace. At regular interval of times we also do ATL/BTL activities like radio campaigns, SMS blast, advertisements in movie theaters, health awareness campaigns etc. along with street plays. These are organised on various events/ occasions depicting people’s current health condition in those areas, how it can be treated/prevented to motivate people to visit these digital health centers. This way we ensure common citizens are not only acquainted with this concept but also adopt it and motivate others to receive the worldclass services from healthcare providers to contribute for a healthy India

Is your model really helpful in decreasing inefficiencies, reducing costs, improving access, and making care more customised? Yes. Firstly, decreasing inefficiencies would not be possible without establishing an effective monitoring system. If overlooked, every mistake turns an inefficiency. Digitalisation, that has been a by-product of our model, has enabled empowering the system with better process monitoring

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tools and methods that track developments of every process, so that the inefficiencies, ranging from clinical protocol breaches to non-clinical process outliers, can be recognised on time so that they would be easy to be commandeered back into the process. Then when we talk about reducing costs and improving access, for us both are valued core elements and go hand-in-hand for every service we provide. Due to lack of concrete PHC’s service system, people would end up seeking secondary and tertiary healthcare services after the diseases/ ailments have established in an irreversible manner that would cost the people spending lifetime earnings. As Remote healthcare strengthens pillars of primary healthcare enhanced by various health services like laboratory and other Diagnostic Services, TeleEmergency etc, the health services have been made more accessible to everyone bypassing boundaries of distance, socio-economic status, environmental conditions etc. We are very much aware that IT has improved accessibility of umpteen services, and when we have combined it with the Healthcare Industry, we were obliged to create a system that effectively guides and helps people to develop a cost effective health seeking behaviour. The equation would be as simple as the people having an ease of access to IT Augmented healthcare services and thus reducing the time and money spent on accessing these health services through usual conventional modes. Lastly, the care would be tailor-made for two reasons. Firstly, the chain of in detail health history data tagged into the Electronic Medical Record of each patient. Secondly, the various Health Risk Assessments that we conduct for patients before the patient is started on any service involving the “Continuum of Care”. Our healthcare providers are enabled with all the patient centric data and each line of treatment & advice is supplemented by the same.

eHEALTH Magazine

July 2018

Technology Perspective

and Communication Technologies (ICTs) are playing a very critical role in improving healthcare delivery for individuals and communities. By providing new and more efficient ways of accessing, communicating, and storing information, ICT is helping bridge the information divides that have emerged in the health sector in developing countries—between health professionals and the communities they serve, and also between the producers of health research and the practitioners who need it. Through data analytics and other applications, ICTs also provide the capacity to improve health system efficiencies and prevent medical errors. Also, with the help of data analytics we will be able to do fool-proof planning of Service Case Delivery system for future. Presently, with initiatives like “Digital India”, the Government is putting a lot of efforts to make rural India connected enough so that all Government to Consumers and Business to Consumers services are available to every individual. This helps telehealth in making healthcare more accessible through available digital infrastructure.

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Childhood Obesity — Causes, Complications and Prevention The problem of child obesity is getting worse and has increased the risk of developing various health problems, writes Madhusudan Phadke, Founder and Managing Director, Healtho.

besity is increasing at an alarming rate throughout the world and India is one of them as it has more obesity concerns. Childhood obesity is a serious medical condition that affects children and adolescents. Children, who are obese, are above the normal weight and it is a condition of excess body fat often associated with a large number of debilitating and lifethreatening disorders and diseases, like diabetes, high blood pressure, and high cholesterol. It can also lead to poor self-esteem and depression. We have high impact of technology in our lives. Children are also spending maximum time of the

day on electronic gadgets like video games, mobile games, television that have replaced physical activities. This is one of the significant causes of child obesity. According to a report from urban South India, 21.4 per cent of the boys and 18.5 per cent of the girls, aged 13-18 years, are overweight or obese. The prevalence of obesity among school children in India has been reported between 5.74 per cent and 8.82 per cent. Causes of Obesity Social and Environmental Factors It has been the factor that has doubled the childhood obesity over the last 30 years. It is encouraged by marketing,

Madhusudan Phadke

Founder & Managing Director, Healtho

based on consumer behaviour and targeted marketing of high calorie food, beverages and fast food.  Physical activities Electronic media, video games, Mobile games, and others have taken the place of physical activities  Stressful day Due to stiff competition in education, children are busy studying during school hours and even post-school (tuitions). Hence, children get very short time for themselves.  Psychological factors Personal, parental and family stress can increase a child’s risk of obesity  Family factors If yours is a family comprising overweight people, the child is more likely to put on weight Symptoms Not all children carrying extra

july 2018

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pounds are overweight or obese. Some children have larger than average body frames. And children normally carry different amounts of body fat at the various stages of development. So, just by looking at your child you might not know if weight is a health concern. The body mass index (BMI), which provides a guideline of weight in relation to height, is the accepted measure of overweight and obesity. Your child’s doctor can help you figure out if your child’s weight could pose health problems by using growth charts, the BMI and, if necessary, other tests. Complications Childhood obesity can have complications like physical, social and emotional well-being. 1. Physical complications • Type 2 diabetes. • Metabolic syndrome. • High cholesterol and high blood pressure. • Asthma.

• Behaviour and learning problems. • Depression.

Whether a child has a healthy weight or becoming overweight, to avoid risk of overweight we need to take measures to get or keep thing on the right track.

• Sleep disorders. • Non-alcoholic fatty liver disease (NAFLD) 2. Social and emotional complications • Low self-esteem and being bullied.

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Prevention Whether a child has a healthy weight or is becoming an overweight, to avoid the risk of overweight we need to take measures to keep things on the right track. Following simple preventive suggestions will help: • Limit your child’s consumption of sugar-sweetened beverages • Provide plenty of fruits and vegetables • Eat meals as a family as often as possible • Limit eating out, especially at fastfood restaurants • Adjust portion sizes appropriately for age • Limit TV and Other screen time • Visit child specialist at least once in a year to check BMI and other checkups. (Disclaimer: The writer is Madhusudan Phadke, Founder and Managing Director, Healtho. The views expressed here are personal opinion.)

eHEALTH Magazine

July 2018

Technology Perspective 30

Neuronavigation Improving Precision in Neurosurgeries Brain tumour navigation technology provides a high-refined and improved surgical precision and reduces the extent of incision due to the accurate localisation of lesions, writes Dr Kamal Verma, Director, Neurosurgery, Asian Institute of Medical Sciences.

euronavigation works like a GPS for a neurosurgeon. However, precision is needed in all fields of surgery. But its importance in neurosurgery where brain and spinal cord is being operated is peerless in comparison with any other fields. Even a slightest error can be disastrous and add to serious and permanent complications. Neuronavigation systems have been developed for image-guided neurosurgery to aid in the accurate localisation of lesions and to increase the margin of safety. We operated a patient with

july 2018

a brain tumour, which was very near to the speech area on the left side of the frontal lobe. A tumour could not be seen on the surface of the brain, which was normal all around. Neuronavigation helped us to precisely localise the lesion and we were exactly on the target. Thus, complete tumour removal was done without the fear of injuring the normal brain with the constant help of navigation. We also used navigation in a skull base tumour and in the clipping of anterior communicating artery aneurysm. In both these cases, navigation helps us to localise

Dr Kamal Verma

Director, Neurosurgery Asian Institute of Medical Sciences

important vessels with accuracy and increase the speed and safety of the surgery. The basic principle of navigation is to establish a virtual space in which a reference frame is localised. A tracker attached to a probe pointer or an instrument is then registered in relation to the reference frame. The images of the MRI or CT of the patient are then loaded on the system and the pointer can be localised on the images. Hence the system shows the pointer on the images as it is moved in the patient surgery field. The navigation systems available today give accuracy to about one to two millimeters. Navigation is also used to mark the lesions for radiotherapy, which can be precisely delivered to the target without fixing a frame to

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the head; this is called frameless stereotaxy. It also has used in frameless stereotactic biopsy of deep-seated lesions. It also increased the safety in skull base surgeries, such as pituitary tumours. Accurate shunt placement in smaller ventricles can be easily done with help of navigation. It is very helpful in functional surgeries such as epilepsy surgeries. The use of navigation has also extended to spine surgeries. In spinal surgeries, the registration has to be done after fixing a reference frame or tracker on a fixed bony landmark, such as spinous process. The main indication in spine surgery is to correctly put pedicle screws in deformities. The advantage of navigation is accuracy and reduction in the margin of error. It also reduces the extent of incision due to correct localization. There are concerns like intraoperative brain shift due to CSF drainage or retraction, but still, it is

The advantage of navigation is accuracy and reduction in the margin of error. It also reduces the extent of incision due to correct localisation.

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very advantageous to use navigation as compared to anatomical knowledge alone. Hence, it can be concluded that Neuronavigation is an invaluable tool, which reduces the margin of error and serves as a guiding tool in the complex and precision dependent field of neurosurgery. We at Asian Institute of Medical Sciences are always committed to excellence and keep upgrading ourselves to achieve more and more precision and best possible patient care. We are also pleased to inform that we are starting a dedicated separate Neurosciences ICU as a further step in our endeavour to deliver the best possible healthcare. We assure you of continuing our efforts in this direction and welcome you all to be part of this journey.

(Disclaimer: The writer is Director, Neurosurgery, Asian Institute of Medical Sciences. Views are personal.)

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July 2018

Technology Perspective

Aosta’s Sustained Engineering Enabling Hospitals to Improve IT Operations Our application is smart in terms of automating most of the areas. The Electronic Medical Record (EMR) module being completely inter-linked with all other Healthcare Information Management System (HIMS) modules, is able to reduce the patient’s consultation time as the data flows seamlessly between the EMR & HIMS suite, says Aravindan Selvaraj, Director, Sales and Marketing, Aosta Software Technologies India Ltd., in conversation with Elets News Network (ENN).

Aravindan Selvaraj

Director, Sales and Marketing, Aosta Software Technologies India Ltd

How do your IT solutions and services help healthcare facilities to streamline their operations and boost business potential? Our flagship product BackBone is a complete HIMS Suite, scalable from primary care to tertiary care multispeciality hospitals. With all modules being interlinked with each other and provision for various third party integrations, the hospitals can have their operations streamlined. BackBone’s Mobile Dashboard is a BI tool for the management to track the real time performance of the hospital across various dimensions which results in potential decisionmaking. The system’s data management helps the hospital to

july 2018

increase its revenue and patient count by facilitating the patient follow ups. By providing more than 50 per cent scope for automation across various modules, the manual intervention is reduced. With 90 per cent scope for checks and balances across all important transactions, the errors can be minimised and any financial losses can also be prevented. Using our patient-centric application with the above said functionalities, any hospital can effectively improve its

business potential.

Your hospital management software enables hospitals to track, monitor, and optimise operations, could you explain how this model works? Our application is smart in terms of automating most of the areas. For example, based on the ReOrder level set in pharmacy and inventory, the purchase orders can be automatically raised against the suppliers tagged as preferred suppliers in the application. EMR

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module being completely interlinked with all other HIMS modules is able to reduce the patientâ&#x20AC;&#x2122;s consultation time as the data flows seamlessly between the EMR & HIMS suite. With the DMR solution to the Medical Records Department (MRD), all the patient records and prescriptions are digitally available in the system making the MRD go paperless. The system provides a request and approval mechanism for most of the critical transactions where the tracking and controlling is necessary.

In terms of data security and data management, how helpful are your IT solutions? We truly understand the importance and confidentiality of the client data and are proud of our long term relationships with the customers who believe in our systemâ&#x20AC;&#x2122;s security measures. Our application is tightly integrated with security features making it HIPAA compliant. BackBoneâ&#x20AC;&#x2122;s DMR helps in the storage and maintenance of the patient data in an easily accessible digital manner which provides an added advantage towards the data management.

Which of the hospital functions your hospital management system caters to or has solutions for?

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BackBone is an Enterprise resource planning (ERP) for the healthcare industry providing them solutions for all clinical, administrative and operational aspects. From the time a patient gets registered till the final discharge, all the intermediate processes can be monitored and handled by BackBone. Based on this, various reports can be generated for an effective decision-making. We also provide solutions for pharmacy whole sellers or retailers, diagnostic centers, eye cares, etc. We focus on automations of various functionalities so that the manual intervention is reduced and the productivity is improved seamlessly. As said earlier, the system also provides checks and balances for transactions of higher importance and security. We are part of a large group with a reputed chain of hospitals where all our latest releases are tested before providing it to our clients. We thereby ensure that the system we provide to our clients is bug-free and reliable which we can boast of. We have an excellent support mechanism in place. Also our Product and support teams are with us from the inception which helps us to deliver best service.

eHEALTH Magazine

July 2018

Industry Perspective

Samsung: Facilitating Healthcare Delivery With Innovative Solutions Samsung believes everyone should get a uniform access to healthcare irrespective of their social status. With the objective to provide healthcare access to a huge population of India, we incorporated the latest technologies like AI (Artificial Intelligence) which can help doctors to do accurate diagnosis, says Atantra Das Gupta, Director, Head-Health and Medical Equipments (CE), Samsung India, in conversation with Elets News Network (ENN).

Samsung is commonly known for electronic gadgets, give us an overview of your journey in the area of healthcare, especially in India. Globally, we started our journey six years back and acquired Medison, which is a South Korean company dealing with ultrasound. From there, we started to expand our business operations in India. We have expanded in terms of channels, dealers, and manpower. We came up with an inclusive range of ultrasounds and digital radiography. Our objective has been to provide healthcare access to a huge population of India, so we incorporated the latest technologies, like AI (Artificial Intelligence) to help doctors to do accurate diagnosis.

What prominent initiatives is Samsung taking to achieve its vision of diagnosis, costeffective solutions and improved workflow to customers? We have to understand Indiaâ&#x20AC;&#x2122;s medical device market which stands at USD 5.2 billion. It is almost four to five

july 2018

Atantra Das Gupta

Director, Head-Health and Medical Equipments (CE), Samsung India

per cent of the whole healthcare market in India. When we talk about economic and affordable solutions, it has to be truly affordable without any negotiation on quality. Sometimes quality is compromised to make the solution affordable. Samsung stands apart on this front. From our entry-level ultrasound equipment to the premium ones, we try to maintain a uniformity in terms of quality, which in turn benefits the customers. We havenâ&#x20AC;&#x2122;t distinguished between premium customers and those from tier-2 and tier-3 cities, as Samsung always believes that everyone should get a uniform access to the healthcare.

What are your latest innovations in the medical technology field? One of the biggest challenges in

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the area of medical technology is radiation. Radiation hazards are maximum while dealing in X-rays. A recent WHO study explained the case of diagnosis with X-ray based equipment. It was found that amount of radiation the equipment produced was much more than the radiation emitted during World War II. So in its endeavour to help the mankind and to make diagnosis process better, we have come up with a much eco-friendly solution (low dose), which is approved by the FDA (Food and Drug Administration) as well. Our digital radiography not only gives a crystal clear image to help in accurate diagnosis, but it also brings down radiation level to help patients, radiographers, and doctors from its harmful effects.

Tell us something about your diagnostic imaging devices and in-vitro diagnostics specialisation. How distinctly placed are you in the market? We believe equipment should reach the patients, not the other way around. In India, we are primarily dealing with ultrasound and digital

radiography. On ultrasound front, our entire range is mobile and the equipment can be dragged down to the patient’s bed. In the case of X-ray, we have got a mobile solution that is GM 85 with all the advanced

We haven’t distinguished between premium customers and those from tier-2 and tier3 cities, as Samsung always believes that everyone should get a uniform access to the healthcare

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specifications incorporated in it. GM 85 has got all the features with less radiation in comparison to other X-ray equipment.

Tell us about Samsung’s innovation in healthcare and its growing presence internationally. How prominent is the company’s presence in India and what are its objectives here? Primarily, we are dealing with ultrasounds and x-rays. We have also acquired Neurologica and going to introduce mobile CTs in near future. Though it is already being done by international dealers, in future we will be able to sell it through our own Samsung brand.

Would you like to share something more from your vast experience in healthcare? Despite being a new brand in healthcare domain, we have panIndia presence. It is not only limited to individual clinics and diagnostic centers but in many corporate hospitals as well. In the future, you will see our presence in many government and private hospital too.

eHEALTH Magazine

July 2018

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HEALTH

Andhra Pradesh Education Minister Ganta Srinivasa Rao (second from left) and Chief Minister Nara Chandrababu Naidu along with eminent personalities inaugurating the Andhra Pradesh Health Festival.

When Andhra Pradesh Pondered Innovative Healthcare for Better Patient Care To deliberate upon various facets of healthcare ecosystem, an Andhra Pradesh Healthcare Festival was organised in Visakhapatnam recently. The four-day health festival comprised Health Datathon, Health Hackathon and Healthcare Conference. The first three days were dedicated to Datathon and Hackathon while the last day was reserved for the health conference, award and expo. The 18-21 June health festival was organised by Elets Technomedia, the premier technology and media research organisation of Asia and the Middle East, along with Health Medical and Family Welfare Department, Government of Andhra Pradesh and Andhra Pradesh Medtech Zone. Of about 1,000 participants in the competition, total 60 teams (30 each from datathon and hackathon) participated, leading to emergence of three winners for both formats. Winners received a cheque of Rs 25,000 from Andhra Pradesh Chief Minister Nara Chandrababu Naidu. The occasion was participated by various eminent personalities including Andhra Pradesh's Special Chief Secretary, Health Medical and Family Welfare Department Dr Poonam Malakondaiah; Advisor (Health) Dr Jitendar Sharma; Additional Secretary, Health (GoI) Arun Singhal; Ayushman Bharat CEO Indu Bhushanm and NITI Aayogâ&#x20AC;&#x2122; Member Prof Vinod Paul. Representatives of International agencies including World Bank, World Health Organisation (WHO) and United Nations Development Programme (UNDP), also attended the Health Festival. The Chief Minister shared his vision through various initiatives undertaken to create a healthier State of Andhra Pradesh. A special issue of eHealth Magazine, highlighting various steps taken by the Andhra Pradesh Government to transform healthcare industry, was unveiled on the occasion. An industry roundtable was also organised with Andhra Chief Minister where various healthcare solution providers talked about various innovations to strengthen healthcare delivery in the State. They also shared their vision to create a healthier world.

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Andhra Pradesh as a leading destination for quality and Cost-Effective Healthcare Nara Chandrababu Naidu Chief Minister of Andhra Pradesh

Technology will be playing a very crucial role in future. In Andhra Pradesh, we are doing a new experiment. We have established a very cost-effective communication. We all say to give 15 mbps internet. Every home will be connected with video, internet and free telephone, so that telemedicine technique will be leveraged. You can contact doctors of your child sitting at home. Telemedicine will be harnessed in a big way.Â e-SubCentres would enable patients in remote areas to consult doctors.

Key Dignitaries Including Andhra CM Nara Chandrababu Niadu releasing eHealth Magazine

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Dr Poonam Malakondaiah

Our honourable Chief Ministerâ&#x20AC;&#x2122;s priority area in development is to take Andhra Pradesh towards Arogya Andhra Pradesh. Under the dynamic leadership of Chief Minister, the department of Health and Family Welfare, Government of Andhra Pradesh has been taking a number of steps to strengthen the public healthcare facilities right from sub-centers to teaching hospitals. And also in a big way to educate people in health areas so that we can reduce the communicable and non-communicable diseases. This is first State in the country to roll out all the programmes designed by the Ministry of Health and Family Welfare (GoI). The footfalls have increased in our hospitals.

Arun Singhal

Indu Bhushan

Andhra Pradesh has been galloping forward. The Government has Swarna Andhra vision 2029, under which the State has vision to be amongst best three States in the country by 2022 and best State by 2029 and to be leading global investor destination by 2050. The good thing is that the rural development is a priority for the State Government. Chief Minister emphasises on creating smart villages. The State is one of the best in most of the healthcare indicators.

It is a key milestone for Ayushman Bharat because Andhra Pradesh is the first State in South India which has signed MoU with Government of India. We are hoping the Ayushman Bharat will further help the State Government in its vision to achieve Universal Health Coverage. We also hope that your success in providing health insurance will also be helpful to other states. We also appeal other States to learn from you and implement healthcare initiatives in their respective States.

Additional Secretary, Ministry of Health & Family Welfare, Government of India

Dr Jitendar Sharma

Advisor (Health), Government of Andhra Pradesh, CEO & MD Andhra Pradesh Medtech Zone (AMTZ) Andhra Pradesh in last four years conceptualised and implemented over 20 to 30 national programmes like national dialysis programme and national radiology programme. Andhra Pradesh is number one in implementation of healthcare initiatives. This is the only State which has not only implemented all the programmes conceptualised, but actually conceptualised much more and implemented. When National Human Rights Commission gives notices to many States, when they see a dead body is being carried away on bicycle or shoulders, this is the State which gives Mahaprasthanam (the great journey to a new world) free with dignity transport.

Special Chief Secretary, Health Medical and Family Welfare Department, Government of Andhra Pradesh

july 2018

CEO Ayushman Bharat

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Prof Vinod Paul

Dr Pallavi Jain Govil

Member NITI Aayog

Commissioner Health Government of Madhya Pradesh

I congratulate you on the behalf of the country for use of technology in all sectors including healthcare where you have taken a lead. You conceived Dr NTR Vaidya Seva, a universal healthcare scheme based on which we build the model of Ayushman Bharat. You implemented it with aplomb. Your progress in infant mortality is remarkable. Your record of MMR is unbelievable. Andhra Pradesh has shown a stellar leadership in health sector.

Madhya Pradesh took very early decision that it will be free drugs and diagnostics for all. Madhya Pradesh has reinvented itself in last 10 years and has shown progress in all sectors including healthcare. We have adopted tried and tested models of many States to improve things here. The state has thin resource. We have paucity of doctors and healthcare workers in the State. They have positioned in a very optimal places as per the requirement. There is grouse that different healthcare programmes and departments run in silos, which must be broken down and should be converted into useful schemes. We are using data to serve public interests.

J Satyanarayana

Ms Payden

Advisor (IT) Government of Andhra Pradesh

Acting Representative and Deputy Head World Health Organisation (WHO)

Better health for everyone, everywhere is the slogan of WHO. Health informatics, health analytics are important aspects of healthcare technology. We should move from silos of development to solutions, from system to ecosystem and health to wellness. These strategies are needed to transform the healthcare sector. We need political will and leadership, enterprise architecture, standards, and partnership to execute things in healthcare domain.

A resolution on digital health has been moved by India and was adopted at World Health Assembly last month. I am happy to share that Andhra Pradesh will be one of the five States to test integrated health information platform which is world enabled real time electronic information platform developed by Ministry with WHO as technical platform. We have been supporting the Government since 1997 in polio eradication efforts.

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Sheena Chhabra

National Programme Manager United Nations Development Programme (UNDP)

Andhra Pradesh has been true trailblazer in the healthcare reform in the country. It is one of the first States which is marching towards Universal Health Coverage and providing quality healthcare to the population. We have heard many firsts the Andhra Pradesh is responsible for, in terms of significant progress the State has made like infant mortality, maternal mortality, replacement fertility. The Department of Economic Affairs has approved Govt of Andhra Pradeshâ&#x20AC;&#x2122;s proposal for World Bank support for very innovative healthcare strengthening project worth $327 million.

We are very happy and proud to partner with the Andhra Pradesh State Government introducing a supply chain innovation on digitizing the health centers for vaccine tracking through a project called electronic vaccine intelligence network which will be rolled out to all the 1,400 health centers in the State. Where vaccine supply will be digitally tracked, the supply chain management from the States to the last mile is tracked.

Pallavi Jain

july 2018

Dr Manish Pant

Senior Health Specialist, Global Practice on Health, Nutrition and Population, World Bank

KL Murthy

Managing Director Krsnaa Diagnostics

Head Pre-sales Dhanush Infotech

Krsnaa Diagnostics started seven years back with the vision of getting healthcare to rural India at very cost-effective model. Andhra Pradesh being one of our starting projects of teleradiology where we connected 125 rural locations which include CHCs, PHCs. We have a teleradiology hub in Pune, providing quality healthcare in about 1,800 plus rural locations in India. Krsnaa connected all these centres where scans are done. Using IT platform and technology all these images are transferred to radiology hub. The technology is helping patients a lot.

Dhanush Infotech has been working across the globe in healthcare and IT solutions area. We are associated with the Government of Andhra Pradesh in managing eUHC in two districts, east Godavari and Vijayanagar. With innovative concept of eUHC, the Government of Andhra Pradesh has completely revolutionsied the concept of primary healthcare service delivery where three things were ensured-medical consultations at the premises, availability of labs and diagnostics and monitoring of services.

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Dr Praveen Patil

Hari Kumar

Vice president Medall Healthcare

Senior Director, Business Strategy & Planning Cerner India

Medall Healthcare is one of the largest integrated diagnostics services providers in country. We had the opportunity to provide free diagnostics service under NTR Vaidya Pariksha for Andhra Pradesh. Right from border of the Chennai to the border of Odisha which is around 800-900 km, we have 1,400 facilities of the Government. We have 3,000 people working across 105 labs and carrying 20,000 samples for processing. It is extremely challenging for us to cater 180 tribal locations where transportation and other challenges are perennial issue.

Cerner is operating from 40 countries and has a total workforce of 27,000 associates across the globe. We have spent a whopping amount on research and development. Cerner caters more than 3000 patents. Our expertise directly benefits our clients, ranging from profit organisations, non-profit organisations to government departments across the globe. We are making innovations, which are made in India and make for India.

Dr Sony Agarwal

Vikram Thaploo

Vice President eVaidya Pvt Ltd

Chief Executive Officer Apollo Telehealth Services

eVaidya is providing UPHC and PHC services in the district of Visakhapatnam. To provide any time medical help we have health ATMs. It is a kiosk like sub-centres which facilitate people healthcare using digital technology. People who used to visit specialists seeking tertiary care are getting similar facility at these sub-centers.

Apollo runs 164 UPHC projects with the State of Andhra Pradesh. We also run all 115 tele-orthopedic centers. We have services like tele-emergiencies with the State of Himachal Pradesh. We have facilitated affordable healthcare services to people close to China border which remains cut-off from rest of the country for eight months of the year. Apollo has serviced more than two-and â&#x20AC;&#x201C;a-half lakh people under tele opthalomology service.

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Hanmantrao Gaikwad

Senior Director and Consulting Services Cerner India

BVG India operates 108 ambulance service of Andhra Pradesh. Apart from this, we operate Maharashtra emergency medical service, Delhi emergency response, and Madhya Pradesh Police response. Every day, we take care around 20,000 emergency cases. Trauma is the third cause of death in our country. In the State of Maharashtra, last year, we trained 10,000 first responders. This was a pilot model which will be taking in as a regular model. Whoever is the organised player in the government, if he or she could be taught for the first response, we can save many precious lives.

As a part of knowledge command center for the Government of Andhra Pradesh, we are keeping track of many KPIâ&#x20AC;&#x2122;s. And it is really amazing how the insights are delivered at various service levels, which is probably not possible without the technology. People now can access their reports online and doctors can do conclusive diagnosis based on the reports.

Surjeet Ranjan

Prof Yogesh Chawla

Swasthya Piramal is working in public health from last 10 years. It is one of the largest public health organisations. We started our operation from Andhra Pradesh. Our focus is to reduce maternal mortality and NCDs (diabetes, hypertension, cervical, cancers). We have 4,000 plus staff members and 600 doctors with us. In Andhra Pradesh, we have 292 mobile medical units reaching to all 13 districts of Andhra Pradesh. Mobile medical unit is one of its kind service in India. Availability of doctors is almost hundred per cent. We have best coordination within team.

Ensuring Universal Health Coverage in multi-speciality treatment is a bit problematic, but it can be resolved if we use telemedicine extensively and if more and more doctors will be sent to multi-specialty hospitals for training in different disciplines. And to achieve it on ground level, all the State Governments and healthcare establishments should come on the same stage.

Chief Operating Officer Swasthya Piramal

Arun Kharidehal

CMD (Chief Managing Director) BVG India

july 2018

Former PGI Director Chandigarh

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Col. A K Nath

Subash Punja

Executive Director Centre for Development of Advanced Computing

Joint Forum Coordinator Association of Indian Medical Device Industry (AIMED)

Low cost indigenous technology is need of the hour. We are working on the development of indigenous MRI machine and treatment plant software for radiation therapy and other initiatives. CDAC is working on lots of technologies high performance computing, telemedicine, hospital management information system, drug supply chain management systems, and preventive healthcare portals. Technology has potential to transform lives of people.

Today, there is no dearth of start-ups and ideas in the healthcare sector. But the problematic area here is implementation and lack of strategic process. So, first of all every start-up trying to get into the business should gather insights of their target market and indentify what are the actual requirements of the market. They should work collectivity on the aspect of knowledge sharing and get rid of the practice of working in isolation.

Dr Rama Venugopal

Gaur Sundar

Executive Director Value Added Corporate Services

Joint Director Centre for Development of Advanced Computing (CDAC)

Medical devices sector has been in the country for quite some time, but I would say that the real momentum is picking up in the last few years. As a country, we are import-driven when it comes to medical devices. Recently, many initiatives have been taken, such as Make In India to encourage domestic and international firms to manufacture in India, but still, this approach in medical sector is still very reluctant.

CDAC has been working as an enabler of e-health in many ways, like it helped in making technology indigenous, which is a major factor to bring down the cost of the implementation of technology. Not only indigenous technologies are cheaper, but they are more manageable for long-run and much more productive in the ground realities of the country.

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