Ehealth June 2018

SPECIAL ISSUE

COVER STORY

volume 13 / issue 06 / JUNE 2018 / ` 100 / US $10 ISSN 0973-8959

Tech-driven Andhraâ&#x20AC;&#x2122;s

GIANT LEAP in Healthcare EXCLUSIVE INTERVIEW

Nara Chandrababu Naidu Chief Minister, Andhra Pradesh

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23/03/2018 13:27

JUNE 2018 | Volume 13 | Issue 06

COVER STORY

Andhra Pradesh Making a ‘Giant Leap’ in Healthcare

Nara Chandrababu Naidu Hon’ble Chief Minister of Andhra Pradesh

exclusive interview

technology perspective 36 Pallavi Jain Managing Director, Krsnaa Diagnostics Pvt Ltd 38 D S N Murthy Chairman and MD, Dhanush Infotech

Nara Lokesh

40 Thomas Fuhrmann

Dr Poonam Malakondaiah

CEO and Managing Director, TÜV Rheinland India

Minister for Information Technology and Communication Panchayat Raj and Rural Development, Government of Andhra Pradesh

Special Chief Secretary, Health Medical & Family Welfare Department & Mission Director National Health Mission Government of Andhra Pradesh

Kalyan Varma

Vice President Products, TÜV Rheinland India

state Perspective 54 Nidhi Khare Principal Secretary, Department of Health & Family Welfare, Government of Jharkhand

56 B K Agarwal Additional Chief Secretary, Department of Health & Family Welfare, Government of Himachal Pradesh

58 Rajeev Sadanandan Additional Chief Secretary, Department of Health,

68 Madhusudan Phadke Founder and Managing Director, Healtho

industry Perspective 44 H R Gaikwad Chairman and Managing Director, BVG India Ltd 46 Dr Devaiah Pagidipati Board of advisors, eVaidya

amtz ceo speaks

Government of Kerala

60 Vishal Chauhan Commissioner-cum-Secretary, Department of Health & Family Welfare, Government of Sikkim

62 Dr Yashpal Sharma Mission Director, National Health Mission, Jammu and Kashmir

city Perspective 34 Pravin Kumar Collector and District Magistrate, Visakhapatnam

32 Dr Jitendar Sharma Managing Director & CEO

Andhra Pradesh MedTech Zone (AMTZ) and Advisor (Health and Medical Technology) Government of Andhra Pradesh

Editorial Tech-driven Andhra Pradesh Goes Extra Mile in Healthcare With a growing public awareness and desire to benefit from latest healthcare measures, health has become a central area of interest for people at large. Also, with a growing public awareness every household desires easily accessible healthcare facilities. Andhra Pradesh seems to be endeavouring to be the leader among all States in ensuring an accessible and affordable healthcare ecosystem. In this light, we have taken out a special edition eHEALTH magazine focused on the state of Andhra Pradesh to explore and underline how the State Government is steadily building a healthcare system to improve quality of life. Our cover story ‘Andhra Pradesh Takes Giant Leap in Healthcare Delivery’ explores State Government’s healthcare initiatives, underlininig how the State Government has taken a slew of measures for robust healthcare delivery and to encourage start-ups. In an exclusive interview Andhra Pradesh’s Chief Minister Nara Chandrababu Naidu has shared the State’s overall growth story while mentioning about how Real Time Governance System (RTG) has enabled his State agencies to communicate with beneficiaries and citizens on real time basis through various access mechanisms. Nara Lokesh, Minister for Information Technology and Communication, Panchayat Raj and Rural Development, Government of Andhra Pradesh, in another interview has talked about how technology is driving the State on development path. Other distinguished personalities featuring in this issue are Dr Poonam Malakondaiah, Special Chief Secretary, Health, Medical & Family Welfare Department & Mission Director, National Health Mission, Government of Andhra Pradesh. Other interviews include that of Dr Jitendar Sharma, Advisor (Health and Medical Technology), Government of Andhra Pradesh and Managing Director & CEO, Andhra Pradesh Medtech Zone (AMTZ). Visakhapatnam Collector and District Magistrate Pravin Kumar in his interview has talked about the smart projects that have enabled Visakhapatnam turn one of India’s best livable cities. Other important interviews include that of Rajeev Sadanandan, Additional Chief Secretary, Department of Health, Government of Kerala, Nidhi Khare, Principal Secretary, Department of Health & Family Welfare, Government of Jharkhand, B K Agarwal, Additional Chief Secretary, Department of Health & Family Welfare, Government of Himachal Pradesh, Vishal Chauhan, Commissioner-cum-Secretary, Department of Health & Family Welfare, Government of Sikkim, Dr Yashpal Sharma Mission Director, National Health Mission, Jammu and Kashmir. Pallavi Jain, Managing Director of Krsnaa Diagnostics, has offered the industry perspective in the issue. Also, we have articles of healthcare solution providers Dhanush Infotech, Medall Diagnostics, BVG India and eVaidya shedding light on modern solutions to improve healthcare delivery in the State. To encourage healthcare experts and organisations for coming up with innovative solutions to benefit people, Andhra Government has organised Health Datathon and Health Hackathon from June 18-20 in Visakhapatnam. We take pride that the special initiative has been conducted by ‘Health Medical and Family Welfare Department, Government of Andhra Pradesh, along with Elets Technomedia. With such a bouquet of special stories, articles and interviews, we hope this special 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

(Nara Chandrababu Naidu)

I am happy to know that the Department of Health, Medical & Family Welfare, Government of Andhra Pradesh, in association with Elets Technomedia, is organising Andhra Pradesh Health Festival, Visakhapatnam on 21 June, 2018, highlighting the healthcare activities of the State. Datathon and Hackathon are also being organised from 18-20th June, 2018. It is undeniable that Information Technology increases the pace of delivery of healthcare. I hope the festival will inspire the current and future generations to contribute to healthcare excellence and bring added pride to the nation. I congratulate the Department of Health, Medical & Family Welfare and eHealth Magazine for launching the Special Souvenir, recognising the initiatives of the Andhra Pradesh Government in promoting innovations in Healthcare, Medical Tourism and fostering healthcare facilities. I wish them a grand success.

I extend my best wishes to the Health, Medical & Family Welfare Department, Government of Andhra Pradesh and Elets Technomedia, for organising Andhra Pradesh Health Festival, Visakhapatnam, on 21 June, 2018 to highlight its innovation and initiatives in the healthcare sector in the State. I am pleased to know that the Festival will not only highlight knowledge about the healthcare sector across Andhra Pradesh but also explore opportunities for the innovators, who are working for developing solutions for taking healthcare to the last mile. Datathon and Hackathon are also being organised from 18-20th June, 2018. On this occasion, I congratulate the Department along with eHealth Magazine for the launch of the special souvenir of AP Health Festival, highlighting initiatives of the health sector of the State of Andhra Pradesh and opinions of various healthcare experts on enhancing implementation of IT quotient. I extend my greetings to the Department along with the organisers and wish them success in their future endeavours.

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Andhra Pradesh Making a ‘Giant Leap’ in Healthcare Delivery Realising the significance of healthcare as a key factor to ensure overall growth of the State, Andhra Pradesh driven by the vision of Chief Minister Nara Chandrababu Naidu is steadily witnessing a real transformation in State’s healthcare landscape, explore Gopi Krishna Arora and Mukul Kumar Mishra of Elets News Network (ENN).

ike food and water are essential for human kind to survive, so is the need of quality healthcare for them. The Government of Andhra Pradesh appears driven by this philosophy and thus working towards a grand and robust healthcare ecosystem which offers succour and strength to one and all. A look at the existing healthcare infrastructure and plethora of ongoing projects in various parts of the State, one tends to observe how seriously a Government should take health for all. More importantly, one observes how technology can trigger gigantic change

june 2018

in this endeavour in the modern times. With the objective to develop a healthy State, the N Chandrababu Naidu-led TDP Government has undertaken a slew of measures to provide quality medical facilities which are accessible and cost effective as well for all segments of society.

HEALTHCARE LANDSCAPE IN ANDHRA AT A GLANCE Andhra’s Vision for Healthcare Chief Minister Nara Chandrababu Naidu has reiterated on many occasions that in coming years the

State would be on the top in healthcare delivery. The State healthcare system will set an exemplary role for others to emulate. From ‘Arogya Raksha’ to ‘Chandranna Sanchara Chikitsa’, the Government has implemented many programmes to improve overall health of the State. The Government has adopted Public Private Partnership (PPP) mode to strengthen healthcare infrastructure in the State. Through conducive policies, start-ups have been encouraged to cater people with disruptive technology and innovative solutions.

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cover story

Some of the prominent Healthcare initiatives by the Andhra Government include:

TalliBidda Express Itâ&#x20AC;&#x2122;s a transportation facility, meant for mothers who deliver at Government hospitals. It aims to provide safe and hygienic transportation to mothers to reduce MMR and IMR. A fleet of 279 vehicles are assigned for the service which is coordinated by 102 call center operating 24X7. Pregnant women are provided drop back services between 8 AM to 6 PM. Postnatal women, child and one attendant are transported from Government facility to home.

NTR Baby Kit To reduce the Infant Mortality Rate (IMR), all the pregnant women who deliver in public health facilities are provided NTR baby kit immediately after the delivery. The lists of items in baby kit include baby wrap, baby towel, antiseptic lotion(for hand wash of the mother) and umbrella net.

Chandranna Sanchara Chikitsa (CSC) CSC stands for â&#x20AC;&#x153;Primary medical care on wheelsâ&#x20AC;? which ensures availability and accessibility of medical services to the needy in remote villages. With the help of 289 Chandranna Sanchara Chikitsa(CSC) vehicles, people are catered with best medical facility to their doorsteps. Through this programme, any village with no existing health facilities within 5 km radius (12,000 identified) is provided medical services on fixed days every month with the help of Mobile Medical Units. Diabetes, hypertension, epilepsy, communicable diseases, ANC/ PNC check-ups and other common ailments are investigated and treated.

MukhyaMantri Aarogya Kendralua super specialty mirror for Urban Populace To improve accessibility to quality healthcare, the state-of-the-art

healthcare services are provided free of cost to urban poor and slum dwellers. Under the programme which is available 365 days, assurance of a full time medical officer, 30 diagnostic tests, supply of medicines and availability of specialist services through teleconsultancy are given. Any beneficiary who visits Electronic Urban Health Centre (eUHC) is registered in the first counter following which they receive medical consultation from the doctor. Tele-consultation is provided to those who need specialist medical consulting services including Cardiology, Orthopaedic/ Rheumatology, General Medicine or Endocrinology. This is followed by lab tests and dispensing of drugs at the pharmacy. A total of 30 diagnostics tests including dengue, malaria and TB tests are carried out here.

NTR Vaidya Pariksha - Tele Radiology X-Ray Under this programme, tele radiology services are provided through digitalisation of X-ray film, transmission of the data through licensed software. In the remote hub, a qualified radiologist will do the study using FDA and CE approved Tele-radiology platforms and detailed report with digital signature will be sent back online to the institution.

NTR Vaidya Pariksha (Laboratory services) It provides free diagnostic tests to the patients visiting Government hospitals. This enhances patient care and reduces the out of pocket expenditure for the beneficiaries. Currently, there are 105 labs in operation which includes seven mother labs & 98 processing labs spread across all the 13 districts. There are 19 free diagnostics in PHCs, 23 in Tribal PHCs, 40 in CHCs and 72 in area and district hospitals.

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X-Ray Image taken will be converted into a digital image either through computerised radiography unit or a digitiser. The facility is available in CHCs, area and district hospitals across the state in 113 locations.

NTR Vaidya Pariksha - Tele Radiology CT Scan Under tele radiology services, CT scan machines are installed at four locations along with the interiors and other amenities including HT power connection and power back up. Qualified radiologists and supporting staff are positioned by the service provider. All reports are generated in the facility itself by availing the in-house expertise provided by the service provider. Four CT-Scan centers at Tekkali (Srikakulam), Chirala (Prakasam), Gudur (Nellore), &Proddutur (Kadapa) are for scanning and reporting. Five tele-reporting CT Centres at Anakapalli (Visakhapatnam), Rajahmundry (EG), Eluru (WG), Hindupur (Anantapur) &Nandyal (Kurnool).

NTR VaidyaSeva

To attain Universal Health Coverage in Andhra Pradesh, Govt. of AP has also started a scheme â&#x20AC;&#x153;ArogyaRakshaâ&#x20AC;? for all APL families. Premium will be per head per month Rs 100/-. All the members of the family have to be enrolled. Rupees 2 lakh will be the entitlement for an individual per annum through 400 Government and Corporate Network Hospitals for 1044 procedures.

National Free Dialysis Program The Dialysis Programme was rolled out in 2016 as part of the National Health Mission (NHM) for provision of free dialysis services to the poor. Dialysis centers have been established in all the 13 districts in PPP mode making the quality services accessible to the patients, suffered with kidney disease. There are 18 functional free dialysis centers across 13 districts. Eight Directorate of Medical Education (DME) hospitals have a total of 115 dialysis machines.

108 Services It is a 24/7 emergency service for

medical, police and fire emergencies. There are 468 ambulances across the State (363 BML and 76 ALS) to facilitate continuum of care from ambulance to hospital. Tab facility is available in the ambulances to ensure e-patient care record and real time reporting of emergency patient details.

Feeder Ambulances (108 Bike) Under Tribal Reform Yardstick (TRY), a novel initiative to shift the patients from remote and in- accessible Integrated Tribal Development Agency (ITDA) areas to 108 ambulances, was initiated with feeder Ambulances. These feeder ambulances are intended to save the time taken to reach 108 ambulances and save the lives of the critical patients and pregnant women. These ambulances are equipped with life saving drugs and surgical consumables and the details of services and monitoring of fleet movement is captured real time.

Mahila Master Health Check-up This program is for screening women above 30 years for early detection on seven major non-communicable

The scheme is aimed to provide qualitative medical care to the concerned for treatment of identified diseases involving hospitalisation, surgeries and therapies through identified network of healthcare providers. It also aims to bring advanced surgical treatment within the reach of the poor and to improve health and medical care facilities in the underserved areas. The package would cover the entire cost of treatment of the patient from the date of screening to the date of discharge and 10 days after discharge. With a view to provide enhanced and strengthened services under DR NTR VaidyaSeva, Government is implementing 1044 (873 Surgical and 171 Medical) procedures to the poor people who are Below Poverty Line in 455 empanelled hospitals.

june 2018

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Mukhyamantri e-Eye Kendram/ Tele Ophthalmology

also sought help of international bodies like UNICEF to improve the quality of services and infrastructure at the government hospitals and health centres. To upgrade the health sub-centres across the State, the Union Finance Ministry cleared Rs 5,000 crore World Bank loan for Andhra Pradesh earlier this year in February.

This programme aims to provide high quality eye care to affected population. 115 e-Eye centers have been established in the state of Andhra Pradesh in PPP mode. The beneficiary visits the nearest e- Eye clinic to get their eyes checked. A report is generated at the hub and treatment is initiated based on the report. Correction glasses/ spectacles are then provided free of cost on the basis of report.

Bio-Medical Equipment Maintenance Services

Telemedicine to Boost Rural Healthcare

Maternal & Infant Lifeline (MI Llifeline)

A telemedicine technology was adopted to improve rural healthcare infrastructure. Under PPP mode, a telemedicine network was established by many healthcare providers including Apollo. According to available statistics, it facilitated 18,98,170 consultations during the course of one-and-a-half years. In addition, the State Government

To reduce maternal and infant mortality in a focused manner, a cell, maternal and infant lifeline has been established. The maternal and infant lifeline aims to further strengthen the existing maternal deaths review system. An online tutorial â&#x20AC;&#x153;TalliSurakshaâ&#x20AC;? was also launched to train all the government doctors across state. As part of TalliSuraksha, tutorials are

Bio-Medical Equipment Maintenance Services aims at providing 24 x 7 service support to medical equipments in all public health facilities. The service aims at ensuring an upkeep time of 95 per cent for district hospitals and teaching hospitals, 90 per cent for CHCs and 80 per cent for PHCs. Every medical asset is tagged to an asset identification number.

accessible to all Obstetricians and Gynaecologists as well as PG students across the State having facility to access it from anywhere/anytime using their mobile phones or computer. It includes all major aspects affecting maternal mortality including PPH, Anemia, Eclampsia/Preeclampsia and sepsis.

cover story

diseases namely oral cancer, cervical cancer, breast cancer, diabetes, hypertension, vision, hormonal disorders. 12,000 ANMs are trained for screening for the above mentioned NCDs. Any suspected case will be referred to 57 identified referral hospitals for diagnosis and treatment.

Palakarimpu With the aim to ensure 100 per cent immunisation for all children in 0-5 years age group, the programme Palakarimpu was launched. The objective of the programme is to slash the death of children in the 0-5 years age group at least by half. The Government has not only taken measures to improve situation, but it has also ensured these benefits to reach lower strata of life. In totality, it can be said that the State is making giant leap to provide quality of patient care and his actions speak it all.

Quality Care in Hospitals Hospital Sanitation & Monitoring System: A policy for sanitation, security, and pest & rodent control was started in June 2016 across the state covering 11 teaching hospitals, 11 specialty hospitals, eight district hospitals, 33 area hospitals, 3 MCH centers and 2CHCs. A HSMS application is used to collate various checkpoints of measurable items and is then used to generate average sanitation scores.

NABH Accreditation for 15 hospitals Governmen of AP has entered MoU with Quality council of India, for accreditation of 15 Teaching hospitals under DME, AP. In the first phase the Quality assessors have visited the hospitals from 01.09.2017 and submitted the GAP analysis. In Phase II nodal officers of the concerned hospitals were given training for necessary preparation. Rs 167 crores

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cover story

is approved under this program fior development of hospitals.

Name of the Indicator

Out of pocket expenditure on health is defined as the payment made by the user at the point of service for seeking healthcare. It is one of the measures of Universal Health Coverage which means affordable, accessible and equitable healthcare. The survey is designed with a specific to capture utilisations and expenditure details of sickness or disease with special focus on chronic illness; treatment underwent (out-patient, inpatient, and delivery) with type of public or private provider; expenditure incurred against service delivery for the components like: service fee/consultation fee, medicines, diagnostics, transport, other expenditures for lodging, attendant etc. • Baseline survey was conducted in 2015. Various interventions in health sector has been launched in January, 2016. To capture change the end survey was conducted in

2015

2017

Total out of pocket expenditure (OOPE) per capita per annum (in Indian Rupees)

Impact of the Initiatives:

Indicator/ Innovation

1.1

Per Capita OOPe on Healthcare

5,770

1,205

1.2

Per capita (OOPE on Healthcare — Medical

5,062

1,104

1.3

OOPE on Laboratory Tests

861

388

1.4

OOPE on Medicines and Consumables

2,531

486

deliveries reduced by 55.4% in Government facilities and by 32.3% in Private facilities

India’s First Med-Tech Initative in Andhra Pradesh Medical devices play a pivotal role in overall healthcare delivery. Only the highend technology equipped instrument can detect serious disease at initial stage.

To cut dependency on imported devices and reduce the cost of

of Drugs, Surgicals & Consumable and Equipment is also entrusted to this Corporation by the Government (Medical and Health Department). The Government has not only taken measures to improve situation, but it has also ensured these benefits to reach lower strata of life. In totality, it can be said that the State is making giant leap to provide quality of patient care and his actions speak it all. Looking at the overall healthcare scenario in Andhra Pradesh, one tends to observe a sincere endeavour being made to influence life of every household. It’s being ensured that access to a better healthcare doesn’t remain

CT scan

X-Ray^

Lab

MMU

eUPHC

Program budget as % of total health budget

0.04%

0.03%

1.73%

0.19%

5.00%

8.65%

program budget as % of total NHM budget

0.2%

0.16%

8.55%

0.95%

0.25%

1.75%

per capita cost of the program ( In Rupees)

256.00

0.40

21.36

2.36

13.3

21.62

Average Savings to per Beneficiary in ` (acc. To CGHS rate)

1815

6.53

335

2673

171

194

Notes * Savings is per session for Dialysis Program * Savings is per X ray taken

•

August, 2017 i.e. after 20 months of interventions This survey was conducted in selected 26 villages and 14 urban areas across all 13 districts.

Key findings from Major Indicators: • The per capita OOPe on healthcare reduced by 79% to 1,205 INR in 2017 • OOPe on laboratory tests reduced by 81.25% in Government facilities and by 53.5% in private facilities • Average OOPe for C-Section

Sl.No

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Dialysis*

Rs 721.17 Crores: Total Annual Saving to the population of Andhra Pradesh from June 17-May 18

manufacturing, the Government started Andhra Pradesh MedTech Zone Limited (AMTZ). It aims to put India on the global map of high end medical equipment production and make health care products affordable and accessible. In addition, A.P. Health & Medical Housing Infrastructure Development Corporation (APHMHIDC) facilitates and effective implementation of healthcare programmes in rural and semi-urban areas. The main functions of the corporation are construction & maintenance of hospital buildings. Further, the procurement and distribution

confined to the well off but it turns affordable for even the people from lowest strata of life. This is being made possible due to the State Government’s positive and modern approach towards adapting technological innovations and making them integral part of the administrative system. Even in near future, the Andhra Government looks resolute to develop a healthcare-centric State which will be a torchbearer in terms of disruptive technology and innovative solutions while inspiring other States of the country to go the Andhra way.

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Exclusive Interview

AP Empowering Citizens with Innovative Governance: Nara Chandrababu Naidu Andhra Pradesh (AP) now has Real Time Governance System (RTG) which has enabled Government agencies to communicate with beneficiaries and citizens on real time basis through plethora of access mechanisms with digital and technological interventions, says Nara Chandrababu Naidu, Chief Minister, Andhra Pradesh in an Exclusive Interview with Gopi Krishna Arora of Elets News Network (ENN).

june 2018

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You have been known as a leader for whom it is the outcomes that matter the most when it comes to governance. Where do you place Andhra Pradesh (AP) today when it comes to the overall development of the State? The result-oriented approach of Andhra Pradesh (AP) has been superseded now with public satisfaction and public access-based approach. Every good result is good but it may not be good enough to match the public expectations. AP now has Real Time Governance System (RTG) which has enabled Government agencies to communicate with beneficiaries and citizens on real-time basis through plethora of access mechanisms with digital and technological interventions. At the same time, the result-based approach has given the State lot of credentials and helped to move forward.

Amaravati is now talk of the town as it is being viewed to be the next big thing in building world class city infrastructure. Would you shed some light on the progress of the city in the making? Generally, the city planning happens from an infrastructural perspective, not from a sectoral perspective. Amaravati is the first greenfield capital city in India which is being planned not just from infrastructural perspective, but also with the sectoral perspective approach. It means judicial district, business district, sports district, health district, education zone and many more are already planned while making the design of the new city. Globally, very few cities have been designed in this way where business meets business confined in an ecosystem yet interacting with the multiple parts of the universe. The second characteristic of Amaravati is that it has envisioned future and the city will be petrol-free city. Amaravati will be full of electrical plug points where one can charge the

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vehicles. In this futuristic city of India, waterways will substitute roadways in a big way. The foundation of the city will be sustainable living, the wall will be green living and efficiency will be the roof. Hence, Amaravati will not only be a city itself, but goes rather much beyond that. Amaravati is a concept of remodeling and rethinking our lifestyles, convenience patterns and our social requirements keeping in mind the sustainability of the entire society.

But at the same time, one needs investments to build this kind of infrastructure. What steps have been taken by your Government to attract investors to the state? Andhra Pradesh has been known for having one of the best industrial policies in the entire country. Every decade the next decadeâ&#x20AC;&#x2122; policies are already rolled out. The ease of doing business is what actually attracts the industry. Generally, industry gets excited to invest in a State for the ease of doing business procedure of a State and also look at the sector specific factors. When it comes to Andhra Pradesh, I can happily share with you that most of the logistical aspects are optimally placed and at the same time, every sector has been given its due share in terms of its requirements. Let me take the example of electricity

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Andhra Pradesh has been known for having one of the best industrial policies in the entire country

or water- AP is power surplus State and also has one of the best irrigation or ground water harvesting models. Our State is also the automobile hub and South Korea has invested in the automobile hub in AP. We do have strong IT backbone historically and we are also developing cities like Tirupati as the next big next-gen data hub. If we can put these sector specific

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June 2018

Exclusive Interview factors and super impose them over the general optimum factors which AP has, then we can proudly say that Andhra Pradesh is most well-placed to harness the potential of any sector and if itâ&#x20AC;&#x2122;s a complicated sector like health, then it is even more well-placed.

We know that health and education are the key focus areas for any Government. What has been done by your Government to transform the lives of people with regard to health and education spectrum? Let me first give you the healthcare scenario of the State. Andhra Pradesh is the first State in India to announce universal health coverage in 2017 and doing quite well in that front. Most of the programmes are in Public-PrivatePartnership (PPP) mode which helps, harness the cost effective models of efficient healthcare. The mortality and morbidity indicators are on the decline and the utility and satisfactory indicators are on the rise. Industry

june 2018

promotion has been linked to service delivery. We have Medtech Zone coming up in Visakhapatnam along with the establishment of Pharma City, Health City. The various industry promotion factors are converged with service delivery. Andhra Pradesh is Arogya Pradesh. The progress in healthcare sector in last four years in the State is historic and momentous. Owing to various factor, the paucity of institutions was a challenge in education sector. It has been neutralised to a great extent by setting up new institutions, several universities have been given autonomous status by University Grants Commission (UGC), the number of schools and quality time spending in schools by children have been increased. Data speaks for itself and all these are available transparently in CM core dashboard. Education and health have been improving by leaps and bounds in terms of progress and positivity in AP. Let me take this opportunity to give you an example on how we

have integrated education and health though IT. We have a free pathology programme and that has resulted in large number of data generation on blood test and blood markers. These are analysed with the help of Artificial Intelligence (AI). 57 mandals were identified where certain blood markers are shown to be rising. In these mandals, public food distribution centers, traditionally known as Ration Shops have started keeping brown rice. This has happened only because health, awareness, education, civil supplies and data analytics have all worked together. Nowhere in the world there has been a change induced by the governance model in food habits of people to avoid a disease. This is what we have achieved in Andhra Pradesh.

Coming back to health, how do you perceive and rank AP MedTech Zone? AP MedTech Zone is the only zone in the world of its kind dedicated to medical technology production. If we

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forward for the entire world to learn that if a holistic system of scientific infrastructure is combined together with good industrial facilities, then the gains are incremental. AP MedTech Zone is and will continue to be a benchmark globally for med-tech enhancement, med-tech engineering and med-tech access. AP displays optimal governance in general parameters and also sector specific cutomised efficiency models.

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walk into any hospital, we see medical equipments and they are the most expensive things. India is dependent heavily on imports when it comes to medical equipments and specially for complex medical equipments (like MRI, etc) we are 100 dependent on imports. Andhra Pradesh is an answer to this challenge. AP MedTech Zone is an answer to the global paucity of affordable medical equipment. It is not only a benchmark but a way

AP MedTech Zone is an answer to the global paucity of affordable medical equipment. It is not only a benchmark but a way forward for the entire world to learn that if a holistic system of scientific infrastructure is combined together with good industrial facilities, the gains are incremental. AP MedTech Zone is and will continue to be a benchmark globally for med tech enhancement, med tech engineering and med tech access

exclusive interview 22

â&#x20AC;&#x2DC;Andhra Govt Providing Enabling Environment to Start-upsâ&#x20AC;&#x2122; The Andhra Government has taken a series of measures in terms of infrastructure and technology. To provide enabling environment to start-ups and encourage entrepreneurship in the State, it has been proposed to set up the Andhra Pradesh Innovation Society (APIS). We are in the process of incubating 100 start-ups in next five years, says Nara Lokesh, Minister for Information Technology and Communication, Panchayat Raj and Rural Development, Government of Andhra Pradesh, in an Exclusive Interview with Gopi Krishna Arora of Elets News Network (ENN).

What are the major policies through which the State Government is promoting startups and entrepreneurs of Andhra Pradesh? The department has proposed setting up the Andhra Pradesh Innovation Society (APIS), whose role is to encourage and promote entrepreneurship in the State, through initiatives such as Innovation and Startup Policy 2014-2020, technology ventures, technology incubators and technology accelerators, and campus connect. The APIS is setting up a fund of funds with a grant of Rs 100 crore for entrepreneurs and startups, with the aim of developing an ecosystem of start-ups. Govin Capital, Singapore, in collaboration with APIS has set up a pilot incubator facility in Sunrise Towers, Vishakhapatnam where 14 start-ups have already been incubated. They are in the process of incubating 100 start-ups in the next five years. The State also houses XLr8, a top-6 technology accelerator in the country. In an attempt to promote futuristic

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technologies, APIS is pushing the innovation agenda across verticals through drone incubation center and CoE for IoT. The State has been allotted 131 Atal Tinkering Labs, the highest number of such labs in a single State. These labs will be established across all 13 districts of the State to ensure equal opportunity to citizens and nurture an ecosystem of student entrepreneurship. The IT department has played a key role in collaborating with TiE, a non-profit global community welcoming entrepreneurs from around the world for mentorship and networking, to establish the TiE Amaravati Chapter. TiE events are planned throughout the year, covering a wide range of topics, across the State of Andhra Pradesh.

You took over as the Minister for IT, Government of Andhra Pradesh, a year ago and played a role of visionary leader. Today, Andhra Pradesh is largely seen as a growth story. How would you describe the greatest accomplishment of Andhra Government?

Nara Lokesh, Minister for Information Technology and Communication, Panchayat Raj and Rural Development, Government of Andhra Pradesh I firmly believe that information technology and electronics will form the backbone of our future economy. Since taking charge as the Minister for IT, Govt. of Andhra Pradesh, our Government has successfully brought about a renewed interest among potential investors in the areas of IT, electronics and industry 4.0 technologies. The State has developed a strong vision for the IT sector in the state to enable the creation of one lakh IT jobs and bring in investments worth $ two billion. It also envisions creating two lakh jobs in the electronics sector and bringing investments worth $ five billion in the sector.

The Government of Andhra Pradesh realises the potential of the industry and the growth

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HMIT in Los Angeles meeting APNRT and Telugu NRI Community

opportunities it brings to the State. How are we planning to make the State best investment destination? Our government is on track to achieve its commitment of generating one lakh IT jobs and two lakh Electronics jobs through industry participation in the State. The CII Partnership Summit 2018 saw high-level of interest from potential investors in IT, Electronics and other industry 4.0 technologies. A total of 76 MoUs were signed with committed investment of Rs 30,058 crore and committed employment of 1,31,748 jobs. The State forged 41 MoUs in the IT sector, committing an investment of Rs 9,880 crore with a committed employment 87,273 jobs. Moreover, 30 MoUs signed in the Electronics sector have a committed investment of Rs 19,800.24 crore and committed employment of 42,290. These MoUs include four MoUs with IT infrastructure companies, which will bring in investments of RS 3,450 crore and generate employment of 44,500 in the next 5 years.

Tell us about the state policies in place for the IT, Electronics and Fintech sector. Over the past 12 months, our Government has championed the need for the creation of a number of policies to cater to traditional as

well as emerging technologies. These policies will enable the creation of a best-in-class business environment to encourage and assist companies to set up operations in the State. Some of these policies are: • Cyber Security Policy 2017-2020 • Global In-house Centre Policy 2017-2020 • Designated Technology Parks Policy 2017-2020 • Integrated Innovation and

The State has been allotted 131 Atal Tinkering Labs, the highest number of such labs in a single State. These labs will be established across all 13 districts of the State to ensure equal opportunity to citizens and nurture an ecosystem of student entrepreneurship

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Technology Policy 2017-2020 • Artificial Intelligence Cloud Hub Policy 2017-2020 Besides, our Government is also spearheading the rollout of a policy targeted towards Animation and Gaming sectors. The policy is expected to be released shortly. These business-friendly policies have helped in attracting marquee investments to the State including HCL, Franklin Templeton Investments, Conduent, and ANSR Consulting, among others. We have also directed the development of suitable IT infrastructure in terms of cold shell and plug and play office space. A dedicated team has been working on identifying ready office spaces for IT companies to commence operations. Till date, 19,40,188 sq ft of land with a seating capacity of 24,240 has been identified, and multiple IT layouts extending over 415 acres have also been taken up. The Millenium Towers facility coming up in Visakhapatnam will be IoT enabled and cyclone resistant and house 2,00,000 sq ft. of space for plug and play operators. The Tech Mahindra building in Vishakhapatnam that has been taken up by Andhra Pradesh Electronics Information Technology Agency (APEITA) on lease for providing plug and play infrastructure is filling up

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Nara Lokesh during a CEO roundtable conference

fast, and APEITA is on the lookout for additional space. The department has also been actively involved in setting up of IT SEZs in the State. The State has two SEZs dedicated to IT and is looking to set up four additional SEZs in Vijayawada, Visakhapatnam, Chittoor, and Anantapur. Additionally, during the recently concluded CII Partnership Summit 2018, Vishakhapatnam Urban Development Authority (VUDA) inked a memorandum with the State Government to develop an IT City in its 20 acre land in Madhurawada. Electronics Sector With an aim to create the best of facilities in these clusters and also attract investments in the electronic sector, The Government of Andhra Pradesh has proposed to constitute a Task Force. The members would include secretaries from different departments of GoAP, APEITA, Andhra Pradesh Economic Development Board, Andhra Pradesh Non-Resident

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Telugu, and members from Electronic Manufacturing Industry, and associations representing ESDM sector and Consultants. In lieu of the large scale employment generation potential of the electronics manufacturing sector, the Government of Andhra Pradesh has accorded highest priority to the sector. The State Government envisions the creation of a ‘Silicon Corridor’ in the State, which will provide 2 lakh jobs in the Electronics sector. We have a sustainable longterm vision for electronic clusters, which is to create a comprehensive infrastructure for electronics manufacturing in 6,000 acres of space with a total built up area of 24 million sq. metre. The ITE&C Department has proposed to set up five clusters for electronics manufacturing at Visakhapatnam (catering to medical electronics), Nellore (SriCity), Tirupati (EMC-1 and EMC-2 catering to mobile, consumer electronics and automotive electronics) and Anantapur (Gudipalli, focusing on defence, aerospace and PCB manufacturing). The State has been successful in grounding investments from marquee electronics companies including Celkon, Dixon and Foxconn.

Fintech & Blockchain In the past one year, Visakhapatnam has been developed as a hub for Fintech companies. Fintech Valley Vizag aims to create a global Fintech ecosystem in collaboration with multiple stakeholders such as corporates, universities, financial institutions, technology service providers, startups and accelerators. Under the able leadership of visionary Chief Minister N. Chandrababu Naidu, Fintech Valley Vizag has become a global brand in a short span of time and has been garnering interest from various countries looking for market access in India, in the domains of Fintech cutting across the verticals of cybersecurity, artificial intelligence/ machine learning, analytics, and blockchain. In the past year, Fintech valley has also created India’s largest Fintech use case repository with its 20 leading BFSI corporate partners such as IDFC Bank, Aditya Birla, TATA financial services, Kotak bank etc. with 100 use cases identified. This repository aims to open market access opportunity for startups from across the world to run proof of concepts as well as project implementation with our partners. We have also been actively spearheading the adoption of Blockchain technology, and his efforts have been recognised globally. In

Nara Lokesh with the Vice President of PayPal, Richard Nash

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Hon’ble CM Nara Chandrababu Naidu ( 5th from Right) and Minister Nara Lokesh ( 4th from Right) with industry visionaries in Davos

October 2017, Vizag hosted Asia’s biggest blockchain conference, attended by 1,000+ delegates from over 20 countries. Recognising the dearth of R&D centers based on blockchain platform, our government has encouraged the creation of blockchain centres of excellence (CoE) in collaboration with Broadbridge, Thomson Reuters & GITAM University as well as creating forums for Fintech and blockchain.

Tell us more about Designated Technology Parks Policy 2017 – 2020 and Andhra Pradesh Artificial Intelligence Cloud Hub Policy 2018 – 2020. The Designated Technology Parks Policy 2017 – 2020 aims to create a robust and reliable infrastructure for Information Technology companies to setup operations. And, the Andhra Pradesh Artificial Intelligence Cloud Hub Policy 2018 – 2020 is a first-ofits-kind policy in India, with the potential of transforming Andhra Pradesh into the IoT and Cloud hub of the country.

Today, effective use of ICT is imperative to meet the evergrowing expectations of citizens and businesses. E-Governance is continuously evolving to provide access, equity & empowerment to masses. Tell us about the major e-governance projects initiated in Andhra Pradesh in recent times? The Andhra Pradesh government firmly believes that adopting the latest technology is quintessential to provide effective governance and achieving sustainable economic growth across all sectors, and has championed the State’s fast paced implementation of Industry 4.0 principles within the government. We have been instrumental in conceptualising the digitisation of governance across departments, leading to a more effective and transparent monitoring and delivery of schemes and activities. The State has envisioned the need for a one-stop portal for IT & Electronics investors. The portal will enable online application and processing of incentives and approvals. We have implemented Chief Minister’s Office Real-time Executive

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(CORE) Dashboard that empowers governance, and is now cited by the NITI Aayog as a replicable best practice for other State Governments in India to emulate. The NITI Aayog has a special mention of technology initiatives of GoAP in their report titled “State Forward” published last year. We were instrumental in the rapid progress made by the e-Pragati authority in digitally transforming Andhra Pradesh into the first such State Government in India. The e-Pragati core platform has been designed with the following features: • Ready to use e-services platform • Whole of Government approach • Standardised citizen experience • Big Data and analytics support across the departments Going forward, the services of 33 departments will be digitalised and separate apps will be developed for services provided by each department, to offer one touch access of digital services to the citizens. All the apps will be put on the e-Pragati platform. The e-Pragati Authority has organised the “Digital Transformation in Public Governance” training

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employability to make the youth of state employable?

programme for 96 senior officers, in collaboration with Indian School of Business (ISB), Hyderabad. The e-Pragati Authority has commenced a “Digital Literacy” programme, through which it aims to train more than 50,000 government employees for ICT adoption at extreme ends of the government administration. Our dedicated team has played an active role in conceptualising and monitoring the implementation of e-Office, aimed at restricting physical movement of files between departments, and so far it has been implemented in all 13 districts covering up to the gram panchayat level and has been used to create 22,98,313 files. The e-cabinet initiative was launched on similar lines of e-office, and has since been effectively utilised for conducting 88 e-cabinets so far, for approval of draft cabinet notes, uploading and approval of Cabinet resolutions, and monitoring the implementation of the resolutions. This will lead to more effective, efficient and transparent governance. Being a strong proponent of utilising technology in governance, GoAP has implemented several innovative and citizen centric e-governance projects such as MeeSeva, MeeKosam, MeeBhoomi, to ensure improved delivery of services and faster grievance redressal of citizens. The success of

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these initiatives is gauged from the fact that Andhra Pradesh has consolidated the first position for delivery of e-Services in the country, as per the e-Taal portal of GoI.

How the State Government is using technology to improve agricultural productivity in the State? Latest technology is being utilised by Andhra Pradesh in developing agriculture sector. The government has deployed drones to collect and analyse soil samples, and piezometers to continuously monitor ground water levels at mandal-level. Sensorbased IoT devices are also being assessed for retrofitting old electricity meters with new technology. We are formulating new policies to strengthen farmers and also called agri-tech startup companies to invest in AP. The State government is providing all the help required for the startup companies in regard to the infrastructure and other activities apart from offering quality seeds, fertilizers, and modern equipment, to the farmers.

The Skill Development is another major focus of Government of India. What is the Andhra Pradesh Government’s approach in linking education and

Skill Development and Employment The Andhra Pradesh State Skill Development Corporation (APSSDC), in association with Microsoft, to conduct regular workshops in software development and programming, and organise hackathons for students across the State as part of the State’s up-skilling initiatives to improve employability of the available human capital. Projects such as “Project Sangam” are focusing on providing vocational training in different trades for unemployed youth in Vishakhapatnam, Vijayawada, Tada (Sri City), and Anantapur. These training programmes will be extended to seven (7) additional locations in subsequent phases. In December 2017, Andhra Pradesh Information Technology Academy (APITA) conducted a mega job fair in Vijayawada, where more than 7,700 candidates attended, with 1,000 final job offers rolled out. Implementing the vision of the Chief Minister, the Andhra Pradesh Information Technology Academy (APITA) conducted another mega job fair in Tirupati between March 7-9, 2018 where nearly 3,000 job offers were handed out to eligible candidates by 50 top tier companies, and another such job fair is being organised in Visakhapatnam during March 14-16, 2018. The Government of Andhra Pradesh intended the establishment of the International Institute of Digital Technologies (IIDT) at Tirupati, Andhra Pradesh, to preempt an increasing gap in skill sets in emerging technologies. To this end, the IIDT aims to equip students with next generation technologies (Cyber security and Data Analytics) which are relevant for the growth of the industry in the coming decade.

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‘Our Quest to Excel Guides us to Serve People Well’ Hon’ble Chief Minister has always stressed on Real Time Governance and we have strived to bring forward the same in the Health Department as well and Information Technology becomes very important enabler in this scenario, says Dr Poonam Malakondaiah, Special Chief Secretary, Health, Medical & Family Welfare Department & Mission Director, National Health Mission, Government of Andhra Pradesh, in conversation with Gopi Krishna Arora of Elets News Network (ENN).

Dr Poonam Malakondaiah Special Chief Secretary, Health, Medical & Family Welfare Department & Mission Director, National Health Mission, Government of Andhra Pradesh

What is your strategy to deliver promotive, preventive, curative and rehabilitative public health services to the rural as well as urban population? The Health Medical and Family Welfare (HM&FW) Department’s strategy is derived from the Hon’ble CM’s vision to make Andhra Pradesh the healthiest State in the country. He has stressed only on the curative but preventive aspects of healthcare and has included the concept of emotional well-being as key to achieve this vision of timely, accessible and affordable healthcare. Accordingly our strategy is to strengthen the Public Health facilities with latest medical technology and best practices,

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rope in Private Public Partnership to scale up efficient delivery and ensure universal health coverage through programmes like NTR Vaidya Seva and Arogyaraksha. Underlying all this is the unitisation of latest information technology and data science to integrate all the information and take focused actions, real time, to bridge any gaps in delivery whether urban, rural or tribal.

Affordability and accessibility of healthcare services has become a serious concern for the vast majority of the population. How the department is planning to tackle this? The Government has undertaken several innovative steps to make healthcare delivery accessible to every citizen of the State. We have a vast network of public health facilities which comprise 13 Teaching Hospitals, District Hospitals, Area Hospitals, Community Health Centres, Primary Health Centres (PHCs) and sub-centres that cater to the public across the care continuum.

In addition, flagship programs like the Chandranna Sanchara Chiktsa have mobile medical medical units that deliver primary healthcare services at the doorstep of the rural areas. In the urban areas, we have started the e-UPHCs to provide the same to all the BPL families that also have a free specialist teleconsultation consultation. Through the PPP programmes like NTR Vaidya Pariksha, Free Dialysis Programme, e Aushadhi and Mukhya Mantri Eye Kendrams, the public is benefiting from lab services, medicines etc that has decreased the out of pocket expenditure in the State by crores of rupees over the last one year

What are the challenges involved in ensuring equitable access for all citizens to affordable, accountable and appropriate, assured quality health services? The main challenges are lack of real time data to continuously monitor the efficiency of the several programmes, feedback loop to take corrections

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There are many programmes such as immunisation, population stabilisation, reducing infant mortality and maternal mortality. Where do you utilise the funds most? Govt utilises the funds mostly for Reproductive & Child Health activities to reduce Infant Mortality Ratio (IMR) and Maternal Mortality Ratio (MMR).

What are the major initiatives taken up by the State Government to improve healthcare infrastructure especially in rural areas? One of the major initiatives has been on making healthcare accessible to the tribal areas. For this, we have taken various steps, some of them I have just shared. Also, we have partnered with the Tata Trusts to improve the cancer care being delivered in the State. We are in the process of setting up new cancer centres in partnership with them that will not only bring quality care but affordable specialised treatment to both urban and rural areas. Our programmes like Talli bidda express and feeder ambulances have received tremendous positive response from the rural areas.

What are the government’s priorities under the NHM for the coming year? The Government’s priority is to reduce the Infant and Maternal Mortality rates

by 50% in the next year.

India’s healthcare system consists of a mix of public and private sector providers of health services. What are the challenges and opportunities involved in PPP model for health domain? Through various PPP programs we are delivering various key health services. This has both challenges and opportunities but I can proudly say that we have seen very good outcomes and success with our PPP programmes. Lack of efficient monitoring mechanisms can lead to degeneration of quality of services. Also, the PPP models should be supportive of the business goals of the partner organisation too, failing which the partner might not be able to sustain the service level leading to public dissatisfaction. The Department has successfully ensured that we have the right contractual, IT and financial elements in the PPP programmess that make the PPP program a win-win situation for the Government, the private partners and, more importantly the public. The proof of this is highly satisfactory scores of 90% and above that we achieve in many of these programmes in the Real Time Citizen feedback.

Andhra Pradesh is operating various healthcare programmes in collaboration with service providers and knowledge partners on PPP mode. Tell us about that programmes. In the state of Andhra Pradesh, Health services are also being provided in PPP mode to ensure better delivery with quality by the service providers. Reputed National & International institutions are the Technology Partners to give technical inputs to enrich the programs. The senior state level health officers are working as Nodal officers for effective monitoring on the implementation of the program.

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Funds are utilised mostly for Reproductive & Child Health activities to reduce Infant Mortality Ratio (IMR) and Maternal Mortality Ratio (MMR)

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and also lack of awareness among the public to effectively utilise all the benefits that the government has offered to the public. However, we have taken several steps that help us address these challenges by creating a Knowledge Command Centre that synthesises all this data in the real time and helps take focused actions and create awareness. This is the first time in the country that such a thing is being done. The world’s largest healthcare IT and Analytics firm Cerner is our partner in this initiative.

Services being delivered in this mode are Talli Bidda Express, NTR Vaidya Pariksha Free Diagnostic Laboratory Services, Tele-Radiology X Ray Services, Tele-Radiology CT Scan, NTR Baby Kit, National Free Dialysis, Chandranna Sanchara Chikitsa, Mukyamanthri Aarogya Kendralu, Mukyamanthri e – Eye Kendram, Biomedical Equipment Maintenance Service, Hospital Sanitation, Security, Pest & Rodent Control, CHC Sanitation services, Hospital Linen & Laundry Services, Mahaprasthanam. The technology partners associated with these programs are George Institute for Global Health, New Delhi, International academy of Environment & Public Health (Sulabh), New Delhi, Post Graduate Institute of Medical education & research, Chandigarh, Tata institute of Social Science, Mumbai, World Health Organization, New Delhi, Council of Scientific 7 industrial Research, Chandigarh, Quality Council of India – National Accreditation Board, New Delhi, The Energy Research Institute, New Delhi, All India Institute of Medical Science, New Delhi and Administrative staff College of India, Hyderabad.

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Recently, NITI Aayog appreciated several practices being followed by Andra Pradesh in healthcare system, terming them as the best in the country. Tell us about e- procurement system of Andhra Pradesh. e-Procurement of APMSIDC Indents are received from HODs i.e, Commissioner of Health and Family Welfare, Director of Public Health, Commissioner of APVVP, AYUSH, Directors of RIMS and District Collectors etc. Today, all tenders are invited through e procurement. These tenders are invited from manufacturers or authorised dealers. Emails are sent to prospective bidders and manufacturers identified through websites requesting to participate in the bid for more competition. Also, pre-bid meeting is conducted with all prospective bidders on their queries and during this meet all the queries are discussed by presenting on the screen, and suggestions and clarifications are discussed. As per the outcome of the pre-bid meeting, amendment will be issued duly safeguarding the requirement and ensuring more participation. Once the tender is received, technical evaluation is conducted and evaluation reports are published on the website for bidders’ objections. Thereafter, the objections received on the technical evaluation reports are discussed in the note file and accordingly financial bids of the responsive bidders are opened. The details of technical and financial bids are placed before BFC for its decision. BFC will be chaired by the Special Chief Secretary, and Commissioner of Health & Family Welfare, Director of Public Health, Director of Medical Education, Commissioner of Andhra Pradesh Vaidya Vidhana Parishad (APVVP), Secretary, Finance Department along with Managing Director, Andhra Pradesh Medical Service & Infrastructure Development Corporation (APMSIDC) as members.

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‘All the documents uploaded by all bidders are visible on e-procurement website along with price quoted by the bidders.

Andhra Pradesh is the first State to declare the Universal Health Coverage. Tell us about its implementation challenges and current status. Dr NTR Vaidya Seva Trust is committed to providing quality healthcare services by implementing various health schemes that suit different sections of the society viz, Dr NTR Vaidya Seva scheme for the BPL families, Employees Health Scheme (EHS) for the Employees/Pensioners along with their dependents, Working Journalists Health Scheme (WJHS) for the accredited journalists and their dependent family members, Amaravati Residents Health Scheme for the families located in the 29 villages of Amaravati. These schemes would cover about 90% of the population of AP; and hence the Aarogya Raksha Health Scheme has been introduced to cover the balance population. Thus, under this scheme any citizen of Andhra Pradesh can enrol by paying a meagre premium of Rs 1,200 per year per family member. While the NTR Vaidya Seva Scheme and Amaravati Residents Health Scheme cover 1044 procedures with a cap of Rs. 2.5 lakhs per family per year; the EHS and WJHS schemes cover 1,885 procedures with a cap of Rs 2 lakh per session; the Aarogya Raksha cover 1,044 procedures with a cap of Rs 2 lakh per family member per year. The above services are extended to the beneficiaries in nearly 1,000 empanelled hospitals of both Government and Private corporate hospitals. Though, nothing in particular has to be stated under the head of challenges that are being faced in the implementation of the above Health Schemes, it may faintly be mentioned that the implementation of the Aarogya Raksha needs wider publicity among

the public to achieve its goal in toto.

Could you tell us about the Health Management Information System (HMIS) application software and other such IT initiatives taken up to improve health care systems? Hon’ble CM has emphasised on Real Time Governance and we have strived to bring forward the same in the Health Department as well and Information Technology becomes very important enabler in this scenario. There are currently 19 different data sources, both public and private that the department is synthesizing data from. The Realtime analytics that emerge from this from our Knowledge Command Centre are then disseminated through internal communication apps like Kazila to all stakeholders including District Administration, Hospitals and Private Partners. The Core Dashboard of the CM is constantly updated with real time statuses of all the initiatives. Additionally, upon the guidance of the Hon’ble CM, we have created comprehensive mobile based apps like ANM Digi that we have provided to our ANMs to relieve them of the administrative burden and help then focus on clinical work. We are also planning on deploying Electronic Health records in all public health facilities in a phased manner. It will allow citizens to access their records within no time and with convenience.

What all projects are being initiated in therecent times for better health services? Some of the upcoming programmes are in the maternal and child health areas. The Rashtriya Bal Swasthya Karyakram screening programme is about to be launched which will preventively screen 80 lakhs children for health issues. We are also working aggressively to reduce the Infant and Maternal Mortality rates through a programmatic approach, the details of which we will be sharing soon.

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AMTZ MD & CEO Speaks

Andhra Pradesh MedTech Zone

Indiaâ&#x20AC;&#x2122;s Answer to the World on Medical Technology AP Medtech Zone is an answer to the prayers of patients who are looking for cost effective medical treatment, says Dr Jitendar Sharma, Managing Director & CEO, Andhra Pradesh MedTech Zone (AMTZ) and Advisor (Health and Medical Technology), Government of Andhra Pradesh, in an interview to Souvik Goswami and Gopi Krishna Arora of Elets News Network (ENN).

Dr Jitendar Sharma Managing Director & CEO Andhra Pradesh MedTech Zone (AMTZ) and Advisor (Health and Medical Technology) Government of Andhra Pradesh

Andhra Pradesh has been a leader in many fronts when it comes to healthcare spectrum. Share with us the journey of the State. The healthcare delivery traditionally has been understood as mechanisms to provide better care. But Andhra Pradesh has combined service delivery with industry promotion. This has been the unique trajectory taken by the State. While innovative models of healthcare service delivery are being adopted, innovated and implemented the industrial promotion part of healthcare service delivery, which means fiber optics, bandwidth of internet, production of medical

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devices, etc, Andhra Pradesh has been on the forefront in all of these. This has made Andhra Pradesh the only State in India and perhaps one of the very few provinces in the world that has efficiently integrated industry promotion with service delivery.

Can you give some examples of the unique feature of integration of service delivery with industry promotion? We all know that diabetes is a health concern for many. For this, NCD screening is promoted in a big way. Most of the States or hospitals are buying blood glucose strips at a high cost. What Andhra Pradesh has done is unique. In AMTZ, we are producing worldâ&#x20AC;&#x2122;s cheapest glucometer with Bluetooth and IoT integrated in it. Because of this, we have been able to undertake screening at a much cheaper cost. It means two things -- saving of money for the exchequer and screening of more people at same cost. This is a classic example of integrating industrial promotion with healthcare service delivery. Similarly we are one the forefront of TB diagnostics.

Also let me share with you that, there are only 2 companies in the world which makes linear accelerator (LINAC) for cancer care and it is one of the most complex medical equipment in the global market. Andhra Pradesh is on the verge of making a linear accelerator (LINAC) for cancer care. This will reduce the cost of cancer care.

What has been the progress of Andhra Pradesh Medtech Zone (AMTZ)? AMTZ is yet to celebrate its second birthday. But we are already famous globally in this short span of time. Recently AMTZ has been awarded by the American Association for Clinical Engineering - an international organisation of repute on medical technology. In the history of this organisation, no Indian organisation has been even ever nominated. But AMTZ has got recognition from them. You must be wondering on why AMTZ has been given this award. It is because AMTZ has been able to lay down a costeffective model of medical technology production and all our laboratories

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What fascinated all these companies and experts to come to AMTZ? It’s about just three things. First, the scientific infrastructure provided by the State Government which is of finest class. Second comes the preferential market access policy by the Department of Industrial Policy & Promotion (DIPP), Government of India, which legally and tangibly provides preference to an Indian manufacturer to qualify in government procurement system. Thirdly, good governance in Andhra Pradesh, which is led by none other than the Chief Minister of the State -Chandrababu Naidu, who is recognised

globally for his governance. The success of AMTZ is equally the success of medical technology sector as a whole in India.

Andhra Pradesh has been a leader when it comes to using medical technology for providing better healthcare delivery. What is your opinion on this? We are number one when it comes to the use of innovative technology for providing healthcare services. Andhra Pradesh is the only State in India where most of the technology incentive programmes of National Health Mission are implemented 100 percent.

On the other hand, Visakhapatnam is coming up as the next big medical tourism hub. Shed some light on this. On the occasion of ‘AP Health Festival’ being jointly organised by Government of Andhra Pradesh & Elets Technomedia Pvt Ltd, we are launching an organisation called Andhra Pradesh Medical Tourism Hub (AMRIT) in Visakhapatnam. Most of the hospitals in various metro cities are facing the problem of space cramp. It is possible to send section of the patients to picturesque settings of Visakhapatnam near the beach, with wellness & Spa facility, under the close monitoring of doctors and with tie ups with hospitals, so that patients can recover in a better ambience and can stay in a relaxed mood. AMRIT is being set up with the partnership Ministry of Tourism, Ministry Health & Family Welfare and Department of

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AMTZ has been able to lay down a cost effective model of medical technology production and all our laboratories are near ready

AMTZ MD & CEO Speaks

are almost ready. In the world, there is no place, where all the scientific facilities required for medical technology production are available in one campus itself. This is a unique feature of AMTZ. We have been able to create a rainbow of institutions like Kalam Institute of Health Technology, WHO pre-qualification cell for In Vitro diagnostics, Directorate of Radiation safety, etc and we have also been shortlisted to set up incubation center under the program of NITI Aayog. Our first product is set to be launched on 18 August, 2018. India’s first MRI, Dialysis machine will be produced in AMTZ too. 40 percent of the area is already sold out and more than 50 companies have been roped in there. So, in terms of policy front or infrastructure, AMTZ is ready to lead the discourse on medical technology sector in India and globally.

Ayush, Government of India. Also a state-of-the-art Health City is being set up which will have 40 hospitals in it and this will attract patients from world over for major surgical medical treatments. This ‘Health City’ near Visakhapatnam can be the next Thailand, Hong Kong or Singapore. Our aim is to make Visakhapatnam the next prominent address of healthcare envelope in the world.

Share with us your vision on AMTZ along with the overall healthcare spectrum of Andhra Pradesh. Andhra Pradesh is the first State in India to have announced Universal Health Coverage in 2017 and doing quite well on that front. The State will become an example of one-of-its-kind through outcome- based approach, result-oriented efficiency model and evidence-based monitoring. It is going to be a model for the rest of the world to follow in healthcare. On the other hand, AMTZ comes with a great advantage of being the only zone of one of its kind, globally. It comes with lots of advantages. It’s an apple of the eye of med-tech industry in India. AP Medtech Zone is an answer to the prayers of patients who are looking for cost-effective medical treatment.

eHEALTH Magazine

June 2018

city Perspective

Visakhapatnam Being Evolved as Best Livable City With a series of ongoing smart projects, Visakhapatnam is rising in the rank of cities that have emerged as finest in the country. The cityâ&#x20AC;&#x2122;s projects like city surveillance, pollution monitoring, smartstreet, command and communications centre are meant to ensure better satisfaction level of citizens, says Pravin Kumar, Collector and District Magistrate, Visakhapatnam, in conversation with Elets News Network (ENN).

Andhra Pradesh is known for delivering good governance through e-Governance. How Visakhapatnam fairs with regard to delivering better citizen services? Andhra Pradesh is the leader in e-Governance initiatives in India. e-Pragati platform is one such initiative which is unique in terms of any such global initiatives. Each activity related to governance is monitored by Real Time Governance (RTG) society and Command Control

Centre (CCC) in Amaravati. Use of the Internet of Things (IoT) in governance is to improve service delivery and transparency. Like ration or pension distribution are biometric enabled. Employees and studentsâ&#x20AC;&#x2122; attendance is being marked on real time basis. Real time weather forecast, groundwater level measurement etc, are helping us to monitor environmental issues on real time. Monitoring of health and nutrition activities in far off

Pravin Kumar Collector and District Magistrate Visakhapatnam

places is conducted using technology. Parishkara Vedika 1100 Call Centre is a scheme to facilitate citizens in raising various issues before the direct notice of Chief Minister. All the services i.e. approvals of building plan, death certificates etc are today available online. These can be availed without any human interface.

Visakhapatnam is all set for urban transformation through Smart City Mission. What is the future course of action? Even before smart city mission, the Government of Andhra Pradesh (GoAP) and Chief Ministerâ&#x20AC;&#x2122;s vision was to develop urban infrastructure and use of technology at par with the best in the world. Projects like city surveillance, pollution monitoring,

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city Perspective

education and road/telecom connect in tribal areas.

smart-street, command and communication centres are meant to ensure a better satisfactory experience for citizens. Today, we are one of the cleanest and greenest cities of India. Besides, beach front developments, international convention centre, sport city projects etc. will be done at the earliest.

What are the focus development areas in Visakhapatnam? The focus areas include industrial growth including pharma and other industries in three different clusters of the District. Health City, Sports City and making the District the best in terms of ease of doing business are some of the priority areas. Other focus areas include marine and aquaculture productivity. Also, resolving all kinds of land issues and completing International Convention Centre figure top in the priority chart. There are Smart City Projects, Urban Development Projects like Master Plan Road and World Bank projects like Beach Front development, road works. Also, my priority is to improve health and

Q We are one of the cleanest and greenest cities in India. Beach front developments, international convention centre, sport city projects etc. are to be done at the earliest

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‘The Jewel of the East Coast’ is set for a new identity -- AP MedTech Zone and Medical Tourism Hub. How will these two initiatives help Vizag in getting highlighted as a global investment hub? Med-tech zone will be a world class facility for the production of healthcare devices.

How is the District administration ensuring affordable and accessible healthcare services? Andhra is a leader in health services. It’s duly bringing in service provider model. Almost 25 such services are being provided. NTR Vaidya Seva and ‘Health for All’ initiatives have been undertaken to achieve universal healthcare coverage goal. Infrastructure is being strengthened in seven teaching hospitals to provide best healthcare facility to the people of the State. To promote health tourism, a Health City is to be established in the heart of the city.

eHEALTH Magazine

June 2018

Technology Perspective

Krsnaa Providing Unmatched Diagnostic Services Our vision has been to provide quality healthcare at affordable prices by reaching out to as many people, especially, the rural India folks. We make use of state-of-the -art healthcare technologies to cater people, says Pallavi Jain, Managing Director, Krsnaa Diagnostics Pvt Ltd, in conversation with Elets News Network (ENN).

Pallavi Jain Managing Director Krsnaa Diagnostics Pvt Ltd

Having commenced its journey in 2010, Krsnaa Diagnostics has come a long way in providing quality services to its clients. How has been the experience? Krsnaa Diagnostics has come a long way overcoming all the odds in the hyper-competitive Indian market and has achieved nationwide recognition in diagnostics field. It has only been possible because of the great determination and dedication of these many years, innovation blended with advanced technological approaches, consistent efforts and hard work invested by all the employees for the growth of the company. Krsnaa Diagnostics, one of the fastest growing diagnostics chains in India, has developed a strong network

june 2018

across the country through various social and charitable activities in the field of healthcare. Our presence, currently pan-India, is in 15 States and across 1,800 plus locations providing radiology and pathology services 24/7 delivering quality healthcare to the masses. Krsnaa has, by now, reported over two million scans and has a team of 70 radiologists on its panel. At Krsnaa Diagnostics, we have a tradition of offering services at the same rates, throughout the 24 hours, without applying any kind of extra charges even during the odd hours. In order to meet the quality standards, we adopt the latest technology, equipment and standard operating procedures. We have top of the line equipment like 1.5T and 3.0T MRI systems, 16 Slice and 128 Slice CT Scan systems, Hi-End Ultrasound machines etc. from world leaders like GE Healthcare, USA; Hi-End Pathology equipments from ROCHE, Lilac, Horiba, Mindray, etc. to provide unmatched diagnostic services. Our vision and aim at Krsnaa have been to provide quality healthcare at affordable prices by reaching out to as many people especially the rural

Indian folks. We try and reach out to the needy patients directly, thereby cutting down on the intermediary. We work on a business model that is based on high volume, high efficiency, and yet not compromising on quality. We make use of state-of-the -art healthcare technologies to meet our requirements.

You provide a range of services from radiology to pathology. Tell us something about your services which sets you apart from others? At Krsnaa Diagnostics, our goal is to deliver the best possible services and to play a pivotal role in saving patients’ lives. We ask ourselves these questions every day, “Would we be willing and proud to get the diagnosis of one of our family members done in our diagnostic center?” “How do we assure our diagnosis is making a difference?” With these questions in mind, we are continuously assessing and improving our care-delivery programmes. Some of the things which make us different from our competitors are:

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l l

of equipment, use latest technology and maintain the standard operating procedures. We solicit feedback from our patients and constantly learn and work upon that feedback. Each of our facility is designed for comfort and healing. We hire and partner with compassionate and caring personnel. We offer computer-based education and recovery management programmes both during and after diagnosis. We use best-practices and evidence-based clinical and medical treatment protocols. We provide extensive community outreach services, on-site education and support groups. We measure our outcomes so that we can hold ourselves accountable.

Off late what kind of modern technologies and innovative practices have you adopted to enhance patient care in radiology department? To chase dynamics in radiology, we have adopted accelerated image processing speed which is essential to create high quality diagnostics images, accuracy in findings, 3D anatomical visualisation in the hands of physicians and surgeons to treat patients better, automation in work flow which gives hassle-free service delivery direct to the patient.

Shed some light over teleradiology. How is it beneficial for patients? The benefits can be summed up in 8 points: Faster diagnostics Remote radiology offers almost instantaneous viewing of medical imaging results. This enables physician, practitioners and hospitals to provide better patient care, allowing them to diagnose and treat patients quickly and

more efficiently. Reduces cost Teleradiology eliminates the necessity for radiologists to travel where the patient image was captured. This enables radiologists to work from practically any remote location. Cost will be saved on not having to employ a full-time, in-house radiologist. Improved consultation Remote radiology services give radiologists and physicians the ability to collaborate and derive the best treatment method for the patient. Second opinions can easily be reached from a sub-specialist radiologist without having to transfer the patient. No shortage of radiologists Many hospitals and medical practices are experiencing shortages in their radiology staff, especially during holidays and night shifts. Teleradiology helps practices do more with less staff because radiologists donâ&#x20AC;&#x2122;t have to be on-site to view and interpret images. This saves time and allows them to perform their functions more efficiently. Improves rural-area care Teleradiology enables rural medical practices and hospitals to expand their networks with other medical facilities and hospitals, without having need to over-staff. Rural hospitals can easily send their patient images to teleradiology providers to receive quick and expert interpretation of medical images. Improves staffing Teleradiology helps provide weekend, emergency, holidays, vacation, and after-hours services. Radiologists can essentially telecommunicate and, therefore the medical facilities that utilise this branch of telemedicine can provide services round-the-clock. Educational opportunities Teleradiology gives physicians and radiologists the ability to learn and expand their ability within the field. The technology can be helpful as an educational device through

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Our goal is to deliver the best possible services and to play a pivotal role in saving patientsâ&#x20AC;&#x2122; lives

Technology Perspective

l We do not compromise on quality

presentations from clinical radiologists or other knowledgeable healthcare experts in the field. 24/7/365 coverage Krsnaa Diagnostics provides 24/7, 365 days/yearly coverage. You can always count on KDPL for unlimited access to ensure your practice is running smoothly and efficiently.

Please tell us about your association with Andhra Pradesh Government. What projects are you currently working on? The State of Andhra Pradesh has been one of the most organised states when it comes to introducing innovative social projects particularly those providing access to health and education, focusing on best technologies and, implementing the projects in the given timeline. We feel honoured to be a partner with the Government of Andhra Pradesh and with great support from the Government we are providing seamless teleradiology services for X-ray through digitisation and transmission of reports at 125 centers in district hospitals, community health centers and primary health centers. Apart from this, we also have four advanced CT centres in area hospitals. Since inception from January 2016, we have served more than 12 lakh people for X-ray and CT scan.

eHEALTH Magazine

June 2018

technology perspective 38

Dhanush Infotech enabling advanced healthcare solutions D

hanush has effectively forecasted the drastic changes that are happening in the Healthcare segment of developing economies and it has made significant investments in last 10 years in developing competency, building Healthcare Solutions and capacities for delivery of end-to-end healthcare services, especially in the primary healthcare segment. Dhanush has acclaimed the honour of working with prestigious entities like, Ministry of Health & Family Welfare, Govt of India, Govt of Andhra Pradesh, UN bodies and Govt of Kenya at the strategy level of National Health Policy definition and execution of the various programmes across India and Africa. Dhanush has vast experience of working in Africa, Australia over last 10 years in Healthcare Technology and Innovative Solutions. The company has developed comprehensive suite of Integrated Healthcare solution covering all the Public Healthcare institutions starting with ASHA/ ANMs with ANMOL Solution, eSub Centre/ Wellness Center Solution, eUPHC/ePHC Solution and also developed mobile based solutions for NCD and RBSK Screening. Dhanush Healthcare Initiatives in Andhra Pradesh • Electronic Sub-Center Solution eSubCenteris the peripheral outpost and the first hope of health care for the remote population and fulfills the basic primary and

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DSN Murthy, Chairman and MD, a Post Graduate in Business Management from NITTE, an extreme innovator and a strong believer and Investor in the strengths of the Emerging Markets and the potential it can offer to the world. DSN, having sensed the future of Healthcare business being strongly aligned with ICT Technology, has made early investments in this domain 10 years back, which have placed Dhanush in the league of Leaders in the Healthcare ICT Services market, especially in Telemedicine and Public Primary Healthcare segments.

quality healthcare needs. eSubCenter solution has the features for creating the electronic Health record, Tele Consultation, Integration with Pharmacy Vending Machines, Screening and Out Reach camps. Dhanush is currently establishing 40 eSubCentres in State of AP by bringing various innovative technologies. • Electronic Urban Primary Healthcare Center Solutione eUPHC/ePHC caters to healthcare needs of the urban and rural poor population, by making essential primary healthcare services available to them and reducing their out-ofpocket expenditures for medical treatment. eUPHC is a single window for primary healthcare where Doctor Consultation, Diagnosis, Specialist

Doctor Consultation and Pharmacy are available. Dhanush has established 29 eUPHCs in two districts of Andhra Pradesh, covering 15 lakh people, with all the modern telemedicine equipment and facility to capture the Electronic Medical Record of the patient and provide the live transactions through Dashboard. • Healthcare Screening Services Solution-RBSK Services Rashtriya Bal Swasthya Karyakram provides early screening, detection and referral management for the children aged between 0-18 years on the selected health conditions (4 DsDefects at birth, Diseases in children, Deficiency conditions, Developmental Delays that includes Disabilities). Presently, Dhanush is conducting RBSK Program in the State of Andhra Pradesh by deploying 450 Mobile

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Model District Project –UP TSU “Model District Concept” is being implemented at Sitapur district of UP with Support of Bill& Melinda Gates Foundation, with an aim to attain a significant reduction in Mother Mortality Rate, Infant Mortality Rate and improve Patient Satisfaction towards Public Health Services Dhanush Indicator Monitoring System, tracks vital parameters of healthcare related to Institutional Delivery, out of pocket expenditure, OPD Improvement and others. • ANM Online (ANMOL) – Development and Implementation Services Dhanush has been working with Ministry of Health, under UN bodies, for the Implementation of ANM Online (ANMOL) solution across the country, which has been implemented in the State of Andhra Pradesh, Telangana, MP, HP and Odisha.

technology perspective

Health Teams (MHT) covering a 80 lakh children. Each MHT consists of 2 doctors, 2 ANMs and one driver. Dhanush Healthcare Initiatives in India • eUPHC Project-Govt.of Uttar Pradesh Dhanush has established and is running 12eUPHCs in the State of UP These eUPHC are supported by the Dhanush Solution, Medical Equipment, Training to the Staff along with monitoring dashboard

Dhanush has developed unique ANMOL Intermediate Server solution (AIS), wherein it would bring in localisation to each State and consolidation at the Center level. AIS is solution has been rolled out successfully in the state of Telangana and it is getting rolled in other states across India. Telemedicine Services • Implementation, Rollout and Support • Setup, Operation and Maintenance of Digital Clinics for Private Organisations • Implementation of “Medical Equipment Kit” based Telemedicine Solutions

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Hospital Information Management System (HIMS) • Implementation, Rollout and Support of HIMS • End-to-End Solutions for Management of Hospital Operations and Administration • Integrated with Outreach Programs CSR Activities We have taken concrete steps as part of the social outreach to realise our CSR objectives and established Digital Health Clinics in association with following NGOs and institutions1. Rastriya Vidya Kendra at Ghatkesar, Hyderabad, Telangana 2. Kasturba Gandhi National Memorial Trust at Hydershakote, Hyderabad, Telangana 3. Andhra Vanavasi Kalyana Ashramam at Mattam, Vishakhapatnam, AP 4. Gayatri Vidya Parishad Institute of Healthcare & Medical Technology at Gidijala, Visakhapatnam, AP 5. SwamiVivekananda Health Mission Society at Chardham and Dharmawala, Uttarakhand.

eHEALTH Magazine

June 2018

technology Perspective

Enabling World-Class Medical Device Manufacturing in India With over 70 per cent of medical devices in India imported, coupled with a booming healthcare industry, there is clearly a need to create the right context for local medical device manufacturers to flourish, write Thomas Fuhrmann, CEO and MD, and Kalyan Varma, VP, Products, TÜV Rheinland India for Elets News Network (ENN).

uv Rheinland is a leading global services independent technical service provider with more than 145 years of experience in Testing, Inspection and Certification (TIC) industry. The independent experts stand for quality and safety of people, technology, and the environment in nearly every sphere of economic and personal activity. TÜV Rheinland tests products around the world in more than 250 laboratories. Products tested include consumer electronics, glass, furniture, textiles, toys, leisure items, and domestic appliances. Other categories of products are medical devices, solar modules, batteries, and fuel cells. In India, TÜV Rheinland has been operating for more than two decades. Headquartered in Bengaluru, it has nationwide footprints across100-plus

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Thomas Fuhrmann

Kalyan Varma

CEO and Managing Director TÜV Rheinland India

Vice President Products TÜV Rheinland India

locations, with best-in-class technical services related to management systems, industrial services, mobility, product testing and certification, ICT and personnel training. TÜV Rheinland India operates state-ofthe-art testing facilities, laboratories and training centers spread over a cumulative area of more than 1,00,000 sq. ft. related to product safety, electromagnetic compatibility, solar photovoltaic, chemical, material, fire and safety, fiber optics, lift technology, textiles and footwear. Its testing facilities are accredited to national and international standards such as NABL, MNRE, CB Scheme, BIS and FCC, among others. More than 2,500 services offered by the company cater to nearly all industries and sectors, ranging from domains as diverse as manufacturing, renewable energy, oil and gas,

automotive, healthcare to IoT, consumer goods and market access. The medical device manufacturing industry is estimated at around $9.4 billion. The overall healthcare industry in India is valued at $90 billion and is expected to reach $220 billion by 2020. About 800 medical device manufacturers in India cater to both local and international markets. However, this number may not be adequate to cater to the growing healthcare industry in India. With more than 70 per cent of medical devices in India imported coupled with a booming healthcare industry, there is clearly a need to create the right context for local medical device manufacturers to flourish. Due to changes in public policy resulting in more stringent regulation environments, combined with increased consumer awareness

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will enable manufacturers to access world-class testing services for their innovative products. The park aims to create a comprehensive medical device ecosystem for medical manufacturers to manufacture locally. The objective behind this medical zone is to create a one-stop solution for medical device manufacturers. AMTZ aims to reduce the import dependency for medical devices, places India on the global map of high-end medical equipment production and make health care products affordable and accessible in India and around the world. TÜV Rheinland was selected by AMTZ for the operation, management and maintenance of Electro-Magnetic Interference (EMI/EMC), Electrical Safety & Biomaterial Testing laboratories in this zone. Medical device manufacturers will be able to access TÜVRheinland’s globallyacclaimed testing and certification services. Benefits to medical device manufacturers include reduced product developmental life cycles, better logistics and significantly improved speed-to-market. Medical device testing services from TÜV Rheinland: Opening doors for manufactures to local and international markets The state-of-the-art 10 meters anechoic EMI/EMC testing laboratory at TÜV Rheinland provides extensive capabilities to manufacturers to test their medical products that emit electromagnetic radiation. All electric or electronic medical devices transmit and receive electromagnetic waves that can potentially cause interferences with other electronic or electrical equipment. To prevent this, electric devices need to adhere to EMC guidelines and bear the mandatory European CE marking. As an authorised body and international service provider, TÜV Rheinland offers flexible and competent services to enable medical device manufacturers meet the requirements

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Safety and quality are two pillars of our services at TÜV Rheinland. We look forward to the opportunity to contribute to the growth of the health care industry in India. We are honoured that AMTZ has selected TÜV Rheinland as a testing and certification partner to establish testing laboratories within this prestigious MedTech zone

technology Perspective

of product safety, medical devices are increasingly being scrutinised for safety and quality, before entering the market. With the majority of medical devices sold in India being imported, the Government faces a growing challenge in providing affordable healthcare to the masses. Medical manufacturers in India often do not have convenient access to highquality product testing facilities. Setting up in-house testing facilities is cost intensive and therefore prohibitive for most manufacturers. Factors such as these drive manufacturers to import subassemblies and assembling them in India. The cost of importing such components significantly increases the overall cost of producing the finished product. Such increased costs are passed to hospitals and other institutional buyers, who then tend to pass them to the end consumer via healthcare services they offer. The result? Overall increase in medical costs for the common person and an increasing healthcare burden for the Government due to unaffordability of healthcare services. TÜV Rheinland is set to address and help overcome critical barriers that medical device manufacturers face in producing quality products for the Indian and overseas markets. The company will play the role of a catalyst in the manufacturing of world-class medical devices in India. The German MNC has partnered with the Government of Andhra Pradesh for its initiative to set up Andhra Pradesh MedTech Zone (AMTZ) in Visakhapatnam, Andhra Pradesh, India’s first medical technology manufacturing park. AMTZ will house nearly 300 independent medical manufacturing units spread over 270 acres. Scientific facilities provided in the tech-park, along with state-of-the-art testing laboratories from TÜV Rheinland

Thomas Furhmann, MD, TÜV Rheinland India

of this directive. Medical devices may be exposed to extreme climatic changes and mechanical stress, variations in temperature, moisture, dust, shocks or strong vibrations that impact their functionality. TÜV Rheinland labs test medical devices and their accessories for their reliability. Medical devices with wireless technologies is a fast-growing market. Technologies such as Wi-Fi, Bluetooth, and ZigBee enable devices to be linked together, making transfer

eHEALTH Magazine

June 2018

technology Perspective

of data and instructions faster and easier. TÜV Rheinland inspects and certifies wireless medical devices for the European market as well as for the non-European market. ISO 13485 is a vital certification for medical manufacturers as it signifies that the manufacturer follows high standards for quality and continues to improve its processes. TÜV Rheinland auditors conduct stringent audits and certify organisations for ISO 13485 by examining quality management practices for medical devices, with a focus on design and development, production, customer service, and assembly. Medical devices with electronic features or those that interact via wireless technology are often exposed to the threat of hacking or failure. Additionally, they run the risk of compromising the confidentiality of patient data that is stored and transferred electronically. TÜV Rheinland helps such manufacturers protect their software and hardware from cyber-attacks, through extensive software testing and consulting services. Besides testing and certification, TÜV Rheinland conducts customised technical consultation and training and vocational skill development, under its Academy division. Professional trainings offered

are customised as per industry standards to enable a professional or an organisation become more successful. Typical training areas include ISO 13485 (Internal Auditor Training), Reliability, Electrical Safety, EMI/EMC and IEC 62304. TÜV Rheinland Academy partners with training and educational institutions to certify courses for personnel certification that meet globallyrecognised standards of technical competence. TÜV Rheinland Academy certified courses, such as in Clinical Engineering Management, train personnel on the operation and maintenance of medical equipment used in clinical settings. Such courses create technically competent professionals that can contribute to the growth of the medical device ecosystem, from manufacturing to consumption of healthcare services through these devices. TÜV Rheinland NIFE academy has the capability to serve the healthcare including the medical device manufacturing industry, with an entire spectrum of vocational training options. The company can enable medical device manufacturers in general and specifically at AMTZ to set up secure and safe facilities with trained fire and safety experts. With the range of technical services offered by the company in

“Test facilities like EMC chambers, acoustic chamber and biocompatibility testing at AMTZ are one-of-its-kind and rare to find under one roof, anywhere in the world. With this partnership, we can extend our services beyond QMS to include biocompatibility, which contributes to a significant portion of regulatory requirements for medical devices in the non-active medical devices segment Kalyan Varma, Vice President, Business Stream ProductsIMEA, TÜV Rheinland

the field of public safety, and the enabling role the company plays in the medical device manufacturing industry, TÜV Rheinland looks ahead at a bright future that brings in higher standards of safety and quality regulation in this industry. For More Information Visit: www.tuv.com/in

june 2018

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Industry Perspective 44

BVG India Emerging as Indiaâ&#x20AC;&#x2122;s Best Facility Management Service Provider

n todayâ&#x20AC;&#x2122;s competitive world, any enterprise needs quality infrastructure, employee satisfaction, efficient management and skilled workforce to succeed as an organisation. These are the prerequisites that help companies actualise their goals of profitability and enhance customer satisfaction at an effective cost. This is where facility management service providers have gained prominence as a value-addition to the business. With an emerging market and new priorities, facility managers have become indispensable and an essential part of the decision-making authority of an organisation. The activities of facility management span across various dimensions like organisation resource management, asset management, procurement, employee safety, and services, among others. BVG India Limited, Indiaâ&#x20AC;&#x2122;s largest integrated services company, is serving over 750 customers, including the Supreme Court of India, the Rashtrapati Bhavan, the Prime Minister Office, many ministries, local governments, State power utilities, along with private customers like Tata Motors, Bajaj, Mahindra, Volkswagen, Accenture, Shirdi Sai Baba Temple, and many others. It provides services like mechanised housekeeping, gardening, landscaping, waste management, factory

june 2018

construction and relocation, civil engineering, farm management, power projects and many others. Leading from Rural Maharashtra to a Nationwide Network BVG India Limited took roots as a non-profit Bharat Vikas Pratishthan in 1993, by the then engineering student HR Gaikwad, Chairman and Managing Director, inspired by Swami Vivekananda. Gaikwad set out to help rural youth with funds for education and opportunities for jobs and livelihood. Two years later, Gaikwad was inducted as a graduate trainee engineer in Telco (now Tata Motors), where he earned management appreciation for saving huge costs through his innovative use of cables otherwise meant to be scrapped. He used this opportunity to request the management for some jobs for rural youth from his village. The management agreed and BVG began informally as eight-member in-house outsourced housekeeping outfit within Telco (now Tata Motors) in 1997, with Gaikwad still employed in the company. Taking inspiration from Swami Vivekananda, BVG started its operations in 1997 to cater cleaning service requirements of Tata Motors. Since then, with a commitment to deliver quality work, BVG has grown by leaps and bounds. Today, it is known to be amongst the best facility

H R Gaikwad Chairman and Managing Director BVG India Ltd

management brands. With over 70,000 employees, BVG family is spread over 70 locations all over India. Stopped Recommending and Started Hiring Before leaving Tata Motors, Gaikwad built a strong team of 300 people. BVG was recognised by many companies and being recommended in places like Bengaluru, Chennai, Hyderabad and Delhi. From just one service of housekeeping from where it started, BVG India Limited now provides the entire gamut of integrated services, like construction and relocation of factories, laying of roads, landscaping and plantation of public gardens, rural electrification project, waste management, security, catering, etc.

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Venturing into farm keeping and animal keeping With a focus on introducing modern scientific methods in a major way to improve agriculture and livestock, BVG has diversified through BVG Life Sciences Limited. The company has developed innovative plantation technology as well as crop care products, which delivers minimum 50 per cent increase in farm yield in one crop season and double in three crop seasons. The company’s animal care, meant for cows and buffaloes, delivers minimum 20 per cent increase in milk yield.

Implementing and managing emergency response services Modern-day progressive Governments are realising the need of providing swift assistance to citizens in emergency situations, thus saving the loss of precious human capital. BVG India Ltd. implements medical emergency ambulance response service and civil emergency police response service for Governments. BVG has implemented and now manages Dial-108 toll-free: Medical Emergency Ambulance Response Service (also known as Emergency Medical Services) for Maharashtra Government (from last four years) and Delhi Government (from last three years). We have been in service from last six months in Andhra Pradesh. Dial-108 is a free ambulance on call service for medical emergencies. This is among the world’s largest set up of its kind having 1,700 ambulances spread across Maharashtra, Delhi and Andhra Pradesh, each with a doctor or emergency medical technician and life support equipment available 24 X 7 in the service of citizens. Ensuring beauty through landscape and gardening servicess BVG provides a full-fledged service to beautify cities, townships, roads, factory lands, etc. The BVG landscaping services have been ensuring the beauty of various building, streets, and parks in the cities. In 1999, BVG started its own horticulture and agriculture division on contracts, and eventually gained its reputation in this discipline. India’s best integrated food park Under the Government food processing policy, BVG India has inaugurated Satara Mega Food Park. Awards and achievements Bharat Vikas Group (BVG), has bagged the award for facility Management Firm of the Year 2017 at the ‘9th Realty Plus Excellence

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At BVG, we always endeavour to provide our clients with bestin-class services and our staff strength of over 70,000 has always worked towards this goal

Industry Perspective

Engendering waste to wealth Although, increase in the waste material is becoming a challenge but BVG took this as an opportunity to repay its debt to the society by looking at waste as a ‘resource’ and created a new business vertical ‘Waste to Wealth’. BVG serves government and private entities to process the inorganic and organic waste. The large ones include Pimpri-Chinchwad Municipal Corporation (PCMC), New Mumbai Municipal Corporation (NMMC) and Brahat Bangalore Mahanagara Palika (BBMP). This includes door-to-door collection of waste, primary processing, secondary processing and disposal of waste in terms of lifting and dumping capacity. It handles over 8, 000 tonnes waste per day. In 2017, the Government of India undertook the Swachh Sarvekshan where it ranked cities and municipal corporations on their cleanliness parameters. In the national ranking, Pimpri Chinchwad was at 72 Rank. However, in the section of solid waste processing and disposal, which is completely handled by BVG India Limited, Pimpri Chinchwad was the national topper. “The light of prosperity of my country spreads all over and I shall be a small soldier in it as a small clay lamp,” says H R Gaikwad.

Awards (West) 2017’. BVG contended against some of the big multinationals in this category and for the second time running has pipped them to the post. Realty Plus Excellence Awards is the platform that recognises the contributions made by companies in the real estate panorama. The company’s philosophy is ‘Non-Core Work is Our Core Work’. Revolutionising the future of Indian agriculture by increasing the yield HR Gaikwad’s bigger plan is to double farmers’ income from agriculture, a goal espoused by the Government, with products such as fertilisers, crop nutrients and crop protectors. He commits to a minimum 50 per cent yield increase in one crop season and double in three crop seasons with the use of products and technology from BVG Life Sciences Limited. Gaikwad has also started BVG Foundation with the objective of increasing the living standards and contributing to the development of rural youth, students and farmers.

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June 2018

Industry Perspective 46

eVaidya Creating Innovative Healthcare Solutions H

ealth and access to healthcare is the right of every citizen of India, where 60 per cent or more population reside in rural areas. Providing quality healthcare to the citizens of rural India has its own unique challenges. Furthermore, the country is still fighting with the mortality conditions like infant deaths, maternity deaths and disabilities due to vaccine preventable disease and lack of able healthcare professionals in rural setup. For some villages, the nearest healthcare facility is around three to four hours of drive. This hampers their daily livelihood. There is an inevitable tendency of seeking healthcare when the condition worsens. With such condition of primary healthcare, accessibility to

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specialist is a dream that is too “good to be true”. Technology for rural healthcare and eVaidya Considering the importance of healthcare which has to reach to the least accessible population, evaidya pioneered in rendering the benefits of modern technology to underprivileged population. The organisation has collaborated with the Government of Andhra Pradesh to pilot the eUPHC projects in districts of Andhra Pradesh.

Dr Devaiah Pagidipati Board of Advisors, eVaidya

• Electronic Urban Primary Healthcare Centre (eUPHC) e-UPHC is a Public Private Partnership (PPP) model of Government. eVaidya

with the collaboration of the State Government is implementing the National Urban Health Mission (NUHM) in the urban slums. It focuses on accessibility to the urban slum and vulnerable population. It is a new-age concept to bring holistic care to the local community. It is a combination of primary healthcare centre, physician or tele-consultation, pharmacy, imaging and Lab services combined together under one roof. The centre also has ANM and ASHA workers, who conduct the health and nutrition days, participating in National Public Health programmes like RNTPC, NTPC, family planning, deworming, immunisation, registration of the Antenatal care, promoting institutional delivery, providing epidemic alerts, contributing in reducing the IMR and MMR.

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Complaints and Vitals- Patients complaints, family history are captured post-which, using eVaidya’s MediBox (a proprietary technology) the paramedic/ nurse at the vital station captures the vitals including the blood pressure, pulse oximetry, temperature, BMI, ECG (based on the requirement). Consultation- Physical doctor at the centre gives the consultation to patient and all the details are entered into the EMR (Electronic Medical Records). Based on the requirement, the doctor either prescribes medicines, send to labs for investigations or refers the patient to higher Government hospital. Teleconsultation- Depending upon the requirement post-physical consultation, the doctor may refer the patient to specialists’ consultation which is provided through the telemedicine. Lab services- There are over 64 lab investigations that are done at the centre. Complete Blood picture, Fasting and Post Prandial Blood Sugar, HbA1c, Renal Function Tests, Lipid Profile, Urine Analysis, Pregnancy Confirmation Test, Tests for Typhoid, Dengue, Malaria, Blood Grouping, HIV, HbsAg and others are done. The reports are printed and handed over to the Workflow patient for his records/referral/follow-

eVaidya- the Organisation

Industry Perspective

Workflow Patient registration- Patient registration is done for generating the unique ID. The demographic details of the patient are captured including photo. Government ID is required (preferably Aadhaar) though not mandatory.

up and the results too are uploaded into the patients’ EMR. Other services

Pharmacy- The medicines prescribed

Dial your doctor services: for the patient reflect in the pharmacy

The IT health-tech

Other services Dial your doctor services: With the motto “The Doctor is always in”, the organisation aims at using the most common gadget- mobile to reach to the patients in need of the Doctor.

Dial your doctor services enabling the patients to reach to the doctor through the phone and receiving desired consultation. This reduces the waiting time and the time wasted due to travel to reach to the doctors for minor ailments.

management and the With the mottosystems “The Doctor is always in”, the organisation aims at using the most common provider makes pharmacist dispenses the medicine gadget- mobile to reach to the patients in need of the Doctor. Dial your doctor services primary healthcare enabling the patients to reach to the the phone and receiving desired to the patient. Dosage, duration anddoctor through consultation. This reduces the waiting time and the time wasted due to travel to reach to the easy, quickly the time of the medication intake are doctors for minor ailments. clearly explained to the patients by the accessible and cost pharmacist. The in-built inventory effective by creating management system helps to keep a The way forward innovative consumer tab on the stock of drugs. At any given Non-Communicable Diseases (NCDs) are emerging as one of the most hazardous point of time, the number of medicine driven healthcare healthcare conditions. The organisation aims at working extensively in the field of preventive in stock at the clinic can be known with and curative medical practices to decrease the solutions load of NCDs in the community. a click of the button. The system helps to control fraud, wastage and abuse of the drugs are allocated to themakes centreprimary healthcare easy, quickly accessible and Blurb: The that IT health-tech provider cost effectivebasis. by creating innovative consumer driven healthcare solutions. on monthly

Lab Services

Patient entry

Patient Registration

Vitals capture

Consultation or Teleconsultation

Pharmacy Services

Patient Referred to Higher Centre

Patient exit

The way forward: NonCommunicable Diseases (NCDs) are emerging as one of the most hazardous healthcare conditions. The organisation aims at working extensively in the field of preventive and curative medical practices to decrease the load of NCDs in the community.

1. Patient registration- Patient registration is done for generating the unique ID. The demographic details of the patient are captured including photo. Government ID is required (preferably Aadhaar) but it is not mandatory. ehealthmagazine @ehealthonline Connect with us on family 2. Complaints and Vitals- Patients complaints, history are captured post-which,eHEALTH Magazine using eVaidya’s MediBox (a proprietary technology) the paramedic/nurse at the vital station captures the vitals including the blood pressure, pulse oximetry, temperature,

June 2018

industry Perspective

Medall: A Modern Solution in Diagnostic World

he size of the diagnostics market, considered to be a sunrise industry in India, is at Rs 60,000 crores in 2017. Itâ&#x20AC;&#x2122;s growing rapidly at 17% annually to reach Rs 1.35 lakh crores by 2024. Awareness among doctors and public is increasing rapidly and diagnostics is now becoming a crucial component in any treatment planning. Further growth in diagnostics market is being driven by following factors: l Increasing awareness on NCD/ lifestyle diseases, desire to manage health among affluent, middleincome groups and salaried class. l Deeper penetration of Insurance (Life & Health Insurance). l PPP projects in States under National Health Mission (NHM) of the Central Govt. l Middle-class population is increasing exponentially and with its increasing ability to spend on healthcare.

Medall Journey: l Started in 2009 as a one-stop integrated diagnostics facility to serve patients and doctors with passion, competence and commitment l Affordable services being provided using state-of-the-art technology, highly qualified and committed team of radiologists and pathologists and providing high-level of clinical confidence to doctors and patients alike

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4th Largest Indian diagnostics player

40%+ South India market share

8 Yrs From zero to current scale

Largest Integrated Diagnostics Player in India

9.6 Mn + Customers touched in FY18

7,000+ Customer touch points

30 Mn+ Annual test volume in FY18

45,000+ Network of doctors

176 Labs Including 25 Apex* Labs

134 Radiologists and Pathologists

900+ Pathology test Offered

590+ Radiology tests Offered

5** PPP Projects with State Govts

2,500 Professionals Serving Patients

8 States & 63 Districts Presence

Largest Diagnostics Equipment Buyer in India

*Capable of handling all lab tests

Innovations To serve customers of all types, Medall has accomplished many clinical and technological innovations such as:

**AP, Telengana, TN, Karnataka & Jharkhand

Service Delivery

l PPP Partnering with Governments

to provide affordable diagnostic services to the poor patients

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l l

Corporates in their office premises Mobile Lab Collection Centers (MLCCs) to serve residential and remote areas Lab Collection Centers (LCCs) as convenience centers for all lab tests Home Collection (Service at door step) Tele-radiology (to bring high quality radiology services to far off places

Process Excellence l Data loggers to constantly monitor the cold chain and thereby the integrity of the samples l MIQC (Medall Internal Quality Control) & MSQC (Medall Statistical Quality Control) for consistently improving the quality of lab testing l Highly trained team of QA/QT in all districts l Regularly upskilling our lab operations team by partnering with Health Sector Skill Council, Govt. of India l Deployed online systems to streamline the supply chain for all consumables and reagents Focus on Quality l Strict Quality control measures in place to ensure highest accuracy l 7 NABL accredited labs and 3

more labs under process, 2 NABH accredited labs and 105 ISO certified labs l Quality (External and Internal Quality control systems), Partnering with AIIMS, CMC, RML, Randox, Biorad for Proficiency Testing. Results from these programs are analysed for continual improvement of the various departments in the lab

l Results show over 99% accuracy

Technological Innovations l Online real time portal to monitor the quality on a dailybasis of all 175 labs l Web-enabled real time Digital dashboards for monitoring project performance metrics to customers- (AP CM Dashboard,

Jharkhand CM dashboard)

l Operations monitoring dashboard

(Medall Operations Dashboard).

l Mobile App for customer report

Product Innovations

l SASH Stay Aware Stay Healthy

â&#x20AC;&#x201D; is the new preventive health check-up launched by Medall to cater to a larger universe l SASH is very affordable at Rs 640/ and is for healthy people to proactively monitor and manage

industry Perspective

l Health on Wheels to serve

their health by knowing their health score l Tests to monitor eight major organ systems including vitals, heart, diabetes, thyroid, liver, kidneys, bone and blood l HMP-Health Monitor and Privilege card - a complete family health monitoring product to keep track of the health of all family members l GoH-Gift of Health â&#x20AC;&#x201D; Gift coupons that can be given to near and dear ones Affordable Services State Governments are constantly innovating and becoming a payer rather than investing in the equipment. For example, Medall partnered with Government of Andhra Pradesh to provide free diagnostics to poor patients visiting PHCs, CHCs, AHs and DHs under

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eHEALTH Magazine

June 2018

industry Perspective

PPP mode across 13 districts. Similarly, Medall has partnered with five State Governments to serve poor patients with the same dignity, respect and quality that are usually available to private patients. Partnering with Govt of Andhra Pradesh l Medall Healthcare was chosen to implement the state-wide free lab diagnostic services NTR Vaidya Pariksha under PPP model. l Project covers – 1,400 Govt healthcare facilities including 1,150

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PHCs, 192 CHCs, 40 Area and District Hospitals in all 13 districts of Andhra Pradesh. l 105 Labs set up in a record time of 60 days and over 2,000 qualified professionals deployed across the State to serve these patients and help them manage their health better. l Served over 1.2 crore people in last 28 months and saved Rs 600 crores as out of pocket expenses for the poor patients. l Patients now have access to advanced tests in Biochemistry,

Haematology, Immunoassay, Microbiology, Cytology, and Histopathology with consistent TAT. l We have the highest number of Pathologists, Microbiologists and Biochemists located in each district and dedicated to the State for timely and diligent approval of the patient reports. Under the pragmatic leadership of the Chief Minister, Advisor, Special Chief Secretary and other officials of the Health Ministry, NTR Vaidya Pariksha today stands out as one of the most structured, well-managed and implemented PPP projects in India. We are proud to be associated with the Government of Andhra Pradesh. Medall’s operational excellence strives to enhance customer experience and customer intimacy. As we move forward, we will continue to leverage our proven processes, methodology and practices that we have built over the years to become India’s largest diagnostic company by increasing our footprint in more States in India and internationally.

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industry Perspective

Oncquest: Integrated with Clinicians, Offering Precise Diagnosis Oncquest has evolved into a reference laboratory in the field of oncology, and more recently into a multi-platform Pathology Service provider with a core focus on Molecular, Haematology & Surgical Pathology Services, says Dr Ravi Gaur, Chief Operating Officer, Oncquest Laboratories Ltd., in conversation with Elets News Network (ENN).

Dr Ravi Gaur Chief Operating Officer Oncquest Laboratories Ltd

Oncquest, India’s leading super specialised laboratorynetwork, which is today known for its excellence in molecular and clinical diagnostic. Tell us briefly about the journey. Oncquest Laboratories is India’ s most leading molecular diagnostic service provider with special focus on molecular oncology for almost 17 years. Our beginning as a research-focussed entity in 2001 has had a significant impact on the way we have evolved and progressed. Starting with a thenadvanced technology platform of multiplex PCR, we later added Next Gen Sequencing, digital droplet PCR, advanced surgical pathology including Immuno-

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histochemistry, Flow-Cytometry, FISH, Haematology, Cytogenetics and much more in our portfolio. We are a technology and skill driven laboratory and our quest to perform and excel, makes us stand out amongst strong competitors. Our hunger for technology will never end. From its first avatar as an R&D focused entity, Oncquest has evolved into a reference laboratory in the field of oncology, and more recently into a multi-platform Pathology Service provider with a core focus on Molecular, Haematology &Surgical Pathology Services. Oncquest accreditation by College of American Pathologists (CAP& NABL) offers a range of laboratory tests for understanding the molecular basis of malignant transformations of the cells. These tests are designed to provide diagnosis and prediction of disease progression and can be used to tailor treatment to the individual patient’s cancer. Oncquest utilises the experience and expertise of trained scientists and pathologist to provide clinicians with an incisive diagnosis to identify the disease process at the fine point of differentiation.

You provide world class facilities to your clients. Tell us about your services ‘specialised services’ and ‘general pathology’. Oncquest offers one of the largest test portfolios especially in molecular oncology, in exploratory and end-point biomarkers, genomics, Haematology& Surgical pathology. Our ‘specialised services’ cover over 1,500 advanced technologybased assays covering screening, final diagnosis, monitoring and prognosis. The capabilities include, real time and multiplex PCR, Gene Sequencing, Next Generation Sequencing (NGS), Cytogenetics, FISH-based assays, advanced Haematology and Flow cytometry, Immuno-histochemistry (IHC) and Surgical Pathology. In general pathology space, we offer almost entire spectrum of biochemistry, immunology, hematology, clinical pathology and microbiology helping in clinical diagnosis, prevention, prediction, early diagnosis, monitoring, Hospital Lab Management& much more. Today, we have a state-of-the-art Molecular and Clinical Diagnostics Referral Laboratory, with a national

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What distinguishes you from others in terms of adoption of cutting-edge technology and quality of service? We handle over 15,000 tests every day. We have a highly skilled team of doctors and scientists, trained in most advanced technology driven platforms. Our team is well integrated with clinicians and patients to provide final and correct diagnosis which can help the clinicians in designing personalised and target based therapy, early diagnosis and its recurrence. Our majority of partnerships are in tertiary care or super specialised hospitals catering to oncology, gastroenterology, infertility, immunology, nephrology, cardiology, critical care ,infectious disease, preventive and wellness space .We bring proven international assays to India, validate them for India specific environment and make it affordable to Indian population. Today, Oncquest is known as final opinion provided and more so for complicated cases. The pathology is all about guiding the clinicians in their diagnostic dilemma. I personally believe that all pathologists are clinical solution provider and they should keep themselves fully

updated and work hand in hand with clinicians to provide themsolutions for better treatment outcome.

Shed some light on molecular tests which you have launched in Indian market recently. Oncquest Laboratories has launched many new advanced assays and on high-end technology driven platforms for first time in India. With rapid advancement and availability of new technology many more new assays are now being offered. Next Generation Sequencing (NGS) based assays for better and focused tumor profiling, Liquid biopsy for very early diagnosis of cancers, Minimal Residual Disease (MRD) in leukemia, Final diagnosis of cancers on tissue, FISH based assays, Bone marrows for Myeloma & blood cancers and cytogenetic testing for hematological malignancies are few of the recently launched tests.

Oncquest is pioneer in oncology and market leader in tests like BCR ABL and Minimal Residual Disease (MRD). Please elaborate about these tests. Oncquest is Indiaâ&#x20AC;&#x2122;s Largest Cancer Diagnostics Laboratory in South East Asia and market leader. Oncquest is pioneer in oncology and market leader in so many tests like BCR ABL and MRD. Over 60 per cent BCR/ ABL testing and 70 per cent MRDs

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(Minimal residual disease) testing in India is performed by us. We have been continuously improving our TAT (Turnaround Time) and technical platform for the same. These advanced assays have helped researchers, clinicians and patients to understand molecular basis of cancer and plan more specific and successful target based therapies. BCR/ ABL Testing with International Scale Reporting helps in the diagnosis and monitoring of chronic myelogenous leukaemia (CML) and few , though rare acute lymphoblastic leukaemia (ALL). We have been continuously improving our TAT (Turnaround Time) and technical platform for the same. These advanced assays have helped researchers, clinicians and patients to understand molecular basis of cancer and plan more specific and successful target based therapies. BCR/ABL Testing with International Scale Reporting helps in the diagnosis and monitoring of chronic myelogenous leukaemia (CML) and few , though rare acute lymphoblastic leukaemia (ALL). Both these cancers affect the mature blood cells and their precursors in the bone marrow; Chronic myelogenous leukaemia and certain types of acute lymphoblastic leukaemia are caused by the product of abnormal BCR-ABL gene fusions. Minimal residual Disease ( MRD) refers to the presence of leukemic cells below the threshold of detection by conventional morphology. MRD analysis aims at estimating total burden of leukemic cells during remission. It is helpful in identifying those patients whose outcome with conventional chemotherapy treatment is likely to be poor, patients with high risk and providing sensitive monitoring post treatment. Oncquest is preferred for BCR/ ABL &MRD testing because of its quality parameters and highly skilled interpretation.

eHEALTH Magazine

June 2018

industry Perspective

footprint of over 36 laboratories, 200 collection centers and 1,300+ service associates across India and South East Asia.

jharkhand Perspective

Jharkhand Boosting

Its Healthcare Ecosystem The Government of Jharkhand is trying to strengthen the primary, secondary and tertiary healthcare at all levels. So at one level all the district hospitals and First Referral Units (FRUs) have been strengthened with blood banks, says Nidhi Khare, Principal Secretary, Department of Health & Family Welfare, Government of Jharkhand, in conversation with Elets News Network (ENN).

Nidhi Khare Principal Secretary Department of Health & Family Welfare Government of Jharkhand

How do you analyse healthcare industry in Jharkhand? As per the Indian Public Health Standards (IPHS) norms, there is lot of wanting in terms of both health infrastructure as well as manpower in this field including doctors, specialists, GNM staff nurses, ANM, paramedics and other health service providers. However, the State Government is opening five new Government Medical colleges. An AIIMS at Deoghar is being set up in 236 acre area.

What initiatives have been taken recently to improve healthcare delivery in the State? We are trying to strengthen the primary, secondary and tertiary healthcare at all levels. So at one level all the district hospitals and First Referral Units (FRUs) have been strengthened with blood banks. The Government has made available the Neonatal Intensive Care Unit (NICU) facilities for neonatal and maternal care. Free drugs and diagnostics have been made available. A decision has been taken to start

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dialysis at all district hospitals in PPP mode. Quality services are being strengthened at all maternal OTs, particularly, those experiencing more than 100 deliveries a month.

To provide the universal health coverage, the Narendra Modi Government recently announced Ayushman Bharat programme, how is the State Government planning to implement the scheme? Jharkhand is one of the frontline States in terms of preparedness for Pradhan Mantri Swasthya Suraksha Yojana (PMSSY). Today, we have signed an MoU with National Health Agency. Our list of 25 lakh beneficiaries, as per SECC database, is completely digitised, Aadhaar seeded and verified. However, the other 32 lakh beneficiaries, who are part of Food Security Act database would also be extended the same benefits of insurance coverage up to Rs five lakhs under the Mukhyamantri Swasthya Bima Yojana. A State Health Agency has been created to implement and closely supervise the various issues arising in the implementation of universal health coverage under the Ayushman Bharat scheme.

Jharkhand Cabinet recently passed a proposal stating any student passing out from the Stateâ&#x20AC;&#x2122;s medical college will have to serve three

years in the State. Tell us more about this proposal. This proposal is with a view to retain doctors in the public health system as the State has only 300 MBBS Seats. Hence, there is great dearth of doctors for far-flung tribal areas. To fill in the gap of medical practitioners, the State has increased the superannuation age from 60 to 65 years. Doctors/ super specialists are also being engaged on contract. Thus, the bond amount for students joining Jharkhand Government medical colleges for higher studies has been increased from Rs 10 lakhs to Rs 30 lakhs. They will be liable to pay if they discontinued the course in the middle or fail to serve mandatory three years in public health.

The Government hospitals often lack modern equipment and cutting-edge technology in comparison to private healthcare providers. Off late what steps have been undertaken to improve the situation on this front? Of the several steps undertaken by us, Free Medicines, Free Diagnostics (CT SCAN, MRI etc ), ICU (NICU/ PICU)- are few of them. With the target to establish more than 700 Health and Wellness centres in the States, the hospitals are further going to be strengthened. Now, they would have modern facilities of screening for diabetes, hypertension, cervical/ oral/ breast cancer, TB detection.

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AN ENTIRELY NEW SYSTEM OF HEALTHCARE DELIVERY www.medecube.com

Clinical coordination across multiple specialties is complex and requires clinical knowledge beyond the reach of a non doctor. We are focused on delivering a crucial service- coordinating healthcare for people.

Himachal Perspective

Himachal Going All Out To Boost Healthcare The Himachal Pradesh Government is consistently undertaking various steps to bring succour to the public at large in healthcare… Also, with opening of one more medical college in Hamirpur, this year, total number of Government Medical Colleges in the State will be raised to six, says B K Agarwal, Additional Chief Secretary, Department of Health & Family Welfare, Government of Himachal Pradesh, in conversation with Elets News Network (ENN) free transport facility from home to hospital and back.

B K Agarwal Additional Chief Secretary Department of Health & Family Welfare Government of Himachal Pradesh

Please tell us about Himachal Government’s schemes and programmes to strengthen healthcare delivery in the State. The major schemes and programmes which strengthen the healthcare delivery system in the State of Himachal Pradesh are: Child Health Programme: State has Infant Mortality Rate (IMR) of 25, whereas India has 34. Newborn mortality rate is 16, which is one of the best in the country. Maternal Health: Under Janani Shishu Suraksha Karykram (JSSK), all the pregnant women (right from conception to 6 weeks after delivery) and infant up to 01 year of age are provided with free diagnostic, free medicine, free operation, free blood (if required), free food and

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Immunisation: 11 antigens are given to the eligible children, under this programme and coverage is almost 95 per cent. Family Planning: Total Fertility Rate (TFR) of State is 1.7 whereas for India it is 2.3, birth rate of State is 16 against all India average of 21.6 per 1,000 people. Revised National Tuberculosis Control Programme (RNTCP) – Diagnostics and Treatment facility for all the TB Patients are free under this programme. State aims to end TB by 2021. Non Communicable Disease Programme (NCDP): Under Universal screening against NCDs, all the citizens above age of 30 years shall be screened on four parameters (Weight, Blood Sugar and Blood Pressure). Disease Control Programme and Integrated Disease Surveillance

Programme (IDSP) - Surveillance is done to identify any warning signals and to prevent outbreak of diseases along with effective management, if it occurs. Free Drug Services Initiative (FDI) – Under this programme, 330, 216, 116 and 43 No. of free drugs and consumables are given at District Hospital, Civil Hospital/CHC, PHC and Health Sub Centre respectively, to all the patients visiting public health institutions to reduce out-ofpocket expenditure. AIDS Control Programme: 100 per cent screening of all the pregnant women against HIV is being done in public health institutions.

What steps have been taken to improve healthcare infrastructure in rural areas? l With opening of one more medical college in Hamirpur, this year, total number of Government Medical Colleges in the State will be raised to 6. There is one Medical College for every two districts. l AIIMS is coming up in District Bilaspur. l Satellite centre of PGI Chandigarh

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of 800 at the cost of 142 crore are coming up. 289 more Medical Officers have been recruited, since 1 January 2018. Apart from strengthening National Ambulance Services, Bike Ambulance Services have been started this year to further reduce the response time. Very soon, Air Ambulance services shall be started in the State, which shall further reduce the response time in rural areas at no cost to patients. 5 Dialysis centres have been made functional at Mandi, Dharamshala, Solan, Bilaspur and Kullu 10 cancer care units have been established to benefit the rural population where till date 676 chemo therapies have been started. Routinely Multi-Speciality Surgical camp are being conducting in Tribal & difficult public hard area in the State in which 60 major surgeries are to performed free of cost which includes 20 General surgeries, 20 OBG Surgeries and 20 eye surgeries.

Shed some light on the challenges you face while implementing schemes in these areas. Major Challenges in Himachal Pradesh are: l Availability of trained Human Resource remains a challenge in hilly State like Himachal Pradesh. l Being hilly terrain, with extreme climatic conditions and disaster prone areas, the State has issue of poor connectivity particularly during monsoon and winter months hampering healthcare delivery services.

Generally Government hospitals are found to be in bad shape i.e. lack of modern equipments and

The Government Hospitals are providing high quality healthcare services. This is being further improved based on the feedback received through software “MERA ASPTAAL” (patient feedback system)

trained manpower. What has been done to improve things? As far as Himachal is concerned, the Government Hospitals are providing high quality healthcare services. This is being further improved based on the feedback received through software “MERA ASPTAAL” (patient feedback system). All the hospitals are fully equipped with required modern equipments. Shortage of trained manpower is being addressed by way of outsourcing the services through private agencies. l Recently we have outsourced the radiological imaging services at 182 locations through competitive bidding. l Laboratory services at 24 locations and CT Scan services at 12 locations are outsourced for long. l Tele-Stroke project is in place, at 17 Public Health Institutions, where consultation is being done

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by Neurologist sitting at IGMC Shimla & Dr. RPGMC Tanda. l Tele-Medicine services are being extended to far flung areas in Himachal Pradesh. At present Tele Medicine Services are functioning at 30 different public health Institutions which includes SC, PHC, CHC & CH. It is proposed that during financial year 201819, Tele Medicine Consultation services shall be started at 50 more sub centres.

Himachal Perspective

is coming up in District Una.

l 9 MCH wings, with bed capacity

Nipah virus recently created havoc in Kerala killing more than 10 people across State. Himachal also issued advisory on the same. What preparations were done to meet with any kind of worst situation? As soon as information regarding outbreak of Nipah Virus (NiV) was received from Government of India, an advisory was issued by the State Government on 24 May, 2018. Following measures were undertaken: l Press release was issued for general awareness, so that there is no panic reaction l Surveillance is being done and daily reporting is done by all the districts. l Samples from dead bats were analysed at National Institute of Virology, Pune. Those were found negative for NiV. l Similarly Blood, Urine and CSF samples from suspected cases from Dharampur in District Solan also were found negative for NiV at National Institute of Virology, Pune. l All the medical colleges in State are fully prepared for treatment and management of NiV cases, if at all it occurs. l Media is very supportive in dissemination of right message to general public, due to which there is no panic. People with symptoms of high grade fever with muscle pain and other conditions are directly visiting public health institution.

eHEALTH Magazine

June 2018

state Perspective

Kerala Boosts Emergency Care System The triage GO is part of the initiative to build capacity of the health staff in Government to properly triage and save lives. This initiative is going on with the support of the faculty of the Jayprakash Narayan Trauma Centre in AIIMS, says Rajeev Sadanandan, Additional Chief Secretary, Department of Health, Kerala Government, in conversation with Poulami Chatterjee of Elets News Network (ENN).

Rajeev Sadanandan

Additional Chief Secretary Department of Health Government of Kerala

In a recent move, the Directorate,Â Health Services, Government of Kerala, introduced Triage System to revolutionise emergency medical care in the State. How will this service benefit common people? Triage is only one of the components of the emergency care system that we are developing. The crucial part is the development of an App-based, call centre managed, evacuation system through PPP. Here an aggregator (much like UBER or OLA) engages private ambulance that satisfies basic parameters, ensures that the driver and EMT have the needed training, administers the App by which any

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registered person can call down an ambulance and track the GPSenabled ambulances as they move towards the spot of accident. On arrival, the EMT makes an assessment and briefs the call centre. The call centre finds the nearest empanelled hospital with the required expertise, calls up the hospital, alerts them and directs the ambulance there. The hospitals are paid the cost of treatment from a corpus by a contracted fund management agency. This fund will be recouped from the company insuring the vehicle. The triage GO you are referring to is part of the initiative to build capacity of the health staff in government to properly triage and save lives. This initiative is going on with the support of the Faculty of the Jayprakash Narayan Trauma Centre in AIIMS. The standard of training would be further raised by a state-of-the-art training and simulation centre being established with the support of the TATA Trust and the Major Trauma Centre at the Warwick Medical School. The

order is an attempt at formalising the training that is going on so that it is made mandatory.

Despite the government promoting deceased donor organ transplant, not much has happened towards the initiative in the State. What could be the reasons behind such a low response? What measures the State health department is taking to improve the situation in the coming days? Kerala had started the diseased donor initiative in 2012 and had become a leading State in the percentage of RTA cases that went on to donate their organs. But the adverse publicity generated by a PIL in the Kerala High Court led to drop in donations. We have revised the guidelines to remove any misgivings and are in the process of revamping the Kerala Network for Organ Sharing. We have also issued guidelines for exchange donations. We are hopeful that this would lead to Kerala getting back to our past performance in disease donor transplantation.

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What ideal measures should the CentralÂ Government undertake to put a check onÂ NonCommunicable Diseases (NCDs)? Is creating public awareness enough to bring our society to regularity? The Central Government can hardly do anything. This has to happen at the lowest level of organisation, preferably, at the community level. Their behaviour has to change to lead to good quality diet with adequate fruit and vegetables, adequate exercise, tobacco elimination, prevention of alcohol abuse. Governments can support these to reduce the cost and increase availability of fruits and vegetables, tax tobacco and strictly enforce COTPA, promote abstinence or responsible drinking and create facilities for exercise. The Central government can use the GST mechanism to tax health harming foods (as Kerala had tried to do in the FAT TAX as part of our VAT but now lost in GST) i.e. Sugared beverages and food high on sodium and incentivise food that promote good health.

Under the hospital automation module of the public health department, what major initiatives are being undertaken? The e Health project has three main components: 1. Creating Electronic Health Records for all individuals 2. Digitising hospitals processes 3. Linking them to each other so that the data in EHR is available to hospitals and the data from hospital transactions are used to update the EHR. At each level there are different modules: e.g.: The demographic module, which creates the basic data on individuals, the ANC module which tracks pregnant women, the immunisation module, the NCD module etc. These are layers created on the basic layer which

is the demographic module. Data collection for the basic module has started. Others are in the pipeline. At the hospital-level, there is the queue management module (which lets you book your appointments online, registers you when you reach, directs you to the consultants in the queue and channels you in), consultation module, pharmacy module (where consultants order drugs on line, drugs are filled and inventory updated), Laboratory module (orders received and results returned online), IP module. Once the system is fully functional there would be a huge accumulation of data as well as seamless portability.

Is the State Health Department using Artificial Intelligence for ensuring advanced healthcare services to citizens? Please elaborate. As of now, we do not have anything going on in AI. But some activities are planned for the future. eHealth will generate the data that can be used in AI, when we are ready for it.

What are the major challenges that the State Health Department is facing to provide the best in class solutions to the last mile? I. Shortage of resources. Our PHC strength will be needed to be increased four-fold to meet the needs of a personalied health system. Similarly, the public health system now serves only 35 percent. So if a government paid UHC has to be provided, resources have to at least double. II. Having proper organisation of health sector in place. Reengineering the health system with primary care teams as the basis and all higher levels as referrals. The numbers in primary care has to go up, their capacity has to increase, referral

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Kerala had started the diseased donor initiative in 2012 and had become a leading State in the percentage of RTA cases that went on to donate their organs

state Perspective

systems have to be in place. Here more than resources it is the planning capacity that is the challenge. Since no other state has done this in India we will need to get support from countries that have a functional GP system. III. We are yet to develop a good emergency and trauma care system, even though efforts are on. IV. Emergence of Antimicrobial resistance is forcing us to rethink the way we practice medicine. Soon, in almost every case we will have to test drug sensitivity and modulate our antibiotics accordingly. This is a major shift in our hospital practices. V. Engaging the private sector in good public health practices. VI. We are committed to eliminate Malaria, Filariasis and Leprosy by 2020 and TB by 2025. Since India would not have reached there by this time, we have to move for sub-national certification of elimination to confirm success. This is an arduous process.

eHEALTH Magazine

June 2018

Sikkim Perspective

Better Infrastructure Helping Sikkim In Healthcare The Sikkim has improved health infrastructure which has been instrumental in enhancing patient care. Primary Healthcare Centres (PHCs) have been equipped with all the modern facilities including X-Ray, says Vishal Chauhan, Commissioner-cumSecretary, Department of Health & Family Welfare, Government of Sikkim, for Elets News Network (ENN).

Vishal Chauhan Commissioner-cum-Secretary Department of Health & Family Welfare Government of Sikkim

How do you analyse current state of healthcare in Sikkim in terms of quality, accessibility and cost-efficiency? The State of Sikkim has healthcare facilities as per the population norms of Government of India. These are accessible in terms of distance and time. All the facilities down to the PHCs provide services 24X7 and all the sub-centres are manned by required HR (Human Resource). There are provisions of free drugs, diagnostics, diet and other services. The State is showing upward trends in all health indicators.

Tell us about the Government’s various schemes and programmes to provide

june 2018

comprehensive healthcare facilities to people. The STNM Hospital, Gangtok which is the apical hospital of the State, provides services related to all the specialities and is the Centre Referral Hospital for the whole State. There are four district hospitals headed by chief medical officers with all specialities and AYUSH providing comprehensive healthcare. The PHCs are manned by medical officers and staff providing comprehensive primary care where all the national health programmes are being implemented along with the state flagship programmes i.e. Chief Minister’s Comprehensive Annual Total Health Check-up for Healthy Sikkim (CATCH) in which people are enumerated and screened for all diseases annually. Following are the benefits/schemes given to the beneficiaries in addition to Government of India benefits: l Mukhya Mantri Jeevan Raksha Kosh (MMJRK) l Sikkim State Illness Assistance Fund for BPL patients l Mukhya Mantri Sishu Surakha Avum Sutkeri Sahayog Yojana

(MMSSASS).

l Mukhya Mantri Shrawan Shakti

Yojana (MMSSY)

l Reimbursement facility for all

Government servants.

Despite various schemes and programmes rural healthcare in India remains in tattered state. What initiatives have been undertaken to improve healthcare infrastructure in the State’s rural areas? The rural area of the State has facilities as per the population norm of the Government of India. All the PHCs have medical officers in place, providing 24X7 comprehensive primary healthcare. In the rural area of Sikkim, the role of private healthcare sector is negligible. Majority of the population utilises the public healthcare facilities. There is robust Referral Transport System in place to provide continuum of healthcare. Out of four district hospitals, three are First Referral Units (FRU) providing free blood and C-section facility by specialised manpower.

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How the State Government is planning to implement Centreâ&#x20AC;&#x2122;s Ayushman Bharat scheme? Under the Ayushman Bharat Programme announced by the Prime Minister of India, there are two major provisions: l Conversion of all sub-health centres (SHC) in the country to Health and Wellness Centre (HWC) by 2022. l National Health Protection Scheme (NHPS) / Pradhan Mantri Rastriya Swastha Suraksha Mission (PMRSSM) Conversion of all Sub Health Centres ( SHC) in the country to Health &Wellness Centre ( HWC) by 2022: The Government of India has announced 1,50,000 Health and Wellness Centres (HWC) would be created and the transformation activity has to be completed by the 2022. Similarly, in urban context the Urban Primary Health Centres would be strengthened to deliver comprehensive primary healthcare. The HWC is envisaged to provide comprehensive 12 sets of services through a team led by Mid-Level Health Provider (MLHP) who could be a B.Sc nurse/GNM, after undergoing suitable Bridge Course in public health and primary care. The Government of India has introduced a partnership with Indira Gandhi National Open University (IGNOU) for a six-month bridge course for nurses. The transformation of SHC (Secondary Health Centres) to HWC in Sikkim is proposed to be in a phased manner starting from this FY 2018-19 and it is to be completed by the FY 2020-21 thereby fulfilling the mandate of 100 per cent transformation of SHC to HWC ahead of target year of 2022. In the above context, a total of 34 HC are proposed and approved to be transformed into Health and Wellness Centre in the State of Sikkim in this current financial year (2018-19). It is also proposed that 60 SHCs will be transformed in 2019-20 and remaining 53 in 2020-21 so that the State shall achieve 100 per cent transformation of

District

West

South

Primary Health Centre (PHC)

No. of Sub centre

Dentam

Bongten, Hee-Yangthang, Utteray, Karmatar, Radu-Khandu and Lingchom

Soreng

Buriakhop, Zoom, Chakung, NayaBazar, Dodak, Singling, Chumbong, Pakkigaon and Tharpu.

Namthang

Phongla, Bingbong ,Perbing, Kabrey, Kateng and RateyPani

Namthang

Lingmo, LingiPaiyong NiaBrummanzing and Sripatam

Melli Jorethang

4 5

Sadam, Sumbok, MelliDara & Turuk Wok, NanduGaon, Salghari, Omchu

Total

and Tingmoo

SHC to HWCs by 2021 before the set national target year of 2022. Status as on 6 June, 2018: l The following facilities have been identified and approval accorded from the Government for transforming to H&WC l The Mid-Level Health Provider (MLHP), who is to lead the H&WC team, will be approved from the Government, a B.Sc nurse/GNM from regular cadre, who will receive six months bridge course in a Programme Study Centre (PSC) identified by the State and certified by the IGNOU Sikkim for certification l Total 24 councillors/ trainers from the facility have been identified and a proposal for certification forwarded to the RD, IGNOU, Gangtok l Two PHC are also identified for converting to H&WC for referral and continuums of care in aspiration District i.e. west Sikkim namely Dentam and Soreng PHC National Health Protection Scheme (NHPS) / Pradhan Mantri Rastriya Swastha Suraksha Mission (PMRSSM): The nodal officer for the implementation of PMRSSM has been identified. ASHAs have been working for validating the data of the beneficiaries of their respective areas as per the Socio Economic Census Database of India.

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Sikkim Perspective

PHCs are manned by medical officers and staff providing comprehensive primary care where all the national health programmes are being implemented

Many a times the Government hospitals lack modern equipments and latest technology to cater to people. What steps have been taken to improve the situation on this front? The State has provided all the diagnostic facilities including other specialised facilities like Digital X-Ray, MRI, CT Scan. The PHCs are equipped with X-Ray facilities and Semi-automatic analyser. There is 1,000-bedded hospital under construction which will be equipped with all the modern facilities.

eHEALTH Magazine

June 2018

State Perspective

Reducing Infant Mortality in J&K: Progress Report and Way Forward Jammu and Kashmir National Health Mission (NHM) has been at the forefront of activities directed towards reducing maternal and child mortality. With proper strategy and focussed efforts, the State has witnessed exceptional improvement on this front. Still a lot needs to be done, writes Dr Yashpal Sharma, Mission Director, National Health Mission, Jammu and Kashmir, for Elets News Network (ENN). Figure 1: Trend of child mortality rates (J&K), (Data source SRS)

Dr Yashpal Sharma Mission Director, National Health Mission, Jammu and Kashmir

he Government of India recognises child survival and development as essential for overall development of the society. This is reflected in its policies committed to providing adequate services for mothers and children. The same vision is shared by the Government of Jammu and Kashmir which wants to reduce child mortality and morbidity to the lowest achievable levels. J&K National Health Mission (NHM) has been at the forefront of activities directed towards reducing maternal and child mortality. The additional support provided to the existing health systems after launch of NHM has been instrumental in decreasing child mortality rates. Post 2010 there has been a decrease of around 50 per cent in all child mortality rates. The decrease has been much higher than the decrease at national levels. This has been possible by adopting various strategies under NHM which are directed towards reduction of E-NMR, NMR (Neonatal mortality rate), and IMR (Infant mortality rate) & under five mortality rate in addition to MMR (Maternal mortality rate) & TFR (Total fertility rate). Trend of reduction in child mortality rates There has been a significant reduction in all child mortality rates in the State from the start of National health mission. Figure 1 is showing the trend of different child mortality rates in the State for the last eight years.

june 2018

The mortality rates are well below the national average particularly for under five mortality rate (U5MR) which is 26 for State in comparison to national average of 43. Figure 2 is comparing the current status of child mortality indicators at national and State level. Figure 2: Comparison of State and national child mortality indicators (SRS 2016)

The strategies which were adopted have been discussed below using health system framework. NHM has provided support in all the components of health systems. Strategies which were adopted Infant mortality rate of a region is determined not only by availability of health services but by interplay of multiple factors which span from education levels of mothers, access to safe drinking water and sanitation and also socio-

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Type of Facility

Tenth plan (2002-07)

Eleventh plan (200712) 1907

Twelfth plan (31st March 2017) 2697

Sub 1888 Centres PHC 374 396 637 CHC 80 84 84 Data source: Rural health statistics 2017

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Shortfall as per 2011 population 0% 0% 0%

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3. Health workforce: Human resources for health are key components of any health system. The final output of any health system is dependent on available of trained and motivated health workers in requisite number. Providing manpower and then building their capacity has been a core area of intervention on NHM. Required Sanctioned R S 2967 4337 3604 4886

In Position P 4225 4737

ANM at SC ANM at SC & PHC Health worker 2967 817 672 male at Sub centre LHV at PHCs 637 154 99 Health assis- 637 50 26 tant Male at PHCs Doctors at 637 1347 704 PHCs OBGY special- 84 87 59 ists at CHCs Paediatricians 84 61 44 at CHCs Nursing staff 1225 1710 1480 at PHCs and CHCs Data source: Rural health statistics 2017

Vacant

Shortfall

S-P 112 149

R-P * *

145

2295

55 24

538 611

643

230

state Perspective

economic status of overall population. The significant decrease in IMR is attributed to all these factors. National health mission played a significant part in addressing the gaps in health systems ranging from providing leadership to proving support in the form of manpower and capacity building of human resources for health. The strategies which were adopted can be explained by using the health systems framework. These include 1. Leadership and governance: NHM helped in developing program management units at State, divisional and district level which provided the necessary leadership and governance support. These units provided technical support at relevant levels. 2. Healthcare financing: Funds for healthcare had always been scarce. India is one of the countries with least public health spending on health in terms of GDP. The public health expenditure in India has remained constant at 1.3% of GDP which is much lower than world average of 6%. The National health policy proposes to increase it to 2.5%. NHM has been able to fill the funding gap to some extent. The State has spent Rs 2,837.5 crore since 2005. These financial resources have been critical in setting up new health infrastructure, upgrading existing infrastructure, provision of human resources for health and providing medical products and consumables. NHM also provided support in upgrading the health infrastructure available in the State. The health facilities were made operational as per population norms.

4. Medical products, technologies: Medical products and technologies are an important component for ensuring diagnosis and management of diseases. NHM has provided support in making advanced care available by procurement of these products. It particularly included â&#x20AC;˘ Equipment for SNCU/NBSU and NBCC: Radiant warmers, phototherapy units, oxygen delivery equipment â&#x20AC;˘ Strengthening of ante-natal care diagnostics: ANC

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June 2018

State Perspective • 5.

•

june 2018

Diagnostics by ANM Online, Hb meters, BP Apparatus etc. Improving care around birth: Procurement of equipment like delivery sets, Information and research: NMH also supported in strengthening the information systems available so that data can be used for action. Service delivery: NHM has been able to improve delivery of key RMNCHA (Reproductive, Maternal, Newborn, Child and Adolescent Health) interventions which impact child mortality. Provision of care across the life cycle has improved due to multiple interventions being implemented by national health mission. The key intervention under NMH includes Promotion of institutional deliveries through Janani Suraksha Yojana(JSY) and improving access to delivery points by increasing the number of functional delivery points: The period around birth is critical as 46% maternal deaths, over 40% still births and 40% newborn deaths take place around the day of delivery. NHM has been able to increase the number of women having safe delivery to above 80%. Improving quality of care provision during ante-natal, intra natal and post natal period: Delivery points were developed and made functional as per population norms. The delivery points were equipped with human resource. Referral network was strengthened. There has been an increase in institutional delivery rate to 85%. Facility based newborn care at different levels to reduce child mortality: NHM provided support in strengthening SNCUs (Special newborn care units) in terms of infrastructure, equipment, manpower, drugs

and consumables. 24 SNCUs have been established and made functional. Three Neonatal Intensive Care Units (NICUs) at Government Medical Colleges are also being supported under NHM which provide tertiary care management of sick neonates referred from districts. In addition to SNCU’s 76 Newborn stabilisation units (NBSUs) and 281 Newborn Care Corners have been established in the State. • Capacity building of human resources for health: Trained manpower is critical for ensuring quality care. In this regard NHM has conducted/ facilitated multiple training for healthcare workers. The primary training which impact infant mortality include integrated management of neonatal and childhood Illnesses (IMNCI), Navjaat Shishu Suraksha Karyakram (NSSK), Skilled Birth Attendance (SBA), Facility based Newborn care (FBNC), Life Saving Anaesthesia Skills (LSAS), Comprehensive Emergency Obstetric Care (CEmOC), Basic Emergency Obstetric Care (BEmOC). 70 doctors and 88 nurses posted in SNCUs at District Hospitals and NICUs at GMC Jammu / Srinagar have been trained in facility based newborn care training programme. 3369 MOs/ SNs/ANMs have been trained till date under Navjaat Shishu Suraksha Karyakram (NSSK) • Universal immunisation programme: more children were immunised to ensure protection against vaccine preventable diseases. Proportion children fully immunised had increased to 75%. The State is planning to increase it further to 95%. • Infant and young child feeding: the breast feeding rates and malnutrition rates in children have decreased in last decade. The State will be rolling out newer

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state Perspective

interventions like home based care of young child (HBYC) to improve child feeding practices further. • Reducing out of pocket expenditure by Janani– Shishu Suraksha Karyakram (JSSK): State has been able to provide free care to all pregnant women and neonates under JSSK. • Other national health programmes: NHM has also rolled out all national health programmes with good coverage which include intensified diarrhoea control fortnight (IDCF), Mothers absolute affection (MAA). Changes in key coverage indicators in NFHS 4 compared to NFHS 3 Way forward The State envisions a health system that eliminates preventable deaths of children and still births, where mothers and children survive, thrive and reach full

Total fertility rate Women married by age of 18 Women age 15-19 years who were already mothers or pregnant at the time of the survey (%) Use of any method of family planning Mothers who had at least 4 ANC Visits Mothers who consumed IFA for 100 days or more when they were pregnant (%) Mothers who had full antenatal care (%) Mothers who received postnatal care from any healthcare provider within 2 days of delivery Institutional births (%) Births delivered by caesarean section (%) Children age 12-23 months fully immunized (%) Children age 9-59 months who received a Vitamin A dose in last 6 months (%) Children with diarrhoea in last 2 weeks who received ORS (%) Children under age 3 years breastfed within one hour of birth (%) Children under age 6 months exclusively breastfed (%) Children under 5 years who are underweight (%)

NFHS 4 (2015-16) 2 8.7 2.9

NFHS 3 (2005-06) 2.4 14.4 4.2

57.3 81.4 30.2

52.6 60.4 16.3

26.8 74.9

12.7 44.5

85.7 33.1 75.1

50.2 13.5 66.7

64.7

12.6

69.1

40.6

31.9

65.4

42.3

16.6

25.6

potential.The specific goal is to achieve single digit IMR by year 2022. To achieve single digit IMR by year 2022 the State needs to accelerate the rate of decline in IMR Figure 3: Acceleration in rate of decline required to achieve single digit IMR Accelerated efforts will be required to improve care provided to prospective mothers. It would be needed right before conception till and after delivery. In addition to

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Projected AARR: 4%

Average Annual rate of reduction (AARR) 2010-2016: 3.21

strengthening existing activities, new strategies will need to be put in place for accelerating the growth. Key interventions to be started/ strengthened for achieving this target • Pradhan Mantri surakshit Matritva Abhiyaan (PMSMA) • Dakshata for improving care around birth • Home based care of young child (HBYC) • Family centred care and KMC • Integrated management of diarrhoea and pneumonia in children.

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eHEALTH Magazine

June 2018

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Technology Perspective 68

Healtho: Empowering People to Manage Health Records Healtho is a revolutionary digital platform that makes recording, retrieval and analysis of its users’ health records and reports about the irregularities in their health condition in seamless manner, says Madhusudan Phadke, Founder and Managing Director, Healtho, in an interview with Mukul Kumar Mishra of Elets News Network (ENN).

Madhusudan Phadke

Founder and Managing Director, Healtho

Healtho is an innovative solution which helps its users to take better healthcare decisions, what motivated you to start Healtho? My two decades of experience running several healthcare projects gave me a great understanding of doctor and patient interactions. In most interactions, I observed patients lacked a good understanding of their health conditions. The key reason for this is patients typically visit doctors to cure their illness and all they get is prescriptions which then became the chemists job to interpret and give them medicines. In this transaction there are two areas of concern. Firstly the doctors have limited information about the patients earlier health history and limited time to diagnose. Secondly, most of the patients are not self conscious and don’t realise the value of maintaining their health history i.e. health becomes important only during onset of illness. Because of this even with best intentions of doctor, the diagnosis

june 2018

process becomes weaker. With lack of patient’s health (history) information and increasing pressure on doctors to do faster diagnosis due to decreasing available time, diagnosis becomes severely impacted thereby impacting patients adversely. Imagine what if people are able to store their health information systematically with ease and able to access it whenever they want. What if they can share required information with their trusted ones and their doctors. Will it not open a new world for people to develop a proactive health mindset and for doctors to do better cure? A team of six senior business leaders with cross domain expertise joined hands to pursue one vision on how to “empower a common man to take better and informed health decisions”. It took us nearly two years to come up with this innovative business concept. We see Healtho as a great enabler to drive people towards getting more health conscious and making more informed decisions relating to their health. “Empowering people for better health became our key motivation on our journey to start Healtho.

How the Healtho caters to all the requirement of every stakeholder of healthcare ecosystem? To start with, users are required to

upload their existing health records on Healtho by logging in to their respective account. To enable people to have a richer health profile, Healtho also provides a questionnaire that they can fill up and the same can be uploaded to Healtho site. Based on the initial information uploaded, Healtho users may be advised to undergo certain tests to assess their exact medical condition. The test reports are then uploaded to Healtho. In case of any existing illness, users can visit their doctors for treatment and share their relevant profile information with their doctors also. The soft copy of doctor’s prescription can be uploaded to Healtho for updating their health record. Users are encouraged to keep it updated with any or all recent health information they have with them. In certain situations, Healtho may also advise users to take second opinion for a certain illness they are getting cured for. Healtho enables users to manage their health records much better, by providing easy access to their health information anywhere and anytime, by providing insights about their health condition and enabling more informed decision making among others. It is important to emphasise that Healtho also helps doctors to diagnose and prescribe much better. Healtho has a section called

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june 2018

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Technology Perspective

“Medical History” where users can upload all medical information about their earlier illness, their parents and also earlier generations . It provides insights to doctors and helps them understand more about a user’s health condition. The medical history section has been made based on our discussions with doctors panel and specialists. The idea is to enable doctors to get a clear picture about the user in a short span of time. Considering that the average time a doctor dedicates his or her patients for diagnosis of any disease is around seven minutes, such handy information about patients helps doctors diagnose better and prescribe better treatment. For example, incase of a diabetic patient, doctor’s can’t have the information about patients data for more than three months. But through the Healtho dashboard , the doctors can view the details of patient’s sugar levels in a graphical format from the time diabetes was detected along with his or her Body Mass Index (BMI), pulse rate and information of any other organ health condition. The information is usually presented in date range. Similarly, the dashboard is like a secretary for users and guides them on the ups and downs of their

health conditions. Visiting a doctor and visiting a hospital are two different scenarios. A doctor to whom you are visiting for last many years may be aware about your health condition a bit but we go to hospital only in a critical condition. You have to wait for at least a few hours for Blood Pressure (BP) check up, blood and other tests before getting the required treatment. Under critical health conditions health of patients may worsen due to delays in getting access to health information. Patient’s Healtho dashboard may help the hospital to understand patient’s health condition in few minutes leading to early treatment. Healtho can also help the insurance companies in a way that they can provide better coverage and more customised plans to customers. Healtho guides it users for improving their health conditions on regular basis and alarms them before the onset of a sever health problem. It saves its users by early indication thereby reducing costly health expenses and also saves insurance companies from claims.

You provide a wide range of healthcare services to your customers like online booking of medical tests and ambulance, how

does this exactly work? We are facilitating things. These services are provided through the various organisations whom we have partnered. Let’s say a person wants to go for a blood test in Noida. From the list of our channel partners, he/ she can book for the test. The reports will automatically be uploaded on the dashboard with all the details.

Please give brief details about Healtho Baby Care and Healtho Diet. Healtho baby care is about taking care of a child’s healthcare from his/her birth to death. The Healtho helps a mother to keep track of all her ward’s vaccinations and medications. By entering a child’s date of birth, the Healtho will inform the parents about the vaccinations at the prescribed time. The Healtho is thus very helpful for working mothers to keep a balance between their profession and child’s care. The Healtho also stores the information about the vaccination’s batch number and manufacturing/expiry date which will help the user in case of any side effects caused due to it. Healtho diet is about providing details to the users on the basis of the data entered by them. It helps the users to eat the food required as per their health conditions.

Majority of Indian population still lives in the areas where it is difficult to make them aware about such apps, how are the efforts being made to bridge the gap? The people in villages are fit than the persons in cities as they have to do a lot of physical activities for their livelihood. To make people aware about the Healtho, our volunteers make a visit to panchayats of several villages. They inform local people about Healtho’s benefits and how it supports them to search for better healthcare services in their nearby cities.

june 2018

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2:51:31 PM

Industry Perspective

Alpha Healing Center Creating Healthier India

Widely recognised as one of the most effective inpatient drug and alcohol rehabilitation centers in Gujarat, Alpha Healing Center provides state-of-the-art evidence-based treatments and holistic healing to create a unique recovery experience for individuals struggling with alcohol, drug and other addictions, says Vijay Patel, CEO, Alpha Healing Center, in conversation with Mukul Kumar Mishra of Elets News Network (ENN).

Vijay Patel

CEO, Alpha Healing Center

he Centre has hypnotherapy, music therapy, and animal assistance therapy. These are all add-on therapies which provide client the relaxation. It gives patients an ability to manage stress as well as the negativity that surrounds them. Excerpts of the interview:

Alpha healing center serves patients with a holistic healing approach. What is the philosophy behind the treatment? We have got two types of therapy -psychotherapy and holistic therapy. Psychotherapy is a type of evidence based therapies like Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), Motivational Enhancement Therapy, Relapse Prevention Therapy which help a client to maintain a positive attitude towards life. At the same time it gives them the medical strength and confidence to manage the stress as well as the cravings. On the holistic side, we have

june 2018

hypnotherapy, music therapy, and animal assistance therapy. These are all add-on therapies which provide client the relaxation. It also helps the client to overcome all the negative energy they have been going through. It gives them an ability to manage stress as well as the negativity that surrounds them.

What kind of innovative therapies do you offer at your rehabilitation centers? All our therapies are evidence based which have been well documented. It adds value to patients. In terms of new therapies, we have animal assistance therapy where we use a dog as a pet. As we know, dogs provide unconditional love and are very faithful. When our clients sit with these well-trained dogs, they learn lessons of life. They understand that in life it is always important to be good and to be very honest and straightforward. Since last one year, it has been helping our clients a lot. Moreover, our all therapists are well trained. As compared to other centers, the outcomes which we offer are much better.

Shed some light over ‘alcohol addiction treatment’ and ‘drug addiction treatment’

programmes. How do these work? Any types of addiction whether it is alcohol or drug, the basic principles remain the same. There are three important things which need to be fulfilled from the clients’ side. One is the intent and motivation of client whether he or she wants to come out of this. Second is family support. After the treatment, the family support is utmost important so that patients could maintain the sobriety and start a new life.The last important thing is patience. Many a times, the family members feel that by admitting in rehab centre their job is over. But that is just beginning. When we talk about recovery, one should understand that it is the journey and not an event. There are always chances of relapsing. It doesn’t mean that therapy has failed and the amount that family has paid has gone waste. Possibility of relapsing never goes away. Whenever it happens the family has to immediately contact us. We take appropriate steps to counsel the patient and start working on him again. When we talk about alcohol and drugs, it is important to understand that detox is important process which we adopt at Alpha. Whenever the clients get admitted at our center, the first four to five days they are being

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In our society, depression is not perceived as a serious disease. What kind of family counselling programme you provide at the center? Today, depression is part and parcel of every individual’s life. In normal cases, the body has its own mechanism through which the individual comes out. When we talk about the depression of a client who has been suffering from depression from three or four years and he or she doesn’t have the ability to overcome that, then doctors and counsellors must be consultant. At Alpha healing center, the counsellors are well-trained. Counselling process involves understanding the past history which the patients have undergone. Certain situations or certain incidences drive

Our center offers a lot of recreational activities i.e swimming, fitness centers and spa. We have tennis and badminton court. In the evening, the clients are engaged in all these recreational activities as per their choice and their area of interests

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kept into detox under observations. Detox is the process where the client’s body is totally detoxed from all the toxins that exist. Once the detox process gets over, the client is moved to rehab cottage where rehabilitation works start.

a person into depression. The counsellors try to look for positive things and skills within the patients. On the basis of that, the counsellors provide positive stimulus to patients. The stimulus provides them a confidence to think that depression is easily manageable. It makes them to think that it can happen to anyone. The way we counsel a patient is very important. We do have family counselling sessions. Last Sunday of every month, the family members are called upon. Our psychologists and psychiatrists have a four-hour well planned agenda to discuss with the family teaching them how to behave with patients once they come out of the center. Families are taught how to support and motivate the patients. Our experts teach how to ensure that patients don’t undergo the same stress-level again.

Healthy diet plays a crucial role in keeping a person fit and fine. How do you ensure healthy diet and nutritional habits of patients? Healthy diet is important for every individual. At our centers, we have dieticians who come every week taking care of patient’s eating habits. They guide the client towards a healthy diet plan during their stay at Alpha. Clients follow the diet schedule. They are also given the diet

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plan and asked to follow the same when they go out of the centers at the time of discharge. Same is also discussed with family members during family counselling sessions. Along with diet, exercises are also very important as an individual should be fit both physically and mentally. Our center offers a lot of recreational activities i.e swimming, fitness centers and spa. We have tennis and badminton court. In the evening, the clients are engaged in all these recreational activities as per their choice and their area of interests. At the end of the day, the clients feel that right from morning -starting with yoga till evening, he or she can manage without alcohol and drugs. If that goes on for two to three months, the patients feel motivated and confident that they can live a life full of vigour and energy without even thinking of alcohol and drugs.

eHEALTH Magazine

June 2018

Comprehensive Integrated Digital Healthcare Solutions

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