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THE PREMIER MONTHLY MAGAZINE ON THE ENTERPRISE OF HEALTHCARE IN ASIA & THE MIDDLE EAST volume 13 / issue 02 / FEBRUARY 2018 / ` 75 / US $10 / ISSN 0973-8959
SPECIAL INTERVIEWS
Prashant Gupta
Executive Director Sharda University & Sharda Hospital
COVER STORY
UNIFYING
HEALTHCARE
CL UD TECHNOLOGY DELIVERY WITH
INDUSTRY PERSPECTIVE
Dr J Sivakumaran
COO Kovai Medical Center & Hospital
Michael Allwyn
Director & Co-Founder Business Operations Gem3s Technologies Pvt Ltd
SPECIAL STORY
Medical Tourism PROVIDING CONTINUUM OF CARE BY SYNERGISING HEALTHCARE SERVICES Sangita Reddy, Joint Managing Director, Apollo Hospitals
A Novel Introduction of India Among Globetrotters
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february 2018 | Volume 13 | Issue 02
08 COVER STORY
Unifying Healthcare Delivery with
Cloud Technology Clinical Initiative 12 Dr Gaurav Dahiya Mission Director National Health Mission, Department of Health and Family Welfare, Government of Gujarat
healthcare transformation in andaman 16 Dr Monica Priyadarshini Special Secretary, Department of Health and Family Welfare, Andaman and Nicobar Administration, Government of India
Technology Perspective 18 Abhimanyu Bhosale Co-Founder, CEO, LiveHealth 20 Geoff Siegel Vice President, Innovation, Breg Rajmohan Nair
CEO, Adtech
32 Manikandan Bala Managing Director, Elekta India
industry perspective
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24
Sangita Reddy Joint Managing Director Apollo Hospitals
Dr J Sivakumaran COO, Kovai Medical Center and Hospital (KMCH)
Dr Tushar Mehta Director, Orthopaedics Plus (P) Ltd
hospital Perspective 30 Commander Navneet Bali Regional Director Northern Cluster, Dharamshila Narayana Superspeciality Hospital 34 Prashant Gupta Executive Director Sharda Hospital and Sharda University 40 Dr Dinesh Arora Chairman Yashoda Super Speciality Hospitals
Medical Tourism 36 Annu Puri Co-Founder of IndiCure Health Tours 46 Pankaj Chandna Manish Chandra Co-Founder of Vaidam Health
Budget Perspective
52
38 Dr Lalit Singh Director, Clinical Solutions and Product Strategy, Elsevier Health 42 Rajesh Maurya Regional Vice President India and SAARC, Fortinet
special feature 26
Medical Tourism A Novel Introduction of India Among Globetrotters
Industry Hails Jaitley’s Budget Taking Healthcare to All
Editorial Empowering India with Tech-driven Healthcare With the country embracing modern technologies at a steady pace in every sector, healthcare is a prominent area where it is needed most urgently. Making healthcare affordable, accessible, and its delivery transparent, however, are the challenges only technology can answer in contemporary times. Our cover story “Unifying Healthcare Delivery with Cloud Technology” is an attempt to explore and highlight how this technology can play vital role in streamlining things in healthcare industry. It is believed Cloud computing is the future and managements need to move from routine solutions to cloud computing solutions. The new computing paradigm makes it possible to access photos, videos or documents from any Internet-linked computer. Various experts have expressed their views on this latest technology which would bring incremental change in the healthcare ecosystem. Observing the growing trend of medical tourism in the country, we have carried a special feature on ‘Medical Tourism: A Novel Introduction of India Among Globetrotters’ highlights major key elements fostering the industry and attracting foreign tourists. Various key healthcare service providers shared about how it is becoming a major emerging opportunity for the Indian healthcare sector. One of our special stories is ‘Industry Hails Jaitley’s Budget Taking Healthcare to All’. It highlights industry’s take on Union Budget especially in terms of healthcare sector and underline how they are perceiving the Narendra Modi Government’s move to take healthcare to all. We also have some insightful articles and interviews from experts of healthcare sector. In an article, Joint Managing Director of Apollo Sangita Reddy says Apollo caters patients by integrating IT with healthcare. In this issue, Dr Monica Priyadarshini, Special Secretary, Department of Health and Family Welfare, Andaman & Nicobar Administration, Government of India, has shared initiatives undertaken to boost medical tourism in the Union Territory. Dr J Sivakumaran, COO, KMCH, Coimbatore in his interview has talked about evolving technologies of healthcare sector. In another article Dr Gaurav Dahiya, Mission Director, National Health Mission, Department of Health & Family Welfare, Government of Gujarat, has mentioned about the ongoing project on School Health Check-up Programme. With such a variety of special stories, articles, and interviews of distinguished personalities, we hope to receive an invaluable feedback. Also, taking our mission a step forward, we are set to organise Healthcare & Wellness Awards 2018, Conference & Expo on 29 March in New Delhi. One of the biggest extravaganzas in healthcare sector will witness participation from a galaxy of India’s top hospitals, healthcare providers, nursing homes, medical devices and hospital equipment companies.
Dr Ravi Gupta Editor-in-Chief, eHEALTH magazine & CEO, Elets Technomedia Pvt Ltd ravi.gupta@elets.in
Cover Story
Unifying Healthcare Delivery with
Cloud Technology The Indian healthcare ecosystem seems to be steadily witnessing creation of comprehensive and world-class facilities with best clinical practices, courtesy technology integration, with Cloud Computing being a prominent one among them, writes Mukul Mishra of Elets News Network (ENN).
I
t has enabled delivering enhanced patient care services with an emphasis on quality, service excellence, and empathy. With the help of this webbased computing technology entire healthcare system can be synchronised. The Cloud, most importantly, helps stakeholders of healthcare Industry including patients, hospitals, clinics staff to establish better coordination. Information can be disseminated in an easy manner and data can be analysed in effective way with the help of this internet based technology. With the influx of technological advancements in every walk of life, things have become much easier in today’s world. It feels interesting when we look back and notice how far we have travelled in terms of latest technologies and various innovative inventions in
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February 2018
healthcare sector. In today’s Internet era when people have easy access to all the information, the healthcare service providers face huge challenges to cater patients to their satisfaction. Hospitals and other healthcare personnel know that people have to be gratified with best of services within a prescribed budget. With the motive to provide safer, faster and more efficient healthcare delivery, these organisations are exploring various ways to leverage existing facilities. “One of the most significant expenses that any start-up in the tech space or any start-up that leverages technology in the provision of its services, is the cost incurred for procuring the right technology infrastructure,” says Samara Mahindra, founder, CARER Program. He says cloud computing
technology is the need of the hour. The technology has enabled healthcare providers to enhance whole service delivery process. “Because of cloud technology we have not had to invest in servers, virtual machines, software licenses and instead have been able to use cloud platforms such as AWS. This has helped us to avoid a heavy capex model for set-up, to pay-as- go oppex model of set up and in turn has contributed in channelling our financial resources into building a better product and service and delivery of them.” “The flexibility of cloud computing has enabled us to scale up at almost no cost and deliver our services into tier 3 cities of India,” Mahindra said. It will not be exaggeration to state that recent technological advancements including Cloud Computing, Artificial Intelligence,
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Big Data and Internet of Things (IoT) have served the purpose well. The innovative applications have helped both, healthcare service providers and patients to get best of medical facilities in a cost effective way. There is need to understand it is likely many of us may not have even heard of Cloud Computing. But we could have been benefitted with this technology directly or indirectly through other applications. Most of us have been using this technology to store data, photo and videos through many platforms like Google’s Gmail and its online document management system. Even many features of Facebook, Netflix and Microsoft SkyDrive are based on the same principle of cloud computing.
Leveraging Cloud Technology With the help of this web based computing technology entire healthcare system can be synchronised. Cloud helps every stakeholders of healthcare Industry including patients, hospitals, clinics, dispensaries, laboratories, doctors, pharmacist, medical consultants and counsellors to become part of a system and manage workflow. Information can be disseminated in easy manner and data can be analyzed in effective way with the help of this
Cloud is a new innovative computing paradigm which makes it possible to access photos, videos or documents from any computer with an Internet connection
Cover Story
paradigm which makes it possible to access photos, videos or documents from any computer with an Internet connection. The internet-based computing technology uses a secure network of remote servers hosted online to store, manage, and process data which can be easily accessed by anyone sitting across the globe. Cloud encompasses several variations of service models (i e., IaaS, PaaS, and SaaS) and deployment models (i.e., private, public, hybrid, and community clouds). By using cloud computing, organisations can consolidate their IT infrastructure and reduce IT energy costs.
internet based technology. Experts believe this technology will play significant role in transforming healthcare Industry in coming years. Hospitals are investing more on the technology to meet with the high demands of patients who want value for their money. According to BCC research report, the global healthcare cloud computing market will hit $35 billion by 2022 with compound annual
Cloud Computing At a Glance Cloud is simply a new computing
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Cover Story growth rate of 11.5 per cent. Though in comparison to European market, Indian healthcare has been slower in adopting the cloud computing technology, nevertheless industry has realised its potential in recent past. A study by Zinnov Management consulting firm says that opportunity for Cloud solutions in the Indian healthcare industry is estimated at $600 million by 2020. Dr J Sivakumaran, COO, KMCH, maintains that Cloud technology could be a gamechanger. “Cloud computing is the future and many healthcare providers are already using this extensively. The top management needs to change from the routine solutions to cloud computing solutions.” He says with our Government’s Digital India move and better connectivity, “we foresee our IT infrastructure deployed on the private cloud in the years to come”. Healthcare Information Exchange is required within our own group hospitals, where information is shared by our stakeholders. “HIMS and clinical systems deal with mission critical process, and can make the difference between life and death,” Sivakumaran added. He has also suggested that
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February 2018
healthcare providers must take precautionary measures before transferring whole data on the cloud. “It is always debatable whether the patient privacy and sensitivity of the data is safe. Cloud computing for healthcare will need to have the highest level of availability and highest level of security.” Cloud computing is an ideal platform through which entire healthcare industry works in more systematic manner. It ensures efficiency and productivity by maintaining records and providing ease of access to the medical professionals. Let’s have a look how cloud services can help healthcare Industry to provide better care to patients. Electronic records Healthcare service providers are harnessing the potential of this technology to archive patient records and medical images. This new approach to data will improve access, increase storage capability, and boost security. Better collaboration and coordination Medical professionals find the platform helpful to collaborate with patients to provide them better care in
real time. Not only that, this platform also enhances coordination among doctors to expedite whole process of diagnosis. Though various mobile applications and video conferencing facilities already exist, cloud services perform better on this front. With this technology, patients receive the expertise whenever they need it. This allows for the healthcare information to be shared electronically across organisations within a region, community or hospital system. Data storage and analytics The cloud provides secured data storage platform. Hospital and diagnostics centre generate huge amount of data on daily basis and it becomes very challenging and tough job to analyse these data. Cloud computing makes things easier. Healthcare providers can “harvest” data for medical research with the help of cloud computing technology. Clinical Research The cloud platform is beneficial for medical research too. It enables a lot of high-powered data solutions to spur the research process. Experts have this opinion that Big data used to be far too comprehensive for smaller computers to handle, but through the advanced
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Telemedicine The ‘health care from a distance’ has become reality with the help of this cloud computing platform. The cloud enables higher-tech devices, and mobile technology to make this possible. Telemedicine includes consultations, tele-surgeries, and monitoring patients without having physical presence of specialist doctors. General physician, local nurses get directions from experts how to move forward or what drugs to be prescribed for a patient who is located at remote areas. Apart from those above applications, the cloud computing platform allows data to be available in real-time with minimal downtime and speeds up whole process of medical treatment in cost effective manner. Rajesh Maurya, Regional Vice President, India & SAARC, Fortinet says: “Cloud use, especially in instances of IaaS, drastically reduces the upfront costs of research that would otherwise require building comprehensive data centers and storage capabilities. “Rather than having to build
The cloud computing platform allows data to be available in real-time with minimal downtime and speeds up whole process of medical treatment in cost effective manner
out this infrastructure themselves, research facilities can delegate it to third-party cloud providers, thereby reducing the cost of entry and making research more accessible.” Dr Jonathan Stoeckel, CEO, Stradus India says this latest computing technology is changing the face of Indian healthcare. “Cloud computing provides everywhere access and reporting opportunities as well as high data security and offsite disaster recovery.
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Hybrid solutions, like Stradus Hybrid RIS PACS, will become the standard for Indian healthcare users as they combine the advantages of a local PACS and a Cloud PACS.” Navneet Bali, Regional Director, Dharamshila Narayana Superspeciality Hospital opines, “We are moving towards these cutting edge technologies where AI, big data crunching would be used in the treatment of patients across healthcare. The cloud is basically huge storage capacity available to everyone where the recovery of data would be at fingertips anywhere, anytime. Best part of this technology is that you have tremendous amount of storage capacity on cloud and you have any place any time access to the data.” “The security of the patient data is most important aspect of the cloud technology as confidentiality of patients’ data is very critical. Big data crunching is helping us to analyse patient data in big way so that you will be able to bring in statics into it and then provide treatment which can be optimal treatment for particular type of disease. Big Data, Robotics, and AI are going to play huge role in healthcare sector,” he further added.
Cover Story
computing power of the cloud, using these giant data sets for progress becomes a reality.
Challenges With each technology having its share of foibles, Cloud Computing is not an exception. But it can be applied and utilised in optimum way, considering patients data security is one of the biggest challenges of this technology. As patients’ data is very crucial and its privacy is utmost important, one should choose vendor (cloud provider) with lots of research and background check. In addition to data security, other challenges are skilled IT workers and compatibility factor. Crux of the matter is Cloud computing is to bring an incremental change in Indian healthcare Industry though some precautionary measures need to be taken to make best out of it.
eHEALTH Magazine
february 2018
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Clinical initiative 12
School Health Check-up Programme in Gujarat Developing the human capital of nations especially the intellectual, social, mental, and physical abilities of children and adolescents is fundamental to the improvement of the quality of life of the citizens, writes Dr Gaurav Dahiya, Mission Director, National Health Mission, Department of Health and Family Welfare, Government of Gujarat for Elets News Network (ENN).
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eveloping human capital is also critical for nations to enjoy political stability and economic growth. Nations that have invested in health and education tend to experience corresponding economic development. Accordingly, in 1909, Sir Sayajirao Gaikwad, King of Baroda, started School Health Programme in Baroda region. It was the first school health programme in the country. In 1946, the Bhore Committee reported that School Health Services were practically non- existent in India. Where they existed, they were in an underdeveloped stage. In 1953, the Secondary Education Committee emphasised on the need for medical examination of students and school feeding programme. To ensure good health for our school children the Department of Health & Family Welfare conducts School Health Programme every year. This is the single largest health programme operating in the state of Gujarat. The Government of India launched the ‘Special School Health Check-up Programme’ in 1996 in coordination of Department of Health & Family Welfare and Department of Education for school going children of Primary Schools with the following objectives: • Detection of health-related problems that are commonly occurring amongst primary school children.
February 2018
• Screening of children for appropriate referral. • Building of health awareness in the community through primary school children. • Follow-up arrangements for detailed check-up and treatment of referral cases at Government’s Health Facilities. It was a six-day programme throughout the country and the MultiPurpose Health Workers undertook primary screening. Referral services were provided at the Primary Health Centers. The programme, however, was discontinued after some time. The Department of Health in collaboration with Education Department started innovative School Health Programme since 1997. The steering committee takes important policy decisions regarding School Health Programme and decides the date as well as the time duration of the programme and before start up meetings of CDHOs, CDMOs, RDDs and programme officers are called and detailed discussions held for effective implementation of the School Health Programme. Individual Medical Officers prepare micro plans at the PHC level which include date, time and place of examination, number of schools and number of school children to be examined. District health authorities collect and compile micro plans and
Dr Gaurav Dahiya
Mission Director, National Health Mission, Department of Health and Family Welfare, Government of Gujarat
send the same to the state authorities for compilation and analysis. At the State-level, Health Education Bureau compiles and analyses all information and prepares a statelevel master plan, which includes the requirement of: • Manpower • Drugs • IEC Materials • Stationary • Contingencies Medical officers with their teams examine all schoolgoing and I.C.D.S. beneficiaries in the primary schools and Anganwadis. Children with minor ailments are treated on the spot in the school. Children requiring examination by specialists are sent to the related referral centers where different medical experts like ophthalmic surgeon, physician, pediatrician, dentist, skin specialist and E.N.T. surgeons examine and treat them. Those children, who require spectacles, are provided
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many students had been given super specialty treatment like Kidney transplant, Cochlear implant, Bone marrow transplant, club foot surgery and cleft lip/palate surgery as well. SHP Week Day 1: Activities related to sanitization (personal and environmental) and medicinal tree plantation in collaboration with Education department and Water supply department Day 2: Primary health check up by health care professionals like FHWs and MPHWs Day 3: Activities related to nutrition and healthy diet, healthy child and healthy pregnant women competition in schools and Anganwadi centers, jointly celebrated by Health department and WCD, Dada dadi meeting. Day 4: Medical examination, on the spot treatment, proper referral by Medical officers, Parents’ meeting. Day 5: Cultural programme, prize distribution and felicitation ceremony. School Health programme was initiated in 1997 in Gujarat state and was running through state government health department. Children up to 18 years of age have been included in beneficiary group.
To ensure good health for our school children the Department of Health and Family Welfare conducts School Health Programme every year. This is the single, largest, health programme operating in the state of Gujarat.
Clinical initiative
the same free of cost. Children suffering from heart, kidney, ear problems and cancer diseases are examined by superspecialty hospitals. Operative treatments including renal transplant, lever transplant, cardiac surgeries, Bone Marrow transplant are given free of cost. Transportation is also provided by the State Government. This is single largest State Health Programme. The State government had included secondary school students under the programme in 2007-08. In 2017-18, School Health Programme was launched by Dr Gaurav Dahiya, Mission Director, National Health Mission, Gujarat. One-day workshop was organised under the Chairmanship of Mission Director for the orientation and motivation of doctors who are visiting school for screening children and also identified the problems faced at grassroots level and resolved it. Because of that School Health Programme achieved a milestone by screening 1,54,09,243 (One Crore fifty four lakh nine thousand two hundred forty three) from that 17,31,625 (Seventeen Lakh thirty one thousand six hundred twenty five) students were treated on the spot. From this,
In 2014, it has been merged with new initiative of central government health department i.e. Rashtriya Bal Swasthya Karyakram and named as “School Health- Rashtriya Bal Swasthya Karyakram” in which newborn to 6 years anganwadi children have been included and health screening at delivery points for birth defects has been given priority. Data base of health check up is prepared with the help of National Informatics Centre. NIC develop software of School Health Programme. Data entry of health checks up through e-gram network and out sourcing in urban area. All information about School Health Programme is now online and access from http://shp.guj.nic.in, Evaluation of School Health Programme was carried out by an independent agency, preventive and social medicine departments of all medical colleges of Gujarat every year, which gives input to improve the programme. (Views expressed in this article are of Dr Gaurav Dahiya, Mission Director, National Health Mission, Gujarat )
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Industry Perspective 14
Technology for Trusted Healthcare Medicine has been practised in various forms for possibly over a million years and it has always been a revered science. It was over the last few centuries that with the need to grow the role of the healer, ‘healthcare’ as the discipline as we know it today, came into being and has been evolving ever since, writes Sangita Reddy, Joint Managing Director, Apollo Hospitals for Elets News Network (ENN).
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multidisciplinary field; healthcare stretches the reach of medicine and it involves the application of science, technology and finance for the delivery of care. To be true to its intent, its core purpose, healthcare must be equitable and this singular goalhas been the driving force for India’s pioneering healthcare family – Apollo Hospitals. Healthcare in our country has witnessed a sea change especially since private healthcare began in the early eighties. In 1983, Apollo Hospitals in erstwhile Madras opened its doors and introduced advanced medical care which was accessible and affordable for the people of India. Hundreds of businesses emulated Apollo’s model and currently over 60 percent of India’s healthcare needs are met by the private health sector in India. Reverse brain drain of skilled doctors, investments into healthcare and ease of sourcing high-end medical equipment and technology
February 2018
in particular has been a gamechanger in the growth of healthcare in India. Apollo was amongst the first few healthcare providers who harnessed the power of technology to introduce cutting edge medical equipment for diagnosis and treatment of diseases, to perform minimally invasive surgeries, introduce Hospital Management systems, Electronic Medical Records etc.,and more recently to bring about a paradigm shift in accessibility with remote healthcare. Apollo Remote Healthcarewhich includes Apollo Telehealth Services, HealthNet Global and Apollo Networking Foundation has revolutionised healthcare with IT. It has taken healthcare to remote locations, shrunk distances and improved turnaround time thereby, providing continuum of care by synergising healthcare services, information and communication technologies (ICT), latest medical equipment’s and patient information systems.
Sangita Reddy
Joint Managing Director Apollo Hospitals
Formerly known as ATNF (Apollo Telemedicine Networking Foundation), it is one of the world’s largest and oldest multispecialty telemedicine networks in South Asia. The organisation, Apollo Remote Healthcare has been purposedesigned to provide specialised solutions such as Tele Consults, Tele Radiology, Tele Cardiology, Tele Ophthalmology, etc. The innovative models of care offered by Apollo Remote Health model garnered interest from the Central Government and also from several States across India. Innovative partnerships have been forged and some of the major initiatives currently under the aegis of Apollo Remote Healthcare are: • e- UPHC (electronic urban
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• •
•
•
•
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Each of these partnerships underscore a commitment to deliver care seamlessly to our fellow humans and the passion of the organisation to facilitate timely medical attention, critical to saving lives. A decade ago, technology was more of an enabler, but over the years, it has been transformative and has greatly accelerated positive change. However, juxtaposed against this, a rather unpleasant development has been one of individuals searching the internet for quick fixes, often dubious remedies to treat ailments and often make ill-informed decisions. Moreover, as health care systems
Apollo Remote Healthcare which includes Apollo Telehealth Services, HealthNet Global and Apollo Networking Foundation has revolutionised healthcare with IT. It has taken healthcare to remote locations, shrunk distances and improved turnaround time
around the globe shift towards models that emphasize self-care, there is increasing curiosity to obtain health information online. Various modes of information sources i.e. search engines, online clinical validation reports, newspapers articles; blogs, social media etc. have contributed to patient anxiety because of their “inadequate e-health literacy”. Sadly, this in an odd manner has also triggered mild distrust of doctors and their recommendations, especially when it is about diagnostic tests and medications. Medicine is a very complex science and a doctor spends years studying and mastering it. In addition, when it is a complex case, doctors discuss patient care with their peers and seniors before they take major decisions. Hence, bearing these facts in mind, it would hugely erroneous
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if a layman were to self-medicate or self-diagnose themselves or anyone else. Based on ill-considered knowledge, the decision to ignore a symptom and treat the condition would be tantamount to endangering a life. Trust in the clinician and the hospital is integral to healing and speedy recovery for a patient. It is a team that delivers patient care and belief in them is a must! Cognizant of the fact that quality is important to inspire trust; professional healthcare providers across our countries have invested in technology to drive transparency and visibility of information to requisite authorities. Apollo Hospitals in Delhi was the first Indian hospital in the country to be accredited by Joint Commission International (JCI) and today there are over 33 hospitals in our country accredited by this gold standard. This international quality accreditation has encouraged patients from over 140 countries to repose their trust in us. JCI inspired the evolution of NABH (National Accreditation Board for Hospitals and Healthcare Providers. This underlines that India is committed to support the continuous improvement of healthcare for its people. Continuum of care is just as important as care in the hospital and technology helps in delivering care to the individual wherever they may be – in the hospital, clinic or at home. Similarly, to provide the continuum for international patients, the medical teams at Apollo harness technological platforms to monitor patients and also keep doctors in patient’s home country informed and abreast of the patient’s progress and treatment modality. So, right from saving the life of Ram Singh in Keylong, situated at 14,000 feet above sea level in Himachal Pradesh or caring for Abasi in Tanzania, Apollo would never leave a stone unturned to take advanced care closer to the individual in need.
eHEALTH Magazine
february 2018
Industry Perspective
•
primary health centre) with 164 centres all across Andhra Pradesh, formally called as Mukhyamantri Arogyam Kendram. Tele Ophthalmology (Mukhyamantri e-eye kendram – A Public Private Partnership project with 115 centres in association with Government of Andhra Pradesh. Tele Emergency services in the state of Himachal Pradesh. Partnership with the National Thermal Power Corporation of India Tele Geriatric Care - Tele consultations and Tele emergency services provided through skilled manpower and advanced protocols. SEHAT In partnership with the Government of India, Apollo remote healthcare supports over 60,000 CSCs where primary healthcare is rendered across remote geographies at gram panchayat level. Beat Diabetes – A social initiative to screen and treat Noncommunicable diseases with landmark group. “Ask Apollo” - A dynamic portal to provide online consultation at the click of a button, can be accessed globally.
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healthcare transformation in andaman 16
‘Government Boosting Healthcare in Andaman
and Nicobar’
The Health Department of Andaman and Nicobar has been undertaking various initiatives for smooth functioning of health infrastructure as well as the projects implemented, Dr Monica Priyadarshini, Special Secretary, Department of Health and Family Welfare, Andaman and Nicobar Administration, Government of India, shares initiatives taken up by the department in an interview with Rajbala of Elets News Network (ENN).
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Please share the latest digital initiatives implemented by the Health Department in Andaman and Nicobar. Leveraging digital technologies will improvise health making it affordable, efficient and cost-effective. We have taken various digital initiatives to foster healthcare in the region and disseminate reliable, authentic and updated health information for citizens, students, healthcare professionals and researchers. Our recent major projects undertaken include e-hospital which has been implemented in G B Pant Hospital at Port Blair, which is the super speciality hospital in the islands. In addition, we have implemented Direct Benefit Transfer (DBT) in Dulari Scheme for girl child.
Q
Indian healthcare industry has made entry at the global level because of high quality of diverse clinical expertise and low cost of treatment, how do you view medical tourism as an opportunity? High quality of diverse clinical expertise and low cost of treatment are keys to India, becoming world leader in medical tourism. For Andaman and Nicobar Islands, its scenic beauty, clean air, clear water, serene environment and ample health infrastructure availability is best
February 2018
suited to promote medical tourism. The region has a good potential for AYUSH therapies like Panchkarma for holistic well being of tourists. We have plans to setup Panchakarma Wellness centre in Havelock Island which would attract medical tourists.
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How PPP model plays an important role in developing medical tourism sector in the country? Are you also looking forward for any partnership or have done any sort of tie-ups? Projects Executed and Roadmap • Mobile CBNAAT Ambulance for TB is now available in the Islands • Air to Water equipment is available at Chowra and other Islands of Nicobar district where water is scarce to cater the Tribal population. • Cardiac Cath Lab in Port blair will be functional soon • Air conditioning chiller plant unit with all accessories at Modular OT at Port Blair • Triple storied building to be set up at AYUSH Hospital complex; Junglighat upto 50 bedded AYUSH Hospital at Rangat, Port Blair and Car Nicobar. • Establishment of Special Newborn Care Units (SNCU) at Car Nicobar is in pipeline
Dr Monica Priyadarshini
Special Secretary, Department of Health and Family Welfare, Andaman and Nicobar Administration, Government of India
Public Private Partnership scheme was launched during 2010-11 to operationalise two public healthcare centres (PHCs) viz PHC Chouldari in South Andaman district and PHC Kishorinagar in North and Middle Andaman District. Also, Memorandum of Understanding (MoU) was signed between an NGO namely VHAIAparjita and Andaman and Nicobar Administration in this regard. PPP model can play a very important role to boost medical tourism in the country. We are looking forward for private partnership in the AYUSH sector in the near future.
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Technology Perspective 18
Cloud - The Future of Laboratory Automation We build applications for medical laboratories and diagnostic centres, enabling them to go completely mobile, speed up lab operations and provide better customer-patient experience, writes Abhimanyu Bhosale, Co-Founder, CEO, LiveHealth for Elets News Network (ENN).
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loud computing has always been an enabler. When we use it to find the nearest clinic or book the appointment with your family doctor, we use all the computing in the cloud to find you the nearest list of open clinics with appointment slots for each one of them. That is cloud computing in action. It has a lot more applications, like finding patterns in patient data, tumours in the MRI scan, and much more. But we will talk about how cloud computing can be
February 2018
used for end-to-end automation in laboratories. At LiveHealth, we build applications for medical laboratories and diagnostic centres, enabling them to go completely mobile, speed up lab operations, and provide better customer-patient experience. A first step is to start moving to a cloud based ERP / POS (point of sale) system. This de-centralises your daily transactions and gives the administrator the ability to monitor remotely and in real-time. Having your POS on cloud not
Abhimanyu Bhosale
Co-Founder, CEO, LiveHealth
only makes you less dependent on your local limitations and reduces infrastructure costs, but also makes it scalable with ability to grow to multiple locations without any infrastructure dependency. With LiveHealth for laboratories, we power your POS with add-ons enabling you to bill your patients, give options to take online payments, and also view and track their lab results on the app. This helps labs establishing a customer connect in the first interaction with the patient, giving an opportunity to maintain long term relationship with customers. Then comes your Lab information system, consisting of your dayto-day lab operations, reporting, interfacing with lab instruments, and quality control.
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Technology Perspective
Efficient automation has always been one of the cornerstones of a lab operation, but with average transaction volumes per lab growing much faster than ever before in recent times, most laboratories have hit a bottleneck in further improving speed. Moving on to instrument interfacing, it is one of the most important parts of your automation needs. Automation helps speed improvement up to 60 per cent, reduced costs by 40 per cent and reducing error rate by almost 80 per cent. Interfacing not only reduces time spent on managing results and entry, but also provides extra time for your team to do more productive work. We understand how important instrument interfacing plays a role in automation; hence we have made it completely free for our all plans. After the results are transmitted from the instrument, the lab-tech
Enabling mobile transactions not just externally but also internally in between the team and doctors is one of the differentiators of cloud.
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is notified. The doctor then can view the complete report on the app, including the past results of the patient for comparison, and QC of the instruments to take an informed decision. Enabling mobile transactions not just externally but also internally between the team and doctors is one of the differentiators of cloud. Once the results are authorised and signed digitally, it is then dispatched to patients, their consulting doctors and the hospital, thereby reducing the manpower, and time required for the same. So with the help of cloud computing, we were able to achieve end-to-end automation, with improving quality, speed and productivity significantly. We, at LiveHealth, believe in empowering our customers to do more in their time, deliver quality and provide better and more seamless patient experience.
eHEALTH Magazine
february 2018
19
Technology Perspective
Disrupting Health Care Delivery Through Tech Enabled Automation The motion sensor enabled mobile app is one of the first IoT solutions in the international healthcare market for the post-surgery rehabilitation programme. It empowers doctors to be connected to patients throughout their rehabilitation programme, say Geoff Siegel, Vice President, Innovation, Breg, and Rajmohan Nair, CEO, Adtech, in conversation with Elets News Network (ENN).
Q
What is the vision behind developing Breg Flex, the remote therapy monitoring solution? Breg’s mission is to lower the overall cost and improve the quality of care over the entirety of the “Hurt to Healthy” orthopedic episode. Breg Flex™ is the first-of-its-kind digital health technology specifically designed to help physiotherapists and other care providers monitoring orthopedic patient recovery at home. Breg Flex is a mobile health smart device app that works in tandem with an accurate wearable sensor to measure and collect “orthopedic vitals” while the patient is recovering at home, such as extension and flexion range of motion, patient adherence to prescribed at-home exercises, and self-reported daily pain scale data.
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February 2018
Geoff Siegel
Vice President, Innovation, Breg
The application sends these insights automatically to the patient’s care team in real time as patient performs prescribed at-home exercise regimen so that patient’s progress can be monitored and the care team can proactively intervene when needed.
Q
How does Breg Flex add value to physiotherapy care path? Studies indicate that less than 40 per cent of patients are adherent to their at-home exercise regimen, which lead to reduced outcomes, longer time to return to function/ work, the need for additional inclinic physiotherapy and, in a small percentage of cases, additional costly post-surgical interventions. Geoff Siegel, Vice President of Breg’s product development group, responsible for the creation of Breg Flex, says, “We designed the Breg Flex
application to be fun and engaging for patients, to keep them motivated and consistent in completing their at-home therapy. As a result, we have seen patient adherence to their at-home therapy climbing to over 80 per cent. On an average, 30 per cent less PT sessions were needed to return a patient to health and patients had 25 per cent higher functional performance scores at discharge when measured against a national average. It just makes sense that if you can find creative ways using technology to keep patients moving after joint surgery, good things will happen.”
Q
How do you think that Breg, with Adtech as partner, can create impact in the Indian healthcare sector? Given the complex reimbursement mechanisms in the US, remote patient monitoring technologies are seeing a faster adoption rate outside the US in many healthcare sectors. As vital sign sensor technology becomes cheaper and more accurate, it will become one of the best ways to provide access to good healthcare to a wider population at a lower cost. And the ubiquity of smartphones and tablets today has provided the channel to do so. Adtech has been an important partner with Breg to develop this unique sensorbased technology for orthopedics. With their strong product knowledge, they are perfectly positioned to provide quality service to in-country customer and technical support for Breg Flex.
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Q Rajmohan Nair CEO, Adtech
Q
How does Adtech plan to disrupt the healthcare market in India through technology enabled innovative products? Adtech aspires to leverage the technology innovation worldwide and brings in these technologies enabled healthcare services delivery to the India market. A lot of services in the healthcare sector have great potential to be automated without compromising on the quality of the care being delivered to the patients. The company has been working with orthopedic products and solutions market leader, Breg to develop cutting edge software enabled care path solutions for the
How is your experience in the market with the IoT enabled care path solutions in India? Ever since we have hit the market in India with Breg Flex, we received great reviews from all the stakeholders in the Arthroplasty and Rehabilitations space. The motion sensor enabled mobile app is one of the first IoT solutions in the international healthcare market for the post surgery rehabilitation programme. It empowers the doctors to be connected to their patient throughout their rehabilitation program. The 360 degree view in the solution helps the care givers as well as the patients day-by-day, week by week and month by month insight throughout the rehabilitation program. It addresses the missing link in the traceability and feedback mechanism during the rehabilitation which is a critical aspect in the successful outcome of any Arthroplasty or Arthroscopy intervention.
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With our strategic engagement with Breg as their software development partners, we are uniquely placed to serve the Indian market with the latest and greatest technology advancement in care path space.
Technology Perspective
global market. With our strategic engagement with Breg as their software development partners, we are uniquely placed to serve the Indian market with the latest and greatest technology advancement in care path space.
Q
How does this technology minimise the scope of errors and risk factor in the healthcare sector? Adoption of technology helps the stakeholders in the healthcare sector to eliminate potential human errors in their diagnosis and follow ups. Products like Breg Flex digitises the rehabilitation protocol of the patients during the rehabilitation and presents real-time access for the care givers about compliances and scores of the patients. The data gives great insights to the doctors and the care givers and guide them with qualitative as well as quantitative data to make informed decision for a successful outcome. It also brings in a sense of confidence and transparency to the patients in their engagement with the healthcare professionals.
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february 2018
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Industry Perspective 22
KMCH: Using Technology to Serve Patients Better With latest and the best technology, the healthcare services at KMCH are among the best in the region, says Dr J Sivakumaran, COO, Kovai Medical Center and Hospital (KMCH), Coimbatore in conversation with Elets News Network (ENN).
Q
KMCH is known for providing affordable yet good quality medical services to people. How the organisation has evolved in terms of adopting latest technologies? KMCH, started in 1990 with 200 beds, has grown to a 1,000 bedded hospital in 27 years. We at KMCH abide by the principle of delivering high-quality service to the customers. “Patients first” and “quality service to everyone” are the basic mantras for our success as a healthcare brand in the region. Adoption of ethical practices helps us to add value to our healthcare delivery system. Our Chairman has ensured that the best medical practices followed anywhere in the world should be provided by KMCH to its patients at an affordable cost. This is one of the reasons; we are investing in getting the latest technology. KMCH is the first hospital to conduct Kidney transplant, Liver transplant, Heart transplant, Bone marrow transplant, Heterotropic transplant (man with two hearts), Domino liver Transplant and Robotic Surgery in western Tamil Nadu. KMCH is the first hospital in Asia to launch mobile CT in which a CT scan machine mounted on an ambulance reaches to patient’s house within time to initiate the treatment.
February 2018
Q
How the hospital uses smart phones and the Internet to meet high demands of patients and their families and overcome the challenges? The smart phones and online information are big boon for patients seeking medical advises. From booking appointments to postoperative care tips, a good amount of information is available online for any kind of services but one of the biggest challenges with patients is to understand and correlate the symptoms with disease. Often, due to this insufficient knowledge, patients underestimate a doctor’s ability. It is very important for a patient to understand that treatment processes of a disease vary from patient to patient in terms of methodology, time and mode.
Q
Healthcare Industry is getting revolutionised with the influx of technologies i.e. cloud computing, IoT and Artificial Intelligence. As an expert, how do you see the potential of cloud computing in transforming healthcare sector? Cloud computing is the future and many healthcare providers are already using it extensively. With our Government’s Digital India move and
Dr J Sivakumaran
COO, Kovai Medical Center and Hospital (KMCH)
better connectivity, we foresee our IT infrastructure deployed on the private cloud in the years to come. It is very important for the top management to replace the routine solutions with cloud computing solutions keeping every patient’s information safe. As we are growing at a rapid rate and going to add more centres shortly, Healthcare Information shared by our stakeholders will be required to exchange within the group. HIMS and clinical systems deal with mission critical process, and can make the difference between life and death.
Q
Hospitals, diagnostic centres generate huge amount of data on daily basis. How Big Data Analysis streamlines things and
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Q
India is one of the favourite destinations of tourists who travel here to avail best medical facilities at affordable rates. As a health organisation, how do you plan and strategies to cater to these patients? Although India is the best destination for medical tourists, still all the cities
of the country are not well connected by air, which is essential for this business. Quality accredited hospitals are available across the country but it is doubtful whether all the cities are connected with each other through various means of transport. With consistent efforts, now Coimbatore is connected internationally. We have a team to take care of such patients. The team provide them pick and drop services to airport. For all other services like reception to discharge, we have trained professionals to handle everything efficiently. Our quality services are getting us more patients. We have a number of medical tourism operators who also help us in improving the business. We have telemedicine centre which helps patients in post-operative consultancy with doctors.
Q
Experts believe that India has the potential to become a global hub for medical tourism as we produce approximately 50,000 doctors per year with the best accreditation facilities. What is your opinion about it? It is true that India is going to be
Cloud computing is the future and many healthcare providers are already using it extensively. With our Government’s Digital India move and better connectivity, we foresee our IT infrastructure deployed on the private cloud in the years to come.
Industry Perspective
helps hospital staff to serve the patients better? Due to huge competition, hospitals invest heavily to upgrade their technology and infrastructure regularly but the ROI is not at expected level as the man power and other operating costs are going up and hence controlling cost becomes a big challenge for administrators. We need to find ways and means to reduce cost for optimum use of man power and materials. We are working on Big Data as a pilot project for recruitment of nurses to serve their patients as per their disease. We have considered various factors and data to predict staffing of nurses. For such initiatives, big data analysis is very useful in streamlining things and helps the staff to serve patients better.
the global hub for medical tourism. More hospitals coming forward for accreditation and adopting quality programmes indicates that hospitals are following standard procedures only. India is having the highest number of JCI accredited hospitals, next to the US. Our expertise and technology is at par with the best global standards but at one tenth of the cost. Many successful and expert doctors in abroad are Indians and the whole world has strong trust on them in terms of their skills and precision work. The ethical and conscious practice of our doctors makes all of us proud of them. In coming years, India is going to be ultimate destination for medical treatment.
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february 2018
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Industry Perspective
Medical Tourism: Consumers Seek Cost Effective Medical Facilities Rising healthcare costs and lack of state of the art healthcare services are forcing modern-day consumers to search for different ways to reduce expenses to get a quality medical service, writes Dr Tushar Mehta, Director, Orthopaedics Plus (P) Ltd, Life Line Trauma Centre and Health Care for Elets News Network (ENN).
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edical Tourism has been the most sought after word in Indian healthcare sector in the last two decades. Hospitals and their administration are seeking more and more international patients for their big fat revenues and therefore we see more international desks in every corporate hospital these days. Let us try to understand the root of the business here. In Western countries as well as in the Middle East, rising healthcare costs and lack of state of the art healthcare services are forcing modern consumers to search for different ways to reduce expenses to get quality medical service. The solution to that problem is medical tourism where people living in one country travel to another country to seek medical, dental and surgical care. There’s actually nothing new about medical tourism. It was always there. I vividly remember my uncle travelling to UK in early 90s for a CABG (Coronary Artery By Pass Graft). But now even my hometown has more than five Cath Labs. Then what has changed over the years? Traditionally, people used to travel from poor countries to wealthy ones in search of advanced medical attention. The flow has almost reversed today. People from wealthy countries now hunt for healthcare facilities in less developed areas where services are less expensive and more accessible. Patients travel overseas seeking
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February 2018
a high quality of healthcare. But the most basic reason to go to a third world country is the cost. India is blossoming too in the sunshine of Medical Tourism and significant contribution to this is the ease in getting e-Visa for Medical Services. The arrival of foreigners in India on medical visa is showing an increasing trend over the past few years with 1.75 lakh foreign tourists visiting the country in 2016, more than double from 76,000 in 2014, data showed. Another trend that has been observed in last one decade is that the healthcare providers are shifting their operations to African and Sub Saharan countries so that they could explore the potential market and act as aggregators of patients’ right from the spot to divert them to facilities in India. Most elective surgery, such as
India has the potential to become a global hub for medical tourism as we are one of the largest producers of approximately 50,000 doctors per year.
Dr Tushar Mehta
Director, Orthopaedics Plus (P) Ltd
cosmetic surgery, certain dental surgeries, and even hip replacements are not covered by the insurance companies in the US. But if the cost is much lower overseas, one gets excited to make the trip for surgery. A major medical procedure performed in a foreign country may cost less than the out-of-pocket costs for the same procedure in the US. For example, a heart bypass surgery might cost over $150,000 in the US, but can cost less than $10,000 in India. The list of what we might call “hot” medical tourism destinations varies from year to year, and is also largely determined by the type of treatment or surgery. There is no one country as a heaven for medical tourism, however, Mexico, Costa Rica, India, the Czech Republic, Thailand, Malaysia and South Korea keep coming up on various parameters. India has the potential to become a global hub for medical tourism as we produce approximately 50,000 doctors per year with the best accreditation facilities. Disclaimer: (Views are personal and do not abide to any person / healthcare provider in person. The writes holds deep respect for medical profession and highest respect for other fraternity medicos.)
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february 2018
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Special feature
Medical Tourism
A Novel Introduction of India Among Globetrotters
Having become a big gateway to India, medical tourism is drawing people to this land of possibilities for special care across the world. Perhaps, the main charm is to avail medical care without being pinched too harshly on the pocket in one’s native country, observes Rajbala of Elets News Network (ENN).
A
part from opening various avenues of personal growth, Medical Tourism is also adding to India’s economic rise and recognition. Medical Tourism looks all set to create massive array of opportunities not only for healthcare industry but also for supporting ancillary and service providers. India’s healthcare industry has advanced to much extent and has maintained consistency in developing itself in terms of offering advanced treatment and surgeries like cardiology, orthopaedic surgery, transplantation of major organs, etc. Undeniably, the Narendra Modi Government is giving a big push and stressing upon key elements which has strengthened healthcare sector in the country. To name a few, it includes building enhanced healthcare infrastructure and facilities, skilling more nurses and doctors, creating medical education institutions,
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February 2018
focussing on made in India medical equipment and pharmaceuticals, and integrating latest innovative technology. The steps has fostered Indian healthcare industry which serves the patients with affordable, accessible, and quality efficient services. Rise of Medical Tourism Medical tourism refers to rapidly emerging practice of travelling across countries to avail medical services which meets the pocket size and quality as well. It can be a major opportunity for the Indian healthcare sector if tackled in the right manner. The fact that India is able to provide highly subsidised rates for medical services, this opens up a massive door for international patients to be treated in the country. We also produce some the of most specialised and highly skilled doctors with interventions in medical technology evolving at a rapid pace,
Major reasons empowering Indian medical tourism are: • Affordable medical treatments as compared to developed countries • The state-of-the-art medical facilities and infrastructure • Skilled specialist physicians, qualified and trained nurses and paramedical staff • Advanced and quality healthcare treatment in comparison to some countries • Affordable airfares, logistics, and other services • Accessibility to medical consultants, medical tour operators and managers this in turn can allure multiple patients from around the world to be treated in India. Speaking on medical tourism as an evolving opportunity Samara Mahindra, Founder, Carer Programme, said, “We work with multiple international patients as we
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Medical Tourism in India Modi Government has been very supportive and played a vital role in terms of developing medical tourism industry. People across the globe can now access to healthcare treatments which are hassle-free and high-tech. As I mentioned above, our country has been focussed and consistent in developing made in India, medical equipment and pharmaceuticals, interlinking medical institutions and hospitals for training purposes, and integration of technology to offer latest healthcare services. On this, Dr Sadanand Shetty, Consultant Cardiologist K J Somaiya Hospital Super Specialty Centre said, “India, has the unique advantage of offering holistic healthcare solutions. From the ancient science of Ayurveda to the latest in Cardiac care; from yoga to minimally invasive surgeries – India’s expertise in healthcare provides
solutions through various approaches. “Hospitals founded by Charitable Trusts, have evolved and are providing quality affordable healthcare. Such an integrated approach sees people from across the world seeking medical advice here.” Doctors trained in our medical education system can be found across the world. They have shown their mettle and expertise. Their foundations were based through Indian medical education system, the teaching they have been given on human compassion along with medical care is also a demonstration of the care that can be expected. Healthcare players like Asian Heart Institute has a dedicated international cell with trained staff who are well versed with all formalities pertaining to different countries and their consulates / embassies and look after outstation patients. Patients can get their treatment at Asian Heart Institute at 1/4 or 1/5 of the cost that is needed to go to the US. Moreover, when it comes to a patient’s well-being, Asian Heart Institute has a strict zerotolerance policy towards compromises. Dr Ramakanta Panda, Vice Chairman & Managing Director, Asian Heart Institute, Mumbai shares some factors that determine the selection of
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a hospital by medical tourists: Quality of care: Indian hospitals are increasingly adhering to the quality requirements of the global medical tourism industry. Many of the leading Indian private healthcare providers have already acquired international quality accreditations like JCI and NIAHO. These international accreditation standards focus on core aspects of patient care, including fundamental requirements such as an admissions policy that has processes in place for access to and continuity of care, with appropriate measures in place for the discharge, referral, followup and transfer of patients.
Special feature
have tie-ups with major hospitals. Our services are provided to them at their homes in India and can also be extended back to their home countries. Again, the prices are highly subsidized comparatively. Also, to enhance industry in the country much more seamless process, better recovery, rehabilitation and stronger health schemes can also be targeted.” Interestingly, apart from major surgeries dental tourism has also gained trust of tourist patients. India is capitalising on its low cost and well-trained dentists to appeal to the tourists. Dental tourism now forms over 30% of the total Indian medical tourism which has led India ahead providing greater travel and dental experience, from transport, hotels and sightseeing to the best cosmetic dentists in India, according to Dr Dheeraj Setia, Founder, The Dental Roots. “We aim at providing the highest standards of quality dental care despite comparatively lower cost from other developed countries.
Cost of treatment: In addition to the quality of medical services provided by hospitals and its doctors, price advantage is another major selling point. Today, within Asia, India, Thailand and Singapore are some of the countries that receive maximum medical tourists owing to low cost of treatment. Procedures such as hip and knee replacement, face lift, and gastric bypass are more affordable in India, as compared to the west. This is the case, even if you add cost of travel and accommodation. Moreover, these cosmetic procedures are not
eHEALTH Magazine
february 2018
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Special feature
covered by most insurance providers in Western countries. Clinical outcomes: Some other significant factors include highly qualified and skilled doctors, cuttingedge technology, advanced medical procedures, wider treatment options and no waiting list. Enhancement of services to revolutionise the industry As the Indian healthcare sector has witnessed exponential growth in the last one decade or so. Indian doctors and hospitals are no less than any internationally revered healthcare facilities in any part of the world. No wonder, India is fast becoming one of the most preferred destinations for medical tourism, attracting patients from across the world. However we still can do a lot more in terms of: • Infrastructure investment: The Government perhaps needs to step in and provide basic infrastructure services which will improve basic access to high quality centres. We also need to improve our hygiene conditions to boost medical tourism in the country. • Streamlining the visa process: At present, foreigners need the “M-Visa” to come to India for medical purposes. Obtaining the visa is a huge barrier for medical tourists wanting to come here. India should consider offering visa-on-arrival type of services and partner with medical and tourism providers to streamline administrative processes. • Indian Government is still to recognise and take active steps to promote medical tourism. We have an example of Singapore Government which has taken keen interest in increasing the country’s share in the global medical tourism pie. We need to invest heavily in the IT infrastructure and Hospital Information Systems in order to
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February 2018
further enhance the internal processes and make the processes free from human intervention as much as possible. This makes communication seamless for the patient thus giving him more access to information and relieves them of their anxiety by providing more transparency. This is already being practiced in the US, UK and India needs to quickly adopt such practices, says Dr Rakesh Gupta, Chairman and Medical Director, Sarvodaya Hospital. Apart from relaxing visa norms, on arrival visa etc we need to aware people across the world about the medical facilities available in India. For this international healthcare and medical tourism seminars, a dedicated website, 24*7 helpline and guidance, testimonials of successful cases,and most importantly Indian Diaspora can help in building positive perception. Dr Saarthak Bakshi, CEO, International Fertility Centre adds, “India has made significant advances in high end medical procedures and now offers comprehensive treatment across the entire spectrum of medical sciences.” Today, India host world-class medical facilities at the most economic cost but still our share in medical tourism is way below the potential. According to the Government reports, in the next 10 years, health service is estimated to grow more than 5
percent. Exhibitions, trade fairs and associations with international bodies can be an approach to enhance medical tourism. The healthcare segments can flourish well if hospital managers are directly involved in promoting services globally, leaving no space for further ambiguity in the minds of medical aspirants, explained Dr Dheeraj Setia, Founder, The Dental Roots. We are “contributing to the medical tourism in a big way by marketing our Indian hospitals at overseas market”. We are “regularly travelling to the countries” that are in need of medical treatment and interacting with them, according to Dr M S Guru Prasad, General Manager – International Marketing, Narayana Health, Bangaluru. “We also advertise and market the specialities that are in need of the patient’s immediate requirement. We do a study on the disease profile and cater to their exact requirements.” Hence, medical tourism will carry a bundle of emerging opportunities to India’s economy and will push healthcare industry to the newer levels. According to reports, Indian the Indian healthcare is expected to become a $280 billion industry by 2020 which defines the upcoming developing opportunity for Indian economy.
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Hospital Perspective 30
Cutting-edge Technologies
To Transform Healthcare Industry The cloud is storage capacity available to everyone where the recovery of data would be at fingertips anywhere, anytime. Best part of this technology is you have tremendous amount of storage capacity on cloud and you have any place, any time access to the data, says Commander Navneet Bali, Regional Director Northern Cluster, Dharamshila Narayana Superspeciality Hospital in conversation with Elets News Network (ENN).
Q
Dharamshila Narayana Superspeciality Hospital is well recognised cancer research Institute which believes in providing quality healthcare services with its world class medical infrastructure, what distinguishes you from other players? Dharamshila has changed its avatar from being just a single speciality that is a cancer hospital to a more focused super speciality hospital, as patients who visit the hospital they get access to healthcare services across all specialties. Off-course cancer still remains one of the key specialities of the hospital but we have also added orthopedics and kidney programme. We are soon going to get kidney transplant license, cath-labs and a cardiac programme. Narayana was founded on the dream of Dr Devi Shetty and what sets us apart is that dream, which talks about quality healthcare. Dream of Dr Shetty is to provide quality healthcare to the masses and his dream is being replicated here also at Dharmshila. We are now treating patients across almost all categories of clinical specialities with
February 2018
same kind of clinical excellence.
Q
With the motive to provide best medical facilities to patients, new technology is being explored daily by healthcare experts. What are the innovative treatment approaches you are adopting to cater people? Technology is changing every day. What is in vogue today may become obsolete in coming days. For example, we now have linear escalators to treat cancer and which are going to turn obsolete in coming days. Earlier, it used to take around an hour or more for treating a patient for single session on radiation machine. Today, it takes around 20 minutes which, in near future, might get reduced even to 2-3 minutes. Industry is heading towards such technologies where the patients feel less pain, more comfort and less treating time. We are continuously looking for upgradation of technologies and equipments. We have cutting edge technologies in cancer, going to have best Cath-labs inside hospital and almost all equipments, which are in the hospital, are constantly being upgraded.
Commander Navneet Bali
Regional Director Northern Cluster, Dharamshila Narayana Superspeciality Hospital
In addition to technologies and hardware, the way clinicians deal with the patients it plays an important role. We have tumour boards here in Dharamshila Hospital which comprises doctor, the laboratory people, and radiologists. They all discuss about patients and then the modalities of treatment are worked out. Entire spectrum of clinicians talk about the case and then a conscious call is taken. Innovations mean new technologies, new methods leading to better patient care and more convenience to patients.
Q
General perception is that cancer an incurable disease and the day doctor informs patients about the disease, they
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Biggest problem in India is that people usually visit doctor for cancer treatment at third or fourth stage. Around 80 per cent patients come to doctor at that stages in India while in western countries only about 10 per cent people are found to be at this stage.
siblings, there are chances that those next generations cancer can be determined. Cancer can very well be cured. It depends on two factors, one is type
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of cancer and the other is what stage does the patient come to doctor. In India mouth cancer among males and breast and cervical cancer among females is more prevalent. It is just sad that, in India, people come at third or fourth stage to get treated. Cancer is a very much curable disease. With the advent of new technologies, new drugs even cancers at third and fourth stages can be treated. My suggestions for cancer patients and their families are that they should not lose hope. They should fight the disease with positive attitude.
Hospital Perspective
lose all hopes to survive. What are your suggestions for these patients and their families? What kind of counseling sessions the hospital provides to motivate these patients? Cancer is a disease where primarily the cells inside our human body, for some strange reasons, start behaving in a different manner. They start multiplying in a very random manner. In normal human beings, we have got other cells which are supposed to attack these random growing cells. But some of us have the genetic mutations causing cancerous cell to grow within their body. Biggest problem in India is that people usually visit to doctor for cancer treatment at 3rd or 4th stage. Around 80 per cent patients come to doctor at 3rd or 4th stages in India while in western countries only about 10 per cent people are found to be at this stage. Detection at early stage is key to get better results on cancer front. With the advent of gene counselling and genetics, lots of these cancers cells are found to be hereditary in nature. If we are able to detect it at the level of their parents and
Q
Cloud service is emerging technology to make things easier and cost-effective for both service providers and patients. Being expert, how do you see the potential of this technology? We are moving towards these cutting edge technologies where AI, big data crunching would be used in the treatment of patients across healthcare. The cloud is basically huge storage capacity available to everyone where the recovery of data would be at fingertips anywhere, anytime. Best part of this technology is that you have tremendous amount of storage capacity on cloud and you have any place any time access to the data. The security of the patient data is most important aspect of the cloud technology as confidentiality of patients’ data is very critical. Artificial Intelligence is also making big waves, helping healthcare providers to bring patient care in much better manner. Big data crunching is helping us to analyse patient data in big way so that you will be able to bring in statics into it and then provide treatment which can be optimal treatment for particular type of disease. Big Data, Robotics, and AI are going to play huge role in healthcare sector
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Technology Perspective
Elekta: Elevating Clinical Care Standards with Modern Solutions Elekta’s software solution for care management, treatment management and knowledge management help clinicians achieve the next degree of precision and personalization in patient care, says Manikandan Bala, Managing Director, Elekta India, in conversation with Elets News Network (ENN).
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Give us an overview of Elekta, an organisation known for its innovative approach to cater professionals to their satisfaction. Elekta is leading innovator of equipment and software used to improve, prolong and save the lives of people from cancer and brain disorders. Our advanced, effective solutions are created in collaboration with customers, and more than 6,000 hospitals worldwide rely on Elekta’s technology. Our treatment solutions and oncology informatics portfolios are designed to enhance the delivery of radiation therapy, radiosurgery and brachytherapy, and to drive cost efficiency in clinical workflows. At Elekta, our purpose is to help clinicians to improve patients’ health. Innovation at Elekta has been leading the way for critical technological advancement in radiation therapy since last many decades. Elekta maintains its focus on evidence-based medicine, energised by the fact that we are supporting those whose mission is to save and prolong human life.
Q
Tell us about Radiotherapy, Oncology Informatics and other treatment solutions provided by Elekta.
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Radiotherapy: Elekta is the innovator and leading manufacturer of Radiotherapy (RT) and Stereotactic Radiosurgery (SRS) equipment used for non-invasive method of treating cancers and brain disorders. Elekta offers both external beam RT (Linear accelerators) and internal radiation (brachytherapy) equipment. Gamma Knife surgery is the gold standard for SRS with its delivery of a single, high dose of irradiation to a small and critically located intra-cranial volume through the intact skull. It is preferred for its extreme accuracy, efficiency and outstanding therapeutic response. Oncology Informatics: Elekta innovations in oncology informatics – MOSAIQ have been at the forefront of serving clinician needs since 25 years. To simplify and improve day-to-day work in clinical environments, Elekta offers an oncology-specific software solution powering practice optimisation through continuous learning within four main areas: Single platform solution to enable multi-disciplinary treatment management, workflow management to ensure the patient treatment journey is seamless and highly efficient, quality control and decision support through
Manikandan Bala
Managing Director, Elekta India
intelligent automation, and actionable oncology analytics.
Q
Nowadays, people want quality medical facilities in cost effective way. What sort of strategies you work upon to meet their demands? Elekta’s software and oncology information systems are developed with a profound understanding of patients’ healthcare needs and the systems contribute to enhance efficiency significantly. MOSAIQ oncology informatics offers access to complete patient information, optimising analysis tools and patient data enabling clinicians to make informed decisions for better patient care across the cancer spectrum. Also as clinics are becoming
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Q
In the age of Internet, Healthcare sector has been flooded with new technologies including IoT, Cloud Computing and Artificial Intelligence. How these innovative technologies are pushing healthcare sector to the extra mile? This era of Internet has reduced the gap between patient and healthcare providers, enhanced communication speed and given easy access to knowledge and data to clinicians for taking informed decisions. To improve efficiency and patient flows, Elekta has developed advanced oncology informatics systems that simplify a clinic’s planning, coordination and optimisation of treatment sessions. Caring for patients with cancer and neurological disorders is becoming increasingly complex and increasingly dependent on technology. To provide the best care and stay competitive, healthcare centers need to know that their IT needs are taken care of. Elekta Cloud Solutions lighten
the burden of IT acquisition and management, freeing the staff to concentrate on patient care. This is done by providing a subscriptionbased, platform-as-a-service solution that delivers worry-free operations. With the software housed in the cloud, centres can optimise system’s performance and scale up smoothly. Also it can recover quickly from outages and ensure the continuity of treatments. At healthcare centers every patient generates a new set of data from many different sources: diagnostic, treatment information, images and patients data. Elekta Knowledge management pulls together the data and makes it meaningful. With our suite of cloud-based clinical and business intelligence applications, medical personnel can: • Collect, aggregate, and analyse information from multiple data systems • Use real-time dashboards for effective analysis and to improve the performance of practice • Ensure compliance and support research with standardised data collection and reporting • Leverage best practices from across the globe to personalise treatments and improve patient care
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How big data and its analytical application makes collaboration between doctors and patients an easy task. How does it prove beneficial for medical personnel? Over the years, how have you evolved as an organisation? When every clinic manages its data effectively and shares it with others, the knowledge base available to the healthcare community expands. Information-guided care can guide in new ways and better outcomes. The clinical information available nowadays to be analysed and applied is more than ever before. The data, registries are rich resources of clinical information. Registries offer clear
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Elekta is leading innovator of equipment and software used to improve, prolong and save the lives of people from cancer and brain disorders. Our advanced, effective solutions are created in collaboration with customers, and more than 6,000 hospitals worldwide rely on Elekta’s technology.
Technology Perspective
more collaborative and treatments becoming more personalised, information guidance becomes essential. We believe that clinicians will be able to deliver the most personalised and efficient care when they have: • Access to more timely and complete clinical information of patients • Better tools for sharing, analysing, and applying information • Easier ways to tap into the knowledge and experience of their peers Elekta software brings together the people, the workflows, and the information clinics need to deliver quality care and run smooth operations. Our software help clinicians provide the best possible information-guided care for every patient treated for cancer or a neurological disorder.
views of clinical practices, patient outcomes, safety, and comparative effectiveness. Analytics makes it possible to transform registry data into evidence-based medicine and decision making. Medical personnel can use Elekta’s registry resources to: • Ensure compliance. Standardise data collection and reporting • Simplify clinic’s registry processes. Streamline registry data management from case finding • Advance research. Power clinical decisions and studies with rich registry data and analytics • Improve patient care. Leverage learnings from clinics across the globe to personalise treatments and improve standard of care Elekta provides analytical tools to help medical personnel make faster, more confident decisions about their patients.
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Hospital Perspective 34
Sharda Providing Healthcare at Doorstep through Technology IoT has made it easier for both doctors and patients in terms of reduced treatment cost, improved healthcare and better disease management, says Prashant Gupta, Executive Director, Sharda Hospital and Sharda University, in conversation with Elets News Network (ENN).
Q
Give us an overview of Sharda Hospital, a state-of-the-art multi super-speciality hospital that offers medical care at par with the global excellence. Established in 2005, Sharda Hospital provides its patients world-class medical care at affordable cost. Today, Sharda Hospital has grown to become one of the largest superspeciality hospital (900+ bedded) and research centre in Delhi NCR including casualty, trauma, critical care and various intensive care units like ICCU, CTVUS ICU, MICU, SICU among others. Sharda Hospital offers broad spectrum of medical services from tertiary care, super-specialities, general specialities, advanced diagnostic and radiology services to critical care. Everyone at Sharda Hospital strives to create a highreliability culture that fosters and supports patient care as a core value. The hospital received “Assocham Health and Wellness Awards 2017” by Shri Ramchandra Chandravanshi, Minister of Health, Medical Education and Family Welfare, Jharkhand.
February 2018
We have 11 Centres of Excellence at Sharda Hospital • Institute of Renal Sciences and Transplant • Institute of Neurosciences • Institute of Child Care • Institute of Critical Care and Anaesthesiology • Instituteof Dental Sciences • Heart Institute • Bone and Spine Institute • Cancer Institute • Gastroenterology and Endoscopy • Diabetes and Endocrinology • Minimal Access Surgery • Plastic-Aesthetic Surgery • How have you improvised in terms of technologies to cater to growing demands of patients who expect quick and quality service from healthcare service providers? At Sharda Hospital, we try to be one step ahead in offering new technology advances to our patients. A few of them are:
Prashant Gupta
Executive Director Sharda Hospital and Sharda University
Q
from anywhere in the world. With telemedicine, patients can consult Sharda doctors from wherever they are, using their smart phone or laptop. Sharda Hospital’s telemedicine centre uses live video conferencing and real time medical record sharing/communication portal. The combination of telemedicine technology paired with advanced medical devices enables Sharda doctors to “check” the patients possible in a real environment. The specialist can provide assessment, diagnosis and treatment, request referral, send laboratory test request and provide prescription to the patient online.
Telemedicine The advent of new technologies has given rise to virtual medical advice
Tele Radiology Sharda Hospital extensively uses Tele Radiology for transmission of
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Hospital Perspective
radiological patient’s images, such as MRI’s, CT Scans and X-rays from one location to another for the purpose of sharing information with other radiologists and doctors. This technology helps patients and diagnostic centres in remote locations to connect with Sharda’s radiologists with their radiology images for expert opinion and get appropriate treatment recommendations. This service will play a vital role in reducing patient waiting time for diagnosis, treatment commencement and cost. Tele Pathology Tele Pathology helps to exchange specimen slides with scanned and high-resolution digital images via microscopic digital cameras. Tele Pathology makes it faster and easier to share medical images. Biopsies can be cut, stained, scanned, magnified and sent digitally during an operation. A pathologist can read the slides remotely in real-time and provide the surgeon with an immediate diagnosis. Tele ICU Tele ICU is a new addition in the
The advent of new technologies has given rise to virtual medical advice from anywhere in the world. With telemedicine, patients can consult Sharda doctors from wherever they are, using their smart phone or laptop.
field of healthcare to take Sharda’s Hospital’s critical care unit to a higher level. It is a type of virtual ICU
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(intensive care unit) that remotely observes a patient’s status via state-ofthe-art audio-visual communication and computer systems with the help of a reliable networking with a bedside ICU team.
Q
In the age of Internet, healthcare sector has been flooded with new technologies including IoT, automation and cloud computing. How these innovative technologies are changing face of healthcare landscape? I believe that IoT has a very big role to play in making things easier for both doctors and patients in terms of decreased cost, improved treatment, improved disease management, reduced errors, enhanced patient experience and enhanced management of drugs. Through Cloud computing, hospitals and other healthcare providers can enter into new markets, respond more quickly to changing customer’s needs, collaborate more effectively to drive innovation and business value, and execute on strategies that might not have been cost-effective in the past.
eHEALTH Magazine
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Medical Tourism
IndiCure Offering Customised Solutions in Medical Tourism IndiCure, the pioneer company in the field of organised medical tourism of the country, provides exceptional services to customers in terms of cost-effectiveness, safety, comfort, treatments and offer the best solution as professional medical tourism consultants, says Annu Puri, Co-Founder of IndiCure Health Tours in conversation with Rajbala of Elets News Network (ENN).
Q
Tell us about the IndiCure services and offerings. We started the concept of end-to-end medical travel services under one roof. With IndiCure, the medical traveller can avail complete gamut of services-remote medical consultation, visa assistance, accommodation, currency exchange, local travel and everything that a medical traveller may need by contacting one person. The flow of services is completely seamless allowing the patient to focus only on his/her health and recovery. We offer services like consultation with the best doctors in India, visa assistance, ticketing, airport pickups, accommodation, sightseeing, follow up consultations etc. IndiCure’s preferential arrangement with the top doctors and best hospitals in India allows the patients to get priority treatment at an affordable cost. Our strength lies in our knowledge and understanding of the healthcare system in India. We offer personalised and customised solutions to a patient’s medical problems or aesthetic aspirations. Be it through
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the conventional Allopathic system of medicine and surgery or alternative therapies like Stem cell treatment, Ayurveda or a combined approach, we constantly endeavour to provide the best care and solution to our patients. For our work and offerings, we have earned several accolades over the years and have been rated as the Most Reliable Medical Tourism Company in India.
Q
Today, we see patients travelling from various countries for treatments at the hospitals. How do you ensure in guiding patients to get quality medical treatments travel from different countries? We have a team of people from medical and allied fields having indepth knowledge about the medicine. They work in close connection with the best doctors and surgeons in India. Our team puts in great effort to understand medical history of each patient. It ensures to provide the best possible solution to every patient. Moreover, we conduct extensive research on the hospitals and doctors
Annu Puri
Co-Founder of IndiCure Health Tours
in India to make sure we associate only with the best providers. Our team constantly monitors the services and treatment rendered to make sure our patients get the best.
Q
How can PPP model play an important role in developing the medical tourism sector in the country? Also, are you looking forward to any partnerships or have done any sort of tie-ups? Public Private Partnership (PPP) can play a very important role in developing the medical tourism sector in the country. Various stakeholders involved in the value chain can work together to make India the largest destination for medical tourism.
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The government, hospitals and medical tourism companies can work together to promote India as the best destination, the government can work on making the visa process easy, extend economic benefits/ sops to the players, hospitals and medical tourism companies should work together to provide better services to
the international patients.
Q
What is the scope of medical tourism in the country and how can it be an emerging opportunity for the Indian economy? Medical tourism is a sunrise industry and has a great potential for growth in the coming years. The industry
Key factors behind Medical Tourism 1. Lack of Facilities in the home country Countries in Africa, Middle East and India’s neighbourhood like Bangladesh, Nepal, Pakistan, Sri Lanka lack advanced healthcare facilities and technology required for complex medical procedures like Kidney Transplant, Liver transplant, Advanced Cancer Care, Complex Heart procedures for which patients prefer to come to India. 2. High cost of healthcare facilities Western countries such as the United States have the best medical facilities, but the cost of healthcare is quite high; due to which people travel to developing countries like India to avail quality healthcare services at an affordable cost. 3. Long Waiting time Public healthcare facilities in countries such as UK, Australia and Canada have long waiting lists due to which patients are forced to seek private healthcare which is quite expensive, thereby forcing them to seek medical treatment abroad. 4. Confidentiality/ Privacy reasons People like to keep certain procedures such as cosmetic surgery and bariatric surgery as confidential and getting the surgery abroad is a great option for such people.
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Medical Tourism
We offer personalised and customised solutions to a patient’s medical problems or aesthetic aspirations.
has been growing at a great pace and according to a KPMG report, medical tourism shall be a $10.5 billion market in 2019 to witness CAGR of 30%. The figures say it all about how Indian economy can benefit from the foreign inflow of $10.5 billion. It is a great opportunity like IT where India can project itself as the healthcare destination for the world.
Q
How Government of India can contribute to develop medical tourism in the country? The Government of India can take various steps to develop the industry which includes promoting India both as the tourist and medical tourism destination. Making visa process easy and faster, privileges and incentives to hospitals and health tourism companies. We can learn a lot from South Korea, where the government and private players have worked as a team to make Korea the biggest Plastic Surgery tourism destination in less than a decade.
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Technology Perspective 38
Technology Solutions
Improvising Healthcare Delivery Elsevier has been at the forefront for integrating innovative technology driven solutions to improve the education standards and outcomes on one side, and to improve the efficiency of existing manpower in medical education and healthcare delivery on the other, says Dr Lalit Singh, Director, Clinical Solutions and Product Strategy, Elsevier Health, in conversation with Elets News Network (ENN).
Q
Given the current state of India’s health system, what are the challenges and opportunities emerging as result of these changes? India is presently in a state of transition in terms of health – economically, demographically and epidemiologically. Over-burdened by an increasing population, and persisting and emerging diseases, India’s health system is wrought with challenges. Firstly, the inability to cover the entire spectrum of healthcare needs, even through increased public spending, has led to a rise in the out-of-pocket expenditure and consequent impoverishment in India. Out-of-pocket expenses are very high and estimated to be between 60% and 70% of total health expenditure. According to the National Health Policy (NHP), over 63 million persons are pushed to poverty every year due to healthcare costs. Furthermore, the slow development of healthcare infrastructure over the last several decades and slower improvement in the number of doctors and nurses, as compared to the growth in population, have added even greater strain on the healthcare delivery system. India is currently short of at least two million doctors with a ratio of 0.8 doctors per 1,000 population, putting
February 2018
pressure on care provision and the medical education system. There is also a 30% shortage of faculty and teaching staff across medical schools in the country. Although India has witnessed the establishment of several major hospital chains in last 10 years, there continues to be a shortage of hospital beds. There are many ways to tackle these challenges. For one, greater Government spending is one way to cut out-of-pocket expenses. At the moment, the Indian Government spends approximately 1.2% of GDP on health, but according to the NHP 2017, the government promises to increase public health spending to 2.5% of the GDP. However, the public sector does not hold sole responsibility in overcoming these challenges. The private sector is also responsible for developing tools that will help healthcare providers in tailoring smart care plans (diagnosis, treatment and management) that will help curb costs in the short- and long-term. Additionally, with the support from government to private sector and considering the time and investment needed to set up a hospital, it becomes necessary to incentivise private providers to participate in improving infrastructure. In response to the population, health needs of patients in India,
Dr Lalit Singh
Director, Clinical Solutions and Product Strategy, Elsevier Health
many public and private hospitals are starting to develop, or have developed their own healthcare or information systems that have served patients well in terms of process efficiency at a hospital level. However, health IT is still in the early stages of widespread adoption. Thankfully, the government is committed to bringing the country’s healthcare to the next level, and that is where we see the opportunity. The opportunity to take things a step further by focusing on standards adoption, and the interoperability and interconnection of systems across hospital settings, to achieve continuity of care as well as effective results. The NHP 2017, advocates extensive deployment of digital tools while ensuring interoperability between IT systems for improving the efficiency and outcomes of India’s healthcare system. We believe that India has a huge opportunity to use its rapidly developing digital infrastructure to bridge knowledge gaps, increase capacity, and bring better healthcare
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Q
How can Elsevier’s solutions help to address and solve some of these challenges such as overworked doctors, overcrowded hospitals impacting the quality and safety of care? We support 20 million medical professionals around the world, helping improve clinical outcomes and efficiency. We can bring to India a global perspective and the expertise in delivering digital health solutions that have been proven to work already around the world. Even though India has seen an increase in the adoption of digital health tools, stemming from Government initiatives in the national adoption of electronic health records (EHRs), EHRs alone cannot provide specific information and knowledge of the patient’s clinical history and current clinical status directly to the physician at the point of care. Current, credible, evidencebased information solutions that drive consistent, high quality and cost-efficient healthcare makes EHR smarter. And for that, technology needs to be enhanced with knowledge-based solutions. Elsevier Clinical Solutions’ suite includes embedded workflow and decision support, clinical reference and patient engagement, which are focused on helping healthcare professionals improve clinical outcomes through evidence-based
care. Additionally, Elsevier helps to deliver integrated decision support solutions to the entire care team by introducing world-class standards and increasing coordination of care. We also provide medical training for nurses and health assistants – the backbone of India’s health services – through online adaptive learning, effectively increasing capabilities and capacity in the health system.
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Given the Government’s ambitious digital masterplan for healthcare transformation by 2020, how does Elsevier support nurturing and training India’s healthcare workforce for the future? We are imparting our global experiences and practices to India’s workforce. For example, a key differentiator in the US, is the role nurses play in the delivery of care, and the emphasis on team-based care. It is unlikely that you will see a physician without first being assessed by a nurse, or physician assistant and we are largest Nurse educators and enablers in the US. Applying this to India’s health system, and given that there is significant shortage of both physicians and nurses in India, figuring out how to utilise manpower and maximise resources is key in creating those teams of doctors, nurses and allied healthcare workers in India. Elsevier has been at the forefront of using innovative technology driven solutions to improve the education standards and outcomes on one side, and to improve the efficiency of existing manpower in medical education and healthcare delivery on the other. Elsevier is proud of developing and implementing “Clinical Learning” – a made in India, made by India and made for India medical education solution – that helps medical students learn complex medical concepts easily and helps improve the efficiency of medical teachers.
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Elsevier’s evidence based clinical workflow tools like Order Sets can help reduce up to 81% of medication errors. Similarly, ClinicalKey, a medical search engine for evidencebased clinical reference, helps millions of clinicians from around the world in deploying clinical knowledge at the point of care. Arezzo clinical pathways is another decision support tool, which supports healthcare workers monitor, track and manage patients across the care continuum.
eHEALTH Magazine
february 2018
Technology Perspective
to its huge population, both in its ever growing mega-cities and in rural areas. For one, the policy proposes an integrated health information system (e.g. electronic health records) that develops and links systems into a common network or grid that can be accessed by healthcare providers that are in the public and private sector alike. This is definitely a step in the right direction to address the aforementioned challenges, and elevate the standard of care in India.
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Hospital Perspective
Yashoda Hospitals Aim for Accessible Healthcare Delivery With an aim to enhance service delivery, the Yashoda Super Speciality Hospitals are consistently working towards upgrading facilities, equipments, services to match latest medical technologies, says Dr Dinesh Arora, Chairman of Yashoda Super Speciality Hospitals, in an interview with Elets News Network (ENN).
Q
Tell us about Yashoda Hospitals and its services. With over 20 years as an established and successful healthcare provider, we have become a major tertiary healthcare provider in the NCR region. Currently, we operate from two locations, Nehru Nagar with 300 beds and Kaushambi with 200 beds in Ghaziabad. We are aiming to deliver world-class care services that
are qualitative and accessible. In order to enhance our service delivery, we have been continuously striving to upgrade our facilities, equipments, services to match latest medical technologies. We offer wide array of super specialty services that includes Cardiology, Endocrinology, Gastroenterology, Nephrology, Neurology. Pulmonology, Urology, Neurosurgery, Plastic and
Dr Dinesh Arora
Chairman Yashoda Super Speciality Hospitals
Quality Objectives with Services Standards • Focus on quality of patient care • To improve the performance of all professionals in patient care • To monitor, measure, access and improve performance and to enhance patient satisfaction • To guard, measure and improve patient safety • To inculcate an excellent hygienic treatment process. • To involve all employees to participate in improving quality. • To search for pattern of non-compliance with goals, objectives and standards through
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Hospital Perspective
Reconstructive Surgery. Moreover, we serve medical services to international patients as a mode of medical tourism which has a huge scope in the growth of economy of the country. In addition to that, we have special fully-operational nuclear medicine department and a Cardiac Cath lab for vascular and other surgeries, first. Secondly, we closely consider having well qualified as well as professional consultants, nurses, technicians, and administrative staff.
Q
How technology has helped you improve patient-centric services? In an endeavour to deliver quality and high-tech healthcare services, Yashoda Superspeciality Hospitals have grown to become one of the major healthcare providers in DelhiNational Capital Region. Our focus is to reach and offer services that meet the expectations of the patients. Technology has enabled people improve ability to self-manage their health and well being, alert healthcare professionals to changes in their condition and support medication
In an endeavour to deliver quality and high-tech healthcare services, Yashoda Super Speciality Hospitals have grown to become one of the major healthcare providers in DelhiNational Capital Region.
adherence; and for healthcare providers, it has helped enhance and deliver safer, more efficient and cost effective care . Technology integration has helped us create comprehensive and world
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class facilities with best clinical practices, while delivering enhanced patient care services with an emphasis on quality, service excellence, empathy and respect. Moreover, innovations in science and technology have transformed healthcare, in areas such as middleware, digital imaging and improved digital sensors.
Q
What kind of quality policy and standards of patient care are maintained at Yashoda Hospitals? As a tertiary care hospital with major focus on standard and upgraded high-tech healthcare services, we offer services to the patients ensuring their safety by complying with all legal requirements and significant environmental aspects in alignment with National Accreditation Board for Hospital, commonly called NABH standards. With problem identification and assessment, we find the root cause of a disease and generate solution and plan for the solution implemented. And, also implementation of corrective action and monitoring are given due attention qually.
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Technology Perspective
Securing Medical Research in the Cloud Healthcare clouds are high-value targets for cybercriminals looking to steal and sell personal information of patients on the dark web. In addition to targeting Protected Healthcare Information (PHI), cybercriminals may also target research to steal intellectual property, writes Rajesh Maurya, Regional Vice President, India and SAARC, Fortinet.
T
he digital transformation of healthcare has had far-reaching effects on patient care. Telehealth and connected devices have changed the way patients and physicians interact and create treatment plans, while workflow management solutions have made care providers more organised and efficient. As technology continues to improve day-to-day interactions and the overall patient experience, behind the scenes it is also transforming how medical research is conducted, providing capabilities that were previously impossible for research teams. This is in large part thanks to the capabilities of the cloud. Cloud Use in Medical Research Medical research and pharmaceutical facilities are adopting Infrastructure as a service (IaaS), Platform as a Service (PaaS), and Software as a service (SaaS) cloud environments for multiple reasons. Instances of cloud computing in research environments are likely to grow based on these five key benefits: Data Analytics The cloud has given medical research facilities the ability to correlate massive amounts of data at an unprecedented rate, providing
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actionable information without the need for additional specialised equipment or staff. These computing capabilities allow researchers to analyse structured and unstructured data collected across various devices, enabling them to make informed decisions about treatments plans faster and more accurately. As a result, 59 per cent of health IT leaders intend to adopt cloud solutions to support big data analytics. Scalability The proliferation of connected medical devices has yielded massive amount of data that must be stored and accessed for research purposes. The scalability of the cloud enables researchers to continue to collect and store this data in a cost-effective way, without a negative impact on performance. Cost Efficiency Cloud use, especially in instances of IaaS, drastically reduces the upfront costs of research that would otherwise require building comprehensive data centers and storage capabilities. Rather than having to build out this infrastructure themselves, research facilities can delegate it to third-party cloud providers, thereby reducing the cost of entry and making research more accessible.
Rajesh Maurya
Regional Vice President India and SAARC, Fortinet
Collaboration Clinical research often requires input and participation across different research teams and experts distributed across a variety of locations. The cloud facilitates collaboration between geographically dispersed teams through simplified data sharing, while allowing members of these different research teams to instantly access critical information from any device. Speed Cloud computing allows data to be available in real-time with minimal downtime, giving research teams the ability to process results and make fast decisions as new information comes to light. While the cloud offers huge benefits in this area, research facilities that wish to take advantage of cloud offerings also have to ensure that data stored in cloud environments remains secure and is compliant with all applicable regulatory standards.
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Healthcare Compliance in the Cloud In addition to securing intellectual property and PHI, integrated cloud security controls allow healthcare organisations to ensure they maintain compliance with critical industry regulations such as Health Insurance Portability and Accountability Act (HIPAA). While cloud service providers may include a basic set of built-in security features, medical organizations are ultimately responsible for ensuring compliance and maintaining the consistent protection of data and PHI. This means that medical researchers storing PHI in the cloud need additional controls that provide deep visibility into data movement and accessibility and granular, integrated controls to ensure security and compliance as data moves between cloud environments, local networks, and remote devices, rather than risk fines for noncompliance. Furthermore, research facilities also have to ensure that their cloud provider is capable of maintaining compliance with regulations across geographies. For example, if regulations prohibit data collected on citizens from leaving the country of origin, researchers will have to come to a cloud service agreement
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Medical research and pharmaceutical facilities are adopting Infrastructure as a service (IaaS), Platform as a Service (PaaS), and Software as a service (SaaS) cloud environments for multiple reasons.
Technology Perspective
Securing Medical Research in the Cloud Using the cloud to support medical research means storing the PHI of patients in a third-party database. This makes healthcare clouds highvalue targets for cybercriminals looking to steal and sell the personal information of patients on the dark web. In addition to targeting PHI, cybercriminals may also target research in order to steal intellectual property. To fully leverage the power of the cloud for research – without compromising patient privacy or original findings – medical research facilities need to deploy dynamic cloud security controls designed to adapt and scale as cloud usage expands. These controls should also incorporate application and distributed denial-of-service (DDoS) security to ensure cloud-based apps cannot be exploited for network entry, or to knock organizations offline. To provide this level of security, healthcare organisations need to employ internal segmentation to enhance data visibility in the cloud and isolate threats while maintaining consistent controls between onpremise, remote device, and cloudbased security solutions.
with their providers to ensure they do not store this data overseas. The current trend towards multi-cloud environments complicates security issues even further, as research teams and facilities will need to ensure consistent security posture and policy enforcement across different cloud ecosystems. It is critical, therefore, that organisation look to adopt security solutions designed to work seamlessly across an increasingly distributed and complex ecosystem of networked environments. Cloud Security Systems need to provide consistent protection and controls across devices and networks, combined with centralised management and orchestration, so organisations can easily and securely scale their networks and services. The cloud is enabling medical research in many ways. However, storing valuable data in the cloud makes it a target for cybercriminals, and healthcare organisations are ultimately responsible for its security. In order to take advantage of the benefits the cloud has to offer simultaneously while maintaining privacy and compliance, additional security controls must be implemented across cloud environments.
eHEALTH Magazine
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Industry Perspective
Patient Should Always Have Continuity of Care Provided Systematising the collection of patients’ healthcare data, the platform can be integrated with EHR/EMR (electronic health record/electronic medical record) and with the added attribute of interoperability, the data can be accessed from varying systems, says Michael allwyn, Co-Founder and Director, Gem3s, in conversation with Elets News Network (ENN).
Q
How is telemedicine different in its approach in comparison to traditional ways of providing treatment to patients? The solution which we are offering is different from traditional way of telemedicine where the approach was not patient centric. At the same time we are also different from the present method of telemedicine promoted across globe which is “Uber Model”. Our approach here is that a patient should always have a continuity of care provided. We are not a promoter of the software / product / solution. Instead we provide these solutions to hospitals / clinics and urgent cares who will be running the show. What we do is, we white label our solution and customise it as per the client’s needs. In this case our customers are Urgent Cares, Hospitals and Clinics.
Q
You offer various services including EHR/EMR (EPIC) and ICD-10, CPT Integration, reports/ statics and population health data, can you shed some light over these?
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From Left: J Kirubakaran, Moses E A, Rozario R, Michael Allwyn M, Herald Desosa A
February 2018
Now technologies like us help the patient to take preventive treatment, provide continuity of care and help them to intrude and invade the issue at a very earlier stage and this is all because of easy access
The platform is capable of supporting multiple doctors /facilities without large investments for its installation, making it possible for multi- specialty hospitals or a group of hospitals to adopt the solution without a hitch. Systematising the collection of patients’ healthcare data, the platform
can be integrated with EHR/EMR (electronic health record/electronic medical record) and with the added attribute of interoperability, the data can be accessed from varying systems. Gem3s has also paid special attention to the connectivity obstacles in India and has tailored the platform to perform fairly well in a standard 3G connection.
Q
In the era of the Internet, technology is playing a pivotal role to drive healthcare sector to the extra mile. How cloud technology can play a significant role to help both patients and healthcare service providers? Solutions like us which are cloud based are currently helping out large practices and healthcare to change the way how healthcare system was running before. Now technologies like us help the patient to take preventive treatment, provide continuity of care and help them to intrude and invade the issue at a very earlier stage and this is all because of easy access.
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Medical Tourism
Vaidam Fostering
Medical Tourism in India In recent years, India has emerged as a medical hub for patients looking for affordable, accessible and efficient treatment for various chronic diseases. Founders of Vaidam. com - Manish Chandra and Pankaj Chandna, share their thoughts on the growing scope of medical tourism in the country in an interview with Rajbala of Elets News Network (ENN). Manish Chandra
Q
Medical Tourism is considered as an emerging trend that has potential growth for the Indian healthcare growth. It is interesting to note that the scope and opportunity for India in the medical tourism sector is very high. How do you look at this? Medical tourism is a growing market within the healthcare industry in India with huge potential. Over the years, we have seen a large number of people travelling across continents for medical reasons like cost-effectiveness, quicker and efficient services, dedicated healthcare and enhanced medical treatment when compared to their countries. According to various industry reports, the healthcare industry in India is expected to grow to be a $280 billion industry by 2020. This growth will invariably have a positive impact on the scope of medical treatment provided by hospitals.
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February 2018
Pankaj Chandna
Co-Founder of Vaidam Health
Co-Founder of Vaidam Health
Thanks to this exponential growth, hospitals across India have invested hugely in enhancing their medical services by integrating technology; up skilling doctors and nurses; increasing medical education; building of more medical facilities and infrastructure; and finally enhanced research and development in ‘Made in India’ medical equipment and other pharmaceutical development processes. This has led to the rise of stateof-the art medical facilities and the increase in healthcare tourism, with over 500,000 people visiting the country every year. This number is expected to double by 2020, while being valued at $8 Billion dollars. The impact of this growth in medical tourism will see its reverberations around the country, with huge impact on other industries like food and beverage, tourism, logistics, language
translation and so many more.
Q
How do you ensure that patients visiting India get connected with the right medical experts, hospitals or travel partners? What do you do to make them feel like they have made the right healthcare choice? We started by conducting extensive research into the medical tourism space. Our observations found that India is a go-to medical destination for international as well as domestic travellers, especially for various advanced surgeries. This led us to create the Vaidam.com platform for medical travellers in 2016. The objective of the platform is to offer reliable, verified, efficient and quality medical treatment and travel information and care through one channel for ailing patients. All this is done through a careful process of hiring staff that
[ ehealth.eletsonline.com ] The Largest Portal on Healthcare Innovations in Asia and the Middle East
Q
Healthcare costs are surging due to different reasons which also puts financial burden on the patients. So, how do you offer quality treatments within the budget of the customer? You would be surprised to find that the cost of medical treatment varies substantially across hospitals and
India is emerging as the most preferred destination for Medical Treatment and has an enormous potential to grow. Tourists choose India because it’s economically feasible and providing quality healthcare fits every budget.
cities. We have MOUs signed with 80+ hospitals located in different cities in India. This allows us to present affordable options that greatly benefits the patient. So far, our patients have come from 45+ countries. To create ease in availing services of high quality healthcare, we present options according to their budget. Patients have the option to choose hospital, stay and services according to their budget - while not compromising on quality.
Medical Tourism
is knowledgeable, highly efficient and carries expertise in their respective domains. Our in house staff comes from various industries and backgrounds with skill sets like medical consultation, operations management, language translation, travel and logistics, engineering and digital marketing. Having the right people in the right place has greatly helped our patients identify and make the right healthcare choices. In addition, we conduct market research and communication on an ongoing basis with industry players, doctors and our patients. We channel this information to meet our patients’ needs and try out best to exceed market expectations.
Q
“Treatment to travel”, please explain this in more detail. Treatment to travel at its core is an initiative, that assists our patients at every step with relevant services. This includes helping patient find right hospital, medical visa complete travel and logistical services like flight booking, airport pick and drop, and accommodation. We help patients get priority appointments with doctors and help them with other day-to-day needs in India during their stay. In addition, we help them with their daily travel requirements to and from the hospital and other day-to-day needs, while in India.
Q
What are your expansion plans and roadmap for the future as a medical tourism organisation? In last two years, Vaidam help become India’s leading medical travel platform. Our objective is to become the largest medical tourism brand in India and around the world. We look-forward to entering into more partnerships with medical institutions, health organisations, and ministries of countries from where patients travel to India. This will enable us to penetrate deeper into the industry and which will make Vaidam a credible name in the Indian medical tourism industry.
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february 2018
47
The Latest from Health World News Highlights
UP Government, NHM to offer free-of-cost CT scan service at 28 district hospitals The Uttar Pradesh Government has joined hands with National Health Mission (NHM) to set up CT scan units at District level hospitals across the State that will offer free of cost service. Currently, free diagnostic service in the State is available at three district hospitals. It will be be further available in another nine hospitals—Sant Kabir Nagar, Deoria, Shahjahanpur, Sitapur, Farrukhabad, Kaushambi, Mathura, Aligarh and Hathras—by this month, and in 16 more by March end. Various reports suggest that the Government would be providing a free-of-cost space for CT Imaging Center within these district hospitals, and HLL Lifecare will invest on the CT Scanner Equipment and other associated equipment, undertaking the commissioning, maintenance, testing and reporting at the facility.
Odisha CM launches Measles-Rubella vaccination campaign Odisha Chief Minister Naveen Patnaik flagged off the Measles-Rubella Vaccination Campaign in the state. The campaign aims to eliminate transmission of the diseases like measles and rubella from the community by vaccinating children with MR vaccine. Under this campaign nearly 1.13 crore children will be vaccinated aged between nine months to 15 years. For successful implementation of the programme, the Health and Family Welfare Department has collaborated with school and mass education, ST and SC development, panchayat raj, housing and urban development departments. Collectors have been sensitized to conduct the campaign at the grassroots and dedicated nodal officers are nominated for monitoring district level MR Vaccination Campaign activities. MR Vaccination Campaign has development partners like World Health Organisation (WHO), United Nations Children’s Fund (UNICEF), United Nations Development Programme (UNDP) and professional bodies like the Indian Medical Association (IMA), Indian Academy of Paediatric (IAP) and Lions International.
Maharashtra Government, Johnson & Johnson to improvise healthcare Maharashtra Government and Johnson & Johnson (J&J) have partnered to improvise healthcare status along with implementing skills development programme for healthcare professionals and nurses in the State. As per the agreement, healthcare interventions like hospital-acquired infections, maternal and infant mortality, awareness programmes on the illness, diabetes, TB etc., will be checked. Nine districts—Nanded, Beed, Jalgaon, Dhule, Aurangabad, Jalna, Gadchiroli, Hingoli and Nandurbar—faced the maximum rate of infant mortality. Furthermore, both will run public awareness campaigns on multidrug-resistant TB (MDR-TB) along with training on detection and treatment of the disease. Skill development programmes will be conducted for healthcare professionals and nurses in areas like infant care, infection prevention, diabetes, obesity and menstrual hygiene.
Punjab to launch health wellness centres across State To provide quality healthcare facility to the people of the State, Punjab Government has decided to open health wellness centres in different parts of the State. Unveiling the plan, Punjab Health Minister Brahm Mohindra stated that total 2,950 such centres will be opened across the State in a phased manner. Mohindra said that 240 such centres would be opened in Fazilka, Pathankot and Patiala districts by the end of this year itself. Rs 17 lakh would be the operational cost to run each centres, where doctors would be the visiting faculty from nearby community health centres. State Government also unveiled plan to roll out 50 new ambulances, which will be equipped with critical life-saving equipment. “Our aim is to ensure that emergency ambulances reach at particular place within 20 minutes in urban areas and within 30 minutes in rural areas”, Minister said. It is also planned to start medicine shops and trauma centres across State. Medicine shops would be opened at 22 district hospitals while five trauma centres would also be established.
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February 2018
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The Government recently announced the list of the Padma awardees which featured many prominent names from different walks of life. The list featured total 89 people, who were honoured for their distinguished service on the eve of the 69th Republic Day. From healthcare to social sector, the Government chose many eminent personalities for their contribution. Cricketer MS Dhoni, music maestro Ilaiyaraja and Lakshmikutty – popularly known as the grandmother of the jungle has been featured in the list. Padma Awards are one of the highest civilian awards conferred upon in three categories across the fields. This year, out of total 89 awardees, 3 are from Padma Vibhushan award, 9 from Padma Bhushan and 73 are from Padma Shree category. The list includes medical practitioners who have been conferred the Padma Shree Award are. Doctor couple, Abhay Bang and Rani Bang: The Maharashtra couple has been conferred with the Padma Shree award for their exceptional work in the naxalites hit Gadchiroli district of the State. The couple dedicated themselves to improve healthcare facilities in the area. Yeshi Dhoden: Nonagenerian monk, who has acted as personal healer of Dalai Lama has been honoured for his work on Tibetan herbal medicine. Lakshmikutty: A tribal woman from Kerala has been honoured for her amazing work on herbal medicines. Popularly known as the grandmother of the jungle, she has prepared 500 herbal medicines from her memory. She has successfully treated thousands of people especially in snake, insects bite cases. MR Rajgopal: Famously called as Medical Messiah, he brought into limelight the palliative care in the medical field which proved beneficial for millions of patients to get relief from pain. For his exceptional work on this front, he is also called the father of Palliative care in India. Sanduk Ruit: Using small incision cataract surgery technique, Ruit is known for restoring vision of 100, 000 people across Asia and Africa. This eye surgeon from Nepal is credited with low cost cataract surgery. Pankaj M Shah: This 73-year-old doctor has been feted for his contribution on medical oncology. He has been working for cancer treatment for 43 years.
news highlights
Luminaries of healthcare: Meet the Padma Shree awardees of 2018
PPP Initiative: MEA, Fortis to train 100 African doctors The Union Ministry of External Affairs (MEA) and Fortis Healthcare have joined hands for a Public Partnership (PPP) initiative to train and enable 100 doctors from African nations in advance medical under ‘International Clinical Observership’ programme. According to Fortis Healthcare Clinical Talent and Academics Head Dr Ritu Garg, the partnership provides an opportunity to showcase and implement PPP model in healthcare in developing countries to assist in building clinical capabilities. “Our expertise will help doctors leverage their learning and improve clinical outcomes when they go back to respective countries,” Dr Garg added. It is learnt that doctors from Tanzania, Zimbabwe, Malawi, Algeria, Nigeria, Ethiopia, Kenya and many other African nations will be trained under the programme for four weeks. The training under this programme varies from Bone Marrow transplant, Fetal Medicine, Cardiology, Anesthesia, Nephrology, Pulmonology etc. By exposing the candidates in the state-of-the-art, evidence-based prevention, diagnostic and management services — it is expected that doctors will be able to enhance their experience to apply, and attempt to solve critical medical cases in their countries.
Apcer launches global services delivery center in India Global Pharmacovigilance company Apcer today announced the launch of second ‘global services delivery’ centre in Ahmedabad, after New Delhi, aiming to support pharmaceutical companies with ever-changing regulations. “The delivery centre in Ahmedabad will help life sciences professionals, not just comply but be assured of surpassing drug safety regulations by integrating the latest innovations, technology and digital transformation with ever-changing regulations,” Apcer Chairman Ravi Menon said. Apcer has five established offices in Princeton, New Jersey, USA; London, England, UK; Hong Kong; New Delhi and Ahmedabad, India it house 700 employees globally. The move is also focused to expand and upscale its services in India’s healthcare industry involving global pharmaceutical, medical devices, consumer product companies. To manage business growth, the expansion in Ahmedabad is vital for our organisation. With our initiative to co-create intellectual properties with technology partners, we are entering into next phase of significant growth and expansion.
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49
Product Watch market arrivals
Carestream Health unveils Medical Imaging, IT Product Global medical imaging solutions provider Carestream Health has unveiled its portfolio of new medical imaging and healthcare IT solution. The company has strengthened a range of innovative solutions in medical imaging workflow integrating interactive technology. The showcased products include Acquire interactive touch wall, Vue Clinical Collaboration Platform, Unified Core architecture, Managed Print Solutions (MPS), Carestream MyVue Center Self-Service Kiosk, DRYVIEW 5700, DRYVIEW 5950, DRYVIEW 6950 laser printers, and OnSight 3D Extremity System. The company has further ensured design features for the convenience and comfort of patients; technologies that allow patients to view and manage their diagnostic images; and X-ray systems that enable rapid diagnosis and timely treatment.
VTitan launches made in India Syringe Infusion Pumps Keeping in line with ‘Make in India’ scheme, Chennai-based healthcare Startup vTitan has announced the launch of syringe infusion pumps—a next-generation medical devices—used for critical care administration in hospitals and home environments for accurate and safe infusion of medication. In its first phase of launch, the company has introduced Accuflow SP-550 and Accuflow IBP-550 Syringe Infusion Pumps powered by indigenously developed and patented closed-loop motion control technology. These pumps are capable of supplying fluids such as insulin, antibiotics, chemotherapy drugs, pain relievers, etc. “We are committed to Make in India products for global healthcare industry. To strengthen the same, we are investing in building the R&D team, with strong emphasis on innovation and creativity,” he added. In order to manufacture products in India, vTitan is also training graduates while enhancing their skills in the said field. The move seen to boost the manufacture ecosystem in India.
IL TakeCare app of ICICI Lombard to enhance OPD experience ICICI Lombard General Insurance company has launched a mobile-based health insurance app ‘IL TakeCare’, in collaboration with healthcare platform Practo’s Trinity, that assists Out Patient Department (OPD) customers to covers its expenses. The application further allows customers to make a cashless visits to doctors, standalone clinics and buy medicines at discounted rates with home delivery services. The users can also book a network diagnostics centre for medical test and get reports on the app itself. ‘IL TakeCare’ app caters to a large and neglected aspects of healthcare—outpatient consultation expenses along with diagnostics and medicines. The solution addresses critical needs of the customers to avail affordable outpatient facilities and treatment. The app also features a real-time view of personal health records (PHRs) as well as benefits, billings and transactions. It comes with a one-time password (OTP) for all transactions via mobile or email, offering multiple access points for family members.
Philips launches AI integrated Imaging solutions Health technology company Philips India has launched the Artificial Intelligence (AI) driven imaging solutions in MRI, CT and Digital X-ray to enable radiologists to diagnose accurately in a less time. The imaging solutions—Access CT 32 Slice, Ingenia Prodiva 1.5T MRI and Dura Diagnost F30 Digital X-ray—has been designed with added benefit of lower ownership cost and better patient experience. According to an official statement, Access CT 32 Slice offers flexibility, exceptional image quality and diagnostic accuracy with lower total cost of ownership; Ingenia Prodiva 1.5T MRI accelerates patient throughput with a simplified breeze workflow; and DuraDiagnost F30 Digital X-ray simplifies clinical decision-making, improves outcomes for patients and reduces the imaging department burden.
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February 2018
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Budget Perspective
Belying all forecasts of a please-all budget ahead of the 2019 parliamentary elections’ litmus test, the Narendra Modi Government appears to have initiated a smart move with ‘Modicare’ on the lines of ‘Obamacare’ and to reduce rural distress, observes Sandeep Datta of Elets News Network (ENN).
Industry Hails Jaitley’s Budget Taking Healthcare to All
P
resenting his last full budget before the Lok Sabha polls, Union Finance Minister Arun Jaitley opted to term the world’s largest Governmentfunded universal healthcare programme as ‘Modicare’ as he laid emphasis on rural economy and agriculture in his speech, with a hope to stimulate demand. A section of the industry opines it looked that the Government intended to give an impetus to healthcare
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February 2018
benefits for people living in the most vulnerable sections of society with its ‘Universal Healthcare’. Some of them feel the initiative to cover 10 crore families with 5 lakh per family/per year with insurance cover for secondary and tertiary healthcare, might be a game changer in boosting Government’s image as well. Welcoming the move to provide subsidised healthcare for the poor, Dr Sujit Chatterjee, CEO, Dr L H Hiranandani Hospital, Powai, said: “It
is a splendid step towards building a New India. The only challenge here from an infrastructure perspective is to build the essential point of care network to deliver these benefits to the patients. It is a grand move by the Government towards strengthening ‘Aarogya Bharat’”. Terming the provision of up to Rs 5 lakh per year per family for secondary and tertiary medical care as “a great move” in helping prevent families from extreme financial
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of talent in the industry. The 1.5 lakh centres which will provide free essential drugs and diagnosis is a welcome move and a step towards boosting the Government’s National Health Policy. “The flagship national healthcare protection scheme which will cover 10 crore, underprivileged families, is a highly commendable initiative. Through the budget, the Government has definitely shown its interest in making healthcare more accessible and affordable through the Ayushman Bharat programme,” she added. Another highlight of the budget has been the focus on fighting the ever-growing hazards of pollution from crop burning, promotion of gas connection in houses using wood fire for cooking, among others. By not just talking about healthcare, but its indicators as well, “the Government is definitely on the right track towards improving the sector across the country,” she added. “We truly hope that going forward, the Government also has plans for utilisation management, financial monitoring, audit mechanisms and accountability,” she further added. Congratulating Government
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Key Highlights of Budget 2018-19 for Health Sector: • Ministry of Health and Family Welfare gets Rs 52,800 crore allocated for 2018-19 • It is up 11.5 per cent than current allocation of Rs 47,352.51 crore • National Health Protection Scheme to benefit 10 crore poor families • Annual health insurance coverage of up to Rs 5 lakh per family • 24 Government medical colleges and hospitals to be established • Rs 1,200 crore allocation for setting up 1.5 lakh Health and Wellness Centres • Allocation of Rs 600 crore to provide nutritional support for TB patients • For senior citizens, deduction limit for health insurance premium or medical expenditure hiked to Rs 50,000
Budget Perspective
hardships in availing quality medical facilities, Zoya Brar, Founder & MD, CORE Diagnostics, said: “Another great move is launching 1.5 lakh healthcare centers.” Given that medical insurance penetration is a mere 20 percent in the country, Brar said, this was much needed. However, we still lack foolproof mechanisms for early screening of fatal diseases like cancers. Brar suggested: “We should also look into implementing a system for timely and periodic screening as a routine. This space will require additional funding for research and development in newer fields of medical sciences, particularly in diagnostics and therapeutics.” Satish Reddy, Chairman, Dr Reddy’s Laboratories described the Government’s focus on rural development and agriculture as “a welcome step” while stating “the long overdue emphasis on our rural economy and agriculture will stimulate demand”. “The announcement of the Aayushman Bharat program for healthcare is a game changer and the coverage of 10 crore people under the national health protection scheme is commendable. This will give an impetus to healthcare benefits for people in the most deserving sections of society,” Reddy said. “Overall, while the budget appears to be a progressive one, it was disappointing to note that the reduction in corporate tax was offered only to companies with a turnover under of Rs 250 crores.” Overall, this has been a pro-people and a pro-poor budget. For the first time, Universal Health Care has got the impetus it needs, said Ameera Shah, Promoter and Managing Director, Metropolis Healthcare Ltd. “I am quite happy with the Government’s plan to introduce 24 new medical colleges. That is the only way to address the glaring lack
for investing in creating a “Swasth Bharat” (healthy India) by launching the Ayushman Bharat programme, Dr Prathap Reddy, Chairman, Apollo Hospitals, said such ambitious “out of the box
eHEALTH Magazine
february 2018
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Budget Perspective 54
thinking” was a burning need of the hour and the Government has not disappointed. “The initiative to cover 10 crore families with 5 lakh per family/per year with insurance cover for secondary and tertiary healthcare will be a gamechanger.” Applauding the budget announcements, Naresh Jain, CEO, Ziqitza Healthcare Ltd, said it has “addressed a lot of issues that will help the economy to prosper”. Stating that it aims to create the largest healthcare blanket for world’s biggest democracy, Jain said the Government’s initiative of setting up 1.5 lakh health facilities across the country “will help bring healthcare closer to people’s homes”, and will enable them to receive medical help within the golden hour hence improving the chances of survival. It is a “breakthrough move” and the world’s largest Governmentfunded healthcare program. This will allow the poor to access world class healthcare facilities which was not affordable or available earlier. “Also, the announcement of setting up one medical college for every three parliamentary constituencies is great as this will help in training the emergency medical technicians which will, in turn revolutionise the quality of care of the emergency medical response services in the country.” Zahabiya Khorakiwala, MD, Wockhardt Hospitals group observed there are two announcements which will impact the healthcare delivery industry. “The Suraksha Bima Yojana enhanced limit of 5 lakh rupees per family is yet to be launched. So the details and capital allocation will only be known when it is launched. However, the intent is quite positive.” “Almost 40% of underprivileged population would be able to access the secondary and tertiary care healthcare, and this would increase the market size for healthcare providers radically. The second scheme is for 1.5 lakh healthcare
February 2018
centres, where the budgetary provisions are only Rs 1,200 crores. However, it may be a good beginning for creating healthcare accessibility to the rural poor.” While a large section hailed the budget, it also had its share of criticism and some opted to make themselves counted by sharing their perspective. Rajiv Nath, Forum Coordinator, Association of Indian Medical Device Industry (AiMeD) expressed disappointment over the budget observing it has “giving cold shoulder to the Indian Medical Device Industry”. According to him the medical device industry was expecting the Government to move forward on promised reforms and anticipated conducive measures to boost domestic manufacturing of the medical devices. However, it felt frustrating that contrary to expectations, the Government did not include “any measures for promoting growth of $10 billion Indian Medical Device market in the Union Budget 201819 as has been done for consumer electronics, food processing, footwear, etc.” The sector was looking forward to clear and specific promotional
measures since it was one of the first five sectors included for ‘Make in India’ initiative. Regrettably, nothing has been done to improve domestic manufacturing in the sector. And that too when the Indian medical Device industry has opted for self regulation wherever necessary for strengthening the Government’s hands in improving affordable healthcare in the country. Though budget’s focus on providing universal healthcare services is a step in the right direction for building a healthy nation, the domestic industry is left in the lurch by not giving it necessary protection against imports, he added. Nath said nominal tweaking in custom duty applicable to medical devices is urgently needed to address Rs 27,300 crore import bill and 70-90% import dependency. Other sectors like automobile and mobile phones are flourishing with custom duty protection while medical devices industry is left to languish. He said for ‘Make in India’ programme, the Government can still include some minor legitimate demands of our industry which will go a long way in making medical device industry internationally competitive and world class and boost ‘Make in India’ programme.
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Article
Odisha Enroute to Provide Better Healthcare As part of its endeavour to provide inclusive healthcare services in every nook and corner of the State through noble and innovative steps, the Government of Odisha is resolutely moving forward in this direction, writes Elets News Network (ENN).
I
n a recent development, the State Government’ Health & Family Welfare Department signed four Memorandums of Understanding (MoUs) with reputed health institutes of India. It is meant to ensure an improved healthcare services’ delivery in the State. There are five partnering agencies which are part of this MoUs namely Glocal Healthcare Systems Private Ltd, Kolkata, Centre for Stem Cell Research, Christian Medical College, Velore, Narayana Hrudayalaya, Bengaluru and L.V.Prasad Eye Institute, Bhubaneswar.
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February 2018
On this development, Odisha Chief Minister Naveen Patnaik underlined his Government’s commitment to offer inclusive healthcare services across the State through noble and innovative steps. He also stated similar models and healthcare facilities would be expanded in other parts of the State following the outcome of these plans. In a move to establish digital dispensaries, Glocal Healthcare Systems Pvt Ltd has joined hands with the Odisha Government. The digital dispensary project will be established in 14 locations
of Nawarangpur district in the first phase. This programme will be extended to another 11 locations of the district based on the outcome. As per the understanding, these digital dispensary centres will function as an OPD with virtual consultation with a doctor (through video-consultation) and facility to basic laboratory tests and medication dispensing, to deliver quality primary healthcare free of cost to the patients. Operation and management of digital dispensaries in Odisha’s Nabarangpur district shall be done
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present 820 congenital heart diseases cases have been identified for heart surgeries. With this MoU, the Government of Odisha expects all current and future cases can receive the required surgery
The digital dispensary project will be established in 14 locations of Nawarangpur district in the first phase. This programme will be extended to another 11 locations of the district based on the outcome.
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february 2018
Article
by M/S Glocal Healthcare Systems Pvt Ltd of Kolkata who has been selected through a competitive bidding process. For a better detection and treatment of Thalassemia, Sicklecell Anaemia, the second MoU was signed with Centre for Stem Cell Research of Christian Medical College, Vellore. According to the project plan, this partnership will help reduce major Haemoglobinopathy disorders through screening, counseling, pre-natal diagnosis with an appropriate technology and possible curative options. At present Sickle Cell control programme is being implemented in 12 districts of Western Odisha with a Nodal Centre at VIMSAR, Burla. With a purpose to provide faster and better access to children detected with different heart diseases, the Government of Odisha has signed an MoU with Narayana Hrudayalaya, Bengaluru. With this, it is anticipated that children having Congenital Heart Diseases and Rheumatic Heart Disease can receive required surgery through Narayna Hrudayalaya on a sustained basis. Under RBSK screening, at
through Narayana Hrudalaya on a sustained basis. Under RBSK screening, 1,026 congenital cataract and 1,410 eye defects cases for surgeries have been identified for treatment. It is expected that through this MoU with LVPEI will enable the department in providing specialised care to the needy children for treatment of Congenital Cataract and Retinopathy of Prematurity as a continuous healthcare programme. “These steps will ensure health services at the outreach area of the state through digital diagnosis and medical consultation at remote places,� said Dr P K Meherda, Secretary of Health & Family Welfare department, Government of Odisha, on the objectives of the quality healthcare services through private entities. With the aim to enhance the reach and quality of health care across the State, the Government of Odisha has taken many initiatives in recent years. These include the multi disease surveillance system; several measures towards streamlining drug procurement and distribution and rational use of drugs. Odisha has been a pioneer in many initiatives on healthcare front. District level steps have piloted important components of primary health care such as community participation, improved mobility assistance for field staff, support to training and health education systems, maintenance of built assets and equipment, use of low cost construction for primary health centres and sub-centres. The Mission of the Health and Family Welfare Department, Government of Odisha, is to facilitate improvement in the health status of the people of Odisha with their participation, and to make available health care in a socially equitable, accessible and affordable manner.
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