THE PREMIER MONTHLY MAGAZINE ON THE ENTERPRISE OF HEALTHCARE IN ASIA & THE MIDDLE EAST VOLUME 14 / ISSUE 4 / APRIL 2019 / ` 200 / US $20 / ISSN 0973-8959
COVER STORY
Home Healthcare
BIGHope
A
REAL CARE
SPECIAL FEATURE
EHR—A Potent Digital Tool to Bolster Patient Care Conference Report Urban Healthcare Summit, Mumbai
for
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APRIL 2019 | VOLUME 14 | ISSUE 04
08
COVER STORY
Home
Healthcare A Big Hope for
Real Care LEADER’S PERSPECTIVE
16
Dr Aloke Mullick Group CEO Omni Hospitals,
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Neeraj Lal
Cluster Head & Vice President Rainbow Children’s Hospital, Bangalore
24
Dr K Hari Prasad President Hospitals Division, Apollo Group
INDUSTRY PERSPECTIVE
CEO, Chairman and Group Medical Director, Columbia Asia Hospitals
28
Col Hemraj Singh Parmar Group CEO BR Life
TECHNOLOGY PERSPECTIVE
22 Vivek Tiwari Founder and CEO Medikabazaar
44 Chaitanya Shravanth Chief Digital Officer Cloudnine Group of Hospitals
CONFERENCE REPORT
SPECIAL FEATURE
EHR – A Potent Digital Tool to Bolster Patient Care
26
Dr Nandakumar Jairam
12 27 FEBRUARY 2019 MUMBAI
31
Editorial Innovation-led Healthcare Providing Enriching Experience With modern technologies having an immense potential to provide an enriching experience to consumers, the Indian healthcare sector has a vast scope to leverage it and evolve as an easily accessible, affordable and more effective system. The digital technology and innovative practices have not only bridged existing gaps on various fronts, but they have been instrumental in fostering healthcare delivery system in a holistic way. Technologies like EHR or EMR (Electronic Health Record or Electronic Medical Record), and telemedicine have evoked a big ray of hope for the people at large for a more satisfactory experience and access of medical facilities even while being in difficult terrains. eHealth’s latest issue brings to the fore how a right mixture of technology, innovation and personal human touch is today delivering an improvised version of healthcare. Our cover story titled ‘Home Healthcare -- A Big Hope for Real Care’ explores various facets of private care where patients’ comfort level in homely environment is the first preference. It highlights how home healthcare by professionally trained caregivers is less expensive, more convenient, and just as effective as the care given in a hospital or skilled nursing facility. The magazine also carries a special feature on EHR, which is proving to be an effective tool to bolster patient care. We are also featuring interviews of Neeraj Lal, Cluster Head & Vice President, Rainbow Children’s Hospital; Dr Hari K Prasad, President, Hospital Division, Apollo Group; Dr Aloke Mullick, Group CEO, Omni Hospitals; and Col Hemraj Singh Parmar, Group CEO, BR Life, highlighting their organisations’ contribution to boost healthcare delivery system. The issue also carries articles by Vivek Tiwari, Founder and CEO, Medikabazaar and Dr Swagat Dash, Senior Consultant and HoD – Nuclear Medicine, Sarvodaya Hospital & Research Centre, Faridabad, providing industry insight. The magazine also carries a conference report of Urban Healthcare Summit, Mumbai, comprising outcomes in terms of experts’ inputs to enhance care. With such a bouquet of special features, articles, and interviews, I hope the latest issue of the magazine will evoke an invaluable feedback of our esteemed readers.
Dr Ravi Gupta Editor-in-Chief eHEALTH Magazine and Founder Publisher & CEO Elets Technomedia Pvt. Ltd. ravi.gupta@elets.in
COVER STORY
Home
Healthcare A Big Hope for
Real Care A section of observers believe that the Indian home healthcare sector is actually in its nascent stage. However, its growth trajectory is considered to be very strong. But what is consolidating the potential of home healthcare industry while making it a popular choice? explores Sandeep Datta of Elets News Network (ENN).
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COVER STORY
T
he very mention of ‘Home Healthcare’ suggests it is something related to medical care which can be provided at a patient’s home. UNDERSTANDING HOME HEALTHCARE To understand it a little properly one can visualise how care is provided by skilled medical professionals in terms of skilled nursing care, physical therapy, occupational therapy and speech therapy. It can also include skilled, non-medical care, such as medical social services or assistance with daily living from a highly qualified home health aide.
Home healthcare is unique as a care setting not only because the care is provided in the home, but the care itself is usually less expensive, more convenient, and just as effective as care given in a hospital or skilled nursing facility. Home healthcare encompasses many elements including diagnostics, hiring of therapeutic and monitoring devices, home medical consultation services, mobility devices, medical supplies and telemedicine. In India, the adoption of home healthcare solutions remains at an initial stage. If we compare our country with nations like the US, where home healthcare comprises 8.3% of the $280 billion healthcare
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industry, India lags behind severely comprising merely 2% of the spend, a leading daily stated recently. But the growth rate in India is much higher. This is driven by a few key factors. WHAT’S MAKING HOME HEALTHCARE POPULAR? As the number of elderly people is rising in the country, there is a growing tendency among people to prefer medical care within one’s homely environs. That makes it a good enough reason to be the favourite choice of a lot of people, at least who understand it. Some of the key factors popularising the home healthcare
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FACTUALLY STATING… The global home healthcare market is projected to reach $364.69 billion by 2022 from $220.76 billion in 2016 registering a CAGR of 8.8%. The Asia-Pacific home healthcare market on the other hand, is expected to grow at the fastest CAGR of about 9% from 2016 to 2024. The Indian home healthcare market is expected to grow to around $4.46 billion by 2018 and $6.21 billion by 2020. A LOOK AT HOME HEALTHCARE – INTERNATIONALLY The global home healthcare market is projected to reach $364.69 billion by 2022 from $220.76 billion in 2016 registering a CAGR of 8.8%. The Asia-Pacific home healthcare market on the other hand, is expected to grow
can be mentioned as personalised care, affordability, and growing nuclear family structures. Also, affordability and awareness are driving the need for post-operative care. High stress and the badly influencing worklife balance are other contributing factors to a growing demand for home care. Meanwhile, many of us may have observe how the kind of personal and constant care that elderly patients usually require is usually found unavailable in formal hospital settings. Apart from that, the growth rate by which people aged above 60 is growing, is faster than the rest. It is expected to move from 8% of total population in 2015 to 19% by 2050. Besides, increasing incidence of chronic diseases is one of the key factors.
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at the fastest CAGR of about 9% from 2016 to 2024, according to a media report. The Indian home healthcare market is expected to grow to around $4.46 billion by 2018 and $6.21 billion by 2020, the report added. HOME HEALTHCARE – THE NEED OF THE HOUR Looking at the number of hospitals or limited facilities, especially in terms of critical and personalised care segments, home healthcare ecosystem needs to be boosted in the country. A study by the ICMR reveals that while India accounts for 20% of the global disease burden, it accounts for merely 6% of global hospital beds and 8% share of doctors and nursing staff. As in India the doctor and patient ratio stands 1: 1,000, nearly 40% of the patients
Socially saying, one cannot ignore the fact that in the present nuclear family system, informal support structures are proving to be a failure to take care of the aged or the chronically ill. Most of us know how a lot of children are unable to give quality time to parents. It’s pushing the elderly population into social isolation leading to depression and loneliness. INDUSTRY SPEAKS HOME HEALTHCARE INDUSTRY -- NEAR FUTURE Home Healthcare is constantly on the rise and it is expected to grow exponentially in the coming years. Considering the lifestyle of people working in corporates and travelling approximately two hours to work, and not spending quality time with family has made “At
admitted to hospitals suffer from chronic diseases such as heart diseases, diabetes, stroke and chronic obstructive pulmonary disease (COPD). Despite this most of the people fail to realise that while a patient admitted to the ICU in a hospital setting pays between Rs 35,000 to Rs 50,000 per day, a similar set up at home may range from merely Rs 7,500 to Rs 10,000 per day, a media report said. Home healthcare thus saves on real estate and infrastructure as the model effectively operates at 15% to 30% reduced costs in comparison to hospital expenses for similar treatment. A report by Cyber Media Research revealed that home healthcare has the potential to replace up to 65% of unnecessary hospital visits in India and reduce hospital costs by 20%.
Home Healthcare” the most sought after service for any individual, says Neeraj Gupta, CEO & Founder, Genes2me. “With an ever growing demand of ‘At Home Genetics’ which doesn’t require any external sample collection facility but a simple DIY Cheek Swab which is done by the individual themselves has made it all the more easy, comfortable and simple for making ‘At Home Genomics’ possible and accessible to the masses.” “The Indian home healthcare market is expected to grow to around $6.21 billion by 2022 whereas not even 1 percent of it is tapped by major players in the healthcare industry,” he adds. Talking of challenges of ensuring quality home healthcare, Gupta said, there are quite a
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COVER STORY
few challenges faced by various diagnostic centres currently. Some of them are allocation of skilled staff at home, time management, training staff, lack of insurance cover, affordability, and reliability. According to Pawan Gupta, Co-Founder, Curofy, the challenge is “getting the right personnel and making sure the right personnel has not only the skill but also the emotional intelligence to deal with Indian sensibilities.” Talking of the home healthcare
industry, he says, home healthcare is our step towards a truly quality healthcare. Home healthcare today ensures that you get the best treatment and recovery. It is here to stay for the simple reason that it has dedicated people in the industry.” Asked with urbanisation and stress fast affecting people, is home healthcare set to become an integral part to avail for the present-day working population, the Curofy Co-Founder, says:
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“Most definitely.” “I believe this will soon become legitimate part of the treatment process,” he adds. Conclusively saying, it is important to take home healthcare seriously especially in view of the existing healthcare facilities in the country. It looks immensely significant when one weighs this option in terms of cost and access to provide real sense of healthcare.
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SPECIAL FEATURE
EHR
A Potent Digital Tool to Bolster Patient Care Technology holds such an immense significance today that it has changed the entire narrative of human lives. There is hardly any sector left where technology has not proved its worth. Digital tools including Electronic Health Record (EHR) have huge potential to change paradigm of healthcare delivery system, writes Mukul Kumar Mishra of Elets News Network (ENN) providing insight about various facets of EHR and its applications.
W
ith the Government focusing more on digital aspect of deliverables through Digital India like initiatives, healthcare sector is making big strides in this direction. Digital health is also being used as a facilitator, enabling healthcare service providers to cater finest care available at people’s doorstep. According to Julius Raj Stephen, Senior Vice President – Operations, Omega Healthcare Management Service Pvt. Ltd., “Technology has transformed not
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just the business paradigm but the very way we function and live. This transformational effect of technology has certainly made its way into the healthcare industry with many advancements facilitating improvised patient care.” A section of experts believes that in the next decade or so, everything from doctors’ appointment to diagnosis, lab reports to treatment options, majority of service deliveries will be digitalised, providing quick and better patient care to people at large. “With digitisation making
businesses function in a paperless environment, the healthcare industry is also slowly making a shift to Electronic Health Record (EHR). This allows for an individual’s minute health information to be compiled and stored on a single platform,” says Stephen. Our world has been radically transformed by digital technology – smartphones, laptops and webenabled devices have changed our daily lives and the way we communicate, opines Neha Lal, Senior General Manager -
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DIGITAL TOOL BOOSTS PATIENT CARE The fundamental unit of digital healthcare is the EHR (Electronic Health Record) which holds potential to fill in the existing gaps in healthcare sector on many fronts. “EHR is real time, patient-centric records that make information available instantly and securely to authorised users,” Lal adds. Despite the Government taking all measures to bolster healthcare delivery system, scarce human resources and inadequate infrastructure are proving to be major obstacles, affecting patient care. There is a tremendous pressure on both public and private service provider to thread a calibrated line, balancing cost and quality at the same time. Latest innovative tools including mHealth, telemedicine, mobile applications, and EHR/EMR are answer to above mentioned issues, playing a key role in fostering healthcare delivery system. According to Gaurav Gupta, CoFounder, Navia Life Care, “EMR/
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EHR implementation is needed as India has very low doctor patient ratio- 1:1700, which basically means our doctors are overworked. They do not have enough time to type and maintain patient records as is done in the western countries. “This is the very reason that EMR should be implemented properly, so that patient records are available to the doctors (and patients) at the click of a button which can in-turn save time for both patients and doctors,” he adds. Pawan Gupta, Co-Founder, Curofy, says: “EHRs have the potential to truly disrupt healthcare in ways that we cannot even imagine. Think of a database of all the diseases and their gradual diagnosis. It can help early detection and hence save lives and crores of rupees.” EHR VS EMR EHR/EMR is digital version of paper records of patients which can be accessed on demand, and can potentially save lives, time and money. Both the terms are often used interchangeably. However, they are significantly different: An EMR is a narrower view of a patient’s medical history, while an
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EHR/EMR IS DIGITAL VERSION OF PAPER RECORDS OF PATIENTS WHICH CAN BE ACCESSED ON DEMAND, AND CAN POTENTIALLY SAVE LIVES, TIME AND MONEY.
SPECIAL FEATURE
Operations & HR, GCS Medical College, Hospital & Research Centre, Ahmedabad.
EHR is a more comprehensive report of the patient’s overall health. An EMR contains the patient’s medical history, diagnosis and treatments by a particular physician. It is mainly used by providers for diagnosis and treatment. “EHR helps in streamlining the process and most importantly, saves medical costs, especially when it comes to patient care, for both healthcare providers and consumers as all the records can be accessed from it,” says Amol Naikawadi, Joint Managing Director, Indus Health Plus. EHRs allow a patient’s medical information to move with them to specialists, labs, imaging facilities, emergency rooms and pharmacies. EMRs are not designed to be shared outside the individual practice while EHRs are designed to share a patient’s information with authorised providers and staff from more than one organisation. “The tool helps patients to access the medical reports or any healthrelated document easily which facilitate them or family members to manage and monitor their healthcare needs,” Naikawadi adds. EMRs do not just transmit information they compute but
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SPECIAL FEATURE 14
manipulate the information in a way that makes a difference and provides better quality of treatment. It provides automated functionalities that help improving patient care and safety. “Information gathered by a primary care provider and recorded in an EHR tells a clinician in the emergency department about a patient’s life-threatening allergy, and emergency staff can adjust care appropriately, even if the patient is unconscious,” says Lal. INDIA LAGS BEHIND ON DIGITISATION OF HEALTHCARE SERVICES With an objective to introduce a uniform system for creation and maintenance of health records by healthcare providers, the Union Ministry of Health and Family Welfare issued Electronic Health Record (EHR) Standards for India. The idea behind it was that any person from across the country can go to any healthcare provider, medical practitioner or pharmacy and access fully integrated health records in electronic format. But things didn’t move swiftly, as it was expected and majority of hospitals have not embraced it completely yet. According to 2018 Review Report prepared by the Ministry
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of Electronics and Information technology (MeitY) India lacks the basic requirements to implement the system. The vast majority of healthcare interventions in India take place non-digitally. Even though close to 70% of healthcare in India is delivered through the private sector, with the exception of a few large private hospital chains and major diagnostic laboratory franchises, the digitization of the systems in most of these facilities is rudimentary at best. WHY IT NEEDS TO BE ADOPTED? The tool is need of the hour as many doctors still provide hand-written prescription which remains illegible at times. Other shortcomings include the hand-written paper can be easily destroyed or lost, expensive to copy, transport and store, and difficult to analyse. “EHR represents a quantum leap in legibility and its ability to rapidly retrieve information. With the tool, patient information could be made available to anyone, anytime and investigation results can be retrieved in a much faster manner,” says Dr N K Pandey, Chairman and Managing Director, Asian Institute of Medical Sciences. EHRs are more efficient because
Benefits of EHR/EMR • No bulky paper records to store, manage and retrieve • Easier access to clinical data • With fast, accurate and updated information, there is lesser chance of medical errors • Improved information access makes prescribing medication safer and more reliable. • Improved patient safety and stronger support for clinical decision-making • The ability to gather and analyze patient data that enables outreach to discreet populations • The opportunity to interact seamlessly with affiliated hospitals, clinics, labs and pharmacies they reduce redundant paperwork and have the capability of interfacing with a billing programme that submits claims electronically. “It is designed to store data accurately and to capture the state of a patient over a time period. It eliminates the need to track down a patient’s previous paper medical records and ensures data’s accuracy and legibility. It can further reduce risk of data replication as there is only one modifiable file, according to Dr C. P. Bhatt, Consultant Physicist, Centre for Cancer Care, Sarvodaya Hospital & Research Centre. Every advancement of technology has its own pros and cons and so with EHR. There are challenges in areas of implementation, infrastructure, userfriendliness and data front. If hospital is using client server based EHR then there is a risk of security of data. In addition, doctors and other hospital staff are reluctant to use technologies like these as they have not been trained for the same. In the hindsight, EHRs will prove to be a potent tool, playing a key role to catapult healthcare delivery system to extra mile in the coming years.
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LEADER’S PERSPECTIVE
Omni Hospitals — Delivering Best Healthcare Facilities Cost Effectively To serve people with better patient care, Omni hospital has adopted right mixture of latest technological advancements and innovative practices. It was one of the earliest hospitals to deploy a Net Promoter Score based paperless patient feedback system in India. With its calibrated approach, the hospital has maintained a balance between quality and affordability, says Dr Aloke Mullick, Group CEO, Omni Hospitals, in conversation with Elets News Network (ENN).
Q
What’s the guiding principle of Omni Hospitals? How would you summarise its contribution in boosting patient care? The core vision of Omni Hospitals is to provide corporate level tertiary care to patients. Its objective is to cater patients with empathy and make patient avail finest medical facilities at affordable prices. That is the key differentiator between Omni and other multispeciality corporate hospitals.
Q
How distinctly placed is Omni Hospitals? Shed some light upon your services like
emergency care, ortho oncology etc. We leverage our core strength of providing high quality care at very reasonable prices in clean corporate ambience facilities. Despite facing huge peer group competition and lowering service prices, we managed significant growth in terms of profit in 2018. It was due to stringent cost saving strategies. We were one of the earliest hospitals to deploy a Net Promoter Score based paperless patient feedback system in India. This has given us a wealth of actionable information, helping us to achieve greater levels of patient
Dr Aloke Mullick Group CEO, Omni Hospitals,
satisfaction. Some of our units have a Google satisfaction score in excess of 4.5 out of 5.0, an industry rarity! In areas like interventional pulmonology, multi-organ failure, ortho oncology, complex spine surgery, complex redo joint replacement and neonatal intensive care, we have some
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Q
Quality and affordability are two most glaring issues engulfing healthcare sector today. How challenging is it for the management to maintain a balance? We strongly believe that quality healthcare must be affordable. The key to achieve that is to constantly monitor all cost items against benchmarks, incentivise employees for suggesting out-of-the-box cost reduction ideas, and strict monitoring and prevention of revenue leakage via system controls.
Q
You have been associated with many top hospitals in the past. As an expert how do you analyse evolution of Indian healthcare system in terms of technology and innovations? It is very poor primarily due to two reasons: high prices of above average
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technology products and lack of incentives from payers towards technology adoption. However, the situation is improving, primarily due to introduction of operating expenditure (OpEx) based pricing model for good products, and an increasing understanding by stakeholders that good IT leads to lower costs. I do believe that real growth will happen once a carrot and stick pattern incentive scheme is put in place by key players including the Government.
Q
Shed some light on existing branches in South India. Is there any plan of expansion, collaboration in near future? In Andhra Pradesh, we have branches in Hyderabad, Visakhapatnam and Kurnool district. There are six units with a cumulative capacity over 850 beds. We recently opened a mother and child unit in Visakhapatnam
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LEADER’S PERSPECTIVE
of the best consultants and facilities in the cities we operate in.
THE KEY TO ACHIEVE BOTH QUALITY AND COST-EFFICIENCY IS TO CONSTANTLY MONITOR ALL COST ITEMS AGAINST BENCHMARKS, INCENTIVISE EMPLOYEES FOR SUGGESTING OUT-OF-THE-BOX COST REDUCTION IDEAS, AND STRICT MONITORING AND PREVENTION OF REVENUE LEAKAGE VIA SYSTEM CONTROLS.
under the brand name Giggles. At present, we don’t have any plan to expand our footprint beyond South India. In last one year our units have received following industry awards: TIMES HEALTHCARE ACHIEVERS AWARDS 1. Best Neighbourhood Hospital - Omni Hospitals, Kukatpally, Hyderabad 2. Best Emergency & Trauma Hospital - Omni Hospitals, Kukatpally, Hyderabad 3. Best Orthopaedics Hospital Udai Omni Hospital, Nampally, Hyderabad 4. Reader’s Digest Trusted Hospital 2018 - Survey conducted by India Today Group 5. 3rd in Hyderabad & 9th in South India in Orthopaedics according to Times Health Survey – Udai Omni Hospital.
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LEADER’S PERSPECTIVE
Rainbow Hospital
Carving a Niche in Women, Child Care With many landmark initiatives including first paediatric ICU in the country to adopt simulation as strategy to improve patient outcomes, and to use capsule endoscopy to treat the gastrointestinal disorders, the Rainbow Hospital is carving a niche in the area of women and child care, says Neeraj Lal, Cluster Head & Vice President, Rainbow Children’s Hospital, in conversation with Gopi Krishna Arora and Mukul Kumar Mishra of Elets News Network (ENN).
Neeraj Lal
Cluster Head & Vice President Rainbow Children’s Hospital, Bangalore
Q
Rainbow Hospital is known for catering patients with highstandard care. Tell us about its mission and vision. With its 19 glorious years of excellence in paediatric tertiary care and specialities, the Rainbow Hospital is the first corporate children’s hospital in India commenced in 1999 on Children’s Day (14 November). Managed by highly qualified professionals, it is 1,000 plus bedded chain of hospitals with state-of-the-art paediatric tertiary care and perinatal care services.
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Rainbow Children’s Group of Hospitals has 11 hospital units in Hyderabad (6), Bengaluru (2), New Delhi (1), Vijayawada (1) and Chennai (1). It is also coming up with a facility in Vizag soon, which will raise the number of beds from 1,000 to 1,200 by 2020. Our objective is to provide high standard care to mother, foetus, newborn and children so that none of them remains deprived of a tertiary care facility. The number of smiling faces is the measurement of our success. The values that guide us include care, commitment, and compassion, patient centric care with value for money, and timely intervention. In addition, we also work on effectiveness-sharing knowledge and best practices, efficiency-never ending improvements and maintenance of highest standard of hygiene and cleanliness.
Q
Please shed some light on something significant about a range of services you provide in women and child care segment. The hospital is equipped to provide level-three neonatal and paediatric intensive care, and advanced paediatric surgery and paediatric
specialities including paediatric oncology, gastroenterology, nephrology, neurology, IVF, and foetal medicine. Rainbow Children’s Hospital has the second largest paediatrics DNB programme in the country. Rainbow Children’s Hospital never compromises on quality. Perinatal Coverage Birthright by Rainbow Group of Hospitals is a unique initiative. It aims at providing high standards of care to pregnant women, foetus, and newborn children. We have a record of 8,500 plus deliveries across three cities with very high percentage of normal deliveries annually.
Q
What kind of services are provided under ‘Fertility Care’? Please share some important aspects of IUI and ICSI treatment. Under fertility care, we provide a range of services including semen analysis, sperm processing, intrauterine insemination (IUI), in-vitro fertilisation (IVF), intra cytoplasmic sperm injection (ICSI), frozen embryo transfer (FET), sperm cryopreservation, and cryopreservation of embryo. In addition, we also provide services like laser activated hatching, oocyte
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• More than six lakh patients visit outpatient clinics annually • Largest series of paediatric patients receiving high frequency oscillatory ventilation in India • More than 5,000 surgical procedures are carried out every year at our centres • 30,000 inpatient admissions each year and around 1,800 neonates are treated annually • Critical care supported by our level three, state-of-theart neonatal intensive care units (NICU) and paediatric intensive care units (PICU). • Vaccination and immunisation programmes • 24 x7 pharmacy, emergency and transport services • Hospitals clinical staff includes 250 plus consultants, 800 plus nurses and 150 plus paramedical personnel • Neonatal Intensive Care Unit (NICU) with family-centric rooms Most advanced ventilators and monitoring system Human milk bank Paediatric intensive care Specialised isolated rooms for managing burnt children retrieval, per-cutaneous epididymal sperm aspiration (PESA), testicular sperm aspiration (TESA), testicular sperm extraction (TESE), and micro epididymal sperm aspiration (MESA).
Q
Out-of-pocket healthcare expenditure is a major issue plaguing Indian healthcare today. How does the hospital manage finest patient care in cost-efficient manner? We have initiated Outreach Superspeciality Clinics where the treatment is given at subsidised
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rate. Such clinics are located in Dharwad, Shimoga and Mandya districts of Karnataka. In Dharwad, we are providing endocrinology, orthopaedic, nephrology and oncology related services at subsidised rates. Rainbow helps below poverty line (BPL) patients to get connected with crowd funding agencies. These organisations highlight their plight and arrange funds for them. We also run Kamanabillu scheme for underprivileged section of society.
Q
Would you share technological advancement and innovative practices which have been undertaken in order to ensure better deliverables? Rainbow Children’s Hospital is the first paediatric ICU in the country to adopt simulation as strategy to improve patient outcomes. We have used simulation to improve our preparedness in admitting sick patients to ensure timely treatment, to improve communication between medical colleagues, to train as a team, to identify system issues in Paediatric Intensive Care Unit (PICU) which can hamper patient care, and also as a strategy for root cause analysis of any critical incident in PICU. Birthright Fact File: • 300 plus beds dedicated for obstetrics & gynaecology with experienced medical professionals dedicated 24x7 • 4,000 plus gynaecology procedures annually • Over 1,000 IVF procedures • Outpatient clinics schedule more than 1.5 lakh visits annually with care and counselling for the expectant as well as new mothers • Beside our natural inclination for normal deliveries, we are equally known for our expertise in handling “highrisk cases”
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It also helps to train parents and families to boost confidence in taking care of their sick ones at home. We have formed a society Pedi STARS India to increase awareness and train medical faculty across the country. We are also working on developing low cost medical simulation devices. NICU retrieval services - About 70 percent of the neonatal deaths occur in the first week with more than half of that in the first day itself. All over the world, one in 10 babies is born preterm. These babies can be born with birth defect related issues. They can be treated only at the Advanced Centres and transportation of such babies holds huge importance as they may require lifesaving treatment in the ambulance itself. Rainbow Children’s Hospital has started NICU-PICU retrieval and stabilisation services wherein the hospital provides a well-run road transport with advanced equipment and trained personnel on board. Rainbow Hospital is the first hospital in Bengaluru to use capsule endoscopy on a child to treat the gastrointestinal disorders. • First of its kind centre in South India: Centre of Excellence for Kidney Diseases in Children: Kidney diseases in children are more common than usually thought of and require special expertise and specialised centres to manage such patients. As a tertiary level superspeciality hospital, Rainbow has the vision to tackle complicated cases of kidney disease. The Centre of Excellence aims to provide highest standard of care (at par with Western Standards) to such children. It is the only facility across Karnataka that has been empanelled with Government SASTA scheme for kidney transplants in children having poor economic condition. The facility has already conducted successful multiple kidney transplants in children aged as
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LEADER’S PERSPECTIVE
Landmark Achievements in Tertiary Child Care:
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LEADER’S PERSPECTIVE 20
young as four to five. Apart from transplant, other services like hemodialysis/peritoneal dialysis / CRRT / plasmapharesis / kidney biopsy are done regularly at our hospital to provide finest care to children. • Centre for cochlear implants and advanced hearing: Rainbow Children’s Hospital, Marathahalli is one of the very few hospitals in the country to start comprehensive cochlear implant unit comprising surgeon, dedicated audiologist, speech therapist and rehabilitation specialist. The list of services includes cochlear implant surgeries, post-operative rehabilitation and speech therapy and diagnostic procedures which include BERA, pure tone audiometry, newborn hearing screening, hearing aids and tympanometry. • Child Development Centre: Through multi-disciplinary team approach, Rainbow helps little ones to harness their potential. Comprehensive CDC unit at Rainbow Bangalore will have team including child psychiatrists, psychologists, dedicated speech therapists, occupational therapists and trained paediatric physiotherapists. Our hospital is well-equipped for evaluating and treating children suffering with psychological disturbances. • Centre for cerebral palsy care: Rainbow Children’s Hospital, Marathahalli is home to India’s first centre for comprehensive Cerebral Palsy care ”Pragati”. The centre brings together state-of-theart facilities and expertise under one roof. In a first, a children’s hospital offers services related with advanced 3D GAIT analysis lab, paediatric orthopaedics, orthotic center (for making splints & braces) and all ancillary services needed for world class management of children with
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cerebral palsy and special needs. In addition, the centre also has advanced rehabilitation facilities for sports injuries and gait analysis for runners. • Rainbow Children’s Hospital has launched a paediatric and adolescent diabetes clinic which is India’s first paediatric superspeciality clinic at Marathahalli center, Bengaluru. In the wake of spurt in diabetes cases among children and adolescents in different parts of country, this dedicated clinic will come as a boon, providing specialised multi-disciplinary care to them. Expert panel of specially trained doctors will provide integrated care to these patients. More than 97,000 children in India are reported to suffer from type-1 diabetes mellitus. Not all of them get right care and support. Due to involvement of several interactive psychological parameters and lifelong intensive support in diabetes care, effective selfmanagement is almost impossible, especially among the young adults. The paediatric and adolescent diabetes clinic will have a group of specially trained doctors comprising endocrinologists, nutritionists, and psychologists to provide comprehensive solution to those, suffering from
diabetes at an early age. • The first Ketogenic diet therapy clinic for children in Karnataka has been launched at Rainbow Hospital. The special high fat and low carbohydrate diet is used to treat difficult-to-control epilepsy among children, especially those who don’t respond to conventional anti-epileptic drugs. • 1,000 days campaign: The unique initiative was started at Birthright by Rainbow Hospital, Bangalore. During two-decades of service in the field of child care, we have gathered first-hand knowledge about significance of first 1,000 days of life. We conceptualised the 1,000-day programme to spread awareness and assist mothers-tobe in bringing up a generation of healthy children.
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Do you have any plans in the near future for takeover, government collaborations or new offerings? Soon, we will have a new unit in North Bengaluru, providing paediatric, maternity and fertility services. The paediatric superspeciality services will also be available at this branch. In addition, Rainbow will start few outreach clinics in different parts of Tamil Nadu -- Salem, and Krishnagiri regions.
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INDUSTRY PERSPECTIVE 22
Leverage Vizi – A Definitive Application To Cut Down Operating Expenses
H
ealthcare is undergoing a radical change with the advancement of technology. There is tremendous increase in preventive and curative diagnostic and treatment procedures, each requiring some or the other medical device, equipment, and/or consumables. Therefore, it’s a priority for hospitals to stock the necessary supplies so that surgical cases are executed as and when planned without having to face the problem of unavailability of supplies. However, it is tough for hospitals to plan for the procurement of their supplies due to an unpredictable demand and large number of Stock Keeping Units (SKUs). Hospitals, unlike other businesses, don’t have the luxury of forecasting a particular time when they will get more patients and/or patients with similar types of ailments. Hence, hospitals have to fill their inventories with enough SKUs to cater to an erratic and fickle demand which many a times leads to inventory carrying for almost 90 days and above. In doing so, hospitals are blocking huge working capital and also often end-up seeing stock shortages, excesses, and even expiries, which leads to massive revenue leakages. It is well-known that medical supplies comprise one-third of the expenses in a hospital’s Total Cost of Operations (TCO) and it is the second highest expenditure after salaries and labour cost. Further, according to an article by Definitive Healthcare, a prominent healthcare data publication, the cost of medical supplies will surpass labour costs and become the largest expenditure of
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hospitals by 2020 worldwide. Medical supplies in the form of consumables and pharmaceutical are the primary focus areas for hospitals to achieve operational efficiency. At Medikabazaar, we have been supplying to over 20,000 hospitals with their monthly requirement of supplies. We realised that there were significant fluctuations in their purchases. We then did our own research to gain a better clarity. We stumbled upon a survey by Cardinal Health – a US-based Fortune 500 healthcare services company which revealed some shocking statistics. The survey stated that around 40% of doctors are forced to cancel surgeries, and approximately 69% of them had to postpone cases due to the unavailability of vital supplies. We understood that the problem is faced by hospitals globally. After our personal interactions with hospitals coupled with research statistics, we decided to fulfil this need. With our strong capabilities in Artificial Intelligence (AI) and Machine Learning (ML), we thought of designing a solution that will understand this erratic requirement and provide accurate stock projections to help hospitals procure the right quantity required instead of overstock or unwanted supplies. Vizi – our AI and ML-based intelligent inventory application helps hospitals to plan their procurement by providing them with an actionable purchase list of products showing what and how much needs to be procured. It also recommends the safety or reserve stock of SKUs to avoid stock out situations and the level of safety stock
Vivek Tiwari
Founder and CEO, Medikabazaar
with color indicators. Hospitals don’t need to take any additional steps for data entry to use this application. They can also source supplies at the best prices from a single-point of contact, Medikabazaar, rather than sourcing the same from various suppliers, a task which can be daunting and often unrewarding. Medikabazaar offers best prices due to economies of scale, delivery at their doorstep from our fulfillment centres across India, and thus helping them to slowly move to just-in-time inventory for fast moving SKUs. As hospitals will procure the right quantity at the most competitive prices, they will save approximately 30% in OpEx of medical supplies.
(Spl. Note: The writer is Vivek Tiwari, Founder and CEO, Medikabazaar. Views expressed are a personal opinion.)
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LEADER’S PERSPECTIVE 24
‘Leveraging Technology to Boost Patient Care in Remote Areas’ With latest technological advancements and innovative practices, Apollo Hospitals is trying to boost patient care in rural areas. It is the largest telemedicine provider in India, enabling people to avail tele-emergency services in inaccessible regions, says Dr K Hari Prasad, President, Hospitals Division, Apollo Group, in conversation with Sudheer Goutham of Elets News Network (ENN).
Q
Apollo Hospitals has been at the forefront in adapting and integrating technologies to enhance patient care. Tell us about some recent breakthroughs. We, at Apollo, always believe in getting the best for our patients – clinical teams, processes, and technology. Some of the recent breakthroughs include Proton Beam Therapy where high-energy proton beam is used for cancer treatment. It is one of the most superior forms of radiation therapy in the world. The therapy will usher in a paradigm change in cancer treatment. Unlike any other radiation treatment, it provides targeted treatment and intensification. Conventional radiotherapy uses high energy X-rays for treatment of cancer and certain benign tumours. In doing so, it damages the surrounding healthy tissue. In contrast, proton beam delivers a high dosage of radiation, targeting the tumour cell. The novel method increases chances of cure and minimises adverse effects to surrounding healthy tissues. Moreover, the biggest advantage of this technology is proper dose
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distribution. A low dosage of radiation is being emanated at the body surface followed by a sharp burst once it hits the tumour. Proton Beam Therapy has transformed the treatment process of cancers i.e. paediatric, skull base tumours, brain tumours, breast cancer, prostate cancer and lung cancer. It becomes a feasible option, especially in those cases where treatment options are limited and conventional radiotherapy projects a higher risk to patients. The therapy has traversed the boundary of conventional radiotherapy.
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How does Apollo ensure healthcare services to the remote places? We have a dedicated wing – Apollo Remote Healthcare that focuses on providing patient care to the remote areas. Apollo provides a range of services including teleconsulting for primary and tertiary consults through app and video calls. Through mHealth, a patient engagement platform; medical devices providing continuum of care through real-time monitoring and tracking; teleradiology services like MRI, CT, and X-ray, and telecardiology
Dr K Hari Prasad
President Hospitals Division, Apollo Group
that helps to reduce massive cardiac events, we bolster healthcare delivery process. Apollo is the largest telemedicine provider in India, enabling people to avail tele-emergency services in inaccessible regions. Leveraging Public Private Partnership (PPP) model, we make above mentioned services available in Himalaya region, even at a height of around 14,000 feet from sea-level. Apollo is managing one of the largest PPP programmes on population
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health (eUPHC) in Andhra Pradesh. We have more than 60,000 Rural Teleclinics with Common Service Centres (Government of India). The figure will go up to 2.5 lakh by early 2019. In addition, we provide e-ICU services with more than 100 clinical protocols inbuilt in the system to monitor patients across remote locations.
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Would you share Apollo’s next five years’ expansion or collaboration plans especially in southern States? There is a plan to start a hospital at Kochi. In coming years, we will be focusing more on consolidation of complete hospitals division. Our objectives are to continuously improve efficiencies, services and clinical outcomes.
Q
Cities like Hyderabad and Bengaluru are emerging as medical tourism hub as large number of foreign patients swarms
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here every year. How do you perceive the statement? As per one of the projections, India’s healthcare market may see three-fold jump in value term to $372 billion by 2022. India is making big strides to boost healthcare delivery system, enabling people of lastmile to avail finest healthcare in cost-efficient manner. India used to be known as the “land of healing” and we are proud that once again we are moving towards reclaiming this privileged title. Top Indian cities that are emerging as hub of medical tourism include Delhi, Mumbai, Chennai, Ahmedabad, Bengaluru, Hyderabad, Goa and Kolkata. In terms of number of foreign patients India receives annually, Bengaluru and Hyderabad contribute to an average of 13 percent though Chennai and Delhi are being considered the biggest destinations for patients (this data is for Apollo).
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LEADER’S PERSPECTIVE
LEVERAGING PUBLIC PRIVATE PARTNERSHIP (PPP) MODEL, WE MAKE HEALTHCARE SERVICES AVAILABLE IN HIMALAYAN REGION, EVEN AT A HEIGHT OF AROUND 14, 000 FEET FROM SEA-LEVEL.
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Would you list out sub-domains in healthcare sector Apollo set its foot recently? Apollo is working largely towards smaller formats like dialysis, sugar clinics, diagnostics and other technologically accessible formats to make healthcare accessible for all.
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What would be your message to the readers of eHealth Magazine? Healthcare sector is growing by leaps and bounds and India is already one of the most opted destinations. With good clinical outcomes, technology and service excellence, we are striving to deliver the best to our patients. I would appeal to all the readers to take care of their health and get their health check up at least once a year. In the wake of unprecedented rise in non-communicable diseases due to range of factors including changing environments, our lifestyles, and food habits, it is imperative that we should consider our health as a priority.
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‘Modern-day Tech Catapulting Healthcare Delivery to Extra Mile’ With a team of experts and high-end technologies, Columbia Asia enables people to avail accessible and high-quality patient care. The hospital strives to excel in terms of various deliverables, catering people at large with empathy and care, says Dr Nandakumar Jairam, CEO, Chairman and Group Medical Director, Columbia Asia Hospitals, in conversation with Elets News Network (ENN).
Q
Starting its journey in 1996, Columbia Asia has come a long way catering to people with finest healthcare practices, how has been the journey? Columbia Asia started its Indian operations in 2005. I have been associated with the company from very initial year of inception. The Columbia Asia Group started first hospital in Hebbal (Bengaluru) and expanded its footprints thereafter across country. At present, we have 11 hospitals and are providing healthcare services in seven cities. It has been a fantastic journey. I started as Group Medical Director and was privileged to be offered a position on the board. I continued on the board until 2017
when the board requested me to take additional responsibility of CEO, which I proudly accepted. My stint with the hospital is best part of my life.
Q
Quality and affordability are two major issues, plaguing the Indian healthcare sector. How does the Columbia Asia manage a balance between the two? We are a multi-speciality hospital group, which takes care of medical needs of middle-class India. We believe in providing value for money. With a team of experts and high-end technologies, the hospital enables people to avail accessible and high-quality patient care. We serve people with empathy and care.
Dr Nandakumar Jairam CEO, Chairman and Group Medical Director, Columbia Asia Hospitals
We follow evidence-based care and stringent infection control at our hospitals which help us to maintain quality in deliverables. In addition, it plays a role in bringing down the average length of stay for in-patients and thus reduces costs.
Q
You provide a wide array of medical services. Can you highlight significant aspects of services in areas of general surgery, paediatrics, and obstetrics? We have a full gamut of services in general surgery, including minimally
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invasive surgery, bariatric surgery, and gastrointestinal surgery (GI). Our paediatric services include subspeciality work in specific hospitals and a Neonatal Intensive Care Unit (NICU) which is wellequipped and staffed. We ensure high risk pregnancies to be handled with care. Our obstetrics and gynaecology (OB/GYN) services include a well-structured obstetric service, minimally invasive gynaecology and in specific locations infertility services.
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Technology and innovations are playing a key role in driving healthcare delivery to extra mile. What kind of initiatives have been undertaken by the hospital? Healthcare delivery system has witnessed complete transformation in last decade. This is due to innovations in the digital world. We were the first to use electronic medical records in all our hospitals.
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In an endeavour to make all processes flawless and paperless, we invested more in technology than any other players across country. Today, we have sufficient data that can be used effectively for the welfare and wellness of patients. Data / Technology / AI: Data cannot only help us to treat diseases but identify those that require preventive interventions. In other words, data enables us to promote good health. Big Data Analytics, Artificial intelligence (AI) and Internet of things (IoT) are being seen as the boon for the industry and help in early detection of diseases. We have conducted a few pilot studies with these technologies and will be putting these technologies to use in the coming years. Early detection and de-cluttering the useless data through IoT and AI, significantly improves productivity in hospital operations.
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LEADER’S PERSPECTIVE
BIG DATA ANALYTICS, ARTIFICIAL INTELLIGENCE (AI) AND INTERNET OF THINGS (IOT) ARE BEING SEEN AS THE BOON FOR THE INDUSTRY AND HELP IN EARLY DETECTION OF DISEASES.
These also significantly reduce the time taken by a doctor to arrive at a diagnosis. This is the real future of medicine and we are quickly adapting to it. Investing in this space is vital for survival of any healthcare provider. New equipment: We are also investing in Robotics in one of our existing hospitals and the new hospital at Pune would also have high-end oncology with Radiation Therapy.
Q
Currently, Columbia Asia Hospitals Private Ltd offers 29 medical facilities across Asia, 12 in Malaysia, 11 in India, and 3 each in Vietnam and Indonesia. Would you shed light on expansion and collaboration plan? In India, we have an underconstruction hospital in Pune, which will start operation in 2020. We have completed first phase of growth and would consolidate our position in next few years before we aim for expansions. We are also looking at new investors to help us innovate, achieve and attain the best standards in healthcare.
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LEADER’S PERSPECTIVE 28
‘Replicating the Finest Healthcare Delivery Model in India and Across the Globe’ With a number of healthcare facilities across India and different countries, BR Life has carved a niche for itself in the healthcare space, providing holistic and integrated healthcare services at patients’ doorstep. It is leaving no stone unturned to replicate the finest healthcare delivery model across the globe where people at large would be served with best care in terms of quality and affordability, says Col Hemraj Singh Parmar, Group CEO, BR Life, in conversation with Mukul Kumar Mishra of Elets News Network (ENN).
Q
BR Life is known for serving people with finest healthcare services, leveraging modern technologies and innovative practices. Tell us about its mission and vision. Dr BR Shetty is founder and chairman of NMC Healthcare which has more than 200 healthcare facilities across 25 different countries. It is the 3rd biggest healthcare group in the world, listed on the London Stock Exchange and is a FTSE 100 company with a market capitalisation of close to $11 billion. Dr BR Shetty, the founder of BR Life hails from Udupi, Karnataka. With the intent to improve healthcare delivery system and helping people get access to the finest healthcare facilities cost-effectively, he went to the UAE. The objective was to replicate the finest delivery model in India and across the globe with the founding of BR Life, a path he had already treaded with excellence. We have a hospital in Egypt called Alexandria NMC Hospital and recently we acquired two more hospitals in Afghanistan. BR Life has envisioned expanding healthcare business pan-India. We have one hospital each in Bhubaneswar, Thiruvananthapuram, Bengaluru,
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Udupi (PPP) and Raipur. In addition, we have one 400 bedded multi-superspecialty hospital each under construction in Udupi (Karnataka) and Varanasi (UP). The Government had provided land for the Mother & Child Hospital in Udupi (PPP). We have come up with $2 billion Medicity project in Amravati, the new capital city of Andhra Pradesh near Vijayawada. It would be spread over 100 acres. We have planned a medical college, nursing college, dental college, 1000+ bedded quaternary care hospital, five-star hotel, mall, school, residential areas and virtually everything that should be there in a medicity. We have acquired 25 acres of land for construction of the medical college in Kollar. We have made bid for Seven Hills Hospitals in Mumbai (Maharashtra) and Vizag (Andhra Pradesh). The Mumbai hospital has 1500-bed capacity while Vizag facility has 300 beds. Moreover, BR Life is exploring options to establish its presence in terms of more hospitals across the globe including in Africa, Middle-East and some of the SAARC countries. Heads of many countries globally and many Chief Ministers in India
Col Hemraj Singh Parmar Group CEO, BR Life
have expressed their desire to have BR Life presence in their own countries and States. In India, we have a large number of hospitals under acquisition and construction at various stages. We wish to have 20,000 beds in the next five to ten years time and emerge as the best and the biggest healthcare services provider in the country with global presence. MISSION AND VISION We envision being a compassionate,
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Q
Shed some light on significant aspects of your deliverables in healthcare, which distinguish BR Life from others. If you will have a look on fourdecades of distinguished experience of our promoters in the global healthcare space, there are a large number of investors from India and outside who are willing to invest. In the light of the government’s path breaking Ayushman Bharat initiative, affordability has become one of the major factors for success. We are making significant progress on that count with innovative strategies.
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We wish to have both Greenfield and Brownfield hospital projects across the country, as also PPP projects. We are planning for hospital projects in Tier 1, 2 and 3 cities and also in rural and tribal areas. BR Life also leverages latest technology to standardise our infrastructure and protocols. We have already standardised HIS, PACS, EHR/EMR (Electronic Medical Record) and also the finance, human resource (HR) and supply chain modules. In an endeavour to have a robust healthcare delivery model, we shall be leveraging Artificial Intelligence, IoMT, 3D Printing, Big Data, telemedicine/ teleradiology, wearables and mobile technology and other modern technologies to improve outcomes and to improve access and affordability.
Q
It is little tough to balance both quality and affordability at the same time. How does BR Life calibrate? Cost is certainly an issue today, as the government has put caps on medical devices, implants and drugs. It has severely dented profit margins of healthcare services providers, though they are strategizing to deal with the same.
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WE WISH TO HAVE A VERY COMPREHENSIVE ECOSYSTEM OF HOSPITALS IN THE BROWN-GREEN FIELD SPACE, PPP PROJECTS, HOSPITALS IN RURAL AREAS AND TRIBAL AREAS WHICH WILL CATER TO PATIENTS FROM NOT JUST INDIA BUT ACROSS THE GLOBE. BR LIFE AIMS TO THEREFORE DEVELOP A VERY COMPREHENSIVE MODERN AND TECHNOLOGY DRIVEN HEALTHCARE ECOSYSTEM THAT WOULD BE AFFORDABLE, ACCESSIBLE AND MAKE SIGNIFICANT IMPACT ON THE SOCIETY.
LEADER’S PERSPECTIVE
ethical, innovative and affordable global healthcare services provider by exploiting cutting-edge research and medical technology to boost patient care. Our mission is to bring in holistic, accessible and integrated healthcare delivery to the doorstep of every patient. We believe in the ethos of care with compassion. In the arena of medical technology, we wish to invest in some of the most advanced medical technologies, as also are equally open to investing in some of the most innovative healthtech companies. Our objective is to bring in holistic and integrated healthcare services at patients’ doorstep.
Healthcare service providers are forced to have a de novo look at the entire cost structure. Healthcare industry is capital intensive and lots of money is spent on acquisition of land, construction of hospitals, medical equipment & devices and medical furniture. One starts with substantial front-loaded costs. And then other cost including doctors’ fees, manpower costs, costs incurred on consumables and other administrative costs put a heavy pressure on the hospital’s profitability. Ensuring a higher asset utilization therefore is the key to optimise costs and improve profitability. Similarly, ensuring higher bed occupancies, utilization of laboratories, OTs, MRIs/
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CTs and other infrastructure has to be optimized. In addition, average length of stay of patients and turnaround timings have to be optimised to ensure higher patient turnout and revenue. We are setting up plants for manufacturing of pharmaceuticals products and dialysis machines. This backward integration would further help us reduce our dependence on expensive imports and consequently help optimise costs.
Q
What are your suggestions to the Government to make people available quality and cost-efficient healthcare facilities? One of the major issues is import duty on the drugs and medical devices which is very high. The Government needs to promote investments by making the industry more profitable. Reduction of import duties on medical devices and expensive drugs, tax holidays for investments in rural & tribal areas, promoting PPP projects and medical education are some of the key areas of focus. It will give fillip to the Make in India campaign wherein large number of medical equipment, drugs and implants could be manufactured in India itself at very affordable prices.
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In addition, the Government has also imposed cap on so many items including drugs, stents and implants. The Government of India has planned to cover approximately 100 million families under Ayushman Bharat initiative. This requires active participation of the bigger private healthcare providers to succeed. The rates for about 1350 medical procedures given by the government are extremely low and would dissuade bigger players from participating in the scheme. This anomaly needs to be corrected by coming out with more viable rates. Democratisation of healthcare education is another area that deserves urgent attention since the country has acute shortage of doctors, nurses, technicians and other allied healthcare service providers.
Q
Despite many Government schemes, rural healthcare delivery has not improved substantially. What kind of initiatives have been undertaken to strengthen primary healthcare facilities? It is the most challenging part as majority of population still resides in rural areas where healthcare access is minimal. In a way, this is also an opportunity which can be explored by healthcare providers. Our Udupi
project is of a similar kind and takes healthcare delivery to the last mile absolutely free. We have been invited by many other state governments to replicate this unique model and bid for PPP projects to improve infrastructure in rural areas. Many of the government facilities currently operating in rural areas are devoid of adequate medical facilities and are not adequately equipped and staffed with good clinical talent and infrastructure. BR Life is making a significant contribution there and is planning to scale up its operations in that space. We are in talks with some of the companies which are currently operating in primary healthcare domain for acquisition. We wish to establish hospital and clinics, equipped with required infrastructure to take healthcare delivery to the hitherto neglected last mile. We aim to improve delivery in rural and tribal areas while scaling up operations in bigger cities. Profit making is not the sole objective of our overall healthcare endeavours in line with the philanthropic mindset of Dr BR Shetty, who has also donated significant part of his personal wealth to Bill & Melinda Gates foundation for non-infectious diseases.
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CONFERENCE REPORT
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CONFERENCE REPORT
27 FEBRUARY 2019 MUMBAI
Ajoy Mehta (left), Commissioner, Municipal Corporation of Greater Mumbai, I A Kundan (third from left), Additional Commissioner, WS, MCGM, Hemangi Worlikar (second from left), Deputy Mayor, Mumbai, along with other eminent dignitaries inaugurating Urban Healthcare Summit in Mumbai
Leveraging Best Practices to Boost Healthcare Delivery System
I
n a bid to ponder on finest healthcare practices adopted by public healthcare system, enabling people better patient care in terms of accessibility and affordability, the Urban Healthcare Summit was organised in Mumbai recently. Organised by the Municipal Corporation of Greater Mumbai (MCGM) in association with Elets Technomedia Pvt. Ltd., the healthcare summit witnessed key policymakers, and industry leaders making deliberations on different facets including innovative practices adopted by the corporation, conducive policies and ways to reach out to people living on the last-mile, their vision for it and the huddles in that roadmap. Inaugurated by Ajoy Mehta, Municipal Commissioner, Municipal Corporation of Greater Mumbai, along with I A Kundan, Additional Commissioner, Western Suburbs, Municipal Corporation of Greater Mumbai; Hemangi Worlikar, Deputy Mayor, Municipal Corporation of Greater Mumbai; and Sunil Dhamne, Deputy Municipal Commissioner, Public Health, Greater Mumbai, the conclave witnessed experts from both the corporation and the industry. On this occasion, policymakers highlighted various medical facilities (basic to tertiary level) that are being
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provided at MCGM-run hospitals. They also deliberated upon various issues engulfing these hospitals and roadmap of how trending innovative practices could be leveraged. Industry experts shed light on healthcare trends, role of public private partnership enhancing patient care, infrastructural requirements or building an innovationdriven facilitative system to tackle burgeoning noncommunicable diseases. Various enlightening discussion sessions touched upon issues such as: ‘Emerging Trends and Technologies in Healthcare – Affordable & Accessible Healthcare Services’, ‘Significance of PPP Model in Streamlining Urban Healthcare and Best Practices in Healthcare’, ‘Making the Most of Advanced Technologies to Ensure Effective Treatment to Common Man’, and ‘Controlling Major Communicable and Non-communicable Diseases: Best Practices and Innovation’ were organised at the conference. Through these topics, healthcare stalwarts turned the light on the glaring issues of Indian healthcare sector and how public and private providers can work in coherence to improve the situation. A glimpse of the conclave:
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CONFERENCE REPORT
Inaugural Session Urban Healthcare – Taking Quality Healthcare Services to Common Man at an Affordable Cost
I A KUNDAN
AJOY MEHTA
Additional Commissioner, Western Suburbs, Municipal Corporation of Greater Mumbai
Municipal Commissioner Municipal Corporation of Greater Mumbai
"There are various aspects which determine delivery of urban health. We have to take into consideration various factors-whether the service delivery is inclusive, whether we are able to provide all the services related to diagnostics or therapeutics to lower strata of society, and whether the latest interventions are able to affect out-of-pocket expenditure. Increasing migration, and huge population load, has made policymakers to think of a robust urban healthcare delivery system. Municipal Corporation of Mumbai has an inclusive system, which helps us to make big strides towards Universal Healthcare Coverage."
"Mumbai city faces a number of challenges including its swelling population. The city has a population of 12.4 million which is increasing day by day. When population lives on such a concentrated area, it’s obvious that diseases will spread with much higher rate. Healthcare, sanitation, and other issues are bound to crop up in this scenario. Both administration and healthcare service providers need to chalk out solutions to tackle such issues in the best possible manner."
HEMANGI WORLIKAR
SUNIL DHAMNE
Deputy Municipal Commissioner, Public Health Department, Municipal Corporation of Greater Mumbai
Deputy Mayor Municipal Corporation of Greater Mumbai "The Municipal Corporation of Greater Mumbai (MCGM) has taken up many initiatives to improve healthcare ecosystem within the city. MCGM has encouraged innovations in the health sector, thus the mission to take affordable health to common man has progressed at a rapid speed. The corporation has also encouraged Public Private Partnership (PPP) to speed up various projects. With rapid transforming world of opportunities and challenges, innovations and technologies have played a key role in boosting healthcare delivery."
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"I thank all the esteemed guests for participating and sharing their valuable inputs which will ultimately help MCGM to improve delivery of services in healthcare sector. Under the visionary leadership of Ajoy Mehta and I A Kundan, MCGM is taking number of initiatives to streamline and improve healthcare delivery process."
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CONFERENCE REPORT
27 FEBRUARY 2019 MUMBAI
SACHIN PADWAL
Group President, Chief of Science and Innovation, Metropolis Healthcare Limited
"MCGM is taking several initiatives to improve overall healthcare delivery system, enabling people to avail better patient care. With the objective to boost different deliverables, the corporation recently allocated Rs 4,151.14 crore. The corporation-run hospitals not only cater to Mumbai people, but serve 1.5 to 2.0 crore people annually from across Maharashtra and the entire country."
Founded by Sushil Shah, Metropolis Healthcare Limited is 38-year-old organisation. We offer more than 4,000 tests today having branches in 18 different States. We have a total of 137 labs. We have 2,300 service centres across the country with 5,300 members catering to 20,000 people. A range of services which we offer include clinical diagnostics and reference testing, hospital laboratory management, clinical research and public private partnership and wellness services."
SADHNA NAYYAR
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DR NILESH SHAH
Chairman Prabhag Samiti, MCGM
APRIL 2019
R SATISH
Managing Director Hansraj Nayyar Medical
Head of Marketing, Getinge Infection Control
"Established in 1925, Hansraj Nayyar Medical is Mumbai-based medical devices and equipment company. We are working on economic antimicrobial clean rooms, which play a key role in enhancing patient care at hospitals. We have come up with smart theatre with engineer cladding having many advantages in comparison to modular OT. Silver ions embedded in the sheet inactivate all spectrums of microbes like bacteria, viruses and fungus."
"How do you reprocess something and make it safe so that you achieve infection control, that’s a key point. Reprocessing includes cleaning, disinfection, labeling, packing, sterilising, and documenting. Many places reprocessing is limited to autoclaving and sterilisation which is not a good practice. Cost of preventing infection is cheaper than cost of handling it with all the complications."
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SUDIP BAGCHI
PROF. DR ABHAY CHOWDHARY
"People in India should have access to new technologies. Access to the diagnostics centre and hospital is one of the important issues that needs immediate attention. In India, stroke patient don’t have easy access to CT scan facility, which proves fatal at times. We started mobile CT scanners in 2016. It works on battery and can be easily installed in the ambulance, carrying stroke patient. The mobile CT scanner can do angiography, perfusion and all on the bedside."
"Infection control and prevention are keys to provide better patient care to patients. Hospital Associated Infection (HAI) is infection acquired during course of the treatment. HAIs kill more people each year than breast and prostate cancer combined. On any given day, about one in 25 hospital patients have at least one HAI. Globally, the accepted rate of HAI is up to 8 percent."
Vice President (Radiology) Schiller Healthcare India Pvt Ltd
Professor & Head Dept. of Microbiology, Dr D Y Patil University
Panel Discussion: Significance of PPP Model in Streamlining Urban Healthcare and Best Practices in Healthcare
DR AVINASH SUPE
DR SANJAY MUKHERJEE
Secretary, Medical Education and Drugs Department, Government of Maharashtra
Ex-Director and Former Dean, King Edward Memorial Hospital
"Public Private Partnership is essentially a financing model. There are different permutations and combinations like public funding-private service, private funding-public service, and so on. In the entire framework of PPP, the major issue is Government control. There has to be a proper regulation whether it is public or private control or mix. Regulation is the major factor, which determines success of PPP model."
"PPP model holds huge importance due to increasing demand of quality healthcare and public healthcare that falls short in some areas in Mumbai. It has become part of the system especially in most of the Government sectors projects. Careful monitoring, regulation, and policy framework are needed to make PPP model a successful endeavour."
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DR SANJAY PATTIWAR Retd. Addl. Commissioner, Navi Mumbai Municipal Corporation
"Mumbai is totally different from rest of the Maharashtra. Urbanisation of Mumbai and non-Mumbai areas is totally different. PPP models, outsourcing or CSR may not work in the rest of the area. Navi Mumbai Municipal Corporation has implemented many of PPP projects and vouches for its effectiveness. Local administration should check whether the particular PPP model or outsourcing model will work for them or not. It should fulfill the objective and prove costeffective as well."
Panel Discussion: Emerging Trends and Technologies in Healthcare – Affordable & Accessible Healthcare Services RAHUL BAJPAI
Chief Operating Officer, Healthcare Global Enterprises Ltd, HCG Cancer Centre "Accessibility and affordability both are important issues in cancer care. In last few years, healthcare cost has gone up in an exorbitant manner. Vendor financing provision could be helpful to reduce cost which helps to pass the benefits to patients. Accessibility too holds huge importance as patients have to visit doctors many a times for diagnosis and treatment. From clinical tests to medication, patients need to travel a lot. In case of radiation treatment, a patient needs 30 fractions. One can easily understand the predicament of patient."
DR SUJIT CHATTERJEE CEO, Dr L H Hiranandani Hospital
"Business model has to be changed to provide affordable and accessible healthcare to people at large. Two Cs that is compete and complement can help to improve the situation. Costly equipment is one of the reasons for exorbitant healthcare cost. We can have a consortium of purchase between 10-12 hospitals, which can help in reducing cost."
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APRIL 2019
DR ASHOK MEHTA
Medical Director, Brahma Kumaris Global Hospitals & Research Centre "Every hospital should have Hospital Information System (HIS) as it plays an important role in cost reduction. HIS disciplines the staff as well as improves the performance. Accessibility is one of the biggest areas of concern, especially in Mumbai where commuting takes a lot of time. A cancer patient has to visit doctor repeatedly for follow-up examination. Neighbourhood healthcare facility is absolutely vital. PPP model can be leveraged to improve situation on this front."
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DR NEERAJ UTTAMANI
DR KAVITA VARDHAN
"Affordable model of healthcare is responsibility of both, the government and private sector. It is determined by A, B, C, D and E factors. A stands for attitude towards costreduction, B for bold steps taken by higher and middle management to cut down the cost, C stands for continuous improvement, D for declaration of any innovative step in health communities, and E for education."
"Duration of patients’ stay in the hospital directly affects the cost. Kohinoor Hospital is providing Minimal Invasive Surgery where patient needs to stay only for a day. We are looking for Ambulatory Surgery Centers (ASC) to reduce cost to the patients. Artificial Intelligence can also be leveraged to make healthcare cost-efficient."
Medical Director, Holy Family Hospital and Medical Research Center
Head of the Medical Service, Kohinoor Hospital
Panel Discussion: Making the Most of Advanced Technologies to ensure Effective Treatment to Common Man
DR SHRIPAD BANAWALI
DR HEMANT DESHMUKH
"Technology has not only helped us to diagnose various diseases at an early stage, but it also proves to very effective in treating the disease effectively. In Acute Myeloid Leukemia (AML), till some years ago the outcome was only 15 percent which has now increased to 40-45 percent. But the technology has certain price. Cost of cancer treatment has gone up due to adoption of modern technologies like genomics and targeted therapy."
"With digital radiology, we can take more number of X-rays, store, transfer and archive them. These images get ready within a minute while the paper images used to take a day or two. We have these digital images incorporated into PAC system. Greatest advantage of digital image is that patients don’t need to come again and again for X-rays. picture archiving and communication system (PACS) and Health Management Information System (HMIS) have revolutionised entire imaging system."
Prof. and Head, Dept of Medical & Pediatric Oncology, Tata Memorial Hospital
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Dean, KEM Hospital
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CONFERENCE REPORT
27 FEBRUARY 2019 MUMBAI
DR NEELAM ANDRADE
Dean, Lokmanya Tilak Municipal Medical College and General Hospital
"Nair Hospital receives about 3 lakh patients a year. Our hospital is the first in India which has its own indoor beds in the hospital and OT complex in the medical colleges. Among these 3 lakh patients we get a small group of patients who are referred to us as tertiary centres. These patients suffer from Obstructive Sleep Apnea Syndrome (OSA) where airways get narrowed. We have managed the indigenous machine available to them free of cost."
"When we talk about high-end technology being made available at an affordable cost, one of the best examples would be interventional cardiac services as well as cardiac surgical services which municipal corporations provide through major teaching hospitals. These hospitals have State-of-the-art cardiac catheterisation laboratory. In addition, we have modern equipments including 3-D ecocardiography, intravascular sonography, and optical tomography to provide high standard of care to patients."
DR GANESH SHINDE
DR MAMTA MANGLANI
Dean, Cooper Hospital "Cooper Hospital is making a mark through bestin-class services, though the hospital is still at inception stage. We have been supported by our sister-concerns. Very soon, the hospital will have cath labs, and trauma centres. The referrals (patients refereed from our hospitals) to central hospitals is zero percent. Patients are managed and tackled here with all services except dialysis."
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DR JAYASHREE MONDKAR
Dean, Nair Hospital Dental College
APRIL 2019
Director, Thalassemia Care Centre, MCGM "We provide comprehensive care for Thalassemia under one roof. It’s MCGM-run centre. It is one stop centre where a patient gets endocrine, cardiac, hematology evaluation, as well as audiology and ophthalmology investigation for side-effects monitoring. We also provide pre-natal diagnosis to pregnant women who are mothers of Thalassemic children. All basic tests are being provided by the centre."
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Panel Discussion: Controlling Major Communicable and Non-communicable Diseases: Best Practices and Innovation
DR PREMA VARTAKI
DR DAKSHA SHAH
Public Health Department, MCGM (Retd. Official)
Joint Executive Health Officer, Public Health Department, MCGM
"India is living with double whammy with noncommunicable diseases burgeoning at high rate. Obesity is emerging as one of the most crucial public health problems. Obesity is seed for diabetes, hypertension and cardiovascular diseases. There will be a huge burden 20 years later if required steps are not taken to contain non-communicable diseases. Indians are prone to diabetes due to eating and other lifestyle related habits."
"The Government of India has ‘End TB by 2025’ strategy. In line with the same, we have prepared a plan (201925) to make Mumbai a TB free city. Mumbai has 14 percent of total Multi-drug-resistant tuberculosis (MDRTB) cases in India. Reasons include poor nutrition, private sector and e regulators. In 2015, we started a systematic project called private sector engagement which enables us to notify more than 20,000 cases per year from private sectors."
DR NITEEN KARNIK
DR SHEELA D JAGTAP
"Early detection of diabetes and hypertension is important. In addition, proper compliance to treatment is also needed to control the noncommunicable diseases. We have an excellent system of peripheral hospitals where costly drugs of hypertension are available to general public. That reduces burden on tertiary hospitals."
NCDs contribute to more than 60 percent of total deaths. 80 percent of these deaths can be prevented if issues like sedentary habits, unhealthy eating habits and stress are addressed. MCGM public health department in 2011 started services for these diseases at primary level. There were two objectives-making people aware about NCDs and early screening and prevention. Through 174 primary centres we are providing screening, diagnosis and treatment facilities.
Professor and Head, Department of Medicine, KEM Hospital
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Assistant Health Officer, Public Health Department, MCGM
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27 FEBRUARY 2019 MUMBAI
NARESH HASIJA
Associate Vice President, Public Health Business, Mylan Pharmaceutical Private Limited Mylan Pharmaceutical works on diseases like HIV, viral hepatitis, diabetes, and tuberculosis (TB). Patient adherence and treatment duration are big issues. We are working on drugs which will decrease TB treatment to six months. Pill load in tuberculosis has been found to be very high. Research and Development (R & D) has already started in this area to reduce pill load to one or two tablets.
DR DEEPAK RAUT
DR SANTOSH REVANKAR
"India is facing huge burden of NCDs. People in Mumbai are also facing huge risk of both communicable and non-communicable diseases. MCGM requires lots of counsellors and educators who can make people aware about diabetes and what needs to be done to lead a healthy lifestyle."
"We have developed a system for not only reporting done for municipal hospitals but we have developed a communication system for private hospitals as well. Each death reported is investigated properly. We have a Death Committee for communicable diseases and lots of deliberations are being undertaken."
Director, Family Welfare Training and Research Centre, Ministry of Health and Family Welfare
Dy Executive Health Officer, Public Health Dept., MCGM
Delegates attentively participating in the conclave as experts deliberate
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APRIL 2019
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EMINENT DIGNITARIES VISITING INNOVATION GALLERY
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Organiser
Host Partner
Knowledge Partner
Municipal Corporation of Greater Mumbai
27 FEBRUARY 2019 MUMBAI
for participating and making st 1 Urban Healthcare Summit a Successful Endeavour!
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P
ET (Positron Emission Tomography) scan is a nuclear medicine technique, which produces images at a molecular level. It is a whole body scan, where radiopharmaceuticals or “tracers” labelled with radioactive isotopes of carbon, oxygen, nitrogen and fluorine are used. These isotopes mimic proteins, oxygen, water and glucose. Most commonly used radio-isotope in clinical practice is fluorine-18 (18F) labeled fluoro-deoxy-glucose (FDG). These radioisotopes act like molecular level probes which target disease while giving out radio-signals that are captured by ultrasensitive detectors to produce an image. PET scan thus reveals much more about the cellular level dynamics of a disease than any other modalities like ultrasound, CT scan or MRI. With combination of CT / MRI with PET into a single machine, simultaneous localisation of the disease becomes more accurate with better characterisation of individual lesion(s). The major areas where PET is making critical contributions include cancer care, coronary artery disease (heart attack), neurology and to some extent in psychiatry. ONCOLOGY PET scans are helpful in distinguishing benign (non-cancerous) from malignant (cancerous) disease when carried out at initial stage of diagnosis of cancer. The technique also helps to determine its stage. The metabolic characteristics of the cancer help physicians to decide the best treatment options for such patients. Subsequently, during the course of treatment the PET scans show how the cancer is responding to the treatment.
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As the cancer responds to treatment, the metabolic activity of tumour, as seen in PET scan, starts diminishing which proves that the therapy / treatment is working. On the other hand, if there is no response or if cancer is growing despite treatment, an early PET scan can alert treating physician to alter the treatment protocol thus sparing patient the unnecessary and often very expensive and painful treatment. NEUROLOGY PET scans can diagnose Alzheimer’s disease if early intervention is made. It can also locate tumour in brain and distinguish active viable tumour from post radiation scar tissue. In certain cases of epilepsy, PET scans are used to locate the focus of seizures and accurately assess sites within brain for delicate surgery. CARDIOLOGY In case of heart attack (myocardial infarction, acute coronary syndrome), a PET scan helps to determine myocardial viability. It gives idea whether coronary bypass surgery (CABG) is required or not and what benefits it would bring.
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ARTICLE
PET CT – An advanced, Innovative Tool to Detect Cancer
PSYCHIATRY Schizophrenia, depression, dementia and substance abuse are some of the indications for PET scan, which provides new insights into the biology of the disease, enabling doctors to plan better management protocol and close follow-up. The “Nuclear Medicine & Molecular Imaging department” at Sarvodaya Hospital and Research Center, Faridabad, has recently commissioned a brand new PET-CT scanner from GE (Discovery IQ). It is equipped with state-of-the-art 50 slices per second CT. The machine uses Q-Clear reconstruction algorithm which is the latest innovation in PET technology. The technology helps the machine to detect the tiniest lesions, thus increasing the accuracy of the investigation. The machine makes entire procedure safe and more comfortable for patients. (Spl. Note: The writer, Dr Swagat Dash, is a Senior Consultant and HoD – Nuclear Medicine, Sarvodaya Hospital & Research Centre, Faridabad. Views expressed are a personal opinion.)
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TECHNOLOGY PERSPECTIVE 44
‘Ensuring Best Clinical Outcomes in Maternal, Neonatal Care’
Cloudnine group’s objective is to provide highest level of care through highlyskilled healthcare professionals and state-of-the-art technology. With a sheer focus on clinical outcomes, engagement of teams both clinical and non-clinical, and a pioneering approach to technology and its use, we have built a strong brand, says Chaitanya Shravanth, Chief Digital Officer, Cloudnine Group of Hospitals, in an interview with Mukul Kumar Mishra of Elets News Network (ENN).
Q
With world-class medical expertise and state-of-the-art facilities, Cloudnine has carved a niche for itself in women and child care, how has been the journey? The founding group of promoters with their experience and global awareness, coupled with research through customers, providers, and payor networks found a gap in service as against the demand available for maternal and childcare services in India. We started way back in 2007 with the philosophy that “pregnancy is wellness and not an illness”. We found that choice of couples was either nursing homes or corporate hospitals and both of them had their merits and demerits. Our objective was to provide personalised experience with the highest technical expertise and the best of clinical talent, all along cherishing the journey of pregnancy within an infrastructure catered to “celebration, comprehensive care and clinical excellence”. Child birth is one of the most cherished moments of one’s life and our services in hand- holding couples through this stage of life and being their trusted companion for everything that they need during such a
APRIL 2019
phase, is our goal. Cloudnine Group has three marquee investors in our company i.e Matrix Partners, Sequoia India and True North (Previously called as India Value Fund Advisors) and have attracted over Rs 500 crore towards growth capital. In last few years, we have tripled our capacity to handle deliveries and increased our presence in over 20 locations across seven cities. Headquartered in Bengaluru, we are now present in Chennai, Mumbai, Pune, Gurugram, Chandigarh and Noida with more cities becoming operational soon. We have been growing at over 35 percent CAGR and expect to maintain the same growth rate for next few years. Cloudnine employs over 3,500 strong team members across the country. All of them are motivated and aligned towards vision of the organisation. As a group, we manage over 1,500 deliveries every month.
Q
What are the hallmarks of your services and offerings? Share with us its mission and vision. Starting with one unit in Bengaluru in 2007, we have come a long way. It took about four years to make things fall into
Chaitanya Shravanth Chief Digital Officer Cloudnine Group of Hospitals
place. Taking cue from past mistakes, we moved ahead with fresh aplomb. Since 2010, with a sheer focus on clinical outcomes, engagement of teams - both clinical and non-clinical, investment on leadership roles and a pioneering approach to technology and its use, we have been able to build a strong brand. The Cloudnine Group has been lauded for various achievements and for giving new meaning to forgotten cause of celebrating pregnancy and the journey.
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Q
What is so significant about services like Gynaecology and Paediatrics? At Cloudnine, healthy mothers and happy babies have been the premise of all the services we offer. As India’s premier healthcare centre dedicated to woman and child care, we understand the complexities of women’s health. We care for women of all ages, addressing problems in areas of adolescence, pre-marital counselling, early pregnancy, sexual health, breast care, hysterectomy, urinary incontinence and other gynaecological issues. We also provide comprehensive “Well Woman” check-ups as a diagnostic screening tool. At Cloudnine, we aim to provide the highest level of care through our highly skilled healthcare professionals and state-of-the-art technology. Our expert gynaecologists and obstetricians are devoted to address all the gynaecological needs of our patients effectively. Our care continues beyond delivering the bundle of joy. Our paediatric care service is one of the
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best, delivered by a team of experts across dermatology, neurology, cardiology and developmental paediatrics. Children love coming to Cloudnine having dedicated play areas and friendly doctors. All our facilities across all locations are equipped with Neonatal Intensive Care Units (NICU) along with a complete range of services from 0 to 12 years. A distinguishing feature of the neonatal and paediatric care is newborn screening, specifically the newborn hearing test and guthrie test. We are the only medical facility across the country providing these tests.
Q
Shed some light on stem cell banking and cosmetology. What kind of guidance is being provided to people under ‘Parent Corner’ section? ‘Cryonine on Cloudnine’ is a worldclass stem cell banking service, enabled by Cryoviva that has an international footprint across Thailand, Singapore, the UAE, Nepal, Bangladesh and East Africa, making it the only Indian stem cell bank on international shores. At Cloudnine, it provides a superlative ecosystem for end-to-end stem cell preservation. Patients get access to best qualified counsellors to give the right information, specimen collections done by trained paramedics, 24×7 specimen collection and processing, dual storage facility for added safety, full refund if stem cells are released to other members, free stem cell expansion as advised by physician, comprehensive lab reports and quality assurance. Therefore, stem cell banking is a vertical integration into the entire child birth value chain and building breadth within women’s healthcare (cosmetology) We have also launched a mobile app “It’s Our Baby” that provides expecting mothers with all the tools they need for managing their pregnancy. The
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app facilitates simpler and quicker registration process for all patients, booking appointments, rescheduling and cancellations, digital payments, e-Prescriptions and reports which allows doctor’s notes, lab reports and e-prescriptions right after your appointment on your phone at the same time, what to expect week by week for expecting parents, baby development, nutrition tips, workout advice.
Q
Please share some details about your expansion plans and collaboration with the Government. There is a huge opportunity to expand our services in every major city across the country. We can set up more than one unit and that gives us the distinct advantage of being able to grow our volumes significantly for many years to come. We are further developing collaborative models of capital deployment and also working on a capex light model for tier-two cities. There is a plan to enhance our allied specialities of fertility treatment, neonatal intensive care units, foetal medicine and gynaecological services through co-location as well as standalone units. We are keen to explore more partnerships with the government sector including several public sector providers in areas of breastfeeding, immunisation, gynaecology related issues, screening camps, health checks for children and neonates. We recently launched fertility services in Noida on International Women’s Day. In addition, we also launched a dedicated fertility centre in Bengaluru at HRBR layout which is our third standalone clinic for the Cloudnine Group in Bengaluru. It is the first clinic in North Bengaluru specialised in fertility treatments, offering patients high-quality assisted reproductive services to help and support couples at every stage of their parenting journey.
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TECHNOLOGY PERSPECTIVE
We have also been able to bring together the best-in-class clinicians in all our cities of presence that bolstered our ability to bring in adoption and development of strong clinical practices. We have also been able to attract top talent to helm the leadership of the company from across the globe to take our brand aspirations to new heights. The Cloudnine Group started with a simple metric of achieving about 100 deliveries a month and today we are serving about 2,500 deliveries every quarter and poised to achieve much more. Our aim is to pursue the excellence in providing best maternal and neonatal care. We set high standards for ourselves and aim for continuous quality improvement across all domains with focus being patient safety.
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CORPORATE UPDATE
Corporate Acquisitions/Appointments Cipla Medpro plans to acquire 30% stake in Brandmed Ltd Cipla Medpro, a wholly-owned subsidiary of Cipla Limited and South Africa’s third largest pharmaceutical company in the private sector, will acquire a 30% stake upon closure in the connected healthcare company, Brandmed (Pty) Limited. In February, Cipla had announced a similar partnership in India with Wellthy Therapeutics to offer a clinically-validated digital disease management platform to patients in cardio-metabolic health. According to the World Health Organisation, NCDs – mainly cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes – are the leading cause of death worldwide. Founded in 2014, Brandmed has developed a unique fully integrated end to end solution to address outcomes and value-based care for patients with chronic lifestyle and Non-CommunicableDiseases (NCDs) such as hypertension, diabetes, high cholesterol, asthma and chronic obstructive pulmonary disease.
Gulbahar Taurani appointed president of Philips Personal Health India Royal Philips has elevated Gulbahar Taurani as President, Philips Personal Health Business, India. The 44-year old Taurani having vast experience in electronics, domestic appliances and telecom, will succeed A D A Ratnam. Taurani has been with Philips for 15 years and worked as marketing director for personal health in India in his last role. “I am delighted to see Gulbahar taking on the role of Business Head for Personal Health in India, building on the strong legacy left by Ratnam. We have always believed in being close to our consumers and meeting their requirements through a steadfast focus on world class innovation and quality. I am confident that Gulbahar will continue with this tradition and leverage his knowledge and our extensive line-up of our products to deliver meaningful innovations to our consumers,” said Daniel Mazon, Vice Chairman & Managing Director, Philips Indian Subcontinent.
Funding in Healthcare IT Companies hits $ 2.2 bn in 2019: Report Mercom Capital Group, a communication and research firm released its report on the VC funding in digital health where digital health companies stood at $2 bn from 149 deals for the first quarter of 2019. Since 2010, digital health companies have raised $37 bn in VC funding. This evaluates with $1.4 billion across 142 deals recorded during the sequential fourth quarter of 2018, according to a report by Mercom Capital Group. The total corporate funding for digital health companies – including VC, debt and public market financing amounted to $2.2 billion in Q1, 2019, the report said.
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APRIL 2019
“Funding levels were down compared to last year in digital health, in the absence of larger deals. M&A activity was also flat. However, digital health public equities experienced a turnaround in Q1 with 66 per cent of them beating the S&P 500, compared with Q4 2018 when 63 per cent of the equities we tracked performed below the S&P 500,” said Raj Prabhu, CEO of Mercom Capital Group.
Gurugram-based startup 1mg raises $10 mn
1mg Technologies Pvt Ltd, a Gurugrambased online pharmacy, which makes people avail a range of healthcare related services through its mobile application, has raised a fund of worth $ 10.32 million (Rs 65.37 crore). The funding round was led by South Korean investment firm Redwood Global Healthcare Fund recently. With this investment, the Global Healthcare Fund will have now shares of Rs 49.72 crore in the company. The rest of the funding came from the USbased venture capital firm PinPoint Ventures, NewFlight Co, ES Investor Co Ltd, and some of the existing investors.
TenX2 ropes in Jubin Mishra to foster Indian startups
TenX2, a provider of business acceleration, which mainly deals in health-tech, edutech and smart-tech, has now forayed into Indian market to foster startups, working on latest technologies including artificial intelligence (AI), internet of things (IoT) and big data among others. Started in 2016 by Mike Mastroyiannis, former CEO of Philips and Siemens, the company aims to tap the domestic startup companies that are working in the new technology. The startups, which are working on different technological products to enhance deliverables in different sectors will be identified and funded through its network of venture capital funds. The firm has given reins to Jubin Mishra, the former global head of Sankalp Intellecap, to spur its Indian business.
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Latest from Healthcare World Scientists develop ‘first’ 3-D print of heart with human tissue, vessels
In a major breakthrough, Israeli researchers have unveiled a 3-D print of a heart with human tissue and vessels. Their findings were published in the peer-reviewed journal Advanced Science. The printed heart will prove to be a big boon to patients who require heart transplants. It marked “the first time anyone anywhere has successfully engineered and printed an entire heart replete with cells, blood vessels, ventricles and chambers,” said Tal Dvir, who led the project. “People have managed to 3-D print the structure of a heart in the past, but not with cells or with blood vessels,” he said. In the wake of huge cases of patients with end-stage heart failure, the need to develop new approaches to regenerate the diseased heart is urgent. Though 3-D printed heart gives scientists huge hope of transplantation, challenges remain. The cells are currently able to contract, but do not yet have the ability to pump, scientists said. “Maybe, in 10 years, there will be organ printers in the finest hospitals around the world, and these procedures will be conducted routinely,” Dvir said.
‘India lacks six lakh doctors, two million nurses’ India lacks on front of healthcare infrastructure including doctor-patient ratio, number of nurses and other trained staff, as per the Center for Disease Dynamics, Economics & Policy (CDDEP), US. High out-of-pocket expenditure is another issue, jeopardising healthcare delivery system in India, said report. Lack of staff properly trained in administering antibiotics is preventing patients from accessing livesaving drugs, said researchers at CDDEP. Even when antibiotics are available, patients are often unable to afford them. In India, there is one government doctor for every 10,189 people (the World Health Organization recommends a ratio of 1:1,000), or a deficit of 6,00,000 doctors, and the nurse: patient ratio is 1:483, implying a shortage of two million nurses.
Hyderabad gets first-of-its-kind women hospital Hyderabad has got a first-of-its-kind hospital which is being run by all women staff, providing round-the-clock healthcare services to female folk. Located close to the fast-growing Central Business District of Hyderabad, Femcity, a 60-bedded hospital, was recently inaugurated. A group of investors has invested Rs 7 crore to establish the hospital which will provide 24*7 medical facilities. Women folk residing in localities including Shaikpet, Tolichowki, Mehdipatnam, Masab Tank, Manikonda, Jubilee Hills, Madhapur and Gachibowl, would be largely benefitted. Responding about the objective of this unique concept, Dr Naseem Majid, COO, Femcity Women’s Hospital, reportedly said, “Women have their own set of dreams, desires, wants, needs and issues. We have 33 departments led by women doctors who are aware that women’s health needs are unique and fundamentally different from those of men.”
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After the success of “Happiness Therapy” in GTB Hospital on January 17, 2019, the Delhi Government has again implemented the “Happiness Therapy” in five more hospitals namely are Maulana Azad Institute of Dental Sciences (MAIDS), Lok Nayak Jai Prakash Narayan Hospital, Rajiv Gandhi Super Specialty Hospital, Dr Hedgewar Arogya Sansthan and Rao Tula Ram Memorial Hospital. ‘Happiness Therapy’ encompasses the use of experiential techniques such as dance, songs, yoga, meditation and laughter to enable holistic and speedy recovery. It envisages physical cognitive, emotional and social integration of patients and hospital staff. The Delhi Government directed every hospital to appoint a nodal officer to facilitate the implementation of ‘Happiness Therapy’ right after the launch. One of the five hospitals, MAIDS is spreading awareness on pertinent issues such as harms of tobacco amongst the waiting patients using the mediums of dance and nukkad natak. Director-Principal of MAIDS, Dr Mahesh Verma said: “Happiness has a lot of healing potential. If one is happy,
Scientists identify medicinal property of chilli
Scientists have identified medicinal aspect of chilli, responsible for spicing up your food in daily routine. New research suggests capsaicin present in chilli could be beneficial to patient suffering with lung cancer. The study conducted by researchers at Marshall University Joan C Edwards School of Medicine in the US, says the compound could slow spread of lung cancer, the leading cause of cancer death for both men and women. Most cancer-related deaths occur when cancer spreads to distant sites, a process called metastasis. “Our study suggests the natural compound capsaicin from chilli peppers could represent a novel therapy to combat metastasis in lung cancer patients,” Jamie Friedman, one of the study authors said. “Lung cancer and other cancers commonly metastasise to secondary locations like the brain, liver or bone, making them difficult to treat,” Friedman stated. In experiments involving three lines of cultured human non-small cell lung cancer cells, researchers observed capsaicin inhibited invasion, the first step of the metastatic process. They also found mice with metastatic cancer that consumed capsaicin showed smaller areas of metastatic cancer cells in the lung compared with mice not receiving the treatment.
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the merriment increases the treatment effects. For a doctor to treat the patient effectively, the intrinsic happiness of both doctor and patient is important.”
NEWS HIGHLIGHTS
‘Happiness Therapy’ now extends to 5 more Government Hospitals in Delhi
“While treatment takes its own course, the happiness brings about synergy which complements the effects of the treatment. Ultimately, it is a win-win for patients and doctors alike,” he said.
Traffic pollution caused asthma in 3, 50,000 kids in India in 2015: Lancet report Traffic-related pollution was the prime reason, causing asthma among 3,50,000 children in India in 2015, as per a Lancet report. India emerged second after China that was badly hit by the disease due to pollutants, said the study which analysed 194 countries and 125 major cities across the globe. The first global estimates of their kind published in ‘The Lancet Planetary Health’ journal suggest that more than one in ten childhood asthma cases could be linked to traffic-related air pollution every year. Susan Anenberg, George Washington University, US, said: “Nitrogen dioxide pollution appears to be a substantial risk factor for childhood asthma incidence in both developed and developing countries, especially in urban areas.” “Our findings suggest that the World Health Organisation guideline for annual average NO2 concentrations might need to be revisited, and that traffic emissions should be a target to mitigate exposure,” Anenberg said in a statement. “Our study indicates that policy initiatives to alleviate traffic-related air pollution can lead to improvements in children’s health and also reduce greenhouse gas emissions,” said lead author Ploy Achakulwisut from George Washington University.
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