Patients' Privacy & Data Threat in Digital Era: eHealth Magazine March Issue 2020

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MARCH 2020 | VOLUME 15 | ISSUE 03

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COVER STORY

Patients’ Privacy & Data Threat in Digital Era TECHNOLOGY PERSPECTIVE

12 K K Singh

CIO, Nayati Healthcare & Research Ltd

31 P Hari Krishna

INDUSTRY PERSPECTIVE

28

32

36

Dr Mervin Leo

POLICYMAKER’S PERSPECTIVE

22

Subhsish Panda

Deputy Director, AIIMS, Delhi

CEO & Founder, DayToDay

34

Devanand KT

Executive Director, Medicover Hospitals

Group, CIO, Omni Hospitals

Prem Sharma

CEO – TeleHealth, Apollo Hospitals Enterprises Limited

CEO, Aster Prime Hospital, Hyderabad

Abdullah Saleem

26

Vikram Thaploo

40

COO Aware Gleneagles Global Hospitals, L B Nagar, Hyderabad

Dr Rahul Medakkar CEO, Continental Hospitals

14 Industry Highlights

EXPERTS’ VIEWPOINT ON CORONAVIRUS Preventing the Spread of Coronavirus From Contaminated Medical Devices

19

Ryan Lewis

M.D., Senior Director Medical Affairs and Medical Safety

Jeremy Yarwood

Vice President, Research and Development, Advanced Sterilization Products

Editorial Data Security: Pivotal for Seamless Patient Experience As an enabler, technology has played a crucial role in bringing transformation in every industry including healthcare. One can vouch about the same while pondering on the role of digital tools, modern applications, and automated processes which have not only facilitated things but have changed the whole narrative of delivery of healthcare services.

But technology is like double-edged sword which can have perilous impact as well if not used judiciously. This holds true for the deluge of healthcare data which is vulnerable enough to be compromised easily in absence of proper security compliance.

Our cover story is on similar line which underlines importance of data privacy and security at the time when digital tools are ruling the roost in patient care paradigm.

The story ‘Patients’ Privacy & Data Threat in Digital Era’ encapsulates how tons of data is being generated by various healthcare stakeholders through EHRs, EMRs, personal health record (PHR), medical practice management software (MPM), and many other healthcare data components. A huge onus is on providers to make it safe and secure from the prying eyes of hackers to not let them use for own benefits.

The magazine also carries all the latest happenings of healthcare world, comprising human interest stories to policy news, acquisition & mergers, and corporate appointments.

It also carries interview of Ryan Lewis, M.D., Senior Director of Medical Affairs and Medical Safety, and Jeremy Yarwood, Vice President of Research and Development at Advanced Sterilization Products who explain about the risk of Coronavirus contamination through contact with medical devices.

The latest issue also has insightful articles on technology perspective by K K Singh, CIO, Nayati Healthcare & Research Ltd; Vikram Thaploo, CEO – TeleHealth, Apollo Hospitals Enterprises Limited; Dr Mervin Leo, CEO, Aware Gleneagles Global Hospitals; and Abdullah Saleem, CIO, Omni Hospitals, who talk about how as a game changer technology has enriched healthcare experience to masses.

The magazine also has industry perspective by Prem Sharma, CEO & Founder, DaytoDay, and Dr Rahul Medakkar, CEO, Continental Hospitals, who talk about various trends and practices being adopted to bolster patient care.

With this bouquet of articles, special features and interviews, we hope this latest issue will invite an invaluable feedback of our readers.

Dr Ravi Gupta Editor-in-Chief eHEALTH Magazine and Founder Publisher & CEO Elets Technomedia Pvt. Ltd. ravi.gupta@elets.in

COVER STORY

Patients’ Privacy & Data Threat in Digital Era With healthcare service providers leveraging various digital tools, connected devices, and automated processes to bolster patient care, data privacy and security have emerged as major threat nowadays. As large amount of data is exchanged at various levels especially in form of EHR, and other clinical information, personal data of patients remain at stake which needs to be preserved from prying eyes of cyber attackers. Mukul Kumar Mishra of Elets news Network (ENN) explores various facets of data security, associated challenges and possible way out.

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COVER STORY

I

n the last few decades the whole narrative of delivery of healthcare services has witnessed huge transformation due to sea change in requirements of people who don’t want only quality and affordable care nowadays but want to play an active part in patient care mechanism.

Cutting-edge technology, mobile applications and various automated processes have not only led to personal touch to care but also bridged the multifarious gaps between providers and seekers.

While the technology has proved game changer in facilitating things, it also poses risk at times if not used in prudent manner. Precautionary measures are must to not let it become fatal for patients.

This holds true for deluge of healthcare data which is vulnerable enough to be compromised easily in absence of proper security compliance.

DATA BREACHES, PRIVACY AND SECURITY AMONG BIG CHALLENGES With the healthcare industry making giant leap towards digitalization, there is tons of patient data being generated by hospital chains, labs, and private clinics & practioners.

“Digital Health or Electronic Health Records (EHR) maintains the data of patient’s name, age, contact information, vital Signs, investigation reports, present & past history, allergies and present & past treatment details. It’s challenging task for IT to prevent all the personal and critical information of every individual,” says Chandrasekar Reddy, CIO, Jupiter Hospital In the wake of various automated applications undertaken by service providers to ease of processes and bring more transparency in delivery

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IN THE WAKE OF VARIOUS AUTOMATED APPLICATIONS UNDERTAKEN

BY SERVICE PROVIDERS TO EASE OF PROCESSES AND BRING MORE TRANSPARENCY IN DELIVERY OF CARE, THE DATA BREACHES, PRIVACY AND SECURITY ARE MAJOR ISSUES BAFFLING INDUSTRY PEOPLE.

of care, the data breaches, privacy and security are major issues baffling Industry people.

“Data security in health informatics is a top concern not only for enterprise and small hospitals, but for everyday patients & provider as well. With widespread data breaches exposing everything from healthcare provider’s login credentials to personal health records, patients must be savvy about data security and take steps to protect their own information,” says Abdullah Saleem, CIO, Omni Hospitals.

Shuvankar Pramanik, CIO, Sir Ganga Ram hospital believes, “Healthcare organizations are particularly vulnerable and targeted by cyberattacks because they possess so much information of high monetary and intelligence

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value to cyber thieves and nationstate actors. The targeted data includes patients’ protected health information (PHI), financial information like credit card and bank account numbers, personally identifying information (PII) such as Social Security numbers, and intellectual property related to medical research and innovation.”

DATA—PLAYING PIVOTAL ROLE IN TRANSFORMING HEALTHCARE ECOSYSTEM The recent years have seen a radical shift in how data is collected, stored, maintained, managed, and analyzed, encrypted and visualized.

This new ecosystem has the potential to not only improve disease prevention, but also increase the accuracy of diagnosis, provide safe medications, and make treatments more effective. It encourages a personalized and patient-centric approach to medicine instead of ‘one-size-fits-all’.

TECHNOLOGY-DRIVEN APPLICATIONS MAKE DATA EASILY AVAILABLE AND ACCESSIBLE Individuals today are no longer the passive seekers but they have become actively involved in improving their health. Around 400,000 health apps are available today that monitor a variety of health data - heart rate, blood pressure, sleep patterns, calories intake, physical activity, blood glucose, cholesterol levels, and several other parameters. According to an estimate, we have 2,975 start-ups for digital healthcare solutions in India, which uses IT applications to seamless services.

“Data threats are never static.

There are millions being created every year. Lack of appropriate measures is one of the most

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COVER STORY

important reasons for a majority of security threats. These measures refer to protection provided by upgraded software applications, security patches, threat detection tools, and so on. Any system needs these tools to protect itself from any threat,” Chaitanya Shravanth, Chief Digital Officer & Chief Marketing Officer, Cloudnine Group of Hospitals says.

“With several vendors providing various solutions, you get a more precise defense against the security threats targeting Big Data applications.

Healthcare organizations store, maintain and transmit huge amounts of data to support the delivery of efficient and proper care. Nevertheless, securing these data has been a daunting requirement for decades,” Shravanth adds.

In an attempt to improve the quality, service efficiency, costs of healthcare and reduce medical errors, providers are today leveraging latest digital technology like EHRs, EMRs, personal health record (PHR), medical practice management software (MPM), and many other healthcare data components.

Though these digital technologies have enabled patients to avail best personalised care and services, these tools also put them at risk. This is due to the fact that large amount of data is exchanged at various levels and aggregators hardly have robust mechanism in place to make data safe & secured.

Experts are groping in the dark to insulate IT systems in order to prevent the disclosure of personally identifiable and critical information of every individual. Cybersecurity holds huge significance in this context.

“Differently, hospital should evaluate the application like HIMS, EMR and APPs to run their business as mandatory feature of data security and safety during sharing the patient information internally and externally,” Saleem adds.

RECENT LEAK OF DATA SPEAKS VOLUMES ABOUT GRAVITY OF ISSUE German security firm Greenbone Networks recently revealed that nearly one million medical files and 107 million related medical images of Indian patients were freely

accessible on the internet. This comprises details such as patient name, date of birth and ID, name of the medical institution, ailment, physician names and other sensitive details. Among the leaked data were medical records belonging to two of the Mumbai’s renowned healthcare facilities--Breach Candy Hospital and Utkarsh Scans, a medical imaging provider, the firm found during the investigation. It‘s being said that security protocol to be followed in securing servers storing images had not been followed.

Another incident of 2019 gives inkling that India needs to protect healthcare data in urgent basis. In last year, a US-based cybersecurity firm said hackers stole 68 lakh records of patient and doctor information from a leading India-based healthcare website. Cyber criminals from China were suspected to be behind the data thief.

WHAT KIND OF DATA ISSUES WHICH CONCERN INDUSTRY PEOPLE? On the basis issues cropping up from last some years one can conclude that data privacy and security comprises data theft, unauthorised access, improper disposal of data, data loss, and hacking kind of incidents.

MOBILE HEALTH DEVICES Mobile health devices facilitate collaborative care system between doctors and patients. While at one point doctors enjoy viewing patients’ information and receive clinical information via mobile apps, people are getting more and more access to data, risking security.

CYBER ATTACKS Cyber thieves try to steal information

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COVER STORY

all technology providers before they sell their solutions, and periodic audits both internally and externally to verify if the standards are implemented or not, are key to protect data.

“While some security measures can guarantee that no data security breaches will affect you, implementing multiple layers of personal data security protections substantially reduces the likelihood that your data will be compromised,” Saleem says.

related with billing and insurance records. Their objective is to find out crucial information like security numbers, credit card info, etc., that can prove beneficial to them in monetary terms.

MEDICAL IDENTITY THEFT Healthcare providers need to secure access to all their clinical applications since there have been cases of medical theft identity. Hackers used patients’ data to initiate their access into the information and get going with their way to more.

CLOUD COMPUTING Cloud computing is used widely in the healthcare industry and it has its own set of security issues. Data suggests around 10 percent cloud services used in healthcare fall into category of high risk while 70 percent into medium risk category.

MISTAKING COMPLIANCES Often people mistake a compliant organization for a secure one.

However, more than often, compliances turn out to be a more risky affair. It gives rise to external threats to critical information.

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GOVERNMENT CAME WITH DRAFT PROPOSAL--‘DISHA’ IN 2018 At present, the healthcare sector lacks a single, comprehensive law and procedures that can regulate the collection and use of critical information of patients. In April 2018, the government came out with a draft proposal Digital lnformation Security in Healthcare Act (DISHA), inviting comments from public.

In the draft, the government had proposed to set up a nodal body called the “National Digital Health Authority” through an Act of Parliament that will not only secure electronic health data but also regulate storage and exchange of electronic health records.

WHAT COULD BE DONE TO PROTECT DATA? In the wake of huge risk of data theft, stakes are high on providers to take measures to insulate the system from hackers. As per Dr Naresh Yallapragada, CIO, KIMS Hospitals, measures like incentives to the stakeholders on achieving the implementation of standards, awareness sessions to all the stakeholders about the importance of data security, certifications for

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“We should dedicate at least one-person full time to lead the information security program, and prioritize that role so that he or she has sufficient authority, status and independence to be effective.

Furthermore, updates on our organization’s strategic cyber risk profile to check whether adequate measures are dynamically being taken to mitigate the constantly evolving cyber risk,” Pramanik adds.

Reddy holds the view that we can secure EHR data with secured ways of communication with HL7 protocols/encrypting and security protocols to access data.

“While all efforts are in progress by the Government through the National Digital Health Blueprint (NDHB) and the private players supporting it in laying out a framework in which Healthcare in the future can be delivered in India, it is imperative that all the necessary stakeholders arrive at a consensus in making these efforts mandatory so that Healthcare can be delivered in a more efficient, effective and secure way. Regulations such as HIPAA by the US, GDPR by Europe talk extensively on such issues and every player within this space needs to abide by these guidelines for their existence,” Yallapragada says.

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TECHNOLOGY PERSPECTIVE

‘Data Privacy Key for Seamless Patient Experience’ Data security seems to be a big challenge to providers who have been leveraging digital technology, mobile applications and various automated processes to enhance care. Understanding the threat looming large, Industry is taking many measures including application security and network security, writes K K Singh, CIO, Nayati Healthcare & Research Ltd, for Elets News Network (ENN).

T

heft, data loss, hacking, and unauthorized account access are ways in which healthcare data breaches happen. It includes either the personal health information of any individual’s electronic health record or medical billing information from their health insurance.

Nowadays, every second day hospitals are in the news as victim of a data breach. In the era of digital technology with extensive use of mobile apps, various automated processes & patient portals, data security & data privacy have became critical.

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Protected Health Information (PHI) is recommended to reduce data breaches caused by employee error due to lost device or accidental disclosure.

The healthcare delivery system has witnessed tremendous change in the past few years. As the healthcare industry evolves courtesy latest technology and legislation, the security threat to our most personal data is also changing.

HERE ARE FIVE OF THE BIGGEST HEALTHCARE DATA SECURITY CHALLENGES IN THE DIGITAL AGE:

Proper application security and network security are key to shield data and compromise being happening in the first place.

Encryption is the best way to protect your patients’ data from being accessed by anyone who finds his way into the systems.

1.

Electronic Health Records: Lack of enforcement of law, a reluctant approach from the technology providers as well as care providers are some of the serious challenges for implantation of appropriate solution to prevent data theft.

It is important that encryption is implemented both at rest and in transit. In addition, the third parties and vendors who have access to your healthcare network or databases must handle patient data in proper manner. Training on proper usage and handling of

2.

User error in technology adoption: Another healthcare data security hazard of electronic health record is simple patient user error. If you store your data in unencrypted folders or send your medical records to someone via email,

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K K Singh CIO, Nayati Healthcare & Research Ltd

you pave a simple pathway for a hacker to access your most personal data.

3.

Rise of Hacktivism: Nothing is sacred in the realm of data theft. Increase in the hacking in healthcare shows just how vulnerable healthcare data security can be to a group of determined hackers.

4. Adoption of cloud and mobile technology without proper security measures: Adoption of cloud in healthcare seems to be the future and providers are all set to leverage it to

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bolster care delivery system.

At the same time, hackers are also working overtime to break the security layers. Lack of knowledge to implement right security solution is one the major challenges.

5.

Outmoded technology in hospitals: Running a hospital is costly affair, and when you’re prioritizing the latest equipment technology or increasing staff to meet growing needs, sometimes IT budget can fall by the wayside. End-of-life software and infrastructure provide a healthcare data security risk.

FOLLOWING TECHNICAL MEASURES CAN PREVENT DATA THEFT.

TRAINING ON PROPER USAGE AND HANDLING OF PROTECTED HEALTH INFORMATION (PHI) IS RECOMMENDED TO REDUCE DATA BREACHES CAUSED

BY EMPLOYEE ERROR DUE TO LOST DEVICE OR ACCIDENTAL DISCLOSURE.

1. Infrastructure Security:  Secure Socket Layer (SSL) for Data on Transit with SSL certificates maintained and validated on a regular basis  Filesystem or Database Encryption for Data at Rest  Identity & Access Management using LDAP or similar Login and JWT Tokens  Web Application Firewall & Shield for malicious attacks and DDoS  Access controlled using Bucket Policy  Patch Management Process implemented for regular Security scanning of container images on ECR repository.

2.

Application Security on the Platform  Backend application and Databases should reside on a secured network  User permission boundaries should be maintained using IAM Roles

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 User Authentication (LDAP), JWT tokens, and Role-based Authorization  User Access Governance process should be defined and documented for a web application 3. Data Security & Privacy for the Patients  Data Security using Server-side Encryption databases should be implemented  Data Privacy for Sensitive Personal Information (SPI) and Personal Identification Info (PII) data should be encrypted, such as Auth Token, Email ID, Phone No., DOB, KYC documents, Patient Health info or records, etc.  Key generation and management using Key Management Service (KMS)

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INDUSTRY HIGHLIGHTS

Latest Developments in Healthcare Paradigm INDIA’S EHEALTH SECTOR TO TOUCH $16 BN MARK BY 2025: REPORT India’s eHealth sector is projected to grow at a compound annual rate of 68 percent from $12 billion to $16 billion by 2025, a recent report released by RedSeer Consulting stated. As per the report, rise in receptiveness from consumers, healthcare providers and suppliers towards such models, and increase in investments and supporting regulations will be the drivers of the growth. It is likely to cater 57 million households by 2025.

ASSISTED REPRODUCTIVE TECHNOLOGY (REGULATION) BILL GETS CABINET NOD The Assisted Reproductive Technology (Regulation) Bill proposing the formation of a national registration authority for all healthcare facilities working in the field got the Union Cabinet nod on February 19. Further, the bill includes provisions for penalising those involved in practising sex determination and selling human embryos. An official statement said, the national registry will form a set of guidelines for the healthcare facilities and their employees to follow.

IRDAI PLANS TO CHARGES

REGULARIZE

RISING

HOSPITAL

Insurance Regulatory and Development Authority of India (IRDAI) is toying with the idea to regularize charges for some of the medical procedures. TL Alamelu, an IRDAI member said, the regulatory body is planning to introduce a system where people can choose their third-party administrator (TPA). Also, the company is planning to setup a health insurance forum for settling claims.

UP GOVT TO TURN 16 DISTRICT HOSPITALS INTO MEDICAL COLLEGE SOON The Government of Uttar Pradesh is planning to establish at least one medical college in every district in the state. The Government has identified 16 district hospitals to convert them into medical colleges through Public Private Partnership (PPP) mode. The government will send the proposal to Medical Council of India for relevant permissions.

This is to boost healthcare infrastructure and human resources to improve delivery of healthcare services in the state.

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JAWED ZIA QUITS ABOTT, AMBATI VENU TO TAKE OVER Jawed Zia, who took Abott India to greater heights, quits as the Vice President of Abott India, the second largest drug maker in the country. Ambati Venu, the present General Manager of the company will succeed him. Venu will take charge as the company’s Vice President from March 1, 2020.

GSK RECALLS RANITIDINE POST USFDA INVESTIGATION Due to voluntary recall of popular heartburn medicines like ranitidine in India, GSK Pharma decided to sell its state-of-theart tablet facility situated in Vemagal, Karnataka.

The decision resulted in a financial impairment of Rs 640 crore.

GSK recalled the medicines post investigations conducted by USFDA which raised a global alarm about ranitidine carrying carcinogenic substance.

GOVT EFFORTS REDUCE QUANTITY OF IMPORTED RAW MATERIALS FOR ANTIBIOTICS The Lok Sabha was informed on February 11 about reduction of quantity of raw materials imported for formulating antibiotics to 11,230.50 metric tonnes (MT) in 2019. The slump was due to steps taken by the government to promote indigenous production of the raw materials.

As per the port offices of the Central Drugs Standard Control Organisation (CDSCO), it stood at 12,006.11 MT in 2018 and 5,591.44 MT in 2017, Minister of Chemicals & Fertilizers said in the House.

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INDUSTRY HIGHLIGHTS

DRL TAKES OVER WOCKHARDT’S BUSINESS FOR RS 1,850 CRORE Dr Reddy’s Laboratories (DRL) took over a majority of Wockhardt’s domestic formulations business for Rs 1,850 crore. As per the deal, a portfolio of 62 brands in multiple therapy areas including respiratory, neurology, VMS, dermatology, gastroenterology, pain and vaccines would be transferred to DRL along with manufacturing facilities in Himachal Pradesh. Post this, DRL is set to become the 11th largest pharmaceutical company in the Rs 14 lakh crore India market.

USFDA SENDS EIR POST AUDITING CADILA HEALTHCARE’S AHMEDABAD FACILITY A US health regulator, United States Food and Drug Administration (USFDA) has sent an establishment inspection report (EIR) to Cadila Healthcare, a pharma company, post inspection of its Ahmedabad facility on February 10. Cadila Healthcare while filing the audit report to the BSE said that the audit report signified successful closure.

IN FY 2019-20, FDI IN DRUGS & PHARMA ROSE TO RS 2,065 CR Mansukh Mandaviya, Minister of State for Shipping and Chemicals and Fertilizers, while addressing a question in Rajya Sabha informed the Parliament that total foreign direct investment (FDI) in the drugs and pharmaceutical sector in India rose to Rs 2,065 crore during fiscal year 2019-20. Further, he said that in 2018-19, FDI was at Rs 1,842 crore, followed by Rs 6,502 crore, Rs 5,723 crore, Rs 4,975 crore, and Rs 9,052 crore in 2017-18, 2016-17, 2015-16, and 2014-15 respectively.

DORELLE KULKARNI BECOMES NEW SENIOR VICE PRESIDENT OF PUBLICIS HEALTH Dorelle Kulkarni, a senior health and communications expert joins Publicis Health, a healthcare unit from Publicis Worldwide, India as the Senior Vice President. Kulkarni now leads a team of dedicated healthcare specialists while also manages the growth, strategy and communications output for the agency. She has 24 years of experience in advertising, marketing, communication and sales and had previously held senior leadership roles across various agencies and healthcare set-ups.

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OPPI APPOINTS KG ANANTHAKRISHNAN AS ITS NEW DG KG Ananthakrishnan has been appointed as the Director General of Organisation of Pharmaceutical Producers of India (OPPI).

Ananthakrishnan was former Vice President and Managing Director, South Asia Region, MSD India. He is also on the Advisory Board of various institutions and will continue to mentor healthcare startups.

AIIMS MANGALAGIRI PARTNERS WITH IIT MADRAS FOR AFFORDABLE E-HEALTH SOLUTIONS In a bid to develop affordable digital health-based solutions, the All India Institute of Medical Sciences (AIIMS) in Mangalagiri, Andhra Pradesh and the Indian Institute of Technology (IIT) Madras, Chennai have joined hands. IIT’s artificial intelligence, robotics and health economics courses align well with AIIMS’ goal of creating happy communities through healthcare transformations, said Dr TS Ravikumar, President AIIMS Mangalagiri, who signed the MoU with Professor Bhaskar Ramamurthy, Director, IIT Madras.

INNOVACCER RECEIVES INVESTMENTS WORTH $70 MILLION IN SERIES C FUNDING A healthtech startup Innovaccer recently raised $70 million series C funding from different investors Steadview Capital, Tiger Global, Dragoneer, Westbridge, Mubadala, and Microsoft’s Venture Fund M12. Innovaccer, founded in 2014, is a health tech company that uses artificial intelligence and data analytics to assist healthcare providers in delivering enhanced patientcentred care. With its Data Activation Platform, the company helped it clients to compile 3.8 million patient records saving over $400 million.raised a global alarm about ranitidine carrying carcinogenic substance.

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INDUSTRY HIGHLIGHTS

GURGAON GETS NEW HEALTHCARE INCUBATION CENTRE BY SYNC. WORK With an aim to provide a co-working environment to the healthcare community, pharma companies and young startups in healthcare domain, Synq.work launched its first healthcare incubation centre in in Gurgaon. The coworking space is spread across two floors in an area of 55000 sqft. Presently, it is offering 820 seats. The facility has space for meeting rooms equipped with digital aid, private cabins, high speed internet, and community areas.

BR SHETTY, FOUNDER NMC HEALTH RESIGNS AMIDST CRISIS The middle-eastern hospital operator, NMC Health Plc said that Bavaguthu Raghuram Shetty, the founder of the healthcare chain, resigned amidst investor concern. He faced a margin call and misrepresented his stake. It happened post Carson Block’s Muddy Waters Capital claimed its understating debt and overstating cash.

NMC lost four of its board members since then including Khaleefa Butti, Vice Chairman. Butti’s holdings are being probed.

HEMPSTREET RAISES $1 MILLION IN PRESERIES A FUNDING A Singapore based media house TechInAsia reported that ‘Hempstreet’ has raised $1 million in pre-series A funding. Hempstreet is a healthcare startup that focus on Ayurvedic applications of Cannabis. The startup is India’s first research-to-retail venture in the ayurvedic cannabis sector and looks forward to collaborating with scientists from the Council of Scientific and Industrial Research for their future ventures.

ABRARALI DALAL BECOMES NEW COO OF SAHYADARI HOSPITALS Sahyadari Hospitals, one of the largest healthcare chains in Maharashtra welcomes Abrarali Dalal as its new Chief Operating Officer (COO). Dalal has a rich experience in healthcare and telecom industry. Earlier, he played a crucial role being the COO of Rainbow Children’s Hospitals in building North India’s first private children’s hospital. He has also worked as Facility Director at Fortis Healthcare in New Delhi.

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EXPERTS’ VIEWPOINT ON CORONAVIRUS

Preventing the Spread of Coronavirus From Contaminated Medical Devices

H

ighly contagious novel Coronavirus first reported in China’s Wuhan city has sent shockwaves worldwide with scientists working on vaccines to contain the virus. It has caused death of 1,383 people across the globe and infected more than 64,000. The virus which has been officially named Covid-19 by the World Health Organization primarily targets the respiratory tract of mammals and humans.

As suspected and confirmed cases grow in China and around the world, healthcare professionals globally are reviewing their risk management programmes to ensure readiness for a potentiallyserious, rapid contagion.

Experts Ryan Lewis, M.D., Senior Director of Medical Affairs and Medical Safety, and Jeremy Yarwood, Vice President of Research and Development at Advanced Sterilization Products explain about the risk of Coronavirus contamination through contact with medical devices and how to prevent the spread of this disease to patients and healthcare staff.

Q

CAN YOU TELL US A LITTLE ABOUT WHAT IS CORONAVIRUS AND SPECIFICALLY THE 2019 NOVEL CORONAVIRUS WE’RE SEEING IN THE NEWS TODAY? The novel coronavirus (2019-nCoV) was first identified in Wuhan China

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Ryan Lewis

Jeremy Yarwood

M.D., Senior Director Medical Affairs and Medical Safety

Vice President, Research and Development, Advanced Sterilization Products

in mid-December of 2019. 2019nCoV is believed to have come from animals in a market located in Wuhan city and transferred to humans. The coronavirus has spread widely from person to person in China and now to other parts of the globe as well.

ON MEDICAL EQUIPMENT USED IN THE DIAGNOSIS OR TREATMENT OF CORONAVIRUS?

The WHO declared the 2019nCoV outbreak a global emergency due to the number of countries outside China with infected individuals. Foreign governmental organizations including the CDC are now aiding China in containing the outbreak and diagnosing patients under investigation.

Q

WE’RE HEARING A LOT ABOUT HOW CORONAVIRUS SPREADS PERSON-TO-PERSON. IS THERE CONCERN AMONG HEALTHCARE PROFESSIONALS ABOUT CORONAVIRUS CONTAMINATION

ehealthmagazine

@ehealthonline

News coming from China indicates that healthcare workers are taking precautions to prevent the inadvertent spread of coronavirus in the healthcare setting. Early in the outbreak multiple healthcare workers were infected with coronavirus before the mechanism of spreading was well understood.

Now Chinese healthcare workers are urged to follow infection prevention precautions such as the use of gloves, gowns, respiratory protection and eye protection.

In the course of care, medical devices and instruments will come into contact with patients infected with coronavirus. To prevent patient-to-patient transfer of the coronavirus, reusable medical devices must be sterilized or

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EXPERTS’ VIEWPOINT ON CORONAVIRUS

thoroughly uses.

disinfected

between

Q

WHAT ARE THE SPECIFIC MEDICAL DEVICE TYPES THAT ARE MOST AT RISK TO CORONAVIRUS CONTAMINATION AND WHY? Devices such as bronchoscopes, ENT flexible endoscopes and laryngoscopes are used for the diagnosis and treatment of patients with advanced coronavirus infections. These devices are reusable and must be disinfected or sterilized between uses. A high number of patients needing advanced care for coronavirus could result in a single device being used multiple times a day.

Medical devices used at the bedside such as blood pressure cuffs, thermometers, monitoring equipment and ventilators will also need to be disinfected or sterilized according to the manufacturers’ recommendations.

Q

WHAT KIND OF PATIENTS ARE LIKELY TO COME INTO CONTACT WITH THESE KINDS OF MEDICAL DEVICES?

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Patients who are showing symptoms or who have been in close contact with a confirmed case of coronavirus are termed Patients Under Investigation (PUI). Any patient who begins to show symptoms such as cough, fever, shortness of breath may need advanced care involving the use of items such as bronchoscopes, ENT flexible endoscopes and laryngoscopes.

Q

ARE THERE SPECIFIC TYPES OF HEALTHCARE PROFESSIONALS WHO ARE MOST LIKELY TO COME INTO CONTACT WITH THESE KINDS OF MEDICAL DEVICES? Any clinician using or handling the device for patient care, as well as anyone involved in transporting or reprocessing the contaminated device—particularly in Sterile/ Central Processing.

Q

HOW DO HEALTHCARE FACILITIES PROTECT THEIR WORKERS AND PATIENTS FROM THE SPREAD OF CORONAVIRUS THROUGH CONTACT WITH MEDICAL DEVICES?

ANY PATIENT WHO BEGINS TO SHOW SYMPTOMS SUCH AS COUGH, FEVER, SHORTNESS OF BREATH MAY NEED ADVANCED CARE INVOLVING THE USE OF ITEMS SUCH AS BRONCHOSCOPES, ENT FLEXIBLE ENDOSCOPES AND LARYNGOSCOPES.

Generally speaking, anyone coming into contact with these devices should be wearing PPE (personal protective equipment), including gloves, gowns, masks and face shields.

Q

HOW DO YOU KNOW THAT ASP PRODUCTS INCLUDING STERRAD®

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EXPERTS’ VIEWPOINT ON CORONAVIRUS

SYSTEMS, CIDEX® OPA, EVOTECH® ECR AND ASP AEROFLEXTM AER PROTECT PATIENTS AND HEALTHCARE PROFESSIONALS FROM CORONAVIRUS CONTAMINATION? All sterilization systems and disinfectant solutions that ASP provides have been tested against enveloped viruses, the family of viruses that includes coronavirus.

Furthermore, some of our products, including CIDEX® OPA, have been directly tested against coronavirus, and have been demonstrated to be efficacious.

Q

CAN YOU EXPLAIN HOW MEDICAL EQUIPMENT IS PROCESSED IN ASP SYSTEMS? For STERRAD® (Terminal Sterilization) Systems, devices are generally cleaned and decontaminated with appropriate detergents, either manually or in automated washer/disinfector systems, prior to being placed into the STERRAD® System for sterilization.

For EVOTECH® ECR and ASP AEROFLEXTM AER, devices are generally manually cleaned with detergents and then placed into the system for further cleaning and disinfection. In the case of CIDEX® OPA for manual use/soaking, generally users would clean the device first with an enzymatic detergent and then fill and soak in a basin with the OPA for the recommended contact times.

Q

WHAT IS THE IMPORTANCE OF THE NEW STERRAD VELOCITY® BIOLOGICAL INDICATOR/PCD SYSTEM AS IT RELATES TO THE CORONAVIRUS SITUATION IN CHINA TODAY?

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ASP IS ACTIVELY WORKING WITH REGULATORS AND HEALTHCARE PROVIDERS ACROSS THE WORLD AND SPECIFICALLY IN CHINA TO PROVIDE PRODUCTS THAT CAN AID IN REDUCING OR PREVENTING THE SPREAD OF INFECTION.

The new STERRAD VELOCITY® Biological Indicator and Process Challenge Device allows users to confirm sterility assurance in just 15 minutes. This rapid confirmation allows for faster release of devices that have been sterilized in STERRAD® Sterilizers with the peace of mind of knowing that sterility assurance was confirmed.

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Q

ARE YOU OR YOUR COMPANY OFFERING ANY ASSISTANCE OR GUIDANCE TO HEALTHCARE OFFICIALS IN CHINA WHO ARE DEALING WITH THIS CONTAGION? IF SO, CAN YOU TELL US MORE ABOUT THOSE EFFORTS? ASP is actively working with regulators and healthcare providers across the world and specifically in China to provide products that can aid in reducing or preventing the spread of infection.

Q

WHAT SHOULD HEALTHCARE FACILITIES OUTSIDE OF CHINA BE DOING RIGHT NOW IF THEY’RE CONCERNED ABOUT RISK MANAGEMENT FOR POTENTIAL FUTURE OUTBREAKS OF RAPID-SPREAD DISEASES LIKE CORONAVIRUS? We encourage all healthcare facilities to follow recommendations from local government and health standard organizations such as the CDC and the World Health organization.

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POLICYMAKER’S PERSPECTIVE

AIIMS — Adopting Several Reforms to Bring Quantum Leap in Patient Care All India Institute of Medical Science (AIIMS), Delhi, one of the premier medical institutes across country, has come of age delivering accessible and quality services to masses. With new OPD block, several reforms, and optimizing various processes, and the Institute is set to transform delivery of healthcare services, says Subhsish Panda, Deputy Director, AIIMS, in conversation with Nisha Samant & Mukul Kumar Mishra of Elets news Network (ENN).

Q

SINCE 2028, WHEN YOU TOOK REINS AS DEPUTY DIRECTOR (ADMIN), WHAT STEPS HAVE BEEN UNDERTAKEN TO BOOST THE DELIVERY OF CARE AT AIIMS, ONE OF THE BEST HOSPITALS ACROSS THE COUNTRY? As a team, we have tried to improve the performance levels of our administrative machinery by promoting an atmosphere of trust and confidence in the Institute which has a trinity mission of medical education, research and patient care. Appropriate attention was paid to all the three pillars.

While multiple ongoing projects were given a boost to ensure early completion, maintenance and upgradation of existing facilities was also given due attention. The National Cancer Institute (NCI) India’s largest investment by the Government in a single hospital project - has been dedicated to the Nation by the Prime Minister on 12th February 2019.

A lot of efforts went into channelizing all Institutional resources to ensure its timely commissioning - be it fast

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tracking recruitments/promotions or statutory approvals and coordination with various agencies, etc. - the entire team at AIIMS worked in a mission mode to achieve the target.

Over 25,000 patients visited NCI in 2019 and the waiting list of related procedures, have come down at AIIMS, New Delhi as well. We have also expedited the pace of other ongoing hospital infrastructure projects and we are hopeful that they will all be commissioned shortly.

Subhsish Panda Deputy Director, AIIMS, Delhi

The new OPD in Masjid Moth Campus is set to be functional from February, 2020. It will be a major convenience for more than 8,000 patients that visit the AIIMS OPD every day. With the approval of the Union Cabinet, AIIMS, New Delhi has also initiated the process to prepare a master plan in order to redevelop its various facilities, converting the Institute into a world-class medical university.

Apart from these, many administrative reforms have also been put in place in line with the policies of the Government.

The online registration system for appointments was suitably tuned to allow 50 percent of the appointments as walk-ins. We have embraced digitalization and various eModules like e-APAR, LMS, etc. have already been introduced and many more are in the pipeline.

This initiative of AIIMS will set the pace for its next major transformation in the coming decade.

AIIMS has consistently won the 1st price in the Kayakalp Awards and specific instructions have been given to all departments to ensure

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POLICYMAKER’S PERSPECTIVE

focus on cleanliness and aesthetics.

The premier medical institute has also collaborated nationally as well as globally to promote innovation and research. A special focus has been on innovation and on integration with traditional systems of medicine wherever possible. AIIMS Delhi has also been mentoring and coordinating the development of the new AIIMS that have come up in different parts of the country.

fully-automated smart diagnostic lab is being established there. This lab - the largest of its kind in India - will have a capacity of performing over 270 types of blood tests and up to 2 lakh tests per day. This lab will be capable of handling 25,000 patients per day and will result in approx. 44 percent reduction in turnaround time with blood test results being available within 90 minutes. The new block is set to roll out services from February, 2020.

Q

Q

TELL US SOME DETAILS ABOUT SOON TO BE STARTED NEW OPD BLOCK WHICH WILL PROVE TO BE A BIG RELIEF IN THE WAKE OF HUGE INFLUX OF PATIENTS AND THEIR NEAR ONES. The new OPD Block at AIIMS, New Delhi is a mega out-patient consultation facility having over 70,000 Sqft of built-up area spread over G+8 floors.

It will be a quantum leap in the available out-patient facilities at AIIMS with over 250 consultation rooms. In addition, it will have the capacity to handle over 10, 000 patients a day. A state-of-the-art

THERE IS ALSO A PLAN TO START THREE NEW BLOCKS INCLUDING SURGICAL, BURNS AND MOTHER & CHILD. SHED LIGHT ON THE SAME. The Burns & Plastic Surgery, Surgical Block as also a New Paid Ward are at an advanced stage of completion and are likely to be commissioned in the first half of 2020. Mother & Child Block is in the last lap of completion and shall be commissioned soon. A National Centre for Ageing is also under construction and shall be commissioned by the beginning of 2021. These blocks are an attempt to enhance capacity to meet

THE BIGGEST CHALLENGES THAT HEALTHCARE SYSTEMS GLOBALLY FACE IS ENSURING PHYSICAL AND FINANCIAL ACCESS TO QUALITY HEALTHCARE. THE RELATED ISSUES WHICH INFLUENCE THE SAME ARE AVAILABILITY OF APPROPRIATELY AND OPTIMALLY SKILLED MANPOWER AND INFRASTRUCTURE.

the needs of the ever increasing patient load at AIIMS, New Delhi and will help shorten the waiting list in these departments.

Q

BEDS STRENGTH, REQUIRED NUMBER OF DOCTORS AND SKILLED MANPOWER ARE SOME OF THE GLARING ISSUES OF THE INDIAN HEALTHCARE SYSTEM...HOW DO YOU READ THE STATEMENTS IN THE CONTEXT OF AIIMS? Bed strength, required number of doctors and skilled manpower are all interlinked issues that need to be addressed systemically and parallelly based on quantifiable data. The Government of India has always focussed on these issues.

It has taken a slew of measures including sanctioning new AIIMS & upgrading existing Medical

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POLICYMAKER’S PERSPECTIVE

Colleges under the PMSSY scheme, relaxing norms for opening of medical colleges and focus on skill development among others.

The impact of these reforms is beginning to be seen and will be more evident in the coming decade.

However, we need to keep in mind that the quality of healthcare delivery has to be maintained and constantly upgraded. A long term reforms need time to show their impact. AIIMS, ND is contributing towards this effort of the Government not only at the Institute level by providing high quality medical education, research and patient care, but is also providing expert inputs and mentorship for establishment of the new AIIMS and in the upgradation of other medical Institutions in the country.

Q

WHAT ARE THE BIGGEST CHALLENGES IN THE OVERALL SERVICE DELIVERY OF PUBLIC HEALTHCARE SYSTEM AND WAYS OUT? The

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biggest

MARCH 2020

challenges

that

THE GOVERNMENT HAS TAKEN A SLEW OF MEASURES INCLUDING SANCTIONING NEW AIIMS & UPGRADING EXISTING MEDICAL COLLEGES UNDER THE PMSSY SCHEME, RELAXING NORMS FOR OPENING OF MEDICAL COLLEGES AND FOCUS ON SKILL DEVELOPMENT TO RAMP UP SKILLED WORKFORCE.

healthcare systems globally face is ensuring physical and financial access to quality healthcare. The

related issues which influence the same are availability of appropriately and optimally skilled manpower and infrastructure.

Healthcare policies and systems borne out of them are equally important. Globally, we see different models of healthcare systems with and without State funding. Over the last 70 odd years, India as a welfare state has developed its healthcare systems with right blend of innovation and upgraded technology. The recent policies of programmatic approach towards health issues and patient support through the PM-JAY are game changers. Ayushman Bharat scheme has come as a muchwanted relief for the poor patients who neither had physical access nor the financial ability to meet their healthcare needs. As the system stabilizes and expands, the out-of-pocket expenses of the common citizen of India are going to drastically reduce and shall prove to be a major relief. AIIMS, New Delhi was first off the block in implementing the scheme and we are happy with the impact the Scheme has been able to make in the lives of the people.

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INDUSTRY PERSPECTIVE

‘Enabling Hospitals to Unleash Full Potential of Caregiving’ DayToDay is a care management company that provides platform to clinicians to extend their reach beyond hospital walls and deliver world-class care to patients in the comfort of their homes, says Prem Sharma, CEO & Founder, DayToDay, in conversation with Gopi Krishna Arora and Mukul Kumar Mishra of Elets News Network (ENN).

Q

DAYTODAY OFFERS AN INNOVATIVE PLATFORM TO ADDRESS KEY CHALLENGES ENGULFING THE CARE DELIVERY SYSTEM, TELL US MORE ABOUT ITS VISION AND MISSION. DayToDay’s mission is to become the gold standard in patientcentered care.

The majority of care journeys start at the hospital but reach far beyond the walls of the hospital.

The decision to undergo a medical procedure is a difficult one, and many patients are underprepared for the journey they are about to embark upon. For example, a patient undergoes an acute surgery like cardiac bypass or a Total Knee Replacement. At the point of discharge, the patient is given going home instructions. Research shows patients only remember 20% of the instructions and forget 80% ; forgetting critical elements of care prolongs the recovery or worst case adds complication or requires readmission.

Patients are often inadequately supported in the preparation and recovery phases that determine the quality of their treatment outcomes.

DayToDay

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MARCH 2020

equips

hospitals

to unleash the full potential of caregiving, in and out of the hospital, in order to transform patients’ lives.

Q

HOW DOES IT HELP HOSPITALS TO DELIVER WORLD-CLASS CARE TO PATIENTS IN THE COMFORT OF THEIR HOMES? DayToDay is a care management company that provides a platform to hospitals & clinicians to extend their reach beyond hospital walls and deliver world-class care to patients in the comfort of their homes.

We are customizing the care journey based on clinical pathways, our proprietary knowledge of the procedure along with the surgeon’s (hospital) instruction. Our customised care plans are delivered in the comfort of a patient’s home.

We provide a holistic approach to care ensuring the patient’s mental health is strong enough to help accelerate the recovery.

An educated and comfortable patient is a happy patient, and DayToDay strives to bridge the gap between hospital and home so that when a patient is sent home there is little likelihood of readmission.

Patients using DayToDay will also be prepared with their upcoming

Prem Sharma CEO & Founder, DayToDay

DayToDay PROVIDES STEP-BY-STEP, TAILORED DIGITAL PATHWAYS FOR HOSPITALS TO GUIDE PATIENTS AND CARE GIVERS THROUGH THE ENTIRE CARE JOURNEY.

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INDUSTRY PERSPECTIVE

procedures, assisting hospitals in setting expectations in everything from pre-op expectations to physiotherapy, and everything in between.

Q

DIGITAL TECHNOLOGY IS PLAYING A GREAT ROLE IN BOLSTERING THE CARE DELIVERY SYSTEM TODAY. HOW DO YOU ANALYZE THE STATEMENT IN THE CONTEXT OF THE DAYTODAY PLATFORM? DayToDay’s digital platform provides complete visibility to patients and their clinicians and creates a larger avenue of communication to ensure patients feel heard and taken care of. On the one hand the patients feel at ease that their doctor is a part of their care journey as they have ready access to the DayToDay app, on the other hand doctors find the platform beneficial as it gives them regular updates on the patient’s progress, resulting in positive patient outcomes.

The easier access to information and communication, increases the success rate of a medical procedure!

It provides step-by-step, tailored digital pathways for hospitals to guide patients and care givers through the entire care journey.

From helping patients understand if surgery is the right choice, to the day of surgery, immediate post-op period and the transition to rehabilitation, our care coaches compassionately guide patients through the different stages of their journey and help them to address barriers to care. This process is managed seamlessly with our hospital partners and physicians.

DayToDay’s technology platform is HIPAA & HL7 compliant and able to integrate with a variety of EMR systems.

Q

TELL US ABOUT EXISTING CENTERS IN INDIA. PLEASE UNVEIL YOUR EXPANSION PLAN, AS WELL.

DayToDay’s India office is based in Bengaluru. As a multinational company with headquarters in Boston, USA, DayToDay also has an office in London, UK. DayToDay is dedicated to helping the health systems all over the world address key challenges with care delivery.

Clinicians are being asked to care for more patients within the same amount of time and with even fewer resources every day. They are held as the most responsible for patient outcomes but are often the least supported. This leads to patients and their families feeling helpless as they try to navigate through their increasingly complex episodes of care without proper support. DayToDay will provide the support needed to caregivers, patients and their families, and hospital staff to create lasting and effective care.

Q

HOW DO YOU SUMMARISE KEY OPPORTUNITIES AND CHALLENGES IN THE PARTICULAR SEGMENT YOU DEAL IN? Acute healthcare starts in the hospital, but goes well beyond the walls of the hospital, in most cases. Therefore, there is a need for a Care Management Company like DayToDay to provide the necessary care beyond the hospital and deliver it in partnership with the doctor and the hospital to provide comprehensive and longlasting care. DayToDay’s Care Plans are unique as they are the first-of-its-kind.

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TECHNOLOGY PERSPECTIVE

TeleHealth—Powerful Tool to Achieve Universal Healthcare & Holistic Wellness Telehealth has emerged as a viable tool for healthcare providers to improve accessibility, provide remote care, and helping governments in achieving Universal Healthcare, writes Vikram Thaploo, CEO – TeleHealth, Apollo Hospitals Enterprises Limited, for Elets News Network (ENN).

T

he advent of new age Information Technology has not only revolutionised the field of communication, but has also opened new dimensions in the field of healthcare. Using technology to enable remote populations get better access to doctors might have been unfathomable till a few decades back. However, today Tele Medicine as we call it is a fledgling phenomenon. It allows healthcare practitioners to break the barriers of distance and reach patients sitting even in remote areas using video conferencing tools. The first real use of video communication in medicine can be traced back to the 1950s and 60s when the University of Nebraska established a two-way television set up, which was linked with a state hospital to perform video consultations. In India, Apollo Hospitals Group pioneered the concept of telehealth 20 years back.

On March 24, 2000, Bill Clinton, the then US President, commissioned the world’s first VSAT enabled village hospital at Aragonda in Chittoor District of Andhra Pradesh, marking the formal introduction of telehealth services in India.

Today, telehealth has emerged as a viable tool for healthcare providers and governments to improve accessibility, provide

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remote care, and help them in achieving Universal Healthcare.

According to market research, the global telehealth market is expected to grow to around USD 20 billion by 2026. India’s telehealth market too is growing at a rapid pace as more and more healthcare organisations start looking at telehealth as a workable solution to address geographical disparities in the availability of healthcare services. In fact, NITI Aayog members have also held consultations with stakeholders to analyze the role telehealth can play in making the goal of 1,50,000 health & wellness centres under Ayushman Bharat a functioning reality.

The growth of smartphone ownership and spread of broadband Internet connectivity have been the two most prominent developments that have, in recent years, created a large potential market for teleconsultations.

The market is also buzzing with increasing startup funding. A report by one of the Big 4’s last year stated that if telehealth replaced 30 to 40% of in-person outpatient consultations, India could save up to USD 10 billion and improve care for the poor and those living in remote areas.

Vikram Thaploo CEO – TeleHealth, Apollo Hospitals Enterprises Limited

Let’s take a look at areas where telehealth can play a defining role: BRIDGING THE RURAL-URBAN GAP India’s rural-urban divide in terms of accessibility to healthcare facilities is widely known. Rural areas that are home to over 60% of the population have access to less than 30% of the doctors. In fact, estimates by the National Health Mission (NHM) say that the doctor-patient ratio in rural areas is six times lower than in urban areas. Official figures suggest that there is a whopping 82% shortage of specialists in Community Healthcare Centres (CHCs).

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TECHNOLOGY PERSPECTIVE

Given this huge void, healthcare providers and social entrepreneurs in India have already gauged the potential of telehealth services to grow in under-served areas. The government has also initiated a series of telehealth-based projects to make doctors and consultations easily accessible to people living in rural areas and urban slums. The government’s focus on digital India has imparted a lot of impetus to the adoption of technology-driven healthcare.

increasing number of consultations in rural areas are likely to happen through telehealth.

At Apollo TeleHealth, we have already been partnering with state governments of Andhra Pradesh, Uttar Pradesh, Himachal Pradesh, Jharkhand, among others within the country. In addition, we have also collaborated with countries like Fiji, Malaysia and many others to enable telehealth projects for under-served populations.

Increasing penetration of telehealth services not only enable people in rural areas to depend less on unqualified medical practitioners, but it also saves a lot of people from spending time and money on travelling long distances to seek medical help. Telehealth centres, when made accessible to a large number of under-served people, can help significantly reduce the long queues in government hospitals.

While ASSOCHAM report projects India’s telehealth market to reach $ 32 million by 2020; other reports project the market much above. Over the next 10 years, an

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Even medical emergencies like heart failure, critical accidents, snake bites are being handled effectively by Apollo TeleHealth along with monitoring chronic conditions via connected devices.

ADDRESSING OVERCROWDING AT HOSPITALS BY REPLACING OUT-PATIENT CONSULTATIONS

INCREASING PENETRATION OF TELEHEALTH SERVICES NOT ONLY ENABLE PEOPLE IN RURAL AREAS TO DEPEND LESS ON UNQUALIFIED MEDICAL PRACTITIONERS, BUT IT ALSO SAVES A LOT OF PEOPLE FROM SPENDING TIME AND MONEY ON TRAVELLING LONG DISTANCES TO SEEK MEDICAL HELP.

The report cited above also concluded that telemedicine had

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TECHNOLOGY PERSPECTIVE

the potential to replace half of the in-person outpatient consultations in India, and an accelerated implementation could enable us to tap 60 to 80% of this potential by as early as 2025. Though telemedicine has lots of advantages, it must not be considered as a complete replacement for care by doctors; instead, it must be developed to act as a bridge.

DISEASE SCREENING AND DISEASE PREDICTION With non-communicable diseases (NCDs) emerging as the leading cause of deaths, the need for increasing disease screening has gained much prominence in recent years. Regular screening can help identify diseases such as diabetes, hypertension, heart ailments, and some forms of cancers in the early stages when they can be treated or prevented.

Mass disease screening programmes in western countries have helped successfully reduce mortality rates due to noncommunicable diseases. Telehealth

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MARCH 2020

NITI AAYOG MEMBERS HAVE ALSO HELD CONSULTATIONS WITH STAKEHOLDERS TO ANALYZE THE ROLE TELEHEALTH CAN PLAY IN MAKING THE GOAL OF 1,50,000 HEALTH & WELLNESS CENTRES UNDER AYUSHMAN BHARAT A FUNCTIONING REALITY.

can help India institute wide-scale disease screening programmes through remote monitoring of patients. The health data collected and sent to doctors through electronic means can be studied and interpreted and consultations booked for people needing medical

interventions or advice. Through data analysis of the accumulated data, researchers can also work to develop models to predict disease incidences and outcomes.

HOLISTIC WELLNESS IN THE DIGITAL AGE Reaching out to the under-served consumers in many ways is the primary focus of telehealth services.

However, it is not the only focus.

Enabling easier access to multiple doctor’s opinion and providing holistic wellness advice are another vital components that have gained eminence.

The emergence and success of medical apps indicate that telehealth also offers diverse solutions to healthcare problems of people. Through these applications, patients can have easy access to the best of doctors and wellness experts in different specialties, including alternative medicine experts. This is how mobile health technology is also enabling the creation of an integrated healthcare model for the masses.

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TECHNOLOGY PERSPECTIVE

Smart Hospitals The Future of Healthcare In the light of the healthcare industry facing a sea of challenges pertaining to cost-efficiency, inventory management, cost optimization and shrinking margins, smart hospitals are set to play a pivotal role in transforming delivery of healthcare services, writes P Hari Krishna, Executive Director, Medicover Hospitals.

C

urrently the healthcare industry, particular the hospitals sector globally is under tremendous pressure with the healthcare costs spiralling out of control with global health spend projected to rise by 4.2 percent per year from $7.1 trillion in 2015 to $8.7 trillion by 2020; something that is becoming increasingly unsustainable for most countries.

If healthcare is to remain affordable and widely available for future generations, a critical thinking pertaining to delivery of services and management of processes is crucial. CEO’s/ Hospital administrators are facing numerous challenges such as manpower efficiency, insurance & reimbursements, huge expectation from patients about choice of treatment, data security, inventory management, cost optimization and shrinking margins.

As patients demands keep increasing and margins seeing a downward trend, hospitals are now seeking new ways to enhance the services rendered in a more cost effective way, while keeping the quality and safety at high priority.

In last few years the concept of “smart hospital” is the most talked about and debated topic in

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healthcare forums across the world.

Even though there are no set standard parameters to define the smart hospital, it is up to the user to set goals and match them with newer innovations that can make the processes more effective and efficient in terms of time, money and satisfaction.

Currently, the trend of smart hospital concept is majorly driven

by Information technology (IT) and Artificial Intelligence (AI).

At Medicover hospitals (11 hospitals, 16 Infertility centres across different states in India), the process of automation and intelligent working had seen a sea of changes in the last few years.

From being the only hospital in India to use Microsoft’s Tally software to centralize the billing and audit system, it has leveraged several digital tools like Centralized automated GRN creation for procurement and supply, patient and employee feedback app which saw an increased satisfaction level, and paperless patient treatment & management system to bolster care delivery system.

On the AI front, we are currently testing the most advanced

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P Hari Krishna Executive Director, Medicover Hospitals

programme which can map, track, store and give alerts on employees satisfaction index, attendance and movement restrictions, patient footfall mapping, patient satisfaction index, bio-medical asset and movement mapping through RIFID and AI integration.

The process of automation and AI enabled integrations is not an easy road to climb, as technologies come with a cost. However, with the cost of technology falling sharply, hospitals need to optimise its resources and invest on the required solutions carefully.

In smart hospitals, digitally enabled staff will be able to deliver better outcomes and a more integrated patient experience.

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TECHNOLOGY PERSPECTIVE

‘Optimizing Processes to Ensure Best Patient Outcomes’ Over the years, Aster Prime Hospital has evolved into multi-speciality hospitals with breakthroughs in emergency care, cardiac procedures, and orthopaedics among others. As one of the leading healthcare providers in Hyderabad, patients at Aster Prime Hospital receive advanced diagnosis and treatment for the most acute clinical conditions, says Devanand KT, CEO, Aster Prime Hospital, Hyderabad, in conversation with Mukul Kumar Mishra of Elets news Network (ENN).

Q

WITH THE BEST INFRASTRUCTURE AND EXPERTISE, ASTER PRIME HOSPITAL’S OBJECTIVE IS TO PROVIDE ACCESSIBLE AND QUALITY CARE TO PATIENTS. HOW HAS BEEN THE JOURNEY? The journey has been challenging yet quite satisfying.

Since inception, Aster Prime Hospital has been focusing on providing the best of care through latest technological innovations for diagnosis and treatment of the most acute clinical conditions, highly skilled medical and nursing expertise, round the clock personalized care promoting faster recovery of the patient.

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multi-speciality hospital.

The feather in the cap was the symbiotic association with Aster DM Healthcare in 2015 which leveraged our strengths and helped us in evolving as part of a global conglomerate which operates in nine countries and having more than 325 establishments including 25 hospitals.

Q

TELL US ABOUT ITS MISSION AND VISION.

Being a part of Aster DM Healthcare, we imbibe the mission and vision of the parent organisation which is “A Caring Mission with a Global Vision” with a promise of “We’ll Treat You Well”, a promise that sums up what we do and why we exist. One that we strive to honour every day, every moment.

However, we consider having a team of fabulous clinicians to be our core strength as the soul of clinical care lies with them.

Our team of doctors takes time in having close interaction with the patients and their relatives and makes sure that the entire family is taken into confidence before any treatment is taken up.

Q

This is evident from the fact that our repeat customer percentage is rock steady till date. It has given us the courage to develop from a polyclinic to 204-bed

Over the years, Aster Prime Hospital has evolved into multi-speciality hospitals with

MARCH 2020

WHAT ARE THE HALLMARKS WHICH DEFINE YOUR SERVICES AND DISTINGUISH YOUR HOSPITAL FROM OTHERS IN THE AREA?

Devanand KT CEO, Aster Prime Hospital, Hyderabad

breakthroughs in emergency care, cardiac procedures, orthopaedics and joint replacements, neuro care, diagnostic and interventional services, mother and child and much more.

As one of the leading healthcare providers in Hyderabad, patients at Aster Prime Hospital receive advanced diagnosis and treatment for the most acute clinical conditions.

We are the only tertiary multispeciality hospital situated in the strategic location of Ameerpet at Hyderabad and our focus has always been on patient outcomes and satisfaction. All our internal processes are always targeted

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TECHNOLOGY PERSPECTIVE

towards achieving this feat.

We are an NABH accredited hospital, conducting various paramedical courses other than DNB under the National Board.

We have 80 clinicians, five fully functional OTs, 45 critical care beds, 24 hours emergency services including Trauma and Blood bank with component separation facility. We were the first hospital to perform Transcatheter Aortic Valve Replacement (TAVR) in the entire State of Telangana.

Our hospital is one of the few centres in the country with special expertise in percutaneous laser discectomy. Spine surgery department has good experience in other minimally invasive spine surgeries like Percutaneous endoscopic lumbar discectomy and percutaneous spinal instrumentation.

We truly believe in serving the community and as a part of Aster Volunteers Programme, we have done innumerble medical camps, awareness programmes, BLS training sessions, cleaning drives, health awareness marathons/ walkathons, etc.

Q

ENUMERATE SOME SIGNIFICANT ASPECTS ABOUT THE ‘CENTRE OF EXCELLENCE’ AND ‘WELLNESS PACKAGES’ We have six ‘Centres of excellence’ – Cardiac Sciences, Neurosciences, Orthopaedics, Renal Sciences, Gastro Sciences and Mother & Child.

The wellness solutions include the total “transformation programme” wherein custommade programmes will be devised suiting customers for a total

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transformation with the support of Clinical team from Aster Prime and Wellness Team from Active Life.

Q

WHAT KIND OF FACILITIES DO YOU CATER TO INTERNATIONAL PATIENTS WITH INDIA BEING A HOTSPOT IN MEDICAL TOURISM SEGMENT? Aster Prime Hospital offers comprehensive healthcare packages and treatment options to foreign patients and has a dedicated International Patient relations team who will take care of all aspects – right from planning the package to ensure their treatment period at Aster Prime in comfortable and hasslefree manner.  Facility for tele-medicine / Counselling services before the patient decides to take the treatment where our Doctors interact with patients to give treatment modalities and clear their doubts  A representative of the team receives the guest at Airport (Hyderabadï International Airport).  Transport to Hospital / Hotel as per the admission plan  Helping with a local mobile phone connection after arrival in Hyderabad  Arranging visit/ admission to the hospital  On arrival at the hospital, the patient and bystanders will be taken to the International Waiting Lounge by a member of the International patient assistance team for further formalities like registration, verification of passport and VISA, signing of the consent forms and so on  There is an exclusive floor for International patients  Individual patient attention by

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the Guest Assistants  Guest Relation Executives are given multilingual training to facilitate easy communication with the guests and interpretation services.  Dedicated translator services  International cuisine offered  Free Wi-Fi for an unlimited Internet connection  Sightseeing, and other activities arranged before admission upon request The family of the patient can contact our International Desk through phone/fax/email for medical requirements and concerns, along with investigation reports/referral letters from the referring doctor for the reference of our expert consultants. The International Desk Coordinator will then get in touch with the patient with all details like the proposed treatment plan and cost of treatment. We will also offer travel advice. The most suitable plan can be chosen and confirmed with the Coordinator.

Q

BRIEF US ABOUT EXPANSION PLANS IF ANY IN THE OFFING. DO YOU HAVE COLLABORATION WITH STATE GOVERNMENTS AS WELL? We are soon introducing certain innovative procedures for the first time in Telangana and it will be a little early now to divulge more information on the same.

We are also looking at leveraging the latest technologies including AI to provide the best of care to our patients. We are already in collaboration with the State Government for Arogyasri, Udyogasri, ESI, various other schemes and looking forward to partner with the Government for more schemes and campaigns for the betterment of the society.

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INDUSTRY PERSPECTIVE

‘Personalized Attention is at Core of Our Patient Care Philosophy’ Continental Hospitals is a NABH-JCI accredited multi-speciality quaternary care hospital with a capacity of 750 beds. With the state-of-the-art facilities, advanced medical equipment combined with the latest technology, the hospital ensures utmost comfort and safety to patients, says Dr Rahul Medakkar, CEO, Continental Hospitals, in conversation with Mukul Kumar Mishra of Elets news Network (ENN).

Q

CONTINENTAL HOSPITALS HAS CARVED A NICHE IN HEALTHCARE DELIVERY SPACE THROUGH EFFICIENT CRITICAL CARE TEAM AND STATEOF-THE-ART FACILITIES. TELL US ABOUT ITS MISSION AND VISION. Our vision is to be the global leader in value-based integrated healthcare. We, at Continental Hospitals, believe this can be achieved by taking exemplary care of patients anchored around our people who strive to continuously raise the bar in clinical, operational and service excellence. We value people, excellence and results.

Our following values form the backbone of our existence and daily routine:  Patients first – We put patients’ needs first  Integrity – We do the right thing  Empathy – We listen with our hearts  Teamwork – We are better together  Excellence – We champion continuous improvement and innovation

Q

PINPOINT SOME DISTINCT FACTS ABOUT THE HOSPITAL PERTAINING TO INFRASTRUCTURE AND SERVICES

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WHICH MAKES IT THE LEADING PROVIDER IN THE AREA WHERE PATIENTS AND FAMILY COULD REPOSE FAITH WITHIN. Continental Hospitals is a NABHJCI accredited multi-speciality quaternary care hospital with a capacity of 750 beds. The hospital has state-of-the-art facilities, advanced medical equipment combined with the latest technology. It is designed to deliver utmost patient comfort, safety and avoid cross infections.

The hospital has Great OT, Level 3 Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU). It is known for its Centres of Excellence which constitute emergency medicine, critical care, orthopedics and trauma, neurosciences, oncology, multiorgan transplant and advanced lung diseases.

Our approach to patient care is based on the belief that every individual is unique even if the disease/ symptoms are same.

Clinically and operationally, personalized attention is at core of our patient care philosophy.

Round-the-clock availability of specialist doctors, seamless

Dr Rahul Medakkar CEO, Continental Hospitals

trauma & emergency care, and clinical work at par excellence across all specialities differentiates us for better. Right from inception, the principle of collaborative care is implemented to enable well-coordinated clinical care. No patient is declined the access to vital clinical care due to financial constraints. As far as reposing faith is concerned, we strongly believe that our patient testimonials speak volumes about our up to the mark services.

Q

IN THE AGE OF INTERNET AND APPS, HOW THE HOSPITAL HAS EVOLVED DIGITALLY TO FACILITATE A PLETHORA OF SERVICES?

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INDUSTRY PERSPECTIVE

In this digital age, healthcare consumer is exploring digital route for choosing provider, access to provider, service and extramural engagement.

Continental Hospitals has a very high degree of EMR adaption. Our processes are almost paperless.

We leverage digital technology for various services including appointment, diagnostic reports, patient education, community awareness, and preliminary screening.

Q

QUALITY AND AFFORDABILITY ARE TWO IMPORTANT DETERMINANTS OF PATIENT CARE TODAY. HOW DIFFICULT IS IT TO MAINTAIN A FINE BALANCE BETWEEN THE TWO IN THE LIGHT OF COSTLY EQUIPMENT AND OTHER LOGISTIC EXPENSES? Continental Hospitals is one of the very few hospitals in the world to be accredited by JCI within two years of inception. The compliance to JCI accreditation norms enables unquestionable quality and patient safety outcomes beyond boundaries of cost and affordability.

However, we also face challenges pertaining to changing business environments such as

ROUND-THE-CLOCK AVAILABILITY OF SPECIALIST DOCTORS, SEAMLESS TRAUMA & EMERGENCY CARE, AND CLINICAL WORK AT PAR EXCELLENCE ACROSS ALL SPECIALITIES DIFFERENTIATES US FOR BETTER.

rapidly growing medical inflation, price pressures, lowering margins in drugs, consumables etc.

In this light, we need to be extremely cautious and sensitive to affordability of the target population. Our approach to right sizing cost is through clinical and business process reengineering.

Q

TELL US ABOUT YOUR EXISTING BRANCHES AND FUTURE EXPANSION PLANS. Continental Hospitals is a Gleneagles facility. It is part of IHH Healthcare, one of the largest private healthcare providers in the

world by market capitalization with 80 hospitals across 10 different countries. We are growing along with IHH. Currently, Continental Hospitals is working on inorganic growth through the O&M model. It aims at secondary care hospitals in the target geographic area. The intended value propositions are clinical capability building and improved access to quaternary care to peripheral population.

Q

HOW DO YOU ANALYZSE THE INDIAN HEALTHCARE SYSTEM IN COMPARISON TO SOME OF THE BEST HEALTHCARE DELIVERY MODELS ACROSS THE GLOBE?

Indian healthcare is evolving and learning. There has been significant improvement in availability and access to care in recent years.

However, compared to the mature healthcare systems in world, it still needs to address key issues. These are lack of universal coverage, inequity and accessibility.

Patients face issues due to lack of integrated care among all steps of pyramids i.e. primary to quaternary and prevention to rehabilitation.

Capability building and bridging urban-rural disparity should be top strategic priority for policymakers.

Prevention strategies should be implementation focus for reducing double disease burden (communicable as well as noncommunicable). Synergy building within the healthcare delivery system is a critical success factor.

Quality assurance regulations should evolve further to ensure patient safety and quality.

Mechanisms should be devised to incentivize appropriate ethical medical care and to remain sustainable.

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TECHNOLOGY PERSPECTIVE

Future & Importance of Clinical Analytics Clinical analytics is poised to become an essential tool that makes use of real-time medical data to generate insights, take decisions, predict outcomes, and decrease costs by enabling early interventions for potential clinical complications, writes Abdullah Saleem, Group, CIO, Omni Hospitals for Elets News Network (ENN).

T

he need for clinical analytics is going to increase not only because healthcare organisations gain the ability to uncover more sophisticated analytics, but this is also going to be driven by the steep and rapid increase in available clinical data backed by an imperative to improve clinical outcomes. Clinical analytics is poised to become an essential tool that makes use of real-time medical data to generate insights, take decisions, predict outcomes, and decrease costs by enabling early interventions for potential clinical complications. It will lead to continuous improvement of quality of care, faster development of better treatment protocols and improvement in human health on population scales.

One aspect of this is the increasing use of data enabled, evidence-based solutions across organisations. Patient care is an evolving process and the availability of continuous increasing data sets should produce information that will allow to adopt and enhance patient care. This is true in the provider aspect, where healthcare providers can ensure that they are prescribing the best treatment for patients with certain problems & symptoms, diseases or conditions.

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MARCH 2020

Clinical Analytics will provide better output to examine more population-based data, to compare and contrast treatment plans for the diseases to identify which treatment plan & clinical pathway has the most encouraging outcome as lot of efforts are planned to implement the centralised clinical data repository covering public & private healthcare providers covering primary and secondary care, which could be beneficial for both insurance providers and hospitals.

On the other hand, there is also a concern that the level of clinical analytics, that is necessary, will become little complex. As the field evolves, respondents raised the concern that the items that are appropriate for data analysis today will become mainstream and the healthcare industry will have an appetite for more complex questions that we presently don’t have the software and tools to address with accuracy. One example shared was that it will no longer be a concern that all diabetic patients get two-time hba1c test done per year. The industry will instead be focused on more complex clinical measures.

One of the key factors of clinical

Abdullah Saleem Group, CIO, Omni Hospitals

analytics will be helping individual providers and the hospitals to submit research paper with accuracy of data with reference and evidence Therefore, clinical analytics will be more demanding which could be adding value to the followings areas to hospitals, HCPs and Payers:  Productive R&D  Disease surveillance and preventive management  Development of more effective diagnostic and therapeutic techniques  Clinical trial design to prevent failures and speed up the process of drug research and development  Rapidly identify any adverse effects due to use of a new drug

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TECHNOLOGY PERSPECTIVE

 Improve both provider & patient experience  Prevent crises and reduce morbidity/mortality  Reducing false insurance claims and payments  Continuous care improvement  Improved risk scoring for chronic diseases in population health  Bolstering patient engagement & patient satisfaction  Predicting patient utilisation patterns for optimising resource utilisation  Improve epidemic prediction  Speed up new disease cures  Improved early detection of diseases and their complications CHALLENGES TO CLINICAL ANALYTICS As expected, individuals participating in research have identified several barriers and challenges in their efforts to mine date effectively. One of the most common problems is the format in which the data exists. This manifests itself in several formats.

First, respondents have issues with being able to find and structure data that exists only in a non-standard format, as this requires extensive

data entry and structures to yield a satisfactory format in which the data can be analysed.

Second, just because data is housed electronically into the system doesn’t mean that it is ready for analysis. Several respondents indicated that in some instances, data is captured in a free-form method, such as a text note. As such, the information would need to be structured for data analysis to take place, by using natural language processing technologies.

Another challenge is to ensure “apple-to-apple” comparison of the data analysed. For example, being able to understand when studying an order set where that information begins and where the data ends.

Additionally, it is also important to understand what the clinical context of a data point exists in and how does the clinical context impact the data point. There are also issues with nomenclature and ensuring that data is captured using the same language and medical coding system across the system and other organisations (i.e. data normalisation and semantic interoperability).

CLINICAL ANALYTICS PROVIDES BETTER OUTPUT TO EXAMINE MORE POPULATION-BASED DATA, TO COMPARE AND CONTRAST TREATMENT PLANS TO IDENTIFY WHICH TREATMENT PLAN & CLINICAL PATHWAY HAS THE MOST ENCOURAGING OUTCOME.

Finally, there are concerns related to interoperability that some data elements that are required for data analysis are missing because they were captured in an alternate format that is not streamlined into the main data collection tool. For example, the lab values which might be captured at an off-site that do not seamlessly transfer to the on-line system. Hence, this data must be either manually entered or omitted from the overall analysis which will not give the complete output while analysing the data.

RESOLUTION Availability of cost effective EMR for Asia specific countries excluding Gulf is one of the major issues as cost goes beyond the IT budget/spend allocated. In other words, more than 90% of the hospitals do not allot the budget for their IT spends annually to enable clinical analytics base point EMR/EHR to be implemented.

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TECHNOLOGY PERSPECTIVE

to capture clinical information in discrete data fields and parameters; and the willingness of the healthcare organisation to invest in the analysis of this information, from both the perspective of software and tools, integrated & interoperability.

However, nowadays, there are few EMRs available on transactionbased offering to resolve the budget constraint. On the other hand, there are few world class EMRs available in Open Source community like OSEHRA-Vista, World-Vista etc.

Few Indian IT companies are working to implement them either by offering on IP/OP encounter and episode-based transaction fee or one-time license fee excluding the implementation cost.

Based on the available options, we need to select the right EMR product which could be addressing all the MUST HAVE features clinically by having the capability to run the EMR on any gadgets (gadget independent). The selected product must enable the following user experiences:  Faster than paper e-prescription process that can complete digital prescription in less than manual time taken  Sub-second response times  Minimal training needs  Evidence based clinical content management  Enterprise wide mobile device capable  Excellent data security  Excellent UX design for user ease

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MARCH 2020

CONCLUSION Hospitals and payer organisations, both are key components of the healthcare delivery system.

Respondents from both types of organisations agree that cost, efficiency, effectiveness and safety need to be the guiding principles of healthcare delivery globally.

These organisations have different business models and as such, the key objective of each organisation about the effective use of clinical analytics is somewhat different.

Among the respondents from the hospital community, the costs were identified in the context of being able to deliver quality care at a costeffective price. In comparison, in the insurance provider community, respondents were concerned with being able to provide quality care for their constituents, with an eye for cost-effectiveness.

Clinical analytics can bring huge value to the organisations, yet there are huge hurdles that exist. In order to have effective data to evaluate, healthcare organisations need to consider a number of aspects, including the ability of their software systems to collect the data in a proper format that lend itself to data analysis; the willingness of clinicians

The challenges that organisations face today regarding clinical analytics are only going to be amplified in the future, as is evident in the later stages of clinical use criteria. Several respondents to this research noted that when the healthcare industry figures out the answer to some of the simple questions that we are presently asking, such as, does a diabetic patient get the right preventative care at the organisation level, local community level and at a later stage it would be state and country level. The questions are going to be increasingly complex, requiring a higher skill set and more complex analytical tools. An example may be analysing the genetics and proteomics of people to begin to assess the impact of these factors on their conditions and response to treatments or specific medications.

Now is the right time for the hospital community to take up clinical analytics which is critical for organisations to survive and flourish during changing governmental regulations.

Before bringing the analytics, the organisation should begin with EMR deployment having a goal of complete paperless organisation clinically across all the units of the group. It should be integrated with all TPAs having features to facilitate data interchange which can help the organisation to complete the clinical work flow during treating the patient then only the Clinical Analytics will work to get better and effective outcome to improve the organisation vision & mission.

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An endintegration integration that maintains Anend end to end that maintains integrity parentsystem. system. integrity of of the the parent MULTIPLE PAYMENT OPTIONS MULTIPLE PAYMENT EDC/POS payments OPTIONS MULTIPLE PAYMENT OPTIONS  EDC/POS payments Multiple E-Wallets EDC/POSE-Wallets payments  Multiple UPI Multiple E-Wallets  UPI Online Payments  Online UPI Payments Cash Deposit Machine  Cash Deposit Machine Online Payments  Cash collection management Cash &&management Cashcollection Deposit Machine  EMI / Financing real-time EMI Financing&real-time Cash/ collection management EMIPAYMENT / FinancingPOINTS real-time MORE MORE PAYMENT POINTS With easily deployable solution, you can With easily deployable solution, youacross can create multiple payment points MORE PAYMENT POINTS your hospital. create multiple paymentsolution, points across your With easily deployable you can Also, collect payments via mobile or hospital. create multiple payment points across your kiosk.

Also, collect payments via mobile or kiosk. hospital.

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SUPPORT 24/7 support regarding use, configuration, 24/7 support regarding use, and troubleshooting the Services. for configuration, and for troubleshooting AUTOMATED RECONCILIATION the Services.

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Daily automated 4-way efforts reconciled between HIS, Bank, Processor and Salucro, reports between HIS, Bank, Processor helps in reducing manual efforts and errors. and Salucro, helps in reducing manual PLATFORM STABILITY efforts and errors.

We create a seamless payment experience PLATFORM STABILITY across the platform that stabilizes the system PLATFORM STABILITY We create a seamless payment experience which improves patient experience We create a seamless payment across the platform that stabilizes theand system experience across the platform that satisfaction. which improves patient experience and stabilizes the system which improves satisfaction. patient experience and satisfaction.

PCI-DSS COMPLIANCE With different card compliances already part PCI-DSS COMPLIANCE PCI-DSS COMPLIANCE With different cardcompliances compliances already of thedifferent Salucro solution you get secured With card already part part of the Salucro solution you get payments. of the Salucro solution you get secured secured payments. payments.

CONSOLIDATED REPORTING CONSOLIDATED REPORTING With 10+ 10+ different differentREPORTING payment enabled With paymenttypes types CONSOLIDATED enabled for your location you get for your get a consolidated With 10+location differentyou payment types enabled a consolidated report for the report the entire at aentire single click. for yourforlocation youhospital get a consolidated hospital at a single click. report for the entire hospital at a single click.

DATA SECURITY Also, collect payments via mobile or kiosk.

Information is exchanged via encryption, DATA SECURITY different data attacks are able to Information is exchanged vianot encryption, DATA SECURITY breach information. different dataisattacks are not to breach Information exchanged viaable encryption, information. different data attacks are not ableSalucro’s to breachunified payment solution bridges the gap between healthcare

RESULTS RESULTS RESULTS information.

Salucro’s payment bridges gap between providers,unified multiple paymentsolution companies and the healthcare specifichealthcare software Salucro’s unified payment solution bridgesand the healthcare gap between healthcare providers, multiple payment software platforms including HIS, PAS companies and EMR through seamlessspecific integration. providers, including multiple payment healthcare specific software platforms HIS, PAScompanies and EMR and through seamless integration. platforms including HIS, PAS and EMR through seamless integration.

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Contact us: www.salucro.in | support@salucro.in | +91-7877-000-747

TECHNOLOGY PERSPECTIVE

Role of Emerging Technology in Building Smart Hospitals In the wake of huge patients’ expectations pertaining to quick service, less waiting time and hassle free comprehensive experience, smart hospitals hold a huge significance today. With cutting-edge technologies like AI and ML, these hospitals are automating and optimizing various processes to ensure best care to masses, writes Dr Mervin Leo, COO, Aware Gleneagles Global Hospitals, L B Nagar, Hyderabad for Elets News Network (ENN).

T

he term ‘Smart Hospital’ refers to a hospital which is working towards building an ecosystem using digital tools which help in quick & efficient decision making. If we closely observe, we notice that today’s customer (essentially a ‘patient’) is smarter and more aware.

These days, basic expectations of a patient while visiting a hospital is all about faster service, less waiting time and comprehensive patient experience.

Hospital reviews like Google reviews or YouTube testimonials are also one

of the major deciding factors for a patient to choose a particular doctor or hospital.

This continuous change in the external environment enables both the consumer & provider to take relevant measures to live up to each other’s expectations. I would like to highlight below few of the industry related initiatives which are practiced across the globe: BUILDING SMART HEALTHCARE SYSTEM WITH SMART NOTIFICATIONS

Dr Mervin Leo COO Aware Gleneagles Global Hospitals, L B Nagar, Hyderabad

Wearables and health bands with sensors can be placed near patients and at locations frequented by patients (such as washrooms) where there is a fall risk or other hazards. AI can constantly monitor the data to alert hospital operators and caregivers, which can enable more efficient care and better outcomes. We have seen similar case studies with fall detection app from Apple Watch Series 5.

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MARCH 2020

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CLOUD-BASED ELECTRONIC HEALTH RECORDS HELPING BETTER DECISION MAKING

technologies are constantly evolving and going to be better with upgrades.

Coupled with AI, this can create process efficiencies and improve decision-making necessary to boost quality. Data can be better integrated into daily care and patients can play a role in curating their own data.

PATIENT EXPERIENCE (SMART) INITIATIVES IN HOSPITALS

STREAMLINING THE APPOINTMENT, ADMISSION AND DISCHARGE PROCESS Patient movement will always be there and they will always expect higher service excellence from the hospital. With the help of smart technology, real time OPD booking system, payment system through apps or wallets, use of AI in planning, admission and discharge in hospitals can be achieved digitally with higher efficiency. Clinical, financial, and demographic information can be pre-populated from the patients’ records. As discussed earlier, these records can be cloudbased and easily accessible to key stakeholders. Use of RF IDs, robotics and new wearable

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Use of third party app like Practo and Just Dials are always very trending adoption these days in terms of appointment booking process for hospitals. These apps are third party apps which actually raise the patient satisfaction and better experience.

Predictive billing with AI and smart hospital software development implies to the use of smart technology systems in developing less cumbersome and more customer friendly experiences.

In the years to come, use of digital technologies to build a digital ecosystem between hospital and patients in terms of better connect would help the hospital to maximize patients and business without losing the opportunity. In this endeavor, innovation would play a big role to integrate healthcare and digital systems seamlessly.

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