Ehealth march 2017 web edition

ASIAâ&#x20AC;&#x2122;S FIRST MONTHLY MAGAZINE ON THE ENTERPRISE OF HEALTHCARE

VOLUME 12 / ISSUE 03 / MARCH 2017 / ` 75 / US $10 / ISSN 0973-8959

SPECIAL STORY

Karnataka Hails CSR in Healthcare

COVER STORY

Medical Devices & Equipment Exploring New Horizon of Growth

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ASIA’S FIRST MONTHLY MAGAZINE ON THE ENTERPRISE OF HEALTHCARE Volume 12

Issue 03

March 2017

OUR PUBLICATIONS AND INITIATIVES EDITOR-IN-CHIEF: Dr Ravi Gupta EDITORIAL TEAM - DELHI/NCR Senior Assistant Editor: Souvik Goswami, Gautam Debroy Assistant Editor: Sandeep Datta, Vivek Ratnakar, Priyanka Sharma Senior Correspondent: Shivani Tyagi, Akash Tomer Correspondent: Rashi Aditi Ghosh, Rajbala BANGALORE BUREAU Associate Editor: T Radha Krishna MUMBAI BUREAU Senior Assistant Editor: Kartik Sharma Senior Correspondent: Poulami Chakraborty Correspondent: Harshal Yashwant Desai JAIPUR BUREAU Senior Assistant Editor: Kartik Sharma CHANDIGARH BUREAU Assistant Editor: Priya Yadav HYDERABAD BUREAU Assistant Editor: Sudheer Goutham B LUCKNOW BUREAU Assistant Editor: Arpit Gupta AHMEDABAD BUREAU Assistant Editor: Hemangini S Rajput SALES & MARKETING TEAM Senior Executive: Nilender Kumar, Mobile: +91-8860635837 SUBSCRIPTION & CIRCULATION TEAM Manager, Subscriptions: +91-8860635832; subscription@elets.in DESIGN TEAM Creative Head: Pramod Gupta, Anjan Dey Deputy Art Director: Om Prakash Thakur, Gopal Thakur, Shyam Kishore Senior Graphic Designer: Pradeep G EVENT TEAM Assistant Manager: Amit Yadav WEB DEVELOPMENT LEAD Farhan Khan DIRECTOR, ADMINISTRATION Archana Jaiswal EDITORIAL & MARKETING CORRESPONDENCE

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Contents

MARCH 2017 | VOLUME - 12 | ISSUE - 03

12 Cover Story

Exploring a New Horizon of Growth With a view to bring in the highest degree of professionalism in regulation of medical devices, a culture of self-compliance by manufacturers and push the industry’s growth to new heights, the government has initiated several important reformatory steps.

14 Special Story

Karnataka Hails CSR in Healthcare With the motto of “Health for All and Health Everywhere”, the Government of Karnataka is ensuring quality healthcare services to the people under Corporate Social Responsibility (CSR).

24 Industry Perspective

Fostering Medtech Innovations in India

Having evolved signiﬁcantly in the last decade, the Indian medtech industry is witnessing a high growth trajectory. The recent policy changes initiated by the government to create a predictable and enabling ecosystem are expected to set the ball rolling to make India a powerhouse in manufacturing of medical devices.

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Supported By

PLATFORM FOR INSIGHTS INTO TECH LED PHARMA WORLD

Conference Overview

eHEALTH Pharma CIO Symposium 2017 will take place in Mumbai on 21st April 2017. eHealth Pharma CIO Symposium will be an ideal platform for organisations to meet, deliberate, network and forge strong ties with key attendees who are looking for new age technology solutions to incorporate within their organisations. KEY DISCUSSION POINTS

KEY ATTENDEES

♦ IOT in Pharmaceutical Industry- Driving the Industrial revolution 4.0

♦ Policy Makers from Ministry of Health and Family Welfare, Govt of India

♦ Supply Chain and Big Data ♦ Smart Manufacturing

♦ State Drugs Controllers from Various States

♦ Cyber Security- Risks and Threats

♦ Representatives from NITI Ayog

♦ Business Intelligence and Analytics

♦ CTO, CIO , CISO and Head IT Security

♦ Cloud Computing in Pharmaceutical Industry

♦ CEO,MD and Chairman

♦ Opportunities and Roadblocks by Government – Industry Speak

♦ Industry Experts and Thought leaders from Pharmaceuticals and Lifesciences

♦ FDI in Pharmaceutical Industry

♦ Pharma Associations

Our Publication

GET INVOLVED Nilender Kumar | sales@ehealthonline.org | +91-8860635837 cio.eletsonline.com/events/pharma

Company at a Glance

Industry Speaks

Anand Medicaids: A Legacy of Quality, Innovation

Manu Malhotra Founder Partner at RSMS Architects

Industry Perspective 30

Shaheen Majeed Marketing Director Sami-Sabinsa Group

Vishal Rajgarhia Director & CEO Finecure Pharmaceuticals Ltd

Bruce Schwack Co-Founder and Director-Communications Netmeds.com

Vipin Pathak Co-founder and CEO Care24

Leadersâ&#x20AC;&#x2122; Perspective 34

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Rahul Kumar Country Manager and Director WinMagic India

Expert Opinion 42

Probir Das MD-Terumo and Chairman-Medical Devices Forum, FICCI

V Srinivas Deputy Director, Administration All India Institute of Medical Sciences

Dr Ajay Swaroop Mathur Honorary Secretary cum Treasurer, Board of Management, Sir Ganga Ram Hospital

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editorial

Great Push for Medical Devices Industry India took a giant leap in medical devices and equipment sector recently when the Ministry of Health and Family Welfare notiﬁed Medical Devices Rules, 2017 on January 31. The new rules have been framed not only to provide a framework for the industry to conform to the best international practices, but also seek to remove regulatory bottlenecks to make in India, facilitate ease of doing business while ensuring availability of better medical devices for patient care and safety. The cover story, ‘Exploring a New Horizon of Growth’, in eHealth March issue, is an attempt to provide a comprehensive look at the policy push offered by the government that is aimed at reducing India’s dependency on imports of high-end medical devices. The move also seeks to promote the highest degree of professionalism in the sector, a culture of selfcompliance by manufacturers and fostering India speciﬁc innovations to improve accessibility and affordability of medical devices across the world. Our special story ‘Karnataka Hails CSR in Healthcare’ underscores the state government’s attempt to live up to its motto of ‘Health for all and Health Everywhere’ through quality healthcare services under its Corporate Social Responsibility (CSR) initiative. It offers our readers a sneak peek into the public health programmes of the Karnataka government and its vision behind taking quality healthcare delivery to the door steps of the vulnerable sections of the population in remote, unreached and poorly accessible under-served areas of Karnataka. In the story, ‘Fostering Medtech Innovations in India,’ Dr Suchita Markan, Assistant General Manager at BCIL, examines the growth trajectory of the medtech industry as she highlights how the sector is charged with new energy in the conducive environment that has been created to provide a robust and enabling ecosystem for domestic manufacturers and service providers. This edition of the eHealth magazine carries interviews of industry experts from the government as well as private sector, expressing their views on how new policies, regulations, infrastructure and technology collaborations are gradually, yet surely, changing the face of health delivery system in India. Looking forward to our readers’ valuable feedbacks.

Dr Ravi Gupta Editor-in-Chief

ravi.gupta@elets.in

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Cover Story

Exploring a New Horizon of Growth

With a view to bring in highest degree of professionalism in regulation of medical devices, a culture of self-compliance by manufacturers and push the industry’s growth to new heights, the government has initiated several important reformatory steps. Armed with a clear vision and conducive environment, the medical devices sector is all set to foster India speciﬁc innovations and leverage comparative cost advantage of manufacturing in the country, writes Vivek Ratnakar of Elets News Network (ENN).

ndia, like several other countries in the world, largely depends on imports to fulfill its medical equipment needs. Over 75 per cent of high-end medical devices, critical care equipment are imported, whereas large volume and comparatively low-end consumables and disposables are locally manufactured. Heeding to the long-standing demand of indigenous manufacturers of medical devices and equipment manufacturers, the government recently decided to put in place new rules and regulations for medical devices industry, which was unduly delayed. These new rules seek to internationally harmonise manufacturing of medical devices to attract investment in the sector -- reducing the cost of making medical devices and equipment in the country. “The new Rules have been framed in conformity with Global Harmonisation Task Force (GHTF) framework and conform to best international practices. Only 15 categories of medical devices are, at present, regulated as drugs and to that extent, the current regulatory practices in India were not fully geared to meet the requirements of med-

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ical devices sector in the country. The new Rules seek to remove regulatory bottlenecks to make in India, facilitate ease of doing business while ensuring availability of better medical devices for patient care and safety,” said the Ministry of Health and Family Welfare in a statement. The announcement of the government that regulatory framework can be reviewed from time to time based on industry feedback is commendable. The new rules and regulations will help augment indigenous production and would also bring about qualitative changes in the healthcare landscape and help India achieve universal healthcare faster. In short, the move will be a game-changer for the medical devices and equipment industry. “The move is expected to inculcate discipline. It will enable each stakeholder to know what is expected from him so that he sticks to his role. This has enabled car drivers to drive without maximum speed limits in Germany. Similarly in manufacturing, rules and regulations for medical devices will bring in the discipline to ensure patient safety and this will enable making of medical devices in India

Cover Story

to grow without any limits,” says Rajiv Nath Forum Coordinator, Association of Indian Medical Device Industry (AiMeD). Another major step the government has taken is the decision to soon delink the medical devices and equipment industry from the pharma sector “so that it can chart a distinct and definitive course along with a facilitating regulatory frame work”, according to Minister for Chemicals and Fertilisers Ananth Kumar. “As the Minister of Chemicals & Fertilizers said, it is time for these sector to be delinked and fly like a butterfly. Both pharma and devices are healthcare products and have synergies and similar direction, but need different pathways and strategies as pharmaceutical is an established sector, while medical devices is a sunrise sector and has the potential to grow and overtake pharma,” says Rajiv Nath. To drive the growth of the industry, the government seems quite clear in its vision. “Three areas that we are considering now are promoting medical devices park, R&D and medical value added services like tourism, which can help us to reduce the dependence on imports of medical devices and earn more foreign exchange by promoting value added medical services like medical tourism,” said KL Sharma, Joint Secretary, Ministry of Health & Family Welfare, recently at a government-supported event. So far as leveraging technological innovations is concerned, there is the need for more concrete partnership between the government and the private sector in the medical device space. There should be incentives for startups and industry to go for embedded technologies that are disruptive and relevant to the Indian conditions. “We have to create an ecosystem that promotes smart incremental innovation and spur more startups and incubators,” says Dr Girish Sahini, Director General, Council of Indian Scientific and Industrial Research (CSIR).

Internet of Tings (IoT), big data analytics, and artificial intelligence are positively impacting the growth of medical devices sector and are set to play greater role in years to come. However, Rajiv Nath of AiMeD is of the opinion that the industry first needs to take one step at a time to reach its goals. “These (IoT, artificial intelligence, etc) are buzz words and fads. Before you reach the seventh floor, you have to climb the steps to the first floor. Let’s go step by step,” he says. Speaking of the roadblocks, Rajiv Nath says that counter lobbying by foreign manufacturers is a cause of concern. “Counter lobbying by foreign manufacturers is a roadblock. They are misusing forums of CII (Confederation of Indian Industry) and FICCI (Federation of Indian Chambers of Commerce and Industry) for blocking and delaying any policy initiative that could help ‘Make in India’ to be competitive since they see these initiatives through a short-term tunnel vision as creating loss of competitive advantage and threat to their market share instead of utilising them as a long-term opportunity to invest in Green Field Projects in India and share our growth pains,” he says. India is endowed with a large reservoir of experts in software and other disciplines of information technology, which can help India emerge as a powerful hub for manufacturing of medical equipment. In this regard, medical technology clusters coming up in Andhra Pradesh and Telangana are steps in the right direction. Apart from incentivising the medical device industry, it is necessary to set up similar projects elsewhere in the country. Several medical and equipment companies from countries like Japan and China have already started choosing Indian medical equipment clusters like Andhra Pradesh Medtech Zone (AMTZ) as their base of manufacturing. Till now, due to a number of ecosystem constrains medical devices and equipment industry has not been able to achieve its full potential and has led to a high dependence on imports to meet the domestic demand. The recent policy changes leading to creation of a predictable, enabling ecosystem is expected to promote entrepreneurship, market penetration and provide competitive advantage to the industry. The enabling initiatives taken-up in this sector by the government is expected to set the ball rolling to make India a powerhouse in manufacturing of medical devices, making it realise its full potential of becoming a multi-billion industry in few years from now.

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Special Story

Karnataka Hails CSR in Healthcare

With the motto of “Health for All and Health Everywhere”, the Government of Karnataka is ensuring quality healthcare services to the people under Corporate Social Responsibility (CSR) initiative, writes T Radhakrishna of Elets News Network (ENN).

arnataka is going the CSR way to improve health indicators and healthcare infrastructure in the state. India carries 20 per cent of the world’s disease burden and also records the highest number of maternal deaths in the world, according to available reports. Though India is the third largest manufacturer of pharmaceuticals and has the largest number of medical schools globally (381) and produces the most medical graduates each year (50,000). The reason for the dichotomy is: India lacks the financial resources required to reinforce its deficient healthcare infrastructure and improve its health indicators. Healthcare programmes are funded by government budgets, international aid and charitable organisations, but the money isn’t quite enough for a country of 1.25 billion peo-

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ple, two-thirds of which live in the countryside, where the supply of medical care and the ability to pay for services is limited. Dr Shalini Rajneesh, Principal Secretary, Department of Health and Family Welfare, Government of Karnataka, says the main objective of Health and Family Welfare Department, Government of Karnataka, is to provide quality healthcare services to the people. “Health for All, Health Everywhere is the motto of Government of Karnataka,” she says. “Our vision is to ensure access and availability of quality health care for all. Our mission is to provide comprehensive and quality health care services to ensure equitable access, redress regional imbalances. Stabilise population and make AYUSH systems integral part of health care. In-

Special Story

volve community participation in all the activities for better acceptance,” she further states.

Corporate Social Responsibility

There is a need for improving health indicators and also health infrastructure. Governments as well as regulators have responded to this unrest and the National Voluntary Guidelines for Social, Environmental and Economic Responsibilities of Business and the Corporate Social Responsibility (CSR) clause within the Companies Act, 2013 are two such instances of the steps taken. CSR can be defined as “the responsibility of enterprises for their impacts on society”. To completely meet their social responsibility, enterprises “should have in place a process to integrate social, environmental, ethical human rights and consumer concerns into their business operations and core strategy in close collaboration with their stakeholders.” Since Corporate Social Responsibility and sustainability are so closely entwined, it can be said. It is a company’s commitment to its stakeholders to conduct business in an economically, socially and environmentally sustainable manner that is transparent and ethical.

New Programmes in Karnataka

The Government of Karnataka has implemented several new programmes and strengthened the existing ongoing programmes in order to improve the health care of the community. Various beneficiary oriented schemes are implemented by the Government of Karnataka in addition to the existing schemes. Though the public health programmes are implemented by the government, the success of the programmes is largely dependent on the participation of the community, along with the involvement of the philanthropists, corporates, non-government organisations, charitable institutions, etc. The Government of Karnataka is open for the Corporate Social Responsibility support for effective implementation of the health schemes, say officers working on the new programmes. In the first stage, the following programmes are identified for CSR support:

Araike Yojane

Under this scheme, provision will be made to provide pure drinking water, toilet, bathroom facility and rooms to stay for the patient’s attendants. It is proposed to implement this scheme in all the 21 district hospitals and 146 taluka hospitals of the state.

The Government of Karnataka has implemented several new programmes and strengthened the existing ongoing programmes in order to improve the health care of the community. Dialysis Units

It is planned to strengthen the existing units by identifying the gaps for the non-functioning of the units and to fill the gaps to make the units functional by inviting PPP partners (human resource support viz. specialists and technicians). Further, 100 taluks hospitals are to have dialysis units. It is proposed to have at least two machines in each taluk hospital.

Mobile Health Clinic (MHC)

Aims to take quality healthcare delivery to the door steps of the vulnerable sections of the population in remote, unreached and poorly accessible under-served areas of Karnataka (rural, hilly, tribal and forest with poor communication facilities). The government is proposing to deploy

1,000 Ambulance for this purpose.

Citizen Help Desk

Despite of good infrastructure, public health facilities in urban and semi-urban areas lack quality and reliability. The main reasons are urban poor lack awareness on available services, poor grievance redressal system and lack of information on patient rights, privileges and responsibilities. Hence, Citizen Help Desk (CHD) are required to improve utilisation of available hospital services. It is proposed to start CHD in 146 taluk level hospitals of the state through CSR mode.

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Special Story

Contracting MBBS Doctors and Specialists:

Karnataka is experiencing shortage of Doctors and specialists of all categories in public hospitals at district, Taluka and Community Health Center levels. To overcome the acute shortage of Medical personnel, under Department of Health and Family Welfare and NHM, the services of the Doctors and specialists are hired on Contract basis. It is proposed to approach Private hospitals / practitioners to come forward and spare a day or two per week for catering to the needs of poor patients.

Lysosomal Storage Disorders (LSD) Proposal under CSR Funds

Under existing insurance schemes like Rashtriya Swasthya Bima Yojana (RSBY), Rashtriya Bal Swasthya Karyakram(RBSK) this disease is not covered. It is usually seen in consanguineous marriages and lack of early screening which should be tackled by individual cases. The cost for the treatment of LSD is very expensive and it is impossible for many families to bear the cost of Enzyme Replacement Therapy and also for the complications that arise due to these diseases. Hence, it is the responsibility of the society to support such families both economically and emotionally. As this is very costly treatment, budget provision is yet to be made to in the Public Health Facilities. On an average an amount of `50 lakh is needed per child/patient for this enzyme replacement therapy. CSR can support for enzyme replacement therapy.

National Programme for Prevention and Control of Fluorosis

Objectives are: ♦ To create awareness about the adverse effects of consumption of excess fluoride in water. ♦ To motivate the communities to use only De-Fluorinated

Under existing insurance schemes like RSBY, RBSK LSD is not covered. It is seen in consanguineous marriages and lack of early screening which should be tackled by individual cases. water in daily usage. ♦ To sensitise elected representatives, especially of gram panchayats about adverse effects of consumption of excess fluoride in water and to advocate provision of De-Fluorinated water in daily usage. ♦ To promote rain water harvesting and safeguarding surface water to reduce the consumption of ground water in the long run. ♦ CSR can play a major role in providing safe drinking in fluorosis affected areas. ♦ Out of 8690 total affected villages of 18 endemic districts of Karnataka, provision was made for safe drinking water by installing RO plants in 2917 villages. ♦ CSR support needed for the Construction of RO plant to provide safe drinking water for 5773 villages.

Hygiene Kits

To provide postnatal care for the mother and the child, it is proposed to give hygiene kits to the delivered mother. The objective of this scheme is to encourage poor pregnant women to deliver in health centres and hospitals in order to reduce maternal and infant mortality in the state. This Kit is proposed to be provided free of cost to the BPL families by the Health Institutions. Each BPL family is eligible to get a maximum of two Kits, one for each live birth delivery. The kit contains some useful items for delivered mother and child. CSR support is needed in providing the Hygiene Kits.

Rashtriya Bal Swasthya Karyakram (RBSK):

In this programme children up to the age of 18 years are screened for 38 health conditions. The screening is conducted by two dedicated RBSK mobile health teams constituted in each taluka, consisting of two medical officers, one staff nurse and one ophthalmic assistant/ pharmacist. The main aim of this programme is to conduct health screening so as to identify children with health conditions and to refer for appropriate timely treatment. CSR can provide the services of specialists and super specialists, thereby helping early detection and management of 4D’s (Defects at Birth, Deficiencies, Childhood Diseases and Developmental Delay and Disability).

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Special Story

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Special Story

Nutrition

Under-nutrition is associated with high rates of mortality and morbidity due to common childhood illness including diarrhea, acute respiratory infections, malaria and measles. To prevent deaths due to severe acute malnutrition (SAM) specialised treatment and prevention interventions are required like NRCs and MNRCs. Nutrition Rehabilitation Centres (NRCs): It refers to a unit for ‘inpatient, centre based’ care of children with severe malnutrition. Children with Severe Acute Malnutrition (SAM) without medical complications are usually treated either in facility/hospital based care units. Modified Nutrition Rehabilitation Centres (MNRC): These are referred rehabilitation centres with trained medical officers and staff nurses where SAM children are referred from primary health centres. Apart from the above, the technologies of CFTRI like: ♦ Energy food - that has been used as a great protein supplement, with good amount of vitamins and minerals. ♦ Iron fortified Atta. ♦ Whole drumstick pod powder. ♦ Iron folate enriched cookies. ♦ Methods to make spirulina products (without the fishy taste). ♦ The above Nutrition items can be provided through CSR support. Telemedicine: Providing facilities to give specialist healthcare at grass root level or at-least at the taluka level would largely benefit the health in the community, prevent further morbidity, mortality, loss of man-hour and thus prevent economic and social loss to families in the community. The provision of Tele-Medicine facilities would address this issue to a large extent along with that of non-availability of specialist in rural areas of the State. CSR can play a major role in improving the Telemedicine facility by providing technical assistance.

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National Mental Health Programme: with the rise of psycho-somatic diseases in the society, it is seen that the economically productive age group people in the State are succumbing to the depression, OCD, suicidal tendencies etc. This is proving to be of immense importance in loss of economic growth and also a burden to society both socially and economically. Also, that the number of Psychiatrists in the Public Health Institutions is meagre and sparse, therefore, it is proposed to give Honorarium and Mobility support for the in-sourced Psychiatrists. Information, Education and Communication (IEC): The success of any scheme is in its implementation and benefits to deserved beneficiaries. IEC is playing a major role in giving awareness to the public about the health schemes of the state. AT present the Department is utilizing the following methods for advertising its schemes: ♦ Print Media (Advertisements in Daily/weekly/monthly ♦ Printing & distribution of education materials. ♦ T.V Spot & Radio jingles. ♦ Publicity through bus branding ♦ Tele film & documentary. ♦ Broadcasting and conducting of interviews, on various Health Programme. ♦ Flex in hoardings Wall painting ♦ Disseminated through LED TVs in Railway station & KSRTC Bus stations. ♦ State level Folk artist workshop ♦ Sensitization programme ♦ State Level programmes ♦ Panel discussion ♦ Books, Posters, Folders ♦ Student Debate competition ♦ Press conference, Press meets ♦ Corporate can help sponsoring any of these activities and also ‘Subsidization’ for TV serials and Films/Cinemas that show health issues.

Special Story

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Company at a Glance

Anand Medicaids: A Legacy of Quality, Innovation Anand Medicaids, a leading Indian manufacturer and exporter of suction equipment and accessories, is taking forward its 40 years old legacy of quality products, innovation and good customer service. Continual innovation and high standards of quality have been the driving factors behind the company’s phenomenal growth and success.

t takes an intense commitment and concentrated effort to separate a specialist from a practitioner. Anand Medicaids Private Limited, an institution built four decades ago, truly understands this principle and displays it in every initiative. And this understanding has made Anand Medicaids the specialists in providing high quality suction units - cost effectively. Today, Anand Medicaids is the leading company from India engaged in manufacture and export of suction equipment and accessories. Quality is the company’s legacy, which is reflected by the state-ofthe-art manufacturing facility. Built

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over 1,100 sq. meters, the facility is equipped with the latest machinery for online assembling of suction equipment in dust free environment. The factory organisation includes different divisions, such as production, assembly, testing, clean room and R&D. It also provides in-house facilities for development of dies and molds. Customer service is another main focus area of the company. The company has excellent reach through a sales network comprising dealers and retailers, spread across the globe. The company also provides after-sales service of all its products by providing all the tools and spares for

a period of up to 10 years after sale. Continual innovation and high standards of quality have been the driving factors behind the company’s phenomenal growth and success. The company’s production and quality standards are supported by certifications from the leading evaluation agencies. Anand suction equipment was the first company to be awarded the ISI Mark in 1985. The company was the first company in India to be awarded the CE & ISO 9001:2008 and ISO 13485:2003 certifications for suction units. For details, please visit www. anandind.com.

Industry Perspective

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Industry Speaks

The Architecture of Healing

RSMS is a leading healthcare design firm that has been working closely with healthcare providers for over a decade, building strong ties with clients and continuously adopting to the latest best practices in healthcare, says Manu Malhotra, Founder Partner at RSMS Architects, in an interview with Elets News Network (ENN) while sharing an insights into hospital design process and key differentiators that guide methodology and process at RSMS. What are the focus areas for RSMS in the healthcare sector?

RSMS Architects focuses on constantly updating, innovating and improving past projects and past experiences. We approach every project with a fresh mind, seeking to find out better practices adopted across the fields of healthcare and construction and integrating the same into the existing template of our experience. We have tried to achieve this by constantly interacting with healthcare professionals across diverse specialities and services to understand various points of concern that they face. Another focus area of ours is to understand the different challenges of working in new environments. Taking advantage of working in a diverse country such as ours, we have honed our skills to understand different mindsets, construction technologies, design sensibilities and economic models. Included to this information bank are the relevant local bye-laws, geographic and climatic data. This helps us to quickly derive ideas and working solutions custom designed for each project.

What role do architectural structures play in ensuring the well being of a patient?

Spatial design has the ability to alter the usersâ&#x20AC;&#x2122; state of mind. Patients entering healthcare facilities are usually under mental and physical stress. In order to create a recuperative atmosphere, we try to create an environment which best mirrors the nor-

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malcy of the world outside the facility. Family spaces form important areas of our hospital designs as does the material palette, which reflects visual as well as haptic warmth and comfort to offset the mechanical and often intimidating features of diagnostic-treatment areas. Colour, as much as material, is important in this aspect and the palette of architectural finishes in a hospital should include warm and vibrant colours in patient zones and visitor zones. Another feeling that often overwhelms the patient is one of isolation, which can lead to depression. One way to avoid this is to have a sensory connection between the interior and exterior. While optimising the space to provide the best ergonomic comfort, we introduce healing courtyards, terrace gardens, playing areas for children and so on. These form vitally important buffer spaces in the facility while providing much required soothing respite. Architectural fenestration is a very important part of hospital design as well. Studies have shown the presence of natural daylight in patient areas leading to a reduction in patient stay duration by as much as 25 per cent. Staff productivity has also been known to increase by 8 percent. The increased productivity leads to better patient care and boosts staff morale. To derive the best curative benefits of sunlight, we carefully select the glass that we use based on building orientation, aesthetic appeal, size and function of the fenestration in order

Industry Speaks

to provide an abundance of sunlight with minimal heat gain.

Which important elements do you think are important from an architectural point of view that should be incorporated in the design of a hospital building?

At RSMS, the design of healthcare facilities revolves primarily around patient safety, care and comfort. The threat of infection is one of the major causes of concern in hospitals and often the reason for this is the cross-proliferation of caregivers, patients, attendants, family, non-medical staff, etc. Hence, one of the primary design elements that we incorporate into our designs is the clear segregation of traffic zones. Multiple entry points, while unavoidable in large facilities, need to be properly planned with demarcated routes, control points and signage. We incorporate these things into our design. Staff travel distances are minimised both from staff stations to patients as well as staff stations to areas such as utility rooms, and equipment bays. Visual connectivity plays an important part here in cutting down treatment response times drastically. Our designs aim to provide the best possible visual connection between caregiver and patient while maintaining the privacy and sanctity of the patientâ&#x20AC;&#x2122;s personal space. Way-finding is another important aspect of circulation planning which we focus on at RSMS. To the unassuming visitor, hospital departments with technical sounding terminologies can be intimidating as well as confusing. We simplify the circulation planning in order to keep visitor routes between departments minimal, clear and direct. Added to this, the design of good signage both within and outside the building can be a key factor in ensuring easy way finding. We carefully consider departmental adjacencies for each project both horizontally as well as vertically. While this can often seem simplistic and routine, the fact is that departmental adjacencies vary largely, due to factors such as building reg-

ulations, bed mix and type of setup (based on specialities addressed). Room Data Sheets that incorporate a whole range of information including service requirements, finish materials and environmental factors such as lighting and temperature control are very useful to ensure that the design addresses critical issues of each area of the hospital. We prepare these sheets with careful study. These sheets help to fine tune the design at both micro and macro level, while customising several factors to suit end user flexibility & facility management in a later day.

What do you suggest hospitals should do to reduce their carbon footprint?

It is the responsibility of healthcare providers as well as healthcare architects and designers to ensure that not only the patients who are undergoing treatment within a healthcare facility are provided with a safe and healthy environment, but also the world in general needs to be ensured of a better future. Keeping this in view, hospitals should adopt the best practices and technologies that minimises their carbon footprint. Cooling and heating loads of a hospital are enormous compared to buildings in most other sectors. This is due to the need of airtight sterile environments within most departments of the hospital which negates the possibility of natural ventilation. In order to keep cooling loads down, shading devices, specialised glass designed for high reflectivity and minimal heat gain, the use of green refrigerants as well as high reflectivity or low absorptive exterior finishes can be adopted to keep out heat. Besides, healthcare facilities should also provide efficient water usage systems that are both clean to use and rely heavily on recycled water intended for non-human usage such as irrigation, cooling tower make-up, flushing and so on. Technology is constantly evolving, and water-less and water-efficient sanitary fixtures are the order of the day. The recharging of ground water is anoth-

RSMS follows a â&#x20AC;&#x2DC;biophilic design modelâ&#x20AC;&#x2122; which means that the company focuses on the interconnections between nature on the one side and the user triad of patientcaregiver-attendant. er vital feature that is important both in term of short-term and long-term benefits to the facility, as well as to society as a whole. The harnessing of solar energy for heat as well as power is an important ecological consideration. While we are harnessing solar energy as an important source of water heating in all our projects, we are constantly incorporating newer technologies to use solar energy for lighting and power generation as well. This proves vastly economical for the user in the long run, due to large savings on running costs, and additional incentives and encouragement provided by governments.

What kind of technology do you use while designing of healthcare building?

At RSMS Architects, we use Building Information Modelling or BIM as a vital tool in understanding and solving design problems as well as understanding how our buildings will work, even before they are built. The body of a hospital, much like the human anatomy is made of a maze of service lines, the majority of which like the human body are below the surface, unseen by the naked eye. HVAC ducts, piping and conduiting for various services such as water supply, fire fighting, electricity and medical gas all need to be designed into a tight fit in order to provide ease of construction as well as ease of maintenance. Like parts of a jigsaw puzzle, our design methodology uses BIM to work this myriad array of services into ceiling spaces, service shafts and service cores.

MARCH / 2017 ehealth.eletsonline.com

Industry Perspective

Fostering Medtech Innovations in India

Having evolved significantly in the last decade, the Indian medtech industry is witnessing a high growth trajectory. But due to a number of ecosystem constraints, this industry sector has not been able to achieve its full potential. The recent policy changes initiated by the government to create a predictable and enabling ecosystem are expected to set the ball rolling to make India a powerhouse in manufacturing of medical devices, writes Dr Suchita Markan, Assistant General Manager in Biotech Consortium India Limited (BCIL) for Elets News Network (ENN).

o foster any medical device innovation, we need market push and technology generators such as trained manpower to generate ideas; funding opportunities for nurturing the idea; intellectual property (IP) protection to protect intellectual assets; infrastructure to seed the IP or technology into a company set-up; and tax incentives or policies for ease of doing business. Besides these, well-oriented regulatory policies are required for developing and scaling-up regulatory compliant technologies and mechanisms for supporting technology absorption and market access for the benefit of the nation and the economy at large.

Environment is Conducive for Innovation

Today, India offers a unique and dynamic platform for nurturing medical device innovations to transform ideas into

MARCH / 2017 ehealth.eletsonline.com

reality. Recognising the immense growth potential of medical device sector, the Government of India has identified the medical devices industry as a sunshine sector for the â&#x20AC;&#x2DC;Make in Indiaâ&#x20AC;&#x2122; initiative. Since 2014, India has witnessed numerous fiscal initiatives and policy changes which led to the development of a robust and enabling ecosystem for this sector. To realise the full potential of Medtech sector, the government has taken several steps and policy initiatives including initiatives to facilitate ease of doing business, tax incentives to boost domestic manufacturing, 100 per cent FDI to attract foreign investments, predictable regulatory regime to boost con- fidence of investors to develop quality medical devices and setting-up exclusive infrastructure facilities, etc Although these policy initiatives were taken-up over a

Industry Perspective

period and were functioning in silos, but as a whole, these led to creation of an incredible enabling ecosystem to boost medical technology innovation and manufacturing in the country. The medical device industry in India is a multi-product industry offering plethora of diverse products ranging from low technology medical disposables, technology driven ophthalmic products, imaging, medical equipments, diagnostics, dental equipment to high-end innovative class III devices such as drug eluting stents, emergency healthcare devices, robotics etc. At present, the Indian medical devices industry is fragmented into small and medium enterprise category and is primarily manufacturing products such as disposables or medical supplies. Requirement for high-end medical equipments are met by multinational companies. It is estimated that there are about 800 indigenous manufacturers in the country, primarily in the low-tech domain. Domestic firms generally participate in the low priced, high volume market segment wherein competition is intense. MNCs are generally not much engaged in manufacturing and R&D but primarily in marketing value added, imported technology driven products in India. However, after the recent spur of â&#x20AC;&#x2DC;Make in Indiaâ&#x20AC;&#x2122; campaign, some manufacturing companies are now shifting their focus from capturing the market share to market creation. They are discovering innovative products for market niches.

Fostering Innovation

The government through Department of Biotechnology is also investing substantially on collaborative programmes like Stanford India Biodesign programmes (SIB), School of International Biodesign etc to boost medical technology in novation in the country and for developing the next generation of medical technology innovation and entrepreneurs in the country. Such programs are being implemented at AIIMS and IIT Delhi in collaboration with leading universities of the Western world such as Stanford University, uni-

versities of Australia, Japan etc. with BCIL as techno-legal management partner. These programs are creating medical technology innovators, multiple innovative medical device technologies and start-ups which are making a huge impact. Programmes like SIB are promoting startup entrepreneurship which is crucial for developing innovations, creating new jobs and introducing competitive dynamics into the business environment.

Funding Support

Funding is an essential ingredient for technology development. Today, India offers plethora of funding opportunities from government and private players for all the stages of technology development and commercialisation including ideation stage, proof-of-concept, technology validation, scale-up and commercialisation. Adequate funding opportunities are available in India for supporting scientific, technical, intellectual property, business, marketing and distribution dimensions of a successful medical device venture. SBIRI, BIG, BIPP, SPARSH, Grand Challenge India, CRS, TDB, etc., are the funding schemes which can be availed by medtech enterprises and entrepreneurs. Apart from government funding sources, international funders, VCs and angel investors also provide funding support to path breaking, innovative technology solutions. The funding that can be availed ranges from

Adequate funding opportunities are available in India for supporting scientific, technical, intellectual property, business, marketing and distribution dimensions of a successful medical device venture.

MARCH / 2017 ehealth.eletsonline.com

Industry Perspective

20 lakhs to few crores.

Great Push for Startups

As the startups spur and create new Intellectual Property, they need appropriate mechanisms for protecting their IP which is their key asset. To build a strong eco-system for nurturing innovation and startups in the country that will drive sustainable economic growth and generate large scale employment opportunities, the Government of India in January 2016 launched ‘Startup India’ as its flagship initiative. The government through this initiative aims to empower startups to grow through innovation and design. On January 16, 2016, the ‘Scheme for Facilitating Start Ups Intellectual Property Protection (SIPP)’ under the ‘Start-up India’ action plan, was launched by the government. The registered startups in India are now eligible for 80 per cent concession in patent application fee. Under this scheme, the government has set-up a panel of facilitators to provide legal support and assist start-ups in filing of patents, trademarks and design applications on pro-bono basis and offer fast track processing of patent applications. Only the statutory fee has to be borne by the start-ups. This was the major step taken by the Indian government in order to encourage budding entrepreneurs to enter the market and compete as well as innovate along with the established industries. In the recent past, the start-up culture has begun to emerge in India which is now becoming home to 3,100 startups every year. Apart from facilitating IP filing and protection of intellectual capital of the startups, institutional mechanisms in the form of bio incubators and technology entrepreneurship parks are also being set-up in a big way in the country to nurture bio-entrepreneurship. Different government departments and ministries such as DST, BIRAC, MSME, DIPP, etc are taking various initiatives to setup such facilities across the country. Over the last two decades, DST has provided over 250 crores to set up Science and Technology Entrepreneurs Park (STEP), and Technology Business Incubators (TBIs). The STEPs and TBIs are engaged in nurturing startups and, since 2008, few of them have also been provided support to the tune of `60 crores to implement the seed support system (SSS) for start-ups in Incubators.

MARCH / 2017 ehealth.eletsonline.com

As the startups spur and create new Intellectual Property, they need appropriate mechanisms for protecting their IP which is their key asset. DSIR has provided a support of over `225 crores to industries for development and demonstration of innovative technologies since 1992 and a support of over `25 crores to individual innovators since 1998. Biotechnology Industry Research Assessments Council (BIRAC) under DBT has provided funding of around ` 677 crores to entrepreneurs, startups, SMEs and translational organisations since 2012. DeiTY, under a scheme for Technology Incubation and Development of Entrepreneurs (TIDE), supports 27 TIDE centres till March 2017 in the area of electronics and ICT to strengthen the technology incubation centres at the institutions of higher learning. The government also supports development of national manufacturing facilities and incubators through their scheme namely ‘Support for Entrepreneurial & Managerial Development of Small & Micro Enterprises through Incubators’. Government has also recently declared that it will develop a private-public partnership model for setting up 35 new incubators and 31 innovation centres in cities including Bangaluru, Chennai, Gurgaon, Hyderabad and Mumbai, to name a few.

Medical Device Manufacturing Parks

Another major leap for fostering indigenous medical device manufacturing in India has been the setting-up of an exclusive medical device park in Andhra Pradesh named as Andhra Pradesh MedTech Zone (AMTZ) in August 2016. It is Asia’s first and largest medical technology park being set-up in Visakhapatnam in an area of 270 acres. It will host around 200 independent manufacturing units. The goal of AMTZ is to make Andhra Pradesh an internationally recognised manufacturing hub for medical devices, help in national agenda of import substitution and contribute to volume generated cost reduction of medi-

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Industry Perspective

cal devices for patients. This medical device park with three main USPs – scientific facilities, affordable space and plug-and-play ecosystem is going to provide a major thrust to the indigenous manufacturing of cost-effective and quality medical devices for India and global markets.

Other Major Steps

To further create an enabling environment, various other fiscal initiatives have been taken-up by the government in the past couple of years including introduction of 100 per cent FDI policy to attract foreign investments in 2015; correction of inverted duty structure on import of raw materials for medical device manufacturing in January 2016; and notification of Medical device rules recently in February 2017. The new rules have been framed in conformity with Global Harmonisation Task Force (GHTF) framework and conform to best international practices. Only 15 categories of medical devices are at present regulated as drugs and, to that extent, the current regulatory practices in India were not fully geared to meet the requirements of medical devices sector in the country. The new Rules seek to remove regulatory bottlenecks to Make in India, facilitate ease of doing business while ensuring availability of better medical devices for patient care and safety. These rules envisage creation of a robust ecosystem for all stake-holders including innovators, manufacturers, suppliers, consumers, buyers and regulators. Indian medical device industry is worth over `60,000 crore and country’s humungous import bill for this segment amounts to over `23,000 crore (approximately $4 billion) while exports amount to only over `7,000 crore ($1.1 billion). India’s import dependency on high-end medical devices is over 80 per cent. The global medical devices and technology market is expected to grow to $520 billion by 2020. The Indian market is among the top 20 in the world by market size, and fourth in Asia after Japan, China and

Innovation Ecosystem

Market Reach-out

Start-up

Regulatory

Tax Incentive

South Korea. However, the per capita spend on medical devices in India is the lowest among the BRIC countries at $3 ($7 in China, $21 in Brazil and $42 in Russia). It is significantly behind developed economies like the US ($340). This current under–penetration of medical devices in India represents a sizeable growth opportunity. The inflow of foreign direct investment (FDI) in medical devices was $90 million between December 2014 and August 2015, post the government permitting 100 per cent FDI under the automatic route. Several MNCs have been increasing their manufacturing footprint and locating research centres in India to serve both the Indian and global markets. From the consumers’ perspective, it is imperative that apart from creating a favourable policy framework and support structure fostering medtech innovations in India, suitable steps also need to be taken in order to bring about a change in the mindset of all the stakeholders more particularly, the intended users, so that the “Made in India” devices become more acceptable for adoption and use in India. About the Author

Funding

HR/Manpower

Industry

The new Rules have been framed in conformity with Global Harmonisation Task Force (GHTF) framework and conform to best international practices.

Infrastructure/

Dr. Suchita Markan Works as an Assistant General Manager in Biotech Consortium India Limited (BCIL). She has extensive and rich experience in project and IP management, technology-transfer and strategic collaborations including inter-institutional, industry-academia, industry-academia-government partnerships for promoting innovation in healthcare sector. She has successfully managed number of strategic national and international collaborations with J&J-COSAT USA, Siemens, Stanford University USA, QUT Australia, Tottori University- Japan, Hiroshima University-Japan etc. Contact Details: suchitamarkan@gmail.com

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Industry Perspective

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Industry Perspective

R&D Driving Growth of Pharma Sector

Foreseeing huge potential in the healthcare sector across the globe, Sami Group continues to draw its strength from R&D, launching innovative nutraceutical and cosmeceutical products that meet global standards. Shaheen Majeed, Marketing Director of Sami-Sabinsa Group, highlights the impact of ICT on the group’s growth in conversation with Elets News Network (ENN).

esearch laboratories at Sami-Sabinsa Group endeavour to bring out products with the goal of “Design to Delivery”. To achieve this goal, several independent divisions work in synergy to make products that meet international standards. For the past seven years, Sami Direct, a subsidiary of Sami Labs, has been marketing across India a range of nutraceutical and cosmeceutical products, covering weight management, bone strength, liver strength, detox supplements, skin and beauty care etc. The company’s nutraceutical product range includes Bioprotectant, Calci D Max and Cran DM Plus, to name a few. Johara cosmeceuticals, the beauty brand of Sami Direct, uses hand-picked time-tested botanical ingredients that have evolved from pure science and scripted in many ancient texts across the world. “Our skin care formulae will always be free of parabens, sulfate, synthetic dye or formaldehyde and will always have standardised botanical extracts and be clinically relevant. From the cultivation to the standardisation, our group holds several international patents and accolades on this ingredient, branded as Curcumin C3 Complex. This

MARCH / 2017 ehealth.eletsonline.com

brand finds a place in many of the Sami Direct products today,” explains Shaheen Majeed, Director, Sami-Sabinsa Group. To facilitate the increased demand for innovative application-based products, Sami Labs Limited (formerly Sami Chemicals & Extracts Ltd) was set up in 1991 in Bengaluru as a R&D facility. Today, the main ocus of Sami is on new product development and market oriented research.

R&D Division Providing a Solid Foundation for Business Development

Research is a broad term that includes basic research and applied research. Many companies, especially in India, focus on applied research which is the practical application of research. However, the need of the hour is basic research which the world over has gained more importance, says Majeed. R&D has been pushing breakthrough innovations and acting as a catalyst for speeding up the pace of growth of the company through large scale production. Sami Labs invests 6-7 per cent of its annual turnover in R&D alone, he adds.

Industry Perspective

While other companies allocate less than 10 per cent of space for research, Sami Labs has dedicated almost an entire facility to research. “The number of patented products of Sami Labs/Sabinsa Group is the proof that the research here is result-oriented. At present, we have over 130 International patents to our credit,” says Majeed. Unlike other organisations in the space, Sami Labs houses a research facility with over 120 scientists involved in specialised work in areas of phytochemistry, organic chemistry, tissue culture, plant biotechnology, biochemical pharmacology and clinical research. The recent patents are comprised of ingredients such as stilbenoids, peptides, 3-hydroxypterostilbene and boswellic acids in countries like China, New Zealand, the US, Canada and Mexico. The products help in hypercholesterolemia, weight management, skin aging treatments, inhibiting and preventing adipogenesis, protecting articular cartilage and even a hepatoprotectant molecule. The current R&D impetus of the Sami-Sabinsa Group focuses strongly on immunological basis of disease management based on natural principles. With precise scientific evidence generation at the basic, pre-clinical, and clinical research stages, the group believes in creating reliable and responsible science. This objective has been recognised by the intellectual property systems across the globe, according to Majeed.

Manufacturing Facilities

On the manufacturing front, Sami Labs has a contract manufacturing unit located at Payson city in Utah County of the US. This facility is a state-of-the-art finished goods manufacturing centre, producing capsules, tablets and bi-layer tablets with ingredients from Sabinsa and others for its customers worldwide. In India, Sami Labs have six ingredient manufacturing

ICT ENHANCING OFFERINGS • ICT, better known as Information Communications Technology, concerns itself with storage, retrieval, manipulation, transmission and receipt of digital data. • This data is communicated electronically to the people by different means such as emails, social media sites like Facebook, Twitter, etc. Integration and execution of ICT has reinforced and enhanced our skills which has developed our researches, promotions, offerings, etc. • All the research, new promotions, latest news are circulated through social media outlets like Facebook, Research Gate, Twitter, and LinkedIn accounts. Hence, the latest offerings and research we have on our products reach the intended audience group much faster -- bringing to them solutions they can use right away to affect their lives.

facilities, one located in Hyderabad and the rest near Bengaluru. While several of these facilities are suited for herbal extraction, one facility is only dedicated to probiotic production through fermentation technology. “The probiotic we produce requires no refrigeration and, therefore, can be used in several delivery formats, it’s a great seller world-wide,” he says. “One of our units is the first in Asia using indigenous super critical fluid extract technology. This is an alcohol free set-up for extracting natural extracts. In terms of meeting world demand for ingredients such as Curcumin and coleus forskolhii, we have a continuous extraction plant in place, and a second one is being built as we speak,” Majeed says. “Continuous extraction technology helps to scale up from vessel based input of about 1 or 2 tonnes to nearly 20-25 tonnes of material, thereby increasing our output to meet and exceed world demand,” he adds.

Growth of IT in Pharmaceutical Industry

Digital marketing has considerably impacted the growth of pharma industry in a good way. The commercial promotion of strategies for public health can be done effectively by digital marketing. “At present, most digital marketing efforts focus on specialists and patients, and not on general practitioners. Mobile networking is still in its infancy but mobile phone is the most engaging personal screen for any physician. Hence, efforts in this area could prove worthwhile for brands looking to connect,” says Majeed.

Role of Technology and Data in Shaping Digital Marketing in Healthcare

The main goal of technology and digital marketing in healthcare is to provide information at any time, in any place. The continuously rising cost of healthcare services is a problem and burdens the whole economy. Digital health technologies can reduce the price by centralising the care, according to the Director of Sami-Sabinsa Group. For example, ECG data can be fed in the system/mobile phone of the medical centre and a physician can access within a short period of time and provide the treatment without any delay to the patient. “Most people actively check online for healthcare solutions. Digital marketing includes mobile marketing, search engine marketing, social media marketing, etc. These techniques are inexpensive and more powerful than the traditional marketing. This kind of information, which is considered dynamic and not static, will reach consumers in a short period of time and can be updated more frequently than traditional methods. This can increase the patient’s satisfaction, improve care and lower costs,” he opines. Also, social media has gained prominence among professionals from different industry verticals for networking and is serving the customers with customised solutions.

MARCH / 2017 ehealth.eletsonline.com

Industry Perspective

Pharma Undergoing Paradigm Shift There has been a paradigm shift in the way the government is now interacting with the pharma industry – from one of assertiveness and insistence; it has now become one of collaboration and assistance, says Vishal Rajgarhia, Director & CEO, Finecure Pharmaceuticals Ltd, in conversation with Elets News Network (ENN). How is ‘Make in India’ helping Finecure Pharmaceuticals boost its manufacturing capabilities?

‘Make in India’ is one of the major reforms that our Prime Minister (Narendra Modi) has taken and it is certainly going to boost the pharma industry, given that the pharmaceutical industry is one of the 25 key sectors that the government has identified as a potential sector for foreign companies to invest in. Furthermore, a dedicated team to respond immediately to business entities through

a web portal and easing of statutory and regulatory procedures means that the pharma companies will at last be able to work to their full potential. There has been a paradigm shift in the way the governent is now interacting with the pharma industry – from one of assertiveness and insistence; it has now become one of collaboration and assistance. There will be new infrastructure and a new mindset where we will be competing with the best. Furthermore, increased competition will fuel chal-

lenge and make us less complacent and motivate us to higher standards of customer satisfaction and product innovation.

What implications do you see for the pharma sector once it is delinked from the medical devices industry?

To be honest and fair to the government, over the last many years, many attempts had been made to enact a law regulating medical devices but somehow it could never be done. It

The lack of a regulatory framework along international lines, the industry body felt, has been a major factor as investors were discouraged by the initial move of 22 medical devices being regulated as drugs by CDSCO and state drug controllers. The government has taken the first step in the appropriate direction. But there needs to be a separate law book, separate rule book and separate regulatory authority. 32

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Industry Perspective

is also true that nowhere else in the world are the pharma and medical device sectors governed by the same set of regulations. So, the delinking was inevitable, something that was waiting to happen. I personally feel that it is a step in the right direction. It is a policy decision and the intention of the government should be respected and appreciated. My only concern is that since the medical devices industry is in an embryonic stage and was so heavily dependent on the pharmaceuticals industry for its nourishment, there could be problems that we cannot foresee for the moment. There certainly was scope for a gradual phasing and delinking of the two industries. But it has made price control for medical devices a reality and thumbs up to that. The lack of a regulatory framework along international lines, the industry body felt, has been a major factor as investors were discouraged by the initial move of 22 medical devices being regulated as drugs by CDSCO and state drug controllers. The government has taken the first step in the appropriate direction. But there needs to be a separate law book, separate rule book and separate regulatory authority.

The government has taken the first step in the appropriate direction. But there needs to be a separate law book, separate rule book and separate regHow do you see IoT, big data analytics, and artificial intelligence impacting the pharma sector? What role these latest technologies are to play in improving inefficiencies across the sector?

The arrival of Internet of Things (IoT), big data analytics and artificial intelligence has woken up the pharma industry and made it aware of its immense potential and its ability to bring the Indian pharma industry on par with the best in the world. IoT, big data analytics and artificial intelligence are the future of the pharma industry in India. The ability to convert massive amounts of data into key performance indicators, the ability to check their plants from anywhere in the world over their smart phones, identifying potential problems and implement corrective action, it has offered a new pathway to pharma companies to develop actionable insights, organize their future vision, boost up the outcomes and reduce time to value regarding their management, planning and the measurements. Logistical planning becomes that much easier and production costs will become lower and increase productivity and efficiency. It is a blessing and boon to the industry and will change the face of how we work.

Promoting R&D, innovation and discoveries in technologies and molecules in Indian context is the need of the hour. How is India placed with regard to the industry-academia partnership for promoting innovations in the pharma sector?

We must confess and agree that most pharma companies are under investing in research and development (R&D). Offhand I cannot name even a single company that has tie-ups with the research academia. R&D is the backbone of any company and helps

it to develop new products and services that drive growth and progress. The government should do more to increase this awareness and also initiate incentives and programs that will motivate the industry to channel their resources towards research and development. Without doubt the landscape of partnership between academia and industry has to be expanded and become a prominent feature in the industry. It does seem counter-productive to share data and give away information that can negatively impact business but the benefits of collaboration are huge. It will provide access to new talent and modernisation and enlarged conviction and clearness with customers and other stakeholders. These advantages will happen not only for the pharma companies but also for the academia. itâ&#x20AC;&#x2122;s a win-win situation for all concerned.

What key challenges do you see impeding the growth of the Indian pharma sector?

There are many factors that hinder us from realizing our full potential but instead of looking at them as impediments I look upon them as challenges that need to be overcome so that the Indian pharmaceuticals industry can achieve its potential and convert these challenges into success stories. However, for this to happen it needs the support of the policymakers, academia and financial investors and all other stakeholders. However, since a question has been posed I would say that the three biggest impediments are an unsatisfactory energy infrastructure and poor transport infrastructure. India needs to focus on API to remove dependency on imports of bulk drugs for making drugs. The industry needs to focus on innovative drugs and value addition instead of just making generic drugs. The GMP issuance should be for a longer period and GMP should be recognized in other countries so that they do not need to re-inspect facility having Indian GMP which will give Indian Products a better brand value and revenue.

MARCH / 2017 ehealth.eletsonline.com

Leadersâ&#x20AC;&#x2122; Perspective

New Era of Medical Device Industry on the Anvil

India is growing as a key market for medical devices. The tremendous growth of the medical devices industry over the last decade and the current development trends are indicative of the industryâ&#x20AC;&#x2122;s great potential. Probir Das, Managing Director, Terumo and Chairman-Medical Devices Forum, FICCI, in conversation with Rajbala of Elets News Network (ENN), highlights future prospects of the industry in the light of fresh reforms introduced to push growth. Please share your views on the future of medical device industry in India.

The medical device industry in India has a huge potential. As per reports, the industry is projected to grow from its current $7-8 billion size to about $20 billion through an organic growth model, and to reach $50 billion through an inorganic growth model. This growth will come on the back of new policies, regulations, infrastructure, technology collaborations and strategic alliances with international players to focus on relevant markets globally. Increase in number of hospitals, healthcare service delivery and, consequently, a greater need for accessible as well as quality medical devices,is also expected to drive the growth of medical devices and equipment industry.

FEBRUARY / 2017 ehealth.eletsonline.com

Medical device will soon be delinked from the pharma sector and form a separate ministry. How is it going to boost the medical devices sector?

The potential formation of a separate ministry for the medical devices industry will shape the industry in a more structured manner. It will facilitate new rules and policies for this industry. It will also help to develop end-to-end support system on regulatory as well as policy front, provide a boost to the R&D infrastructure, promote investment, offer a platform for improving the start-up ecosystem; facilitate development of a focused approach to foster innovation, promote education and skill development for the medical devices industry, create deep understanding of the industry, and help develop a distinct identity of the industry.

What are the key opportunities for Indian medical devices and equipment industry?

As a country, we have huge need and, therefore, a big opportunity. However, whether that big opportunity translates into demand and that demand translates into market size are dependent on several things like improvement in healthcare penetration. Medical devices is an ancillary industry and adoption of technology in India, as the current adoption level of medical devices at $3 per capita is one of the lowest in the world. In the growing medical technology market, it is important for enterprises and the government to build global competitiveness and adopt a risk-based approach to develop a sound and comprehensive global supply chain management system that ensures the product quality, integ-

Leaders’ Perspective

rity and identity which is preserved throughout the supply chain. The important fact is that global supply chain will determine our competitiveness.

Please tell us about the implications of new rules and regulations for the Medical Devices notified recently. How will the new rules remove regulatory bottlenecks?

The medical devices industry was regulated under the Drugs and Cosmetics Act for several years. But after years of dialogue, the government has finally notified a draft of new rules and regulations for medical devices industry by separating it from the pharmaceutical industry. ♦ New rules will be able to ease norms for obtaining license and conducting clinical trials. ♦ Will reduce manufacturer-regulator interface by promoting digital platform.

♦ Boost government’s ‘Make in India’ campaign by providing an environment conducive to domestic manufacturers that could lead to greater long-term investments. The new rules will be effective from January 2018. In this transition period necessary changes or distinct interventions can be made such as: ♦ Expiry of medical devices ♦ Classification of devices on categories ♦ Formulation of totally separate act for medical devices from Drugs and Cosmetics Act.

FICCI and the Central government hosted ‘India Medical Device 2017’ in Bengaluru recently to increase overall growth of domestic production and growth in the sector. What were the key takeaways from this international event?

The ‘India Medical Device 2017’ fo-

MEDICAL DEVICES CONSUMPTION IN US DOLLARS India is compared on healthcare delivery parameters with countries like China, Brazil, Russia, etc. Seeing the medical devices consumption across the world, there is a pressing need to improve per capita medical device consumption in India.

INDIA - $3

BRAZIL - $28

RUSSIA - $43

CHINA - $178

Medical devices consumption per capita in terms of US dollar:

rum brought together the highest decision makers from the industry, government, policy makers, international regulators, etc to discuss on overall growth of the industry and encourage ‘Make in India’ for manufacturing of medical technology. The outcomes of the forum meet were: ♦ Realisation to craft a medical technology 2020 vision. ♦ Appropriate debate on whether to support protectionism or drive competitiveness of domestic manufacturing. ♦ Debate on whether to only focus on Make in India or also ‘Develop in India’. ♦ Introduction of Health Technology Assessment.

Medical device sector is to be included as one of the 25 flagship industries of the Indian economy. What does it mean for the industry?

The medical devices industry has gained its rightful place in the list of 25 flagship industries of the Indian economy. This will cause a shift in the industry’s structure, conduct and performance. Medical device industry is comparatively very young and complex. Being a part of the ‘Make in India’ initiative will be valuable for its growth. The government’s task force will address the pressing issues and make recommendations to assist the industry.

What are the key targets the industry should try to achieve in the next few years to become a global hub for medical device manufacturing?

♦ Setting up manufacturing hub under Public Private Partnership (PPP) model. ♦ Setting up Centre of Excellences for medical technology innovation. ♦ Skilling of more manpower for the growth of the industry. ♦ Capital funding for startups and research projects, etc. ♦ Creating necessary bodies to drive the policies and domestic manufacturing.

MARCH / 2017 ehealth.eletsonline.com

Industry Perspective

Netmeds.com: Building Trust, Ensuring Accessibility

The Indian retail pharma sector is huge. In fact one of the largest and fastest growing in the world, but comprised mainly of a rather organised coterie of brick-andmortar shops. Following the emergence of an information-driven society coupled with the advent of enhanced internet services, Netmeds.com has emerged as one of the most trusted online pharmacies in the country – the first pan India licensed e-pharmacy, says Bruce Schwack, Co-Founder and Director, Communications, Netmeds.com, in an interview with Elets News Network (ENN). Please provide us an overview of the products and services offered by Netmeds.com.

Netmeds.com is an initiative of the Dadha & Company – one of India’s oldest pharmaceutical companies, with over 100 years’ experience in dispensing quality medicines. The company offers online access to a wide range of medicines and other health related products across the country through its dedicated platform. Online pharmacy is totally new and important concept for India and Netmeds.com was formed to create the maximum outreach of medicines in the country. At Netmeds, we ensure availability

MARCH / 2017 ehealth.eletsonline.com

Industry Perspective

of medicines from reliable manufacturers. Our aim is to create beneficial and affordable healthcare choices, mitigating risks assuring the best outcomes. We also endeavour to ensure access to reliable drug information to our customers; bring affordability and convenience to them through online shopping for medicines and do direct delivery throughout the country, of a wide range of medicines.

Could you please apprise us about the marketing initiatives being taken by Netmeds for brand promotion?

Every day should be marketing initiative for any successful brand who serves the customers. In this space, we have to understand that we are not building a brand but we are building a category. The important fact is that along with the promotion of the brand, Netmeds also designs and broadcasts messages to create accessibility for medicines digitally. It’s been extremely satisfying to see how well the concept has been accepted and has created desirable disruption of previously accepted paradigms in India. The whole idea of e-pharmacy was conceptualised to offer medicines and generics for the convenience of the customers keeping in mind the affordability element to act

as a one-stop, easy accessible shop for patients seeking medicines and health and wellness needs to be a provider of reliable, authentic and approved medication; and doorstep delivery of medicines in tier two and tier 3three cities.

How safe is to procure medicines online?

It’s perfectly safe if the patient or customer has a valid prescription written by a doctor. The medicines must be dispensed only by pharmacist once the prescription is reviewed. Netmeds operates as all online pharmacies should operate. A qualified team of certified pharmacists approves and digitises every transcription. We are committed to provide safe, reliable and affordable medicines as well as a customer service philosophy that is worthy of our valued customers’ loyalty. We offer a

BENEFITS OF ORDERING MEDICINES ONLINE • Affordable lower prices and no expired drugs on sale • Privacy/Anonymity — You may feel more comfortable purchasing your medication online, or simply want to speak to someone about prescriptions and your health online or over the phone rather than in person. However, to prevent the use of your personal information for unauthorised purposes, make sure the pharmacy has an appropriate privacy policy. This is one of the things that PharmacyChecker.com checks for you. • Convenience — If one finds it physically difficult to make it to the pharmacy, living in a remote rural area mail-order pharmacies enable consumer to buy medicine sitting at corner. It will also remind you when you can order a refill to help you maintain your regimen. • Medical information — Some online pharmacies provide useful information about medications and diseases as well as links to medical resources such as universities, government agencies, and health associations.

superior online shopping experience, which includes ease of navigation and absolute transactional security.

How Netmeds or other e-pharmacies are penetrating and capturing the market in Tier two and Tier three cities? Can you tell us about the expansion plans of Netmeds?

Netmeds continues to deliver its services to every state in India and have delivered in more than 800 cities. The company has planned to keep improving its service, coverage and continue to learn from customers. Company will soon be launching a social networking challenge to deliver its services in remote areas of the country. Currently, Netmeds has over a million registered users and the number is growing at the rate of around 10 per cent month on month basis. Having the ability to deliver our services in 800 cities, we hope to continue to expand the scope of our services in every state of the country. Our endeavour is to continue deepen our penetration in every state, especially the remote areas.

What according to you is the USP of the company?

Netmeds is the only fully licensed online pharmacy to serve all of India. It has delivered in nearly 800 cities across every state in the country. The company employs more than 400 staff including pharmacists, pharmacy technicians, customer service specialists, logistics and warehouse experts, digital payments professionals and programmers.

MARCH / 2017 ehealth.eletsonline.com

Industry Perspective

Care24: Ensuring Healthcare at Doorsteps

Care24 is a first-of-its-kind home healthcare service provider in Mumbai that offers personal and affordable healthcare assistance within the comforts of one’s home, Vipin Pathak, Co-founder and CEO, Care24, in an interview with Elets News Network (ENN) talks about how his company aims to achieve 10 per cent market share of the $3 billion home healthcare industry.

We are not just involved in connecting the patients to the right caregivers, but also specialise in providing reliable, transparent and secure services that enhances the patient experience. The core idea is to leverage technology to track the caregivers and enforce a stringent feedback system. This ensures back-to-back, integrated best quality services to our patients and their family. Through our service, a patient can connect with the right caregiver and seek assistance according to one’s needs.

How does it function and the benefits it offers to the patients?

Give us an overview on Care24?

Care24 was set up with the idea to cater to that segment of population that needs professional care but does not require or cannot afford long term hospitalisation. For such patients, especially those in the age bracket of above 60, turning to untrained help at home may cause more harm than good. Therefore, Care24 aims to provide personalised healthcare at the doorstep of patients.

MARCH / 2017 ehealth.eletsonline.com

Care24 has a network of qualified nurses, attendants and physiotherapists that provide assistance round the clock, for varied requirements, including elderly care, pregnancy care, infant care, neuro rehabilitation and cancer care. Having access to healthcare at home is a very emotional aspect. It makes people less dependent on their family members by offering them the convenience, flexibility and discretion to get in touch with a relevant caregiver. We offer the following benefits to our patients: Complete home healthcare: Care24 offers hospital-like care at home with state of the art medical equipments, diagnostic tests and medicines. We also offer nutrition counselling to those who need to control their diets. Progress monitor and feedback: We ensure that the patients are under constant medical supervision through live monitoring and tracking of vitals. We also offer counselling from certified doctors, when needed. Round the clock service: Our caregivers are available 24 hours/ day, providing round the clock care. We also offer the convenience of mobile app based care, and always have a buffer medical team on standby. Verified and trained c aregivers: We choose our car-

Industry Perspective

egivers on the basis of a stringent background verification procedure, followed by on-boarding and diligent training. We also conduct medical interviews and test their capabilities through assignments and competitive analysis.

How is it different from other existing players?

What sets Care24 apart are its training programmes. In fact, we only exist because of our training programmes that add value to the unskilled workforce, helping them enhance the quality of their work and earn higher remuneration at the same time. There is a large pool of providers to pick from, and we are continuously improving our technology to match patients with caregivers as quickly as possible and improve communication.

What are your plans for the year ahead?

The home healthcare industry is pegged at approximately $3 billion, and we aim to achieve 10 per cent market share in the long term. Also, we aim to take the patient count to around 2,500 per day from the current 900 per day, as we spread to other metros in the country. We also plan to integrate connected devices, like health sensors, into our platform so providers donâ&#x20AC;&#x2122;t have to make home visits to conduct routine checks, like vitals and blood pressure measurements. We also want to connect the home-bound patient with his doctor and hospital in a much more meaningful way

What are your target cities?

Our focus remains to enter a city and establish a strong foothold within that city with a depth of services and network as opposed to achieving scale through a multiple city footprint. We have recently started operations in Delhi-NCR and plan to follow it up to at least two other cities by the end of this year. We plan to enter the markets of Bangalore, Hyderabad, Chandigarh and Ahmedabad.

What are the issues pertaining to home healthcare?

Healthcare in India is a very unorganised sector, and home healthcare is an even smaller, though growing, segment. The biggest challenge of a specialised healthcare business such as ours remains in the areas of education and awareness. In a country like ours where many are still unaware of home healthcare and its benefits, educating the patients and their families has been a major focus area for us. Apart from this, finding skilled staff in the healthcare industry is another challenge, but one that has a solution, and one which Care24 is committed to solving.

Your current state of healthcare options for the geriatric population in India and home healthcare services industry per se?

Currently, chronic care for patients who need long term care constitute around 60% of our patient pool and we have also forayed into cancer care, elderly care, maternity care, and infant care, besides offering expertise in post surgical care and stroke rehabilitation. We have also expanded our portfolio to add services for diagnostics, pharmacy delivery and medical equipments procurement. The idea is to create a complete healthcare ecosystem for any patient in the home environment. We feel that it will make the patients and their families more in control of their well-being than ever before.

How has the overall growth been of healthcare industry in India?

Over the past decade, there have been massive advancements in the healthcare industry in India, owing to well trained personnel, better diagnostic technology and superior quality medical equipment. The overall Indian healthcare market is worth approx $100 billion and is expected to grow to $280 billion by 2020. This has resulted in India becoming a hub for medical tourism, driving increase in expenditure by public and private players. Moreover, India is extremely cost

competitive compared to its peers in Asia and Western countries. The cost of surgery here, for instance, is about one-tenth of that in the US or Western Europe. Also, amid the rapidly increasing burden of chronic diseases, and the demand for quality medical care, especially for the elderly, the market is now opening up for homebased healthcare services. According to a research report by Cyber Media Research(CMR), the market for home healthcare in India is projected to reach USD 6.2 Billion by 2020 at a Compund Annual Growth Rate (CAGR) of 18 per cent.

What is the role of technology in the healthcare industry?

Rapidly transforming medical technology and the availability of technologically advanced diagnostic and therapeutic equipment together with changing practice pattern of doctors has revolutionised the way health care is being delivered today. Today, patient care experiences are top priority in the healthcare industry across the globe.

What are your investment plans for the current year?

Technology, medical expertise and expansion are our three dimensions which require investment. We would continue our investment in further logistic automation, integrated medical devices, remote monitoring, training and geographical expansion in next six-nine months. We are serving nearly 900 patients in Mumbai. We want to extend the services in other cities maintaining highest quality of service. Quality service needs an investment mindset to curate the right skill set and behaviour. We have and continue our different condition based training like cancer care, rehab care, infant care and so on.

What is your revenue mix?

In 2016, we raised $4 million in our Series A round led by venture capital firm SAIF Partners, and $350,000 from India Quotient that we are using to enhance our technology and to train service providers who visit patients.

MARCH / 2017 ehealth.eletsonline.com

Industry Perspective

WinMagic: Securing Data for Indian Healthcare Industry

WinMagic helps pharmaceutical companies secure and encrypt data at rest. Having served the healthcare industry for the past 20 years, they bring leading industry technologies to provide unmatched security solutions specially designed for their clientsâ&#x20AC;&#x2122; needs, says Rahul Kumar, Country Manager and Director, WinMagic India, in conversation with Rajbala of Elets News Network (ENN). Excerpts:

MARCH / 2017 ehealth.eletsonline.com

Industry Perspective

Please give us an overview of your company.

WinMagic is a data at rest security place. We help our customers secure data across all platforms. We have been in this business for the last 20 years and have emerged as one of the largest online security providers for pharmaceutical companies in the country. We take into account our clientsâ&#x20AC;&#x2122; inputs when it comes to providing data security solutions. Many of our clients are working with large healthcare companies in India. Pharma companies want to protect the customer data and we have been providing multiple solutions for the same. The basic security level is at the periphery which leaves the door open for theft. That main door is the piece of encryption which we bring to the core for the companies.

Please tell us about the kind of solutions you provide for healthcare in the country?

We provide security solutions for data at rest. We help in securing and encrypting the data for our customers on their laptops, servers, files, Universal Serial Bus (USB) media or on the cloud workload. We bring to the core leading industry technology and we have the advantage of being the only player who can help the customers in this space. Globally also no company can match our security offerings for the healthcare industry.

What are the upcoming trends you see in the Indian healthcare industry?

In the coming days, India will witness what is happening in the global market place right now. I am talking about the connected healthcare and the healthcare data that is being digitised. Hospitals are moving towards digitising reports, X Rays and scans. Owing to the size and complexity of India, making it a trend will take some time. In future, healthcare would be connected in such a way that a person falling sick in Delhi can seek medical attention in Chennai. The patientâ&#x20AC;&#x2122;s entire case history

I am very optimistic that the healthcare industry will move ahead at a great pace and offer new avenues for growth to companies like ours would be linked to Aadhaar card and it would be easier for the doctor to understand the medication process the patient is going through and treat him accordingly. For this to be happen, a database should be prepared and every point of access needs to be secured.

How digitisation will push the health industry in the coming days?

Convergence of various technologies has become a key enabler for the entire health industry. Earlier everything was on paper, but now everything is on computer. AIIMS (All India Institute of Medical Sciences) has digitised the whole process of registration. We have seen a lot of transformation happening in the space. These changes have been enabled by technology which makes the processes simpler and eliminates the need of middlemen.

What are your expansion plans in India?

Our company is expanding significantly globally. We have a very aggressive set of people. Even in India

our expansion has been significant. There is huge market for our products and we see a huge potential for us to expand and grow.

What are the challenges for the growth of IT in the pharma industry?

The challenge which I see in this industry is that when you digitise you have a scope to move forward at an exponential pace, but that opens lot of loopholes and grey areas. It is of paramount importance to secure pieces as you move ahead. There cannot be a bar on the growth rate but at the same time cognizance of the threats makes sure that the grey areas are properly covered.

What are your views on cloud computing for pharmaceutical industry?

India has a long way to go. We should be able to move in the digitisation direction significantly. I am very optimistic that the healthcare industry will move ahead at a great pace and offer new avenues for growth to companies like ours. Technology will help pharmaceutical industry grow faster. MARCH / 2017 ehealth.eletsonline.com

Leaders’ Perspective

Digital AIIMS: Leading Digital Revolution in Indian Healthcare The Digital AIIMS project, with nearly 45 lakh beneficiaries, has had the highest footfalls of Digital India Projects. AIIMS has been felicitated by the Ministry of Electronics & Information Technology for reaching the milestone of India’s first fully digital public hospital, says V Srinivas, Deputy Director, Administration, All India Institute of Medical Sciences in conversation with Gautam Debroy of Elets News Networks (ENN).

Tell us about the Digital AIIMS Project?

The Digital AIIMS project, implemented as part of the Digital India Initiative, has been widely termed as the First Digital Revolution in Health-

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care in India. It has two components – the e-Hospital Project and the AIIMS Transformation Project. The online registration software for AIIMS and three other hospitals of Delhi was launched on July 4, 2015 as part of

Digital India initiatives by the Prime Minister of India. The Digital AIIMS project, with nearly 45 lakh beneficiaries, has had the highest footfalls of Digital India Projects. AIIMS has been felicitated by the Ministry of

Leaders’ Perspective

Electronics & Information Technology for reaching the milestone of India’s First Fully Digital Public Hospital. The Prime Minister commended the Digital AIIMS project from the ramparts of Red Fort in his August 2016 Independence Day address. The Ministry of Health and Family Welfare has recommended the Project for the Prime Minister’s Award for Excellence in Public Administration. As an official associated with the conceptualisation and implementation of the Digital AIIMS project from January 2015 till March 2017, I can say that the Digital AIIMS project can be termed equivalent to ‘Saving the Titanic’ in creating a patient-friendly hospital at the apex medical sciences university of India. It has reduced patient wait times by six hours per visit and freed up clinician’s OPD timings, brought transparency and streamlined patient records.

What is the role of specialised cadres in Digital AIIMS Project?

The e-Hospital project hitherto has

been implemented in a fragmented manner leading to little impact on the institute activities. The Digital AIIMS project has envisaged and achieved a major change in the management practices of the All India Institute of Medical Sciences. It required creation of specialised cadres in nursing, patient care, software professionals and security personnel. The Nursing Informatics Specialist cadre was created from within the existing nursing personnel to coordinate between the departments and the computer facility to ensure transparency in patient management practices. The new and follow-up appointments data are available on the Aadhar-enabled digital platform for easier patient management. The cadre of Data Entry Operators has enabled speed in registration at the OPD Counters. AIIMS used to have crowds waiting for the OPD registration from 3 am onwards. Today, patients come at 8 am and the registration process is completed by 9.30 am. There are fast track registration counters also for those patients who have made online registrations. The Patient Care Coordinators enable the patients to reach the clinician’s OPD consultation rooms and allow follow up appointments. The Exit OPD counters have been created to ensure that the next visit date of the Patient is available to him along with investigation dates.

You have started OPD registration online. What are its advantages and what is the system of registering online?

The online registration system was commenced in July 2015. Till date the online registration has benefitted 45 lakh patients. The Aadhar linked online registration system enables the patients to develop online OPD cards and has a linkage with Pay Gov portal for making patient payments. It is a huge step forward for creation of patient friendly hospitals and has been replicated in all Central government hospitals as also several state government hospitals. V SRINIVAS Deputy Director, Administration AIIMS

AIIMS has been asked to assist Hospitals in States across India

for digitizing services. How are you going to do that?

The Prime Minister in his 2016 Independence Day address commended the Digital AIIMS project for replication on a pan India basis. The Digital AIIMS project can benefit about 3 crore patients if successfully replicated on pan India basis. AIIMS has conducted several on-boarding workshops for Central Government Hospitals. A Hospital Transformation Cell has been constituted for handholding state medical colleges and hospitals for creation of fully digital hospitals. AIIMS has conducted an on-boarding workshop for 42 medical institutions of Kerala. Several state governments have visited the Digital AIIMS project and a pan India replication process has commenced.

Do you have any proposal for creating online registration facilities for patients coming from other countries?

The online registration system enables patients to register from anywhere across the globe, with an Aadhar-enabled number.

What initiatives have you taken for cashless payments in AIIMS?

AIIMS has taken major steps for cashless payments through Internet banking, POS payments and other digital banking practices. Over 200 kiosks have been operationalised at AIIMS with Internet banking facilities. Patients can make payments through credit cards and other digital payment practices. The hospital services worked seamlessly in coping with the transition in the months of November - December 2016 post demonetisation.

What are the challenges of Digital AIIMS Project?

The replication of patient friendly hospitals requires sustained effort and commitment. The Digital AIIMS project was successful because it could bring together a large group of individuals and ministries who could function in synergy bringing their collective positivity to make a major systemic change.

MARCH / 2017 ehealth.eletsonline.com

Expert Opinion

Leveraging Technology to Better Health Services

Always ready to adopt technological innovations to improve healthcare delivery, Sir Ganga Ram Hospital in Delhi has added another feather to its cap by pioneering the Smart OPD Solution by Mcura, thereby managing overcrowding at the hospital and significantly reducing inconvenience to patients. Dr Ajay Swaroop Mathur, Honorary Secretary cum Treasurer, Board of Management, Sir Ganga Ram Hospital, in an interview with Vivek Ratnakar of Elets News Network, talks about his vision on how technology has emerged as a big factor in improving health services. Generally, what trends do you see emerging in the healthcare industry as far as adoption of Information and Communication Technology (ICT) is concerned?

ICT has already been integrated in almost all services of the healthcare industry. Basically, the back office and front office activities have already been taken over completely by IT. This means everything from accounts to billing and patient admission to discharge has been digitised and computerised. As far as patient care is concerned, IT has started playing a big much bigger role. It is also improving physiciansâ&#x20AC;&#x2122; efficacy. In fact, in the near future, may be in my lifetime itself, I wonâ&#x20AC;&#x2122;t be surprised if virtual examination and virtual treatment of patients is a common sight and clinical history of patients is transcribed by qualified medical transcriptionists.

What we are doing in telemedicine is restricted to diagnosis of the health problem and providing appropriate advice to the local physician regarding the disease management. If a case is such that he or she needs to be referred to a better facility, then we provide whatever treatment is required.

MARCH / 2017 ehealth.eletsonline.com

Will it also help patients in rural areas?

Telemedicine is already a proven method. Even the government is trying to reach rural areas to bridge the health delivery gap. It is a very promising area and Sir Ganga Ram Hospital already has a very active telemedicine programme, especially in Himachal Pradesh. What we are doing in telemedicine is restricted to diagnosis of the health

Expert Opinion

problem and providing appropriate advice to the local physician regarding the disease management. If a case is such that he or she needs to be referred to a better facility, then we provide whatever treatment is required.

Can you explain how Mcura’s Smart OPD Solution works? How does it benefit both doctors and patients?

The way routinely the OPDs are run in big hospitals is an unpleasant experience for the patients and a chaotic situation for the hospital as well as doctors. Even in the case of Ganga Ram Hospital, the patients were coming and crowding in the OPD and doctors had no idea how many patients they had to see in their given slot. This led to a lot of chaos. So, we were always thinking of trying to improve upon the situation. When we came across the smart OPD solutions by Mcura Services, they had already done a pilot project at the All India Institute of Medical Sciences (AIIMS). Since that hospital is also having a high volume of patients like Sir Ganga Ram, we thought that this system may also suit our needs. So we studied it and adopted it. The fundamental thing about the smart OPD concept is that it starts with the appointments of the patient. So now there is a robust appointment system in place, wherein every doctor and every consultant has a list of patients who are booked for him on that particular day. Similarly, the patient also has a list whereby his exact time is booked, thereby avoiding overcrowding. If a patient is booked for 3 pm, at best he is supposed to come 15-20 minutes before, rather than coming in at the time of the slot opening and waiting in the queue and then rushing all over the place. Now it is mostly a syncronised procedure, thereby the patient knows where and what time he is supposed to be seen and the doctor knows how many patients on that particular day are fixed for him so that he adjusts his time accordingly. That is step number one. The step number two is when the

The way routinely the OPDs are run in big hospitals is an unpleasant experience for the patients and a chaotic situation for the hospital as well as doctors. Even in the case of Ganga Ram Hospital, the patients were coming and crowding in the OPD and doctors had no idea how many patients they had to see in their given slot. This led to a lot of chaos. patient reaches the hospital in a particular department he is met by a representative of Mcura Services, who guides him as per his requirements. When the patient reaches the reception, he is asked to fill a very small demographic form, in which his or her particulars are filled and based on that a smart card is generated. Once the smart card is generated, the information is conveyed to the doctor’s chamber that the particular patient has arrived. At the same time, once the smart card is generated, he is asked to pay the consultation fees of the concerned doctor, which again is online. Once the patient is registered, the representative of the company (Mcura) goes to the particular doctor’s chamber where there is a queue system. The person concerned there is told which patient is being seen by the doctor and after how much time. This information is also available with the patient in his android system. The step three is when the patient enters the doctor’s chamber, he is examined and his history is recorded by a qualified medical transcriptionist and this information is then stored on the card and printouts are given to the patient so that now there is a record that what exactly transpired on that particular visit. When the same patient comes back next time, he doesn’t have to carry a bag full of reports of examinations, x-ray reports, etc. Everything will be filled in the card and as soon as the smart card is swiped, all the information can be accessed. The patient can take this card to the investigating areas like radiology or blood test, etc. He just has to swipe his card and all

the necessary information regarding the patient can be seen by the particular department. It is proposed in the near future that the scope of the card will be increased. It may function as an e-wallet, whereby the patient can put in some money in it and doesn’t have to go to the cashier every time there is a need. He just needs to swipe the card and the money is automatically deducted. Similarly, it is also proposed to give certain advantages to the patient having the smart card. Some sort of concessions in subsequent investigations can be given to the smart card holder.

What kind of new innovations you see coming up in the next few years?

We already have a lot of new innovations and to name a few we have something called PACS, which is a Picture Archiving and Communication System. Now by virtue of this, in any given area of the hospital a consultant or a docor is able to view various radiological reports of X-rays, CT scan and MRIs. These images are stored so that at any given time it can be retrieved and the surgeon or physician is able to access. Robotic surgery is gaining more and more prominence now, but we are doing it for the last five years. Our robotic unit has been successfully using robotic surgery in the treatment of tumours, neurological disorders, prostate surgery, gynaecology, and oral cancer. We are continually trying to improve our system with the use of new technology to make the life of the patient as well as the treating physician easy.

MARCH / 2017 ehealth.eletsonline.com

healthsummit.eletsonline.com/karnataka Host Partners

Department of Health and Family Welfare

NHM Karnataka

Supported By

Suvarna Arogya Suraksha Trust

KARNATAKA Bengaluru, November 2016 11th April, 2017, Bengaluru

Transforming Healthcare with Technology...

Chief Guest

Guest of Honour

Shri Siddaramaiah

Shri KR Ramesh Kumar

Hon’ble Chief Minister Government of Karnataka

Hon’ble Minister for Health and Family Welfare Government of Karnataka

Programme Chair

Dr Shalini Rajneesh, IAS

Principal Secretary to Government Department of Health and Family Welfare Government of Karnataka

Co - Programme Chair

Dr Rathan Kelkar, IAS Mission Director National Health Mission Government of Karnataka

We cordially invite you to be part of the Grand and Prestigious National Healthcare Summit in Silicon Valley of India PARTICIPATION FROM:

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DISCUSSION POINTS: Leadership and Governance in Healthcare Delivery Best Practices in Public Health Delivery from Indian States Health System Financing Management Strengthening Coordination - SelfHelp Group Model of Health ICT in Healthcare CSR initiatives in Healthcare. Raising Capital for Healthcare Drug Logistics Management in Private and Public Sector •

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Ministry of Health and Family Welfare, Government of India Ministry of Health and Family Welfare, Government of Karnataka Health Secretaries of State’s Government Mission Directors of Nation Health Missions in State Governments Commissioners of Directorates of Health and Family Welfare of State’s Government International Agencies such as World Bank, Gate’s Foundation, WHO etc Management of Central and State PSUs Private Hospitals: Management Team Medical Technology: Manufacturers / Distributors Technology: OEMs / SIs / ISVs / Consultants BFSI: National / Regional and Private Banks Insurance: Insurance and TPAs Education: Universities and Colleges India’s leading corporate groups Leading NGOs / Health Trusts / Philanthropist District Health Oﬃcers / Taluk Health Oﬃcers

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