Emerging Technology—Laying Strong Foundation of Robust Patient Care

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may-june 2019 | Volume 14 | Issue 05

COVER STORY

Artificial Intelligence Transforming

Healthcare Landscape

policymakerâ&#x20AC;&#x2122;s perspective

Ajoy Mehta

Chief Secretary, Govt of Maharashtra and the then Municipal Commissioner, MCGM

Shalini Rajneesh

Principal Secretary for Planning, Programme Monitoring & Statistics Department, Government of Karnataka

Sanjay Mukherjee Secretary, Medical Education and Drugs Department, Government of Maharashtra

I A Kundan

Secretary, Women & Child Development, Govt of Maharashtra & the then Additional Commissioner, MCGM

industry perspective 22 Tech Care for All

24 LeadSquared

leaderâ&#x20AC;&#x2122;s perspective 28 Bomi Bhote CEO, Ruby Hall Clinic

46 Sr Lucien Thomas Executive Director, Holy Family Hospital

30 Shailaja Suresh Chief Executive Officer, Gleneagles Global Hospitals, Bengaluru

46 Rajendra S Kshirsagar CIO, Holy Family Hospital

32 Rajendra P Patankar Chief Operating Officer, Nanavati Super Speciality Hospital

48 Dr Sujit Chatterjee Chief Executive Officer Dr L H Hiranandani Hospital

CONFERENCE report bengaluru | 25 april 2019

Editorial Emerging Technology—Laying Strong Foundation of Robust Patient Care As an enabler, technology has influenced every facet of human life and played a key role in transforming the narrative of the Indian healthcare delivery system in a holistic way. Nowadays, existence of human life seems unthinkable without computer, laptop, and mobile apps. Emerging technologies including artificial intelligence, IoT, and virtual reality, have not only bridged existing infrastructural gaps in healthcare technology front, but these tools seem to be crucial to improve efficiency and accuracy, providing an enriched healthcare experience to masses. eHealth’s latest issue brings to the fore how AI is proving to be the biggest game-changer to reduce spending and improve patient outcomes in healthcare sector. Our cover story titled ‘Artificial Intelligence Transforming Healthcare Landscape’ explores various aspects of the emerging technology to create an accessible and affordable model of patient care. It highlights various applications of the AI in areas of hospital care, clinical research, drug development, insurance and prediction of deadly diseases like cancer and heart ailments. The magazine also carries perspective of policymakers including Ajoy Mehta, Chief Secretary, Government of Maharashtra and the then Municipal Commissioner, MCGM; Shalini Rajneesh, Principal Secretary for Planning, Programme Monitoring & Statistics Department, Government of Karnataka; and Dr Sanjay Mukherjee, Secretary, Medical Education and Drugs Department, Government of Maharashtra, who shed light on various innovative practices adopted by the State Governments to enhance care. The issue also carries interviews of Shailaja Suresh, Chief Executive Officer, Gleneagles Global Hospitals, Bengaluru; Rajendra P Patankar, Chief Operating Officer, Nanavati Super Speciality Hospital; and Dr Sujit Chatterjee, CEO, Hiranandani Hospital, highlighting best practices adopted by them to bring a difference in the Indian healthcare ecosystem. We have articles from Randox, LeadSquared, and Tech Care for All, providing industry insight. The magazine also carries a conference report of 3rd Healthcare Innovation Summit, Bengaluru, comprising outcomes in terms of experts’ inputs to boost healthcare delivery system. With such a bouquet of special feature, articles, and interviews, I hope the latest issue of the magazine will evoke an invaluable feedback of our esteemed readers.

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

cover story

Artificial Intelligence Transforming

Healthcare Landscape In the light of India facing double whammy of communicable and non-communicable diseases, Artificial Intelligence (AI), an emerging technology, is being hailed for its immense transformational possibilities in providing an enriched healthcare experience to people at large. Mukul Kumar Mishra of Elets News Network (ENN) explores the various avenues where AI can be leveraged to strengthen the Indian healthcare delivery system.

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such as deep neural networks, deep belief networks and recurrent neural networks in applications like computer vision, speech recognition, natural language processing, audio recognition, social network filtering, machine translation, bioinformatics and drug design, where they have produced results comparable to and, in some cases, superior to human experts,” says Dr Lakshmi Vaswani, Assistant Pathologist, Bhatia Hospital. AI bringing paradigm shift in healthcare delivery AI is being touted as the biggest game-changer in healthcare sector and industry experts vouch for its applications in bolstering patient care. It is not only helping scientists and researchers find cures through proteinfolding to beat cancer or enabling gene editing through CRISPR models, but it’s also supporting the need for early disease detection, which is very crucial in preventive treatment. Artificial Intelligence is poised to play a major role in the global healthcare industry, believes Rajendra P Patankar, Chief Operating Officer, Nanavati Super Speciality Hospital. “With modern medicine facing a significant challenge of acquiring,

analysing and applying structured and unstructured data to treat or manage diseases, AI systems with their data-mining and pattern recognition capabilities come in handy,” Patankar says. AI diagnostic tools are bridging the huge demand and supply gap when it comes to quality healthcare. Jyotsna Pattabiraman, Founder and CEO, Grow Fit, says, “Be it virtual assistants, intelligent automation, or cognitive computing, AI is definitely set to make a big impact on various aspects of healthcare, some of them being operations, patient-centric care, and precision medicine. Although there is still a long way to go before AI replaces doctors completely, it will definitely make way for a more efficient and reliable assessment of patients.” The tool is being used to detect early stage cancer symptoms, more accurately than conventional methods by the doctors. Machine-learning models and neural networks can help AI detect such anomalies in a fraction of the time taken by doctors. Sanjay Pathak, Head Healthcare and Insurance Solutions, 3i Infortech, believes that by “leveraging vision, deep learning on sensor-based vital data, physicians will be better

cover story

echnology is fast making inroads in every sphere of life, including healthcare sector. Thinking of leading the life away from laptop, smart phones, and latest mobile applications, seems unfathomable nowadays. Though IoT, virtual reality and blockchain have proven their worth in enhancing different deliverables in healthcare sector, Artificial intelligence’s (AI) transformative power is talk of the town these days. From hospital care to clinical research, drug development, insurance and prediction of deadly diseases like heart ailments, AI applications are proving to be a boon to reduce spending and improving patient outcomes in healthcare sector. Prasad Kompalli, CEO & Co-founder of mFine, opines: “Technology allows you to remove barriers of distance and time. Anyone with a smartphone can connect to a doctor.” As Indian healthcare industry is fraught with challenges including unavailability of requisite infrastructure to understaffed hospitals, lack of equipment and other logistic supports, AI holds huge significance.

What is Artificial intelligence? Artificial intelligence means simulation of human elements by machines/ computers, where they acquire information (learning), process it to reach reasonable conclusions (action). It leverages various technologies like machine/deep learning, vision, Neuro-Linguistic Programming (NLP), robots, or autonomous machines, etc, for delivering better results. In theory, AI systems need to “see” unstructured data, such as radiologic images, graphs, slide images, clinic notes, and literature texts, and then convert them to a knowledge base in a structured format. “AI is based on the idea of deep learning, which uses architectures

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cover story equipped to diagnose ailments. Medical imaging can be taken to new levels where AI on top can accurately diagnose and in some cases even predict diseases.” “Blood smears will use vision to count cells and anomalies. ECG & cardio data can pass through AIto predict outcomes and assist physicians in accurate diagnosis,” Pathak adds. Talking about AI’s role in radiology, Sushant Kinra, Managing Director, Carestream Health India Private Limited, says, “It will be a key enabler for the radiology sector. Although there are many debates surrounding it, there is currently some great work happening in this field. If AI picks up the way it is destined, it will surely enhance radiology and will lead to better patient care.” AI is not about reproducing

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intelligence, but it is use of algorithms to find patterns, similarities and features from large data sets, believes Mangesh Baxi, of Interface Infosoft Solutions. Raghavendra K, Head of Engineering, BOTAIML Pvt Ltd, says “Artificial intelligence (AI) has huge application in radiology. BOTAIML is working on various AI technologies. We also augment computer vision technologies to aid radiologists. AI technology helps radiologists to work with higher efficiencies, accuracies, and shorter turnaround times.”

(EHR), drug development and in analyzing large sets of MRI and CT scans to identify and diagnose malignant tumours, speaks volumes about the huge potential of the tool. According to a research report by Global Market Insights, Inc., the global market of AI is expected to surpass $13 billion by 2025. As per Gartner, world’s leading research and advisory company, most organisations are in the early stages of AI adoption and it would take a while before real benefits of AI could be leveraged.

AI market Growing application of healthcare artificial intelligence software and solutions is set to drive the industry growth. Its worth in areas of clinical research, electronic health records

The Government pins hope on AI to turnaround things However, the Central Government has no qualms about its role in sundry fields including healthcare. In an endeavour to leverage the

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Industry harnessing AI for enriched personal healthcare experience MedikaBazaar, which deals in medical products and consumables, has made an AI/ML based solution called Vizi which helps hospitals to plan their procurement. Elaborating more about the solution, Vivek Tiwari, Founder and CEO, Medikabazaar, says: “Whenever a hospital gets an actionable purchase list of products, our application predicts what and how much is needed to be procured. It also recommends the safety or reserve stock of SKUs to avoid stock out and the level of safety stock with colour indicators. Hospitals don’t need to take any additional steps to maintain data for this application.” Siemens Healthineers has a long history of AI-enriched solutions. AI-Rad Companion is a new dedicated software platform that brings artificial intelligence (AI) to medical imaging. Its first application, AI-Rad Companion Chest CT, automatically performs measurements, prepares results for reports, highlights and characterizes anatomies and abnormalities and in addition to that even creates references with risk scores

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Immense potential of the Artificial Intelligence

cover story

technology for economic growth, social development and inclusive growth, Government’s Thinktank Niti Aayog came up with a National Strategy for Artificial Intelligence in June 2018. Recently, the Aayog wrote to states, asking them to identify key projects where artificial intelligence could be adopted to resolve issues in areas like health, education and agriculture. “I write to request you to identify key projects where AI can be developed to solve problems affecting the health sector that you wish to drive forward,” NITI Aayog CEO Amitabh Kant said in a letter to the states and central ministries.

• The technology equips doctors to diagnose ailments leveraging vision, deep learning on sensor-based vital data • AI assists surgeons in planning surgery and to understand the outcome • The tool proves very handy for early diagnosis of fatal diseases including cancer • It can help physicians with transcripts and voice-assisted case management • Hospitals could leverage the modern technology in efficient planning of processes and functions • Its role is unprecedented in area of telemedicine. AI enables accurate remote health monitoring and predictive diagnosis, paving path to reduce cost of quality care • AI also seems to be potent technology to bring many value-added services together with the care side to bring down the overall healthcare spending

and reference values. The results may eliminate the step of manual image post-processing on an advanced visualisation device and, therefore, increase the accuracy in interpretation and reporting. In addition, healthcare providers like Apollo, Narayana Health, SRL Diagnostics, are working on various AI solutions to enhance patient care. Last year Microsoft joined hands with Apollo Hospitals to use AI for early detection of cardiac diseases. Narayana Health is also adopting AI to predict better cost of surgeries, reduce the time spent by patients in the ICU or monitor consumables and antibiotic use. SRL Diagnostics is also harnessing the technology for more accurate diagnosis in digital pathology and early detection of diseases such as cancer. AI helps to keep diseases at bay The technology has been proving to be very beneficial in preventive healthcare. Tech-led fitness startups firms including GoQii, HealthifyMe and Cure.Fit are leveraging the AI-based fitness apps to alert users about potential lifestyle conditions, so that the disease could be diagnosed at early stage. “Between your mobile phone and wearable, you

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are able to get a lot of health parameters live. The job of a service like GoQii is to use this data and, along with AI, make predictions to warn people of a catastrophic health situation down the line,” says Vishal Gondal, cofounder of GoQii. Another startup Qure.ai uses AI to detect abnormalities in X-rays, CT scans and MRIs. The startup claims that its algorithm takes less than three minutes to detect abnormality with 95 percent accuracy. Challenges Despite the tool having immense potential to transform the delivery of patient care, much needs to be done before AI would prove to be a gamechanger in healthcare ecosystem. It is emerging as key pivot in preventive healthcare, but its role as prescriptive tool has yet to be established. In addition, unintended misdiagnoses generated by AI could lead to costly medical errors. Then there are other issues such as ethical, regulation and compliance, and lack of requisite skill sets, which need to be fine-tuned to harness its potential to develop an accessible, affordable and quality model of healthcare delivery system.

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policymaker’s perspective

Innovative Thinking Needed to Tackle Existing Health Issues: Ajoy Mehta

Ajoy Mehta Chief Secretary, Government of Maharashtra and the then Municipal Commissioner, MCGM

e need to focus on innovative thinking to find solutions of numerous existing problems engulfing the healthcare delivery system of Municipal Corporation of Greater Mumbai (MCGM), said Ajoy Mehta, Chief Secretary, Govt of Maharashtra and the then Municipal Commissioner, MCGM, while delivering a speech at Urban Healthcare Summit, Mumbai. He spoke at length on various challenges in delivering patient care and how one can find best solution of it.

‘Swelling population leads to many issues’ The first challenge is population concentration. Mumbai today has population of 12.4 million and by 2030 it will become 12.79 million. Thereafter it will decrease probably and by 2036 it will go down to 12.44 million. Mumbai

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population will decrease not because of any family welfare programme but because of satellite cities which are being developed. People are shifting outside the city. By 2036, we expect the city’s population to go down. 12.44 million people living in 476 square kilometer in Mumbai; that gives you an average 12 square meter per person in the city. And if we subtract natural areas, hill slopes, mangroves, and roads, you get hardly 10 square meter per person on an average for work, residence and any other social amenities, the corporation provides them. When people live in such a densely populated area, there is bound to be issues regarding sanitation, healthcare, that the corporation renders. ‘Second challenge is awareness’ Awareness is good but it has its downside for a service provider. Awareness makes one informed about kind of services hospital provides. Where one would get best services among private and government hospitals. When population becomes more aware, it becomes more demanding which perturbs service providers. But it should be taken in right spirit and attitude. Rather getting irritated, providers should focus on finding solutions. One should also toy with all kinds of ideas to improve things. ‘Awareness while proving to be a problem at times can be a

solution’ How do you convert awareness from being a problem to a solution, is the next big issue in the minds of service providers. Corporation provides lots of services including health, education, sanitation, water supply, lighting, and hundreds of other services. Most noble service we provide is healthcare services. Infrastructure Third issue is infrastructure. Our capacity is to handle about 70 lakh OPD patients every year. We are performing thousands of surgeries a year. Our existing infrastructure is not sufficient to meet the demand. Our doctor-patient ratio and nursepatient ratio are not ideally what they should be. Similarly on the ICU front, we require 30 beds per ten thousand population, but we have only 10-15 beds. I agree there are issues, but we need to chalk out ways to deal with them. We can’t shirk away our responsibilities. Innovative practices need to work upon to improve delivery of services We need innovative thinking, while dealing with high number of patients. There can be innovative thinking on the technology, processes, and management front. We are primarily meant to cater primary level of treatment, but then if some patients seek tertiary level of care, we have to make them available. We need to resolve a huge number of medico administrative issues.

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policymaker’s perspective

Innovative Solutions must be leveraged to ensure Accessible & Affordable Healthcare to all : Shalini Rajneesh

Shalini Rajneesh Principal Secretary for Planning, Programme Monitoring & Statistics Department, Government of Karnataka

n the light of Indian healthcare sector facing challenges on many fronts including doctor-patient ratio across country, innovations are the need of the hour, said Shalini Rajneesh, Principal Secretary for Planning, Programme Monitoring & Statistics Department, Government of Karnataka while delivering a speech at the 3rd Healthcare Innovation Summit, held recently in Bengaluru. “All countries have to achieve Sustainable Developmental Goals (STD) by 2030. India is lagging behind in terms of malnutrition, which leads to high maternal mortality and child mortality ratio. This paves the path to low immunity, more communicable diseases, more patients in hospitals, and more doctors to patient ratio and

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many other health issues. Therefore, we need to look at innovative solutions,” Rajneesh said. Talking about innovative practices followed by the Karnataka Government, she said, “We brought in integrated solutions in Karnataka where we said that it’s not just allopathy but all streams of medical sciences including Ayurvedia, Ayush, as well as other preventive mechanism, health education and community medicine , have to be part and parcel of the public health policy.” While underscoring the importance of preventive measures in healthcare, she said, “Prevention is better than cure. Everybody needs to be aware about the fact that health is wealth. One should not only preach it but practice it in daily routine. Technology, social media really need to play a big role.” She shed light on many aspects of nutrition which play a key role to help people stay healthy and lead a happy life. “Many of us think that we are having very nutritious food but the way we take the food is important. Ayurveda principles come very handy in it. For an example, as Health Secretary I found that many school children are anaemic despite the fact that every week I was giving them iron folic acid tablets under the Government of India programme but it was not proving to be beneficial to children. It was found the tablets were being given immediately after the

mid-day meal. As per doctors, tablets work better if taken an hour after food intake. It increases absorption rate. If tablet is given with vitamin C like lemon, absorption is much better. Although they were taking the medicine, it was not helping them out.” By educating people about the way medicine or food should be taken so that in day to day life they become their own doctor. It also helps them to stay healthy and help others also to lead a happy and healthy life. Happiness index would be measured to a great extent by health index of any person of any society, she said at the conclave, a congregation of experts, deliberating on different facets of patient care. Shedding light on the fact that poverty is directly linked to maternal health, she said. “One of the goals of United Nations is to end poverty which majorly depends on the maternal health of women during reproductive age and child birth. It leads to impoverishment within family as they end up spending lot of money on healthcare. As per WHO, families spend one-third of their income on health issues.” We look at innovative solutions in our day to day practices. It must be leveraged, ensuring people from all social strata accessible and affordable healthcare,” Rajneesh said. “Everybody should have good health as others can affect your health too. We all have responsibility to contribute to make others healthy,” she said.

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policymakerâ&#x20AC;&#x2122;s perspective

Success of PPP Model Depends on Regulation: Dr Sanjay Mukherjee entity jointly fund a project, he said.

Sanjay Mukherjee Secretary, Medical Education and Drugs Department, Government of Maharashtra

ublic Private Partnership(PPP) plays an important role to give a fillip to healthcare infrastructure, an important component to boost patient care. In light of the Indian healthcare sector facing serious issues on infrastructure front in rural areas, PPP model must be leveraged to improve things, said Dr Sanjay Mukherjee, Secretary, Medical Education and Drugs Department, Government of Maharashtra, while participating in a panel discussion at Urban Healthcare Summit. PPP is essentially a financing model. It involves a funding mechanism where either state or a private entity or the State and Private

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How can these two parties work together? The funding can be public or private. Similarly, service could be provided by either stakeholder. There are different permutations and combinations. For example, public funding-public service which can be seen in hospitals like KEM hospital and Grant Medical College which are entirely public funded. Then you can have public funding and private service. Such kind of set-up has been followed up by Municipal Corporation of Greater Mumbai (MCGM) where services are outsourced i.e CT scan, MRI, Aapli Chikitsa, etc. Third is private funding and public services like Corporate Social Responsibilities (CSR). It means corporate sector pays for the infrastructure which the Government develops. And lastly private servicesprivate funding which is completely managed by the private sector. Regulation is key The main issue in the PPP model is loss of Government control. The key point is whether it is private, public or mix kind of set up, regulation is utmost important. The success or failure of PPP entirely depends on regulation. If you are funding yourself and providing the services yourself, then you are in administration. The moment you moved into PPP, you move from the realm of

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Public Private Partnership is basically a financing model. There are different permutations and combinations of PPP model including state funding-private service, state serviceprivate funding and so on. Main issue in PPP model is loss of the Governmentâ&#x20AC;&#x2122;s control. The key point is whether it is private, public or mix kind of set up, regulation is utmost important.

administration to law, regulation, and contract management. That is the biggest challenges the Government faces.

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policymaker’s perspective

Robust Urban Healthcare Delivery Mechanism Need of the Hour: I A Kundan is inclusive, or it is including all the beneficiaries in a fair and justifiable manner, or there are some beneficiaries who are not getting included in the system,” she said. Kundan highlighted various aspects which could determine the outcome of an ideal healthcare delivery system.

I A Kundan Secretary, Women & Child Development, Govt of Maharashtra & the then Additional Commissioner, MCGM

n inclusive healthcare delivery system should be in place to cater to the people of all strata with accessible, affordable and cost efficient medical facilities, said I A Kundan, Secretary, Women & Child Development, Govt of Maharashtra & the then Additional Commissioner, Municipal Corporation of Greater Mumbai(MCGM), while delivering a speech at Urban Healthcare Summit, Mumbai recently. “There are various aspects which determine the delivery of urban healthcare. While looking into the service delivery system of any corporations, we need to take into consideration various factors. We need to check whether the service delivery

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Healthcare delivery system must address out-of-pocket expenditure An important aspect of a healthcare delivery mechanism is whether it is able to provide all the services related to diagnostics or therapeutics to people of the area and whether it is inclusive or not. Insurance that was expected to reach lower rung of the society whether it has percolated down or not.? The third aspect is whether the latest interventions are anyway affecting out-of-pocket expenditure of the people. Whether we are coming up with a system which will help us to reduce outof-pocket expenditure? Both Urban and rural healthcare need to be strengthened If we understand the demography of Mumbai, the largest proportion of its population is of slum dwellers, who don’t have access to medical facilities. It’s a misnomer that in a city accessibility to healthcare is better than rural areas. We have to understand that emphasis till now was always in strengthening the healthcare delivery institutions in rural areas.

Healthcare delivery system needs to evolved to cater people of all strata.

The mindset was healthcare delivery mechanism needs to be strengthened in rural areas, which has its own merit, but increasing migration to the cities and huge population load have forced everyone, including policymakers, to think of a robust urban healthcare delivery mechanism for the urban poor. MCGM making a big strides towards Universal Healthcare System Urban poor, who constitute 5060 percent slum dwellers, are marginalised and have pushed out of the health delivery mechanism. With the dynamic leadership of the Municipal Commissioner and support of the local leadership including the Mayor, Deputy Mayor, Municipal Corporation of Greater Mumbai has achieved an all inclusive system, which is able to give a very good start to a Universal Healthcare System.

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Sunil Kumar Bhushan Deputy Director General & Head Health Sector, National Informatics Centre (NIC) Government of India

echnology has been playing a crucial role in fostering an effective healthcare delivery system that offers accessible, affordable, and quality care services to the people at large. It is instrumental in enhancing efficiency of different deliverables influencing patient care, said Sunil Kumar Bhushan, Deputy Director General & Head of Health Sector, National Informatics Centre (NIC), while delivering a speech at the 3rd Healthcare Innovation Summit, Bengaluru. “TB, diabetes and other non communicable diseases can be controlled with the help of IT solutions. Unless we have robust IT solutions in place, it is very difficult to monitor patients of non-communicable diseases. Some of the solutions which have been implemented across the

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country include Online Registration System, Reproductive and Child Health programme, National Portal for TB Surveillance called Nikshay and Beneficiary Identification System (BIS) for Ayushman Bharat,” he said. For the past 15 years, NIC is contributing in the growth of Indian healthcare sector by providing IT solutions. “E-hospitals, online registration system, reproductive and child healthcare and central government health scheme are some of the areas where the IT solutions have been adopted.” Stressing further on the e-hospital solutions, Bhushan said, “It is based on international standards which are notified by the Government of India. These e-hospital solutions have been implemented in a total of 321 hospitals in different states across India.” Online Registration System (ORS) facilitates easy availability of services including OPD appointment, lab reports, and blood availability in any government hospital, Bhushan said. “The patient interface of e-hospital is also implemented through the online registration system.” Bhushan stressed upon the Mother and Child Tracking System on this occasion. He said, “It helps in monitoring of immunisation services to children, antenatal care (ANC) delivery and postnatal care (PNC) to pregnant women, and family planning services provided to eligible couples.” Elaborating about Beneficiary Identification System, Bhushan said, “We have identified 50 crore beneficiaries through socio-economic

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it perspective

NCDs can be Controlled with IT-Enabled Solutions: Sunil Kumar Bhushan e-hospital solutions developed by NIC have been implemented in a total of 321 hospitals in different states across India.

census 2011. Identification has been done through ‘aadhaar card’. After identification of beneficiaries, their EMG card is issued.” NIKSHAY Software This system was implemented in 2012 and patients are identified on the basis of certain parameters such as casebased online patient monitoring, DBT to eligible patients and supervisors, focused supervision tools and real time programme management. More than one crore tuberculosis patients have been registered. There are some key points which need to be addressed before trying to develop a personal health record at the national level. Firstly we should have a unique identification for each patient. It requires a centralised database like ‘aadhar card’ which should be integrated with the systems, from the private sector or public sector.

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Expert’s Opinion

India Needs to Focus on Patent and R&D in Healthcare: Dr Sarman Singh

Dr Sarman Singh Director & CEO, AIIMS Bhopal Ministry of Health & Family Welfare Government of India

ndia needs to focus on patent, and research & development which paves path for enhanced patient care, enabling better patient care to people at large, said Prof (Dr) Sarman Singh, Director & CEO, AIIMS Bhopal, while delivering a speech at the 3rd Healthcare Innovation Summit, Bengaluru . India is capital of diabetes. Other non-communicable diseases are also increasing in an unprecedented manner, he further said. Speaking on the occasion, Singh emphasised the role of technology and innovations to catapult healthcare delivery system in India. He also highlighted the role of R&D and patents to boost patent care. “We have minimum patents on

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front of innovations and technologies. One out of seven patents on technology was taken up by the Government of India recently. The patented technology helped us to eliminate Kalazaar, a common disease in eastern parts of country. The kit we developed detects the disease within five to ten minutes. It helped to eliminate Kalazaar. It took years to make the kit and then launch it in the market.” Singh said innovations need investment. But unfortunately, our budget allocation is far less in comparison to other countries. “It is less than one percent of the GDP. India spends less on research and development (R&D). Korea and Japan are among countries which spend maximum amount of GDP on R&D. USA spends 2.3 percent, while Korea and Japan spend close to four percent,” he said. Singh highlighted that patent approval takes a lot of time and is a very cumbersome process in India. “We have only two patent offices in country, in Delhi and Kolkata. Number of applications and reviewers of these applications are lesser in number. After filing the application for patent, it takes five to six years for examination and final approval.” Talking about Tuberculosis, Singh said the Government has announced to contain the disease by 2025, so have other international agencies. But we don’t have proper mechanism in place to exterminate the killer disease. We are working on another

technology related with Tuberculosis (TB), a disease which has affected people across the globe. India is home to the world’s largest number of patients suffering from TB. And at 2.74 million reported cases every year, India has the world’s highest share of all TB cases. More than 40 percent cases are not detected, he said. “The Government aims to eliminate TB by 2025 while WHO and other International agencies target to eradicate the disease by 2030. But scientists say the disease can’t be eliminated by 2050. Presently, there is no technology and system to eliminate the disease,” Singh told the audience. “We have developed a technology to detect TB in just five to ten minute. But we are looking for partners to develop it further to be used by masses.” “TB is a communicable disease which spreads by air. If one person gets the disease, whole community is at risk. It has a unique mechanism to spread from one person to another.” Narrating how Europe put a stop on the disease, he said, “Earlier Europe was having maximum number of TB cases. But they controlled it through simple preventative measures including proper sanitation and emphasing on hygiene. There was no TB drug in those days. Anti-TB drug came into existence in 1945 only. There were no TB cases in India at that time.” I urge the Government to make whole process of patent a smooth affair. Patent examination should be speeded up.

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IT perspective

Technology Should be Leveraged to Reduce Cost Burden: Dr S B Sinha

Dr S B Sinha Advisor- Healthcare Technology, National Health Systems Resource Centre

rimarily, the healthcare service delivery comprises four elements which need to be take care of in one go. When a patient visits the doctor, his symptoms have to be analysed at first, diagnostics need to be done, and finally consultion with the physician & medications. Unless, these elements are taken care of in one single visit, the problems will never cease, said Dr S B Sinha, AdvisorHealthcare Technology, National Health Systems Resource Centre, while delivering a speech at the 3rd Healthcare Innovation Summit in Bengaluru. Expressing concern about the Indian healthcare system, Dr Sinha further said, “The problem exists in India because we are not able to

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deliver all these four elements in the first visit itself and that leads to the poor patients visiting the government hospitals unwillingly.” Underlining the differences in healthcare scenario in urban and rural areas, Dr Sinha said, “These elements are easily available in the urban areas, but rural regions fall short on this front. Moreover, there is no uniformity on availability of services in urban areas. There is huge difference in costing.” “So, challenges need to be addressed in areas of ICU beds availability, cost estimation, and diagnostics & drugs.” eICUs are being implemented world over to increase beds availability and also to make it cost-effective, he further said. ADVANCEMENT of Medical Technology Shedding light on importance of technology to provide enriched healthcare experience to people at large, he said, “Through technology integration, command centres have been developed. Patients get treatment remotely where experts guide local staff how to go about whole process. Technology is being leveraged to reduce cost burden.” “Technology intervention has improved medical facilities in rural areas. Under home care segment, one gets vital parameters monitored by the doctors sitting at telecentres. Such practices are very useful to fill the gap

in terms of shortage of beds, especially in the ICUs.” No uniformity in cost estimation There is no uniformity in the cost estimation. The variation is indeed very high. With game-changer initiative Ayushman Bharat, the government has tried to make a level playing field in the tier-two and metro cities. Under the scheme, there is a fixed estimation. He further opined that initially “the private doctors were very apprehensive in catching up with these kinds of estimates.” Digitalisation of X-ray facilities Due to lesser number of radiologists across the country, service providers are adopting the digitalisation of X-ray facilities. Digitalised images are transported to tele-radiology center for experts’ opinion. Availability of physicians and paramedics is a big concern today. India has been lagging on front of shortage of doctors and other medical staff who play a crucial role in the entire healthcare delivery mechanism. This is more or less a worldwide phenomenon. With technology intervention, both public and private providers are trying to improve things. The Government of India is focusing to establish telemedicine centres across country under public private partnership mode.

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industry perspective 22

Tech Care for All—Enabling Healthcare with Technology

ech Care for All is a digital health company focused on sustainably transforming health outcomes in Africa and Asia. With offices in Brussels, Dakar (Senegal), Mumbai, Nairobi, New York and Paris, Tc4a provides expertise for strategic engagement and planning, and technology solutions that meet client specific requirements. Tc4a also provide businesses in India an opportunity to expand internationally in health-technology or strategise their next health tech vertical. Founded in December 2018, Tc4a India is supported by its global concern and through its network of outstanding professionals and partners who share a profound commitment to make the world a fairer place when it comes to meeting people’s health needs. We are fortunate to have a team that unites extensive national and international experience in pharmaceuticals, technology, healthcare delivery and diagnostics, consulting, regulatory affairs, business development, product innovation, manufacturing, and financials and strategy. In India, Tc4a is engaged with a spectrum of clients that include: complex healthcare networks looking to transform and meet their next set of challenges, public sector institutions to co-discover and implement solutions that improve healthcare access/delivery, NGOs to engage youth of urban slum settlements who champion community health and hygiene through digital applications, private institutions and hospitals

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Meet our Global Management: JörgOhleyer (Head of Transformation), Jean-Baptiste Chardigny (Project Director), Lucien Ndong (CEO, Senegal), Emmanuel Blin (CEO, Global), Marc Delavarenne (Project Director), Sandrine Pognon (CFO), Pam Bolton (Strategic partnerships), Sachin Malhotra (CEO, India), Dr Benson Chuma(CEO, Kenya), Hima Kher(CTO)

Tc4a offers data-rich, clinically validated and customised Telemedicine and frugal EMR platforms

that require multiple solutions to deliver better care and improve organisation efficiency and pharmaceuticals to create strong customised engagements along the patient journey while simultaneously decreasing patients’ financial burden. As a product company, we have

deployed proprietary solutions that serve common healthcare practice and management problems. Notably, Tc4a’s “Medical Learning Hub” (MLH, an online global medical training marketplace) accelerates cost-effective talent development. It is a platform for healthcare institutes and professionals to deploy and administer internal trainings as well as accept payments from trainings marketed regionally/internationally. Tc4a also offers data-rich, clinically validated and customised Telemedicine and frugal EMR platforms that solve healthcare access problems and provide solutions to manage the clinic or institute. We are committed to provide the best in digital health innovation from around the world and help professionals and organisations reach the next milestone and achieve better outcomes.

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Industry Perspective

Increase New Patient Acquisition & Retention Ratios with LeadSquared L

eadSquared is a healthcare CRM, marketing automation and patient management solution. It has created a niche for itself and several healthcare service providers including Cloudnine, Practo, LifeCell, Apollo, Global Hospitals, OMNI Hospitals and many more which deal in various aspects of patient care, vouch for excellent work it is doing. LeadSquared uses predictive patient insights and automaton to increase new patient acquisition and retention ratios. Call center teams, front offices, care managers, center heads, business development managers and the operations team of healthcare businesses leverage its solutions to enrich patients’ experience and doctor satisfaction. Increase new patient acquisition ratios for your healthcare business

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With LeadSquared, you’ll never miss a single new patient inquiry. You can capture patient inquiries and appointment booking requests from your website, healthcare aggregators, paid ads (all digital and traditional channels) and more. Inquiries via phone calls and center walk-ins can also be captured seamlessly. Application program interface (API) can be used to capture inquiries from patient portals, forms and other channels. Automating repetitive tasks and processes help reduce new patient acquisition costs. Here are two examples of this: • You can sync appointments from the appointment scheduling app automatically into LeadSquared, making appointment planning easy for both the doctor and care manager.

•

You can map patients to doctors of their choice or the ones that best fit their requirements in terms of speciality, location, availability and many more. The distribution happens automatically as soon as the patient inquiry comes in, saving care managers’ precious time. It also ensures a faster patient response. LeadSquared helps you increase new patient retention by ensuring a hasslefree experience on the appointment day. For example: • Doctors and Care Managers have all the necessary information they need, to ensure a hassle-free experience for new patients on the day of their appointment – all of their interactions are recorded by tracking, and necessary records are pulled from the patient management system. • Collecting feedback at the end of the appointment is important. Positive feedback indicates high chances of retention and referrals, whereas negative feedback can be used to better future patient experience. It can also be used to even bring back a disgruntled patient by making amendments at the right point of time.

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Increase patient satisfaction with a responsive Healthcare Call Center Patients can call in for a variety of reasons – appointment booking/ rescheduling/cancellation, package inquiries, doctor availability check, feedback sharing, lab report inquiries and more. LeadSquared ensures that the inquiries get routed to the right agent with minimal wait time and that the agents are well-equipped with information to resolve all kinds of inquiries. Once on call, the last thing your patients want is to be kept on hold, or deal with multiple call transfers when they are trying to book an appointment urgently. Avoid this by assigning calls automatically to available agents, matching queries to

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Provide exceptional patient experience right from the start LeadSquared ensures new patient acquisition, ‘higher appointment’ to ‘visit ratios’ and patient retention with flawless patient experience right from the first inquiry. Reduce response time with automated, yet relevant communication on the channel of their choice – email, text messages, phone calls or patient portals (APIs and webhooks help you integrate your patient portals). You can auto-assign the patient to the “requested-for” or best-fit doctor at the desired time slot. In addition to patient retention, it’s important for you to retain your doctors as well, and on-board them fast. LeadSquared can help you run engagement campaigns for your doctors as well. You can send not on-panel doctors’ campaigns with testimonials of other doctors but engage your existing doctors with campaigns, wishing them for important life-events, and sharing information that’ll be useful for them, like information about medical conferences and more..

agents based on patients’ preferred language, exact nature of their query, location and any other criteria important to you. To maximize response rates to patient feedback surveys, you can route the task to call center agents if the patients don’t share feedback at the center and are unresponsive to email and text requests as well Increase the efficiency of your agents with progressive dialler. Automated dialling after each call ensures that agents don’t waste time dialling each number. Priority scoring helps line the calls up automatically so that the most urgent calls are made first. A front-end Healthcare CRM for all your teams Call Center Teams: Access to doctors’ calendar and patient history allows call center teams to perform their tasks easily – appointment booking, cancellations, rescheduling or followups for missed appointments.

Front-desk Executives: It’s easy to register new patients, update their records or book appointments for walk-ins. Integrated systems also make patient feedback collection easy at check-out via mobile app or tablets. Care + Center Managers: With operational tasks completely or partially automated (eg: appointment reminders), care managers and center heads have more time for patient experience management. Feet-on-Street Teams: All feeton-street teams (including doctor empanelment and new patient acquisition teams) have access to the mobile app, which plan their daily tasks and tracks task completion to ensure high productivity. IT Teams: IT teams can easily connect all your systems (patient management system, EMRs, IVR, etc.), to ensure a smooth experience for your patients, and ease of use plus high productivity for your teams. Doctors: In-center doctors can be given access to the LeadSquared mobile app, allowing them to checkin/check-out and view, cancel or reschedule their appointments, helping them plan their day smoothly. Interested in taking a personalized demo? Connect with us: murali@leadsquared. com, +91-9036355991. You can also request a demo here: https://www. leadsquared.com/healthcare-crm/

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Industry Perspective 26

sPLA2-IIA: A new biomarker for Cardiovascular Disease Risk Randox is pleased to introduce sPLA2IIA, an automated assay for research use only, allowing continual development and enhancement of your current niche cardiac risk testing panel. Cardiovascular disease (CVD) is the number one cause of death globally, with an estimated 17.7 million people dying each year. This figure represents approximately 31 percent of all global deaths. This figure is set to increase to over 23.6 million by 2030. These startling statistics highlight the urgent need for better and earlier identification of at risk individuals. This is especially true as in many cases CVD can be prevented with appropriate lifestyle changes. This article elaborates about a novel biomarker for use in CVD risk

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assessment. Traditional and routinely run biomarkers include Total Cholesterol, HDL Cholesterol, LDL Cholesterol and Triglycerides. There is however, a growing body of research indicating that further risk assessment biomarkers need to be considered. These conventional risk assessment markers detect a mere 20 percent of all CVD patients. As the prevalence of

CVD continues to rise worldwide, the need for reliable risk markers has never been more important. Early risk assessment helps to reduce the risk of a cardiac event occurring. Identifying those at highest risk of CVD and ensuring they receive appropriate treatment can prevent premature death. Early risk assessment is particularly important for those people who have one or more risk factors including hypertension, diabetes or hyperlipidaemia. By 2030, it is estimated that almost 23.6 million people globally will die from CVD, with heart disease and stroke projected to remain the leading causes of death. In this light, early diagnosis is an essential step in reducing the number of affected individuals. The financial burden that CVD places on the national health services makes the development of a diagnostic biomarker even more essential. sPLA2-IIA, a member of the secretory phospholipase A2 family, has been found to have clinical utility as an inflammatory biomarker specifically in the diagnosis of CVD risk. The addition of sPLA2-IIA compliments the existing cardiac risk panel from Randox,

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providing a different outlook and method of assessing cardiac concerns in patients. sPLA2 -IIA is the prototypic member of the group II sPLA2 subfamily and has been shown to be induced by pro-inflammatory stimuli in a wide variety of cells and tissues. It has been found to be associated with a number of inflammatory diseases including rheumatoid arthritis, asthma, Crohn’s disease, acute respiratory distress syndrome, coronary artery disease abdatherosclerosis. These factors have contributed to its nickname, “inflammatory sPLA2 “. sPLA2 –IIA, production of fatty acids and biologically active phospholipids plays an important role in platelet, monocyte, and endothelial activation, processes known to be critical steps in atherogenesis. Unlike traditional cardiac biomarkers used to predict adverse outcomes in patients with acute coronary syndrome (ACS), sPLA2 -IIA has been shown to act at multiple pathways involved in atherogenesis, from lipid oxidation to modulation of vascular and inflammatory cell activation and apoptosis. Key benefits of Randox sPLA2-IIA • A niche product-It means that Randox is one of the only manufacturers to provide

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•

the sPLA2-IIA mass test in an automated biochemistry format Applications available providing details about instrument-specific settings for the convenient use of the Randox sPLA2-IIA assay on a wide range of clinical chemistry analysers Liquid ready-to-use reagents for convenience and ease-ofuse Latex enhanced immunoturbidimetric method delivering high performance Dedicated controls and calibrators available- It offers a complete testing package Automated assay which removes the inconvenience and time consumption associated with traditional ELISA based testing

Other niche Cardiac Markers from Randox LDL-Cholesterol (LDL-C) consists of several different subclasses of particles with different sizes and densities. Research has found that these subclasses play a role in the development and progression of atherosclerosis and CVD. Most significantly is the impact that small dense LDL-C (sdLDL-C) has on this

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process. Circulating sdLDL-C readily undergoes multiple atherogenic modifications in blood which increases its atherogenicity. sdLDL-C has a lower affinity to the hepatic LDL-C receptor, thus circulates in the blood longer than larger LDL-C. sdLDL-C has a stronger affinity to vessel wall heparin sulphate proteoglycans (HSPGs), which means that sdLDL-C can more readily permeate the arterial wall. sdLDL-C is also liable to oxidation from its physicochemical properties which leads to foam cell formation. As sdLDL-C is particularly atherogenic, a person with elevated sdLDL-C levels has a three-fold increased risk of myocardial infarction (MI). sdLDL-C measurement provides a more comprehensive understanding of the risk of lipoproteins within a patient and is more comprehensive in detecting cardiovascular risk compared to the traditional LDL-C test. Randox also offer a comprehensive range of niche cardiac assays including adiponectin, lipoprotein (a) and H-FABP. (To find out more, contact our India office at +91 80 2802 5000 or email us at reagents@randox.com. Alternatively, visit randoxonlinestore.com to buy directly from Randox today.)

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leader’s Perspective

Ruby Hall Clinic—Carving Niche in Healthcare Space With a right blend of modern-day technologies and innovative practices, Ruby Hall Clinic is striving to cater quality care to the patients. Through RHC mobile app, daVinci surgical robot, and the Einstein Vision 2.0, the hospital is carving a niche in the Indian healthcare ecosystem, says Bomi Bhote, Chief Executive Officer, Ruby Hall Clinic, in conversation with Mukul Kumar Mishra of Elets News Network (ENN).

branches at Wanowarie and Hinjawadi, but also offered remarkable services in the remotest parts of rural Maharashtra with 24 peripheral centres and 3,000 working staff. Today, Ruby Hall Clinic delivers services that go way beyond traditional healthcare provisions. We will continue to do what we have been doing for over 50 years, which is to continue building on our success through the dedication of our people. We’ll continue to innovate, to explore new and better ways to help people live healthier lives.

Bomi Bhote CEO, Ruby Hall Clinic

Since its inception, Ruby Hall Clinic has come a long way, offering the finest care to people. How has been the whole journey? We started with a small two-bedded nursing hospital and have come a long way indeed. Our journey from a small two-bedded nursing hospital to an 750-bedded multi-speciality tertiary care healthcare institute has been phenomenal. For the last five decades, we have been striving to achieve excellence in hospital care. We have not only spread our wings to different parts of Pune with our

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Tell us about your mission and vision. What are the hallmarks of your services which distinguish you from others? Our late founder, Dr K B Grant, entrusted us with a unique legacy which continues to pave the path and inspires us to strengthen and grow. Enhancing our position as a recognised healthcare leader in India, we have strived to make quality patient care our priority. Blending compassion with the marvel of technology to make a real difference in the lives of our patients, has always been our mission. As a socially responsible hospital, we feel a deep sense of pride and commitment to all those who place their trust in our care and our ‘patient comes first’ policy has been a part of this very philosophy.

In an industry that is evolving continuously, Ruby Hall Clinic has poised itself to be prepared for the changes to the system as they come, particularly as we shift our focus from reactive care to preventive care. We have a history of proactively anticipating these changes and responding to them before the rest of the players. Our 10 NABH and NABL quality accreditations and certifications are proof of this very approach. Our clinical specialist systems have a track record of excellence. Going beyond reputation and word-of-mouth, our tertiary care services are known to have an excellent rate of results. When it comes to investing in the latest technology or even promoting organ donation in the country, Ruby Hall Clinic has the first-mover advantagefurther strengthening our position in the healthcare market. Together, we’ve managed to use our expertise to help people remain healthy. But it’s not just about our expertise. It’s about support, encouragement and care – not only for our patients, but also for our employees.

Technologies and innovative practices play a pivotal role in improving patient care. How does the hospital leverage the

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art equipment such as the 128 slide CT scanner, the Einstein Vision 2.0 and the True beam linear Accelerator are amongst others that will help transform the way we provide care.

Highlight some significant aspects of your clinical services. What kinds of services are offered under the ‘Auxiliary Services’ for speech therapy and clinical research? Gone are the days when hospitals were simply considered places to ‘get cured’ at. With the changing healthcare landscape, hospitals have evolved into places providing holistic healthcare with a host of preventive, curative and supportive services. Riding the waves of this sea of change, Ruby Hall Clinic too isn’t one to be left far behind. Since its inception, the hospital has always looked for innovative ways to provide more than just health and healing. To ensure that no patient in need of treatment is short of finances, the hospital has tied up with health financiers who provide loans in as fast as 10 minutes. A first in the city, this bright idea in healthcare has received an astounding response. Providing hope to cancer patients, the hospital’s cancer unit has time and again worked on pioneering research,

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leader’s Perspective

latest tools to improve different deliverables? I strongly believe that of all the ways that technology has benefitted mankind, no contribution is as important as technological advances in healthcare. From saving countless lives by means of advanced imaging and innovative surgical techniques, to improving the quality of life for others, progress in this field has been remarkable. Not only has the technology changed experiences for patients and their families, it has also had a huge impact on medical processes and the practices of healthcare professionals. At Ruby Hall Clinic, we’ve always believed in thinking about tomorrow’s healthcare today. Our award winning RHC mobile app was amongst the first in the city, keeping doctors and patients abreast with matters related to health, while our virtual clinics have successfully taken healthcare access beyond the brick and mortar confines of our hospital to those who need it the most. We’ve also left no stone unturned when it comes to procuring the latest in medical and surgical technology. For instance, the daVinci surgical robot makes even the most challenging surgeries a reality, while state-of-the-

Our clinical specialist systems have a track record of excellence. Going beyond reputation and word-of-mouth, our tertiary care services are known to have an excellent rate of results.

treatments and therapies to help fight the ailment. With the expansion of the cancer building, the hospital aims to further extend its arms of healing to all those in need. Moreover, the hospital organises numerous support camps — be it for bariatric surgery, multiple sclerosis, organ transplant or breast cancer. With the expertise of our specialists and the support and experience of our former patients and survivors, you’ll never be alone in your journey.

Are you planning expansion or any collaboration with the State Government in near future? We have been participating in all government schemes and also treat their employees. We do provide services to the Central Government, Ex-servicemen, the Police and to various state government offices and municipal corporations. We also treat patients under the IPF Scheme of the Maharashtra Governement. We are open to collaborate with the Governement for any developmental schemes.

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leader’s Perspective

‘Leveraging Modern-Day Technologies to Enrich Healthcare Experience’ In the wake of increasing demands of patients seeking quality and cost-efficient care, the Gleneagles Global Hospitals is leaving no stone unturned to live up to their expectations. With cutting-edge technologies and well-known expert faculties, the hospital ensures best clinical outcome, says Shailaja Suresh, Chief Executive Officer, Gleneagles Global Hospitals, Bengaluru, in conversation with Elets news Network (ENN).

Starting its journey from a small hospital, Gleneagles has grown into a world-renowned brand. How has been the journey? Gleneagles Global Hospital started its journey with a 205-bed hospital in 2007. Since then we have come a long way with two hospitals in Bengaluru (Kengeri and Richmond Road) having 540 plus beds. We have been at the forefront in state-of-the-art healthcare and have introduced the latest in surgical and technological advancements. BGS Gleneagles Global Hospital, Kengeri has had a number of firsts in Karnataka, including the first dual organ (liver and kidney) transplantation; the first to complete 150 computer assisted knee joint replacement surgeries and 2,000 endoscopic ultrasound procedures; the first bilateral lung transplant, and the first successful simultaneous pancreas and kidney transplantation.

Commitment to patient-centric care and excellent services are characteristics of the hospitals…how would you summarise its role in fostering healthcare delivery system? Patient-centric care and quality of

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services are the two tenets of an evolving healthcare system. While the primary goal of providing patient centric care is to improve individual outcomes, hospitals also stand to gain as this leads to a greater patient satisfaction and overall reduction in cost. While star doctors are often a major reason for patients to opt for a certain hospital, various other factors are also taken into consideration. Provision of the best medical facilities and adoption of good natured bedside manners by the medical fraternity are equally important. A hospital must provide care that is respectful and responsive to the individual needs while involving them in the care.

The hospital offers tertiary and quaternary healthcare services with state-of the-art facilities. Tell us something significant about your specialties. Our facilities in Bengaluru, particularly the one at Kengeri, one of the largest of its kind in the city. It consists of 14 operation theatres, advanced imaging facilities and a modern transplant ICU. While we cater to a wide range of specialities; oncology, neurosurgery, liver diseases and gastroenterology

Shailaja Suresh Chief Executive Officer, Gleneagles Global Hospitals, Bengaluru

are considered to be some of our key specialities owing to our wide expertise in these areas. We are also the preferred centre for multi-organ transplantation. Organ transplantation is not a one-doctor show. We invest in a team of trained multi-disciplinary doctors, nurses, technology, academics, research and infrastructure that are required to establish and maintain a trusted organ transplant programme. We receive numerous patients from over

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leaderâ&#x20AC;&#x2122;s Perspective

30 countries who come here seeking world-class treatment at an affordable rate. Our doctors have been consulted in very complex cases and designed best treatment plans to often save patients from the direst conditions. A few interesting cases include a recent renal transplantation managed by the nephrology and transplant team. In this case, one kidney was used to subsequently save two lives as it was transplanted in two different patients over a period of time. Our cardiothoracic team also completed two consecutive bilateral lung transplants in July 2018 followed by a few more, a surgery that is still relatively rare. The HPB (hepatopancreato-biliary) team also achieved a milestone recently by completing 200 liver transplants in Bengaluru.

Modern-day technologies and innovative practices have improved patient care. What kind of initiatives has been undertaken by the hospital in this area? Our hospital has invested significantly

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BGS Gleneagles Global Hospital, Kengeri has had a number of firsts in Karnataka, including the first dual organ (liver and kidney) transplantation, the first to complete 150 computer assisted knee joint replacement surgeries and 2,000 endoscopic ultrasound procedures.

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in advanced facilities. We use TrueBeam STx; the worldâ&#x20AC;&#x2122;s most advanced linear accelerator for radiotherapy delivering accurate and precise radiotherapy for cancer treatment. Our gastro team has long been utilising spy glass, an innovative system that provides unprecedented and direct visualisation of the bile duct. This procedure has been used successfully to treat large liver tube gall stones without surgery. The interventional radiology team at our hospital is well-versed in using the latest and minimally invasive treatment methods to treat cancer and other conditions. Our doctors are adopting procedures including radioembolisation, tumour ablation, and transarterial chemoembolosation to enable better care to patients. The bone marrow transplantation (BMT) team is also known to treat rare blood cancers and bone marrow disorders. The team has spent considerable time and effort in developing effective BMT procedures. Specialities like orthopaedics also manage various international patients with severe bone deformities.

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leaderâ&#x20AC;&#x2122;s Perspective 32

Nanavati Hospital

Ensuring Quality Care with Integrity & Ethics In healthcare ecosystem, Nanavati Hospital is a name to reckoned with. We believe in achieving professional excellence in delivering quality care, pushing frontiers of care through research and education, says Dr Rajendra P Patankar, Chief Operating Officer, Nanavati Super Speciality Hospital, in an interview with Mukul Kumar Mishra of Elets News Network (ENN).

Nanavati Hospital is known for serving patient with finest care through a team of experts and state-of-the-art technologies. How would you summarise the 69-year journey. Inaugurated in 1950, Nanavati Hospital, now rebranded as Nanavati Super Speciality Hospital, is an iconic institution which has over the years treated lakhs of patients. Apart from the yeoman services the hospital has offered to patients and their families, many celebrities have been associated with the hospital at different stages of its life-cycle. When it commenced operations in the mid-twentieth century, Nanavati Hospital was a contemporary stateof-the-art hospital at par with the best private hospitals in the city. The hospital has been one of the leading healthcare destinations for many decades, especially for people residing in north Mumbai. It can boast of best skill sets among doctors, nurses and other paramedical staff. Unfortunately, the hospital didnâ&#x20AC;&#x2122;t matchup to the huge expectations of people in the last few years and especially with respect to upgradation of infrastructure, technology and overall delivery of quality services.

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This was the time when reins of the operations and management were handed over to Radiant Life Care to turnaround things and it helped Nanavati Hospital to reposition as one of the most well regarded tertiary care hospital in western India. We believe treatment facilities should be best in class comparing to any internationally benchmarked hospital and service delivery like a professional hospital experience. The focus has to be LFST (look, feel, smell, touch), and CARE (customer, approach, respectful and engaging) from the service excellence point of view.

With more than 200 resident doctors, 500 nursing staff, and 1500 employees, the hospital has created niche in healthcare sector. Tell us about your mission and vision. The hospitalâ&#x20AC;&#x2122;s vision is to create a patient-centric tertiary healthcare organisation with focus on nonintrusive quality care. We ensure finest services through cutting-edge technologies and compassion. Our mission includes achieving professional excellence in delivering quality care, pushing frontiers of care through research and education and

Rajendra P Patankar Chief Operating Officer, Nanavati Super Speciality Hospital

adherence to national and global standards. In addition, we ensure care with integrity and ethics.

Quality and affordability are two biggest components which determine deliverables in healthcare. How difficult is it to achieve a balance between these two factors? Healthcare is in the throes of great change. And history is full of examples which proves that large-scale disruption incubates innovation. Quality healthcare is essential as it is

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with the right providers at the right place at the right time, reducing unnecessary services and focusing on value is essential for survival in the competitive market of healthcare.

How do you analyse evolving market of healthcare and role of latest technologies including artificial intelligence and telemedicine in bolstering medical facilities? The world around us is changing at a fast pace— thanks to the latest technologies and innovations which have played a key role to bring a paradigm shift in every sector including healthcare. With growing awareness about health among people, there is a strong demand for quality healthcare facilities. Innovations to boost healthcare delivery Leveraging disruptive technologies like artificial intelligence, robotics, internet of things, healthcare aggregators are delivering top-class affordable medical facilities to people in terms of diagnostic equipment, imaging, and telemedicine. Innovations in the areas of new drugs, vaccines, diagnostic tests, telemedicine have also enhanced patient care and contributed towards enhanced quality of overall delivery of healthcare services. New technologies in telemonitoring and diagnostics are enriching telemedicine experience, where people residing in rural areas get better medical facilities through virtual support of experts. Artificial intelligence is poised to play a major role in the global healthcare industry. With modern medicine facing a significant challenge of acquiring, analysing and applying structured and unstructured data to treat or manage diseases, AI systems with their data-mining and pattern recognition capabilities come in handy. Medical AI is mainly concerned with the development of AI programmes that help with the prediction, diagnosis

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and treatment or management of diseases. In contrast to non-AI medical software application, which relies on pure statistical analysis and probabilistic approaches, medical AI applications utilise symbolic models of diseases and analyse their relationship to patient signs and symptoms. As more AI research is undertaken and AI systems become more trained and consequently intelligent, it is foreseeable that these agents replace some of, if not all, the human elements of clinical care. While leaving the communication of serious matters and final decision making to human clinicians, AI systems can take responsibility for routine and less risky diagnostic and treatment processes.

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a critical element in enhancing health of the population. Other priorities include value (getting the best); and the affordability(not spending too much). There is a need to build a stronger healthcare delivery system rightfully led by primary care that seeks to remain cost conscious, efficient in its delivery, and fairly compensated for helping people to attain a healthy life. Healthcare is in the midst of transformational change. Rising healthcare costs-the new approach of cost containment is dangerous omen where high income group of people will be able to afford a wider range of healthcare services than lower income group. Today, consumers’ expectations have sky rocketed with respect to the level of quality care. Service industries have moved towards “data-driven” methods in which they closely monitor their processes for anomalies; the response has to be more efficient systems with fewer errors. New drugs and devices have led people to live longer and healthier lives than ever before. But overall healthcare experience has become complex. Hospitals and health systems will face even more pressure in next few years to establish the core skills needed to thrive in a rapidly changing healthcare market. Healthcare leaders continue to put infrastructure and governance practices in place to support value-based models. Health organisations that are shifting to value-based models must contend with the realities and limits of their local economies; the strategies of large employers for reducing their healthcare costs; concentration of the payer market and physician practice alignment. Health systems with cash reserves and strong margins are better positioned to make investments. The building block is operational efficiency, such as optimising staffing and managing the supply chain efficiently. Changing the way care is delivered

Though technology and innovations have improved patient care in unparalleled manner, how do you access role of human touch in patient care? A core element of physical examination is human touch, a dominant form of nonverbal communication used in clinical care. Although nonverbal communication is addressed in many medical school curriculums, the focus tends to be on body language and use of gestures rather than the intimacy of touch. Yet physical examination is a dynamic process of engagement. For example, when we examine a patient, we perceive on multiple levels—not just the presence or absence of physical signs, but also the patient’s comfort and emotional state. In turn, the patient responds to us—reading our facial expressions, interpreting the pressure of our fingertips, and responding to the gentleness to inform how he or she will proceed within the consultation. This exchange often happens at an unconscious level, yet awareness and attentiveness to these subtleties can, we suggest, make an important contribution to the doctor–patient relationship.

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Shalini Rajneesh, Principal Secretary for Planning, Programme Monitoring & Statistics Department, Government of Karnataka, inaugurating the 3rd Healthcare Innovation Summit, Bengaluru, in presence of Prof (Dr) Sarman Singh (second from left), Director & CEO, AIIMS Bhopal; and Col(retired) Hemraj Parmar (extreme left), Group CEO, B R Life.

exploring best innovative practices to develop an affordable model of patient care I

n an endevour to ponder upon different facets of a healthcare delivery system especially accessibility, affordability and cost-efficiency factors, the 3rd Healthcare Innovation Summit was organised in Bengaluru recently. Organised by Elets Technomedia, the healthcare summit witnessed confluence of key policymakers, international experts and industry leaders. The healthcare stalwarts shed light on innovative practices, conducive policies and ways to reach out to the people at the last-mile; their vision for it and the hurdles in that roadmap. Inaugurated by Shalini Rajneesh, Principal Secretary for Planning, Programme Monitoring & Statistics Department, Government of Karnataka, in the presence of Prof (Dr) Sarman Singh, Director & CEO, AIIMS Bhopal; Sunil Kumar Bhushan, DDG & Head Health Sector, National Informatics Centre; Dr S B Sinha, Advisor- Healthcare Technology, National Health Systems Resource Centre; and Col Hemraj Parmar, Group CEO, B R Life, the conference witnessed one of the finest congregations of top luminaries of the healthcare world. The healthcare experts shed light on trending innovative practices across the globe and how that can be leveraged to improve the healthcare delivery system in India. They also brainstormed on the

may-june 2019

existing issues of the healthcare system and ways to address the same with the PPP model playing a pivotal role on this front. Speaking on the occasion, Sunita Krishnan, Vice President - Digital Marketing & Products, MedikaBazaar; Dinesh Koka, CEO, Onward Assist; and Raghavendra K, Head of Engineering, BOTAIML Pvt Ltd, provided insights of the industry, highlighting the role of artificial intelligence to bolster patient care. Various enlightening discussion sessions touched upon issues, such as ‘Taking Healthcare Delivery to Next Level –Best Practices, Innovation & Excellence’, ‘Role of Public Private Partnership (PPP) for Developing Sustainable Healthcare Ecosystem’, ‘Role of Emerging Technologies for Building Smart Hospitals’, ‘CEO Panel: Ensuring Affordable Quality Treatment and Meeting Patients’ Expectations’, and ‘Ensuring Profitability through Optimum Patient Care’. Eminent dignitaries, on this occasion, unveiled a special issue of eHEALTH Magazine, which has been promoting innovations in healthcare ecosystem for over a decade. Also, industry leaders, diagnostic equipment manufacturers, and healthcare service providers were felicitated with Healthcare Excellence Awards for their extraordinary contributions in the healthcare world.

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Inaugural session: Taking Healthcare Delivery To The Next Level â&#x20AC;&#x201C; Best Practices, Innovation & Excellence

Shalini Rajneesh

Prof (Dr) Sarman Singh

"All countries have to achieve the Sustainable Developmental Goals(STDs) by 2030. India is lagging behind on the front of malnutrition, which leads to high maternal mortality and child mortality ratio. This paves path to low immunity, more communicable diseases, more patients in hospitals, and more doctors to patient ratio and many other healthcare issues. Therefore, we need to look at innovative solutions. We brought in integrated solutions in Karnataka. Everybody needs to be aware about the fact that health is wealth. One should not only preach it but practice in daily routine."

"India is the world's capital of diabetes. Other noncommunicable diseases are also increasing in an unprecedented manner. We have minimum patents on innovations and technologies. One out of seven patents on technology was taken up by the Government of India recently. The technology helped us to eliminate Kalazaar, a common disease in eastern parts of the country. The kit we developed detects the disease within five to ten minutes. India allocates less amount of budget on research and development (R&D). Korea and Japan are among the countries which spend maximum amount of their GDP on R&D."

Principal Secretary for Planning, Programme Monitoring & Statistics Department, Government of Karnataka

Sunil Kumar Bhushan

Director & CEO, AIIMS Bhopal

Dr S B Sinha

DDG & Head Health Sector National Informatics Centre

Advisor- Healthcare Technology, National Health Systems Resource Centre

"TB, diabetes and other non-communicable diseases can be controlled with the help of IT solutions. Unless we have robust IT solutions in place, it is very difficult to monitor such patients. We have been in healthcare sector for the last 15 years and contributing to improve the healthcare delivery system through IT-enabled solutions. Some of the solutions which have been implemented across the country include Online Registration System, Reproductive and Child Health, National Portal for TB Surveillance called Nikshay, and Beneficiary Identification System (BIS) for Ayushman Bharat. "

"Healthcare providers need to tackle challenges in certain areas including ICU bed availability, cost estimation, and diagnostics & drugs. eICUs are being implemented world over to increase bed availability in hospitals and also to make it cost-effective. Through technology integration, command centres have been developed. Technology is being leveraged to reduce the cost burden on healthcare providers. Patients get treatment remotely where experts guide local staff on how to go about the whole process. "

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Col.(Retired) Hemraj Parmar

Dr Reshma Sunil

"Globally the biggest industry is healthcare. The size of healthcare industry is about 10 trillion dollars. India spends very less amount on healthcare which is approx one percent of its GDP. The Government of India launched Ayushman Bharat to provide 100 million vulnerable families free insurance coverage of worth Rs 5 lakh. In the wake of huge running cost of healthcare services, providers need to recalibrate their cost-strategy. Providers need to focus on innovative practices, envisioning designing and operationalising smart hospitals.

"The Centre for Good Governance is trying to strengthen the Government in terms of eGovernance and technology aspects so that they can deliver more. We are into policy formulations, assessment and evaluation of various schemes of Government, blockchain governance and mobile governance. If institutional capacities are properly monitored and accessed the PPP model could be more effective."

Group CEO, B R Life

Head of Operations, Rainbow Children's Hospitals

Industry Perspective

Sunita Krishnan

Raghavendra K

Vice President - Digital Marketing & Products, MedikaBazaar

Head of Engineering, BOTAIML Pvt Ltd

"MedikaBazaar is into sales of medical products and consumables, catering to 18,000 hospitals as customers. It provides AI/ML solutions for operational efficiency and cost saving. We have designed an application called Vizi, which primarily uses artificial intelligence and machine learning technologies to plan what kind of stock you should be buying. It improves operational efficiency in medical supply procurement. Its key benefits include accurate projections, actionable purchase list, and recommended safety stock. We use consumption as base data."

"Artificial intelligence (AI) has wide applications in radiology. BOTAIML is working on various AI technologies with computer vision that does various things including traffic analysis, counting of vehicles, facial recognition, and various other computer vision applications. We also augment computer vision technologies to aid radiologists. AI technology helps radiologists to work with higher efficiencies, accuracies, and shorter turnaround times."

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Dinesh Koka CEO, Onward Assist

"We primarily work with diagnostic networks and lab chains. Onward Assist has developed telepathology platform in collaboration with a diagnostic network. We use an innovative technology to get slide image captured. All institutes and labs donâ&#x20AC;&#x2122;t have slide scanner or digital pathology. We have built the technology to help them out. Images are captured and then uploaded on cloud from where pathologists can analyse the report."

Role of Public Private Partnership (PPP) for Developing Sustainable Healthcare Ecosystem

Rani Desai

Dr Zorinsangi

CEO, Anahat Foundation- Enabling Better Public Health in India

Department of Health Services, Government of Mizoram

"The Government has a number of excellent healthcare programmes. The biggest challenge is implementation part and making people to avail the facility. More than 70 percent of the poor people donâ&#x20AC;&#x2122;t access government programmes due to a number of reasons, including awareness or language barrier. Implementation part can be overcome with private partnership. We have certain strengths which can be leveraged to do away with infrastructural gaps on many fronts which can lead to better care."

"We have implemented many Government of India programmes in Mizoram. Many targeted interventions, including TB control and HIV programmes, have been carried out under the PPP mode. There are many places where PHCs are being run under the PPP mode as the Government alone canâ&#x20AC;&#x2122;t manage it due to several issues, including manpower and other resource allocation related problems. NGOs are very active in providing manpower and logistics support which in turn enables people better care at PHCs. "

Role of Emerging Technologies for Building Smart Hospitals Dr Govindaiah Yatheesh Unit Head, Apollo Speciality Hospital, Karnataka

"Technologies can be harvested to ensure basic patient care delivery with better outcomes. The basic essence of any smart hospital is that it has to be patient-centric. The most important thing we need to look at is the outcome. When you are talking about smart hospitals, you need to run it in a smarter way which could increase profitability. "

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CONFERENCE report 40

Nandkishore Dhomne VP- IT & CIO, Manipal Hospitals

"Smart hospital is a combination of components including great technology, best faculty and services, and good staff. In addition, there should be less turnaround time, processes have to be simple, and information has to be available at point of care. However, such a hospital requires huge investment in terms of money, efforts, and timelines on many areas. Providers must keep such facts in mind while designing blueprint of smart hospitals. At Manipal, we pay attention to clinical excellence, patient centricity, and ethical practices."

Chaitanya Shravanth

Chief Digital Officer, Cloudnine Group of Hospitals "Smart hospital is more about journey. Technology, ease, and convenience are primers of smart hospitals. How you apply the technology and smartness to smart care is what makes a huge difference. Technology is easy to develop but bigger challenge is its adoption by doctors and patients. In maternity and child care segment, customersâ&#x20AC;&#x2122; engagement with hospitals is more than any other segment."

Dr Dilip Rangarajan

Raj Shekher J

Medical Director, NU Hospitals

CEO, Bloom Hospitals

"We have evolved lot of processes in last 18-20 years. Getting the right kind of people who fit your organisation is first requirement for smart hospital. Then using smart technology or using technology smartly holds huge importance. At NU Hospital, appointment at OPD is taken with Practo mobile App. We have another app to track the waiting time of patients. Our HIMS prescription is linked with SIM data base. "

"Evidence-based design is the need of the hour. Out-ofpocket expense and low insurance penetration are big issues, affecting patient care in India. the concept of smart hospital is based on faster, cheaper, and better delivery of services. Just having processes and skilled staff wonâ&#x20AC;&#x2122;t help. A holistic approach to healthcarei.e architecture of the hospital, flow of patients, processes, and cleanliness, is the need of the hour."

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Chairman & MD, Ovum Hospitals

"It is important to involve parents into the care delivery system. Technology enables us to develop new skills and likewise human beings will start getting used to different fields. If you are going to give me less money to run a patient, the patient will spend lesser time in the hospital but then home care services would pickup. Your turnaround time will reduce."

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Dr Adarsh Somashekar

CEO Panel: Ensuring Affordable Quality Treatment and Meeting up with Patients’ Expectations

Dr Nandakumar Jairam

Guruprasad B R

Chairman, Columbia Asia Hospitals

Vice President, Sparsh Group of Hospitals

"Quality can’t be enforced by regulatory agencies and accredition agencies. It has to be self- driven and selfmotivated. One should also keep in mind what KPIs or indicators are important to understand clinical outcome, patient safety and other aspects of quality one wants to monitor. Authentic data collection and its analysis are other important aspects. Quality is a journey that never ends. It has a journey and continuous forward movement. "

"Affordability has different ramifications. In healthcare nobody wants to pay until they faces serious issues which can’t be managed easily. It becomes very difficult at times to gauge who can afford the costly facility or those who can’t manage fund. Every hospital should pronounce that they have some specific standard of quality associated with particular amount of cost. Quality is proportional to cost"

Dr Naresh Shetty

Vice President, Ramaiah Memorial Hospital

"Affordability has different connotation for different people. Accessibility should be first priority followed by affordability and quality. Does accessible healthcare have the right amount of quality that should be the objective of any healthcare service provider. Technology comes into play at this level. Quality hinges on patient safety. Healthcare is a different ball-game altogether. It is all about being kind and right."

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Shailaja Suresh CEO, BGS Gleneagles Hospital

Dr Vijayabaskaran Sundararaju Executive Director, Kauvery Hospital

"We follow patient-centric strategies supported by patients’ insight and analytics. There are many ways of doing the same. We could think of bringing down patients’ waiting time or mull over removing patients’ waiting room. Healthcare providers should anticipate patients’ expectations, and live up to them. We should also look on how we benchmark ourselves. Good practices must be replicated to enhance care."

"Quality and affordability are two factors which decide the patient base of a particular hospital. Patients don’t get influenced by swanky buildings and fancy staffs, but the kind of care they get from the provider. Healthcare providers should try to achieve a balance between quality and affordability. Before starting a project, many factors should be taken into account including locality, demography of patients, and range of services with which a patient will be catered with."

Dr Aloke Mullick Group CEO, Omni Hospitals

"Quality of human touch point is very important. Empathy plays a pivotal role in patients’ satisfaction which in turn influences patient care. Empathy and kindness of the lowest level of staff including nurses and housekeeping employees, are going to bring back patients again and again to your hospital. In our hospital, we have started a regular meditation programme for all of our staff. We have a special trainer who ensures every staff to be kind and compassionate. "

Ensuring Profitability Through Optimum Patient Care Neeraj Lal

Vice-President & Cluster Head, Rainbow Children’s Hospital "Rainbow Children’s Hospital asks doctors to do quality projects to access how patient care can be enhanced in terms of quality and affordability. Every month, they give presentation comprising ideas to improve care. We have a central pharmacy department and central purchasing department which help us to manage cost. We have a lead in every department who is supposed to keep every staff informed about any decision taken by the management."

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Dr Chandrika Kambam

Dr Anil S Mehta

Vice President- Clinical services, Columbia Asia Hospitals

CEO & MD, Nandana Health Care Pvt Ltd Unit – Kaade Hospital

"Optimum patient care is mainly towards the clinical outcomes and objectively measuring what we are delivering to the patients in terms of medical care. Profit is an important aspect to sustain the business. There should not be any divide between doctors and management. In order to survive and remain profitable, a doctor must be treated as a partner. "

"The final outcome of the healthcare industry is patient care. Doctor is at the front end of the entire chain of healthcare delivery system followed by nurses and management. There has been an exponential growth in healthcare industry. Hospital have witnessed multifold growth while doctors have remained at the similar position. They feel left out somewhere. Doctors are the face of a organisation while management is the foundation. Both need to be worked in coherence to bring best results. "

Dr Chandrasekar T

Dr (Maj) Mahendra Kumar

"The volume of patients determines the the profitability factor. Patient outcome should be satisfactory. We get qualified staff not trained as per the respective model of healthcare provider. All staff including nurses, technicians, housekeeping, front office, should be trained to be a part of the healthcare delivery model of a particular hospital. We have continuous training programme, enabling staff to provide optimum care which in turn keeps cost in check."

"There has been a change in patients’ demands and expectations in the last 20 years. Healthcare providers face a tremendous pressure to manage cost and patients’ expectation. Profit margins are shrinking. Considering these facts in mind, cost-optimisation is needed. Nurses, almost half of the total manpower, are considered the backbone of any hospital. Hospital staff should be dedicated, motivated and committed. "

Director, PD Hinduja Sindhi Hospital

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Medical Director, Sagar Hospitals

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Healthcare Excellence Award

Dr Aloke Mullick, Group CEO, Omni Hospitals, receiving the Healthcare Excellence Award at HIS, Bengaluru

Neeraj Lal, Vice-President & Cluster Head, Rainbow Childrenâ&#x20AC;&#x2122;s Hospital, receiving the award at HIS, Bengaluru

Rani Desai, CEO, Anahat Foundation receiving the award at HIS, Bengaluru

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The award being received on behalf of MedikaBazaar

The Award being received on behalf of World Vision

Awardees during a photo-op at HIS, Bengaluru

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‘Leveraging Cutting-edge Technology to Foster Patient Care’ With advanced technology and constant upgradation of equipment, Holy Family Hospital is able to offer patients quality services at cost-effective rates, say its Executive Director Sr Lucien Thomas & Chief Information Officer Rajendra S Kshirsagar, in conversation with Elets News Network (ENN).

Holy Family Hospital is making steady efforts to provide finest patient care to people of all social strata. How has the hospital evolved over the years? Holy Family Hospital, Mumbai, a 268bed NABH accredited, public charitable, trust-run hospital, is a centre of medical excellence. Its humble beginning dates back to 1942, when it started as a 10-bed private nursing home by Dr Austin Da Silva. Over the years, it developed into a multi-specialty hospital and medical research centre under the stewardship of two religious congregations,“Medical Mission Sisters” and “Ursuline Sisters of Mary Immaculate”. Holy Family Hospital was recognised by the National Board of Examinations (NBE) for the Diplomate of National Board (DNB) in 2005 (departments of general medicine, general surgery, gynaecology and paediatrics); in 2007 (super-speciality in cardiology) and in 2011 in anaesthesiology. The hospital has a full range of patient facilities that meet NABH standards, fully- equipped and certified to meet the medical, diagnostic and surgical needs of both in-patients and out-patients.

Both patient safety and satisfaction determine the whole discourse of healthcare delivery. How does the hospital fare on this front? With advanced technology and constant upgradation of equipment, hospital is able to offer quality service

may-june 2019

Sr Lucien Thomas

Rajendra S Kshirsagar

Executive Director Holy Family Hospital

CIO, Holy Family Hospital

at cost-effective rates, making it a preferred medical institution for people at large. We were the first hospital in Mumbai to install a Hybrid Cath Lab / Operating Room way back in 2010, which enabled cardiologists and cardiac surgeons to work together. Our diagnostic services including Pathology Department, Blood Bank & Component Blood Bank, and Department of Imaging, are also ISOcertified.

undertaken by the Medical Research Centre extend from fertility awareness and natural family planning to the evaluation of hospital facilities such as the value of endoscopic surgery, its pros and cons, as well as studies on hospital post-operative infection.

Highlight some distinct features of the specialities the hospital offers to patients. Apart from the main divisions, the hospital has added more specialities over the years. The hospital has achieved several milestones, one of these being setting up of “The Holy Family Heart Institute” in 2002, a pioneer in cardiac diagnostics, treatment and research. Projects

With increasing role of technologies in healthcare delivery, what has been the hospitals’ approach on the same? The hospital has been periodically upgrading equipment to ensure quality care. We are moving on from the current legacy-based HIS to new HIS which will be live from November 2019.With new HIS in place, major clinical and patient care activities will be managed in a better way. It includes investigations for both in-patients and out-patients in addition to patient billing and handling of insurance claim process.

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Dr L H Hiranandani Striving to Ensure Patient Satisfaction, Safety With state-of-the-art technologies and innovative practices, Dr L H Hiranandani is leaving no stone unturned to live up to the expectations of patients. The hospital has incorporated clinical pathways for better patient outcome, reduced hospital stay and also encouraged very minimal use of antibiotics, says Dr Sujit Chatterjee, Chief Executive Officer, Dr L H Hiranandani Hospital, in conversation with Mukul Kumar Mishra of Elets News Network (ENN).

With its ‘patient centric’ approach, Dr L H Hiranandani Hospital has carved a niche in the Indian healthcare sector. In brief, tell us about the journey of the hospital. Inaugurated in February, 2004, Dr L H Hiranandani Hospital aims to render quality care to patients. The hospital has been constantly working towards its mission of ‘being the preferred choice for healing and good health’. After getting the ISO certification in 2006, the hospital took the giant step in 2007 to get the NABH accreditation from the Quality Council of India. It was first such feat not only in Mumbai but across the entire Western region of India. Thus, not a single act of our hospital remains mundane. The hospital marched on to get its laboratory the national accreditation for all its services (NABL) in 2008. It also got NABH accreditation for its blood bank in 2011. The hospital aspires to achieve excellency in nursing and this has led us to get the nurses recognised by the Quality Council with Nursing Excellence in March 2016. We are constantly striving to evolve in terms of delivery of services which paves the

may-june 2019

path for patient safety and satisfaction. Processes are validated for effectiveness and revalidated if any new modality is introduced for better patient outcome. The hospital, thus, has incorporated the clinical pathways for better patient outcome, reduced hospital stay and also encouraged minimal use of antibiotics. This reduces the overall cost to the patient. Clinical pathways have also ensured a degree of safety for patients.

What makes Hiranandani Hospital different from others in terms of clinical excellence and other determinants of patient satisfaction? Right from its design to service delivery aspect, the hospital is different. Its bed to space ratio is high, providing much comfort to patients. In addition, we have been able to convert the entire hospital to a high dependency unit, where every bed can be monitored from the ICU. We were arguably the first in India to focus on the air quality in the hospital. Also the concept of Labour Delivery Recovery and Puerperium suites were among many firsts by the hospital. The elegance of design is such that all

Dr Sujit Chatterjee CEO, Dr L H Hiranandani Hospital

facilities related with maternal care, i.e delivery suites, Neonatal Intensive Care Unit (NICU), ICU, and operating rooms are available on the same floor. The same is with the Cath lab and cardiac OT. We also have ensured that each room gets plenty of sunlight. This helps quick recovery.

How do you analyse evolution of Indian healthcare in terms of accessibility and affordability. What are your suggestions to improve things? Indian healthcare needs robustness

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PHCs and district hospitals must have modern equipment that should be in working condition and are also serviced in regular manner.

imminent. There should be a focus on clinical medicine. In addition, healthcare providers must explore ways to treat patients with minimal investigation and imaging. There has to be subjects on medical jurisprudence and law, medical ethic, information therapy, and communication. There needs to be some insight into alternative medicine. In addition, mental health and social well-being, health economics, and medical administration, need to be made part of the medical curriculum.

leader’s Perspective

like never before. Being the country of youngest people in the world is a big advantage. But at the same time, India should strive to become a healthy young country. Today the accessibility to even basic care is difficult, especially in the mofussil areas. Also, the emergency care is inadequate, which needs to be strengthened. The Government has great vision to make people healthy through gamechanger schemes, but that requires lots of infrastructure to get materialised. Doctors should be available in the remotest areas to render care. They should be given incentive for looking after people in remote areas. PHCs and district hospitals must have modern equipment that should be in working condition and are also serviced in regular manner. This may require a commitment from the manufacturing industry. There should be a robust supply chain to ensure medication. The infrastructure may exist, but if it is not functional then access to care is defunct. The next step is to strengthen and modernise the Government institutions in smaller cities and metros. There are outstanding institutions in cities which are burdened and are unable to render the quality of care that they are capable of rendering. Government institutions in smaller cities and metros must be strengthend. India must look at the concept of prepaid healthcare if quality therapy has to be provided. In the light of huge variation in cost, being most expensive at the metros and least at the PHC, insurance penetration is the need of the hour. The concept of free care will never work. Stratification is needed as costs for the same disorder varies from a PHC to a tertiary care facility in metro. Cost rationalisation should be mandatory. Insurance must take cognisance of the fact that premium for the young needs to be higher (as they have the capacity to work and

Elaborate about the rainbow of facility and services offered at the hospital. The hospital has over 52 facilities and has several verticals in all.

earn) and miniscule for retired and senior citizens. If we want to be a torchbearer among countries of the world on the front of cutting-edge technology and other expertise, then we need the best equipment. ‘Make in India’ can be the watch word for the leading medical equipment manufacturers as it would contain skyrocketing medical cost which in turn would benefit people at the last mile.

What is your perspective about Indian medical education, which lays strong foundation for robust healthcare delivery system? Revamping of the curriculum is

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How well equipped are your medical equipment to cater people with finest care? We source our medical equipment from the world’s leading vendors and are always at the cutting-edge of therapy that we render.

As an expert how do you analyse role of private –public partnership (PPP) to boost healthcare delivery system? PPP model has to be mature in India. The working modality has to be very clear. At the same time, the Government must keep in mind the fact that stakeholders are partners and both need to work in coherence. There should not be a big brother approach to supervise others’ work.

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India’s Biggest Gathering of Health Policymakers and 150+ CXOs from Top Hospitals in CHENNAI Ensuring Affordable, Quality Treatment and Meeting up with Patients’ Expectations

Role of Emerging Technology for Building Smart Hospitals

Integrated Healthcare Delivery: M- Health, Telemedicine, AI & VR

KEY THEMES

Role of Public Private Partnership for Developing Sustainable Healthcare Ecosystem

Transforming the Diagnostics and Lab World through Technology

Making Quality Medicines Affordable

PARTICIPATION FROM HEALTHCARE POLICYMAKERS

TOP 150+ HOSPITAL DECISION MAKERS

HEALTHCARE EXPERTS

INTERNATIONAL SPEAKERS

MEDICAL COLLEGES

INNOVATORS

OPPORTUNITIES Panel Discussions

Exclusive Presentation slot

Exhibition

One to One Networking

Healthcare Excellence Awards

For Details, Please Contact: Gopi Krishna Arora : +91-9582892293

#HISMumbai #EletsHIS | events.eletsonline.com/his

RNI NO. UPENG/2011/38140 UP/GBD-140/2017-19

Posting Date: 20 & 25

KKKJJJSomaiya Somaiya Somaiya

Institute Institute Institute ofofof Management Management Management Studies Studies Studies &&Research &Research Research (Estd (Estd (Estd 1981) 1981) 1981)

Rethink Rethink Rethink Reskill Reskill Reskill Relaunch Relaunch Relaunch your your your skillsets skillsets skillsets

yourself yourself yourself

your your your career career career

#MasterYourFutureAtSIMSR #MasterYourFutureAtSIMSR #MasterYourFutureAtSIMSR Scan Scan Scan toto know to know know more more more

PGDM PGDM PGDM Executive Executive Executive Customised Customised Customised Management Management Management Development Development Development Programmes Programmes Programmes

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Open Open Open Calendar Calendar Calendar Training Training Training &&& Certification Certification Certification Programmes Programmes Programmes

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Contact: Contact: Contact: +91-22 +91-22 +91-22 6728 6728 6728 3000/3050 3000/3050 3000/3050 simsr.somaiya.edu simsr.somaiya.edu simsr.somaiya.edu Vidyavihar Vidyavihar Vidyavihar (E), (E), (E), Mumbai Mumbai Mumbai - 77 - 77 - 77