eHealth October 2013

asia’s first monthly magazine on The Enterprise of Healthcare

eHealth Magazine

volume 8 / issue 10 / october 2013 / ` 75 / US $10 / ISSN 0973-8959

Inside Special Focus Time to Redefine Cancer Care

Policy

Vision of MoHFW on Public Health

Anuradha Gupta Additional Secretary & Mission Director, NRHM, Ministry of Health & Family Welfare, Government of India

Dr Vishwas Mehta Joint Secretary, Ministry of Health & Family Welfare, Government of India

ehealth.eletsonline.com

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ISSN 0973-8959

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Anuradha Gupta Additional Secretary & Mission Director, NRHM, Ministry of Health & Family Welfare, GoI

cover story Tapping the Right Pulse

policy Dr Vishwas Mehta, Joint Secretary, Ministry of Health & Family Welfare, GoI

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Expert speak Dr Govind, Senior Director, DeitY, Ministry of Communications & IT, and CEO, NIXI

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MRK Healthcare Pvt Ltd

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Palash Healthcare Systems Pvt Ltd

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Spigot Software Pvt Ltd

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Transasia Bio-Medicals Ltd

special focus (oncology) cover story

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Dr Harit Chaturvedi, Chairman, Max Institute of Oncology

HealthFore Technologies Ltd

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Dr Shyam Aggarwal, HOD, Medical Oncology, SGRH

Agfa Healthcare India Pvt Ltd

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Dr Sankha Mitra, Consultant Clinical Oncologist, Brighton & Sussex University Hospital

Aosta Software Technologies India Ltd

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Armstrong World Industries (India) Pvt Ltd

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Dr Rakesh Roy, Chief Clinical Tutor& Incharge, Dept. of Palliative Care, SGCCRI, Kolkata

Bird Meditech

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Goldstar Healthcate Pvt Ltd

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Hospaccx India Systems Pvt Ltd HealthFore

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KS Biomed Services

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Maquet Medical

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zoom in

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Dr Arjun Kalyanpur, MD, CEO and Chief Radiologist, Teleradiology Solutions

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Dr Anant R Koppar, Chairman and CEO, KTwo Technology Solutions Pvt Ltd

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Prashant Tandon, MD and Co-Founder of Healthkart.com

asia’s first monthly magazine on The Enterprise of Healthcare volume

08

issue

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OCTOBER 2013

President: Dr M P Narayanan

Partner publications

Editor-in-Chief: Dr Ravi Gupta group editor: Anoop Verma

Editorial Team

WEB DEVELOPMENT & IT INFRASTRUCTURE

Health Sr Assistant Editor: Shahid Akhter Assistant Editor: Monalisa governance Assistant Editor: Rachita Jha Research Assistant: Sunil Kumar Sr Correspondent: Nayana Singh education Sr Correspondent: Pragya Gupta, Mohd. Ujaley Correspondent: Rozelle Laha Sales & Marketing Team Assistant Manager: Vishukumar Hichkad, Mobile: +91-9886404680 (South) Manager - Sales: Douglas Digo Menezes, Mobile: +91-9821580403 (West) Subscription & Circulation Team Sr Executive - Subscription: Gunjan Singh, Mobile: +91-8860635832 Design Team Assistant Art Director: Shipra Rathoria Team Lead - Graphic Design: Bishwajeet Kumar Singh Sr Graphic Designer: Om Prakash Thakur Sr Web Designer: Shyam Kishore Editorial & Marketing Correspondence eHEALTH - Elets Technomedia Pvt Ltd Stellar IT Park, Office No: 7A/7B, 5th Floor, Annexe Tower, C-25 , Sector 62, Noida, Uttar Pradesh 201309, email: info@ehealthonline.org Phone: +91-120-4812600 Fax: +91-120-4812660

Team Lead - Web Development: Ishvinder Singh Executive-IT Infrastructure: Zuber Ahmed Information Management Team Executive – Information Management: Khabirul Islam Finance & Operations Team Sr Manager – Finance: Ajit Sinha Legal Officer: Ramesh Prasad Verma Sr Manager – Events: Vicky Kalra Manager – HR: Sangeeta Biswas Associate Manager – Accounts: Anubhav Rana Executive Officer – Accounts: Subhash Chandra Dimri

OUR UPCOMING EVENT PIN*****

Financial Inclusion & Payment Systems 24-25 October 2013, Eros Hilton, New Delhi

ehealth does not neccesarily subscribe to the views expressed in this publication. All views expressed in the magazine are those of the contributors.

The magazine is not responsible or accountable for any loss incurred, directly or indirectly as a result of the information provided. ehealth is published by Elets Technomedia Pvt. Ltd in technical collaboration with Centre for Science, Development and Media Studies (CSDMS) Owner, Publisher, Printer - Ravi Gupta, Printed at R P Printers G-68, Sector-6, Noida, UP, INDIA & published from 710 Vasto Mahagun Manor, F-30, Sector 50, Noida, UP, Editor: Dr. Ravi Gupta © All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic and mechanical, including photocopy, or any information storage or retrieval system, without publisher’s permission.

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editorial

Technologies of the Future The medical devices market in India is gaining global acceptance and recognition that was long overdue. Today, India is ranked 4th in the medical devices market with over 700 medical devices makers in the country. In the global arena, India is rated among the top 20. A recent report by Grant Thornton predicts that the Indian market shall grow to around USD 5.8 billion by 2014 and USD 7.8 billion by 2016.

Also, health IT is a fast growing segment. As per a report by Gartner, healthcare providers in India will spend `57 billion on IT products and services by the end of 2013, an increase of seven percent from `53 billion in 2012.

Telecommunications will remain the largest overall spending category that is likely to reach `17.2 billion in 2013 from `16.6 billion in 2012 at a growth rate of 3.9 percent.

Big data, cloud computing, social media, mobility, embedded systems and augmented reality are the technologies of the future that are set to revamp the face of the healthcare sector.

The October issue brings the 5th Annual Healthcare Technology Resource Guide 2013, which aims to showcase the latest products and solutions in Healthcare IT and Medical Technology segments. With exclusive company profiles and matrix, the Guide projects to act as the ultimate reference material for healthcare providers for all their planning and decision.

The current issue also showcases the growing concern for cancer – the leading cause of death worldwide. India’s cancer burden today stands at 3,300,000 and by 2020, 70 percent of the world’s cancer cases will be in poor countries, with a fifth in India. We talk to the organisers of the Indian Cancer Congress and leading experts in palliative care.

Our forthcoming mega event is the Global Conference on Financial Inclusion Payment Systems (FIPS 2013) scheduled for October 24-25, 2013.

The conference will stress upon the financial inclusion initiatives in the Indian healthcare fraternity, especially addressing the issue of health insurance penetration in India. As per the World Health Organization (WHO) records, in 2011, India has spent only 3.9 percent of GDP on the health sector, which is comparatively quite lower than many other developing countries. There is a pressing need to increase the coverage of health insurance in the country as out-of-pocket expenditure on health needs is still among the highest in the world.

Dr. Ravi Gupta ravi.gupta@elets.in

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news

pharma

Genomics via EHR Genetic tests can now tell us whether we are at increased risk of various cancers, heart or kidney disease, asthma and a number of other conditions.

Other genetic tests can tell whether you will respond to certain medicines or be harmed by side effects linked to your genetic code. But harnessing that information to benefit individual patients and prevent illnesses in others will require that doctors have access to genomic information for each patient.

As health records are converted to digital form, the most likely place to store and retrieve genomic information will be Electronic Health Records (EHR). But when and how that happens will depend on having good models to build upon.

Life without Insulin is Possible

While life without insulin was inconceivable, a group of researchers, led by Roberto Coppari, professor in the Department of Cell Physiology and Metabolism at UNIGE, has just demonstrated that insulin is not vital for survival. By eliminating this dogma, scientists are now considering alternatives to insulin treatment, which poses many risks to patients. An error in dosage may cause hypoglycemia, i.e., a decrease in the level of glucose in the blood, which can lead to a loss of consciousness. In addition, about 90% of patients over 55 who have been undergoing treatment for several years develop cardiovascular disease due to elevated levels of cholesterol brought on by the lipogenic properties of insulin.

Researchers from UNIGE’s Faculty of Medicine conducted experiments on rodents devoid of insulin, to which they administered leptin.

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Web-Based Screening Tool to Detect Mental Health A novel web-based tool for detecting unhealthy behaviors and mental health issues appears to be feasible, acceptable and easily integrated into patients’ electronic medical records.

Developed by researchers in New Zealand, the web-based eCHAT (electronic Case-Finding and Help Assessment Tool) screens patients for problematic drinking, smoking and other drug use, gambling, exposure to abuse, anxiety, depression, anger control and physical activity, and whether they want help with these issues. In this study, the tool was selfadministered on an iPad in the waiting room by 196 consecutive patients visiting two primary care practices in Auckland, New Zealand.

Discovery of 105 Additional Genetic Errors that Cause Cystic Fibrosis Of the over 1,900 errors already reported in the gene responsible for cystic fibrosis (CF), it is unclear how many of them actually contribute to the inherited disease. Now a team of researchers reports significant headway in figuring out which mutations are benign and which are deleterious. In so doing, they have increased the number of known CF-causing mutations from 22 to 127, accounting for 95 percent of the variations found in patients with CF. In a summary of their research to be published online in Nature Genetics, the scientists say that characterizing those additional mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene will not only bring certainty to families about a CF diagnosis or carrier status, but will also accelerate the design process.

news

pharma

Indian Firms Get FDA Nod for 110 Drugs Indian drug makers, the biggest overseas source of medicines in the US, have got over 100 generic drug approvals from the American health regulator FDA this year so far.

This has taken India’s share in the Original Abbreviated New Drug Application approvals to nearly 40% in the US market in 2013. At least 110 of these approved applications are from the Indian firms, or entities owned or controlled by them, including Sun Pharma, Lupin, Aurobindo Pharma, Zydus, Glenmark, Dr Reddy’s, Emcure, Wockhardt, Torrent, Claris, Alkem, Ipca, Cipla, Famy Care, Natco, Hetero and Alembic.

HLL Lifecare’s Vaccine Complex to Go Live in 2016 The Rs.594 crore Integrated Vaccine Complex (IVC) of state-run HLL Lifecare’s wholly-owned subsidiary HLL Biotech Ltd, coming up in Tamil Nadu, will start supplies in 2016, said a company official.

Addressing reporters here, HLL chairman and managing director M.Ayyappan said the IVC will be producing pentavalent combination (DPT plus Hep B plus Hib), BCG, measles, Hepatitis B, Human Rabies, Hib and Japanese Encephalitis (JE) vaccines.

“Work at the factory complex at Chengalpattu (in Tamil Nadu’s Kanchipuram district) is going ahead as per schedule and by 2016, we are certain that we will start manufacturing the vaccines. We would be operating on the principle of providing quality vaccines at affordable rates,” he said

Measles Elimination by 2020 Health Ministers of 11 South-East Asian countries committed to eliminating measles and controlling rubella and congenital syndrome (CRS) by 2020 at WHO’s Sixty-sixth Regional Committee meeting today. Over 70 700 children died of measles in the Region in 2011 which was about 45% of global measles deaths. WHO estimates that US$ 800 million are needed to achieve this goal by 2020.

“An estimated 8 million children are not protected against measles in WHO’s South-East Asia Region. The measles and rubella vaccines are safe, effective and inexpensive.

The administration of a combined measles rubella vaccine can eliminate both diseases cost effectively” said Dr Samlee Plianbangchang, WHO’s Regional Director for South-East Asia, “Measles outbreaks are a major development obstacle.

With political will and by focussing on the vulnerable and hard to reach populations, we can eliminate measles and control rubella in South-East Asia Region by 2020,” adds Dr Samlee.

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A Novel Drug for Brain Cancer Introduced

A novel drug for patients with brain cancer, 2B3-101, has shown preliminary positive results. The Dutch biotech to-BBB has developed 2B3-101 and initiated a clinical trial to investigate this new treatment.

The Phase I safety results will be presented at the European Cancer Congress 2013 in Amsterdam at the end of September.

“This first clinical trial with 2B3-101 has focused on the safety of this new treatment, yet, promising signs of anti-tumor activity were observed in many of the patients at the higher dose levels tested,” says Dr. Dieta Brandsma from the Netherlands Cancer Institute.

Antiobiotics by Prescription from March 2014

With the Union Health and Family Welfare Ministry notifying amendments to the Drugs and Cosmetics Act, 1940, antibiotics and anti-Tuberculosis drugs will not be sold over the counter from March 1, 2014.

The government had included a new provision, Schedule H1 to the Drugs and Cosmetics Act to check the indiscriminate use of antibiotics, anti-TB and some other drugs in the country. As many as 46 drugs have been placed under this restricted category which mainly comprises third and fourth generation antibiotics, anti-TB and some other drugs.

The packaging of these drugs will have mandatory warning printed on them in a box with a red border on the label and will be sold by chemists on production of a prescription. The chemist will retain a copy of the prescription and maintain a separate register for these 46 drugs.

www.irinn.in

www.nixi.in

Policy

On Mission to Create Healthy India “NRHM is designed in a way that every individual state enjoys flexibility in managing its healthcare needs,� says Anuradha Gupta, Additional Secretary & Mission Director, NRHM, Ministry of Health & Family Welfare, Government of India. In conversation with Nayana Singh and Kartik Sharma, ENN Please tell us about the initiatives taken by NRHM for improving healthcare facilities in rural India?

The National Rural Health Mission (NRHM) aims to improve health services in rural areas and provide accessible, affordable and accountable healthcare. Augmentation of infrastructure and human resources, and increased provisioning of drugs, diagnostics, ambulances and logistics have received focus under NRHM. Mainstreaming of AYUSH to offer choice to patients and broadening the range of services in public health institutions are important priorities.

Over 50,000 health facilities have been newly constructed or renovated, and more than 1.5 lakh human resources have been added, including specialists, doctors and nurses.

The huge surge in service delivery in public health institutions indicates the enhanced public confidence in public health system. It is impressive that annual OPD in government institutions has exceeded 90 crore and nearly 1.66 crore pregnant women are delivering in government and accredited institutions annually.

Other initiatives include strategy to address intra-state inequities through identification of 184 high priority districts that are suffering from

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Anuradha Gupta, Additional Secretary & Mission Director, NRHM, Ministry of Health & Family Welfare, Govt of India

Success Speaks: Key Achievements of NRHM • Introduction of Dial 108/102 ambulance service • 18,000 ambulances transporting patients in 28 states/ UTs with priority accorded to mothers, children and patients requiring critical care • 2,045 Mobile Medical Units delivering health services in remote and far flung areas • 8.89 lakh ASHAs (Accredited Social Health Activists), who act as a strong interface between the community and the health system and mobilise demand for institutional care • Janani Suraksha Yojana has seen phenomenal growth from 7 lakh beneficiaries in 2005 to more than 1 crore from 2010 onwards • Janani Shishu Suraksha Karyakram launched in June 2011 to eliminate out-of-pocket expenditure for pregnant women and sick neonates

the most adverse health indicators.

They would receive higher financial allocation, greater flexibility for needbased innovations and harmonised technical assistance, including from Central level.

What have been the key achievements of NRHM during the last few years?

The rates of maternal and child mortality have declined remarkably. Total fertility rate has also started to decline faster. What is encouraging is the fact that large and populous states with highest maternal and child mortality rates have started to show progress.

‘Janani Suraksha Yojana (JSY)’ has seen phenomenal growth from 7 lakh beneficiaries in 2005 to more than 1 crore from 2010 onwards. Institutional deliveries rose from 47 percent in 2007-08 to 72 percent in 2009. Building on JSY, another major initiative ‘Janani Shishu Suraksha Karyakram’ was launched in June 2011 to eliminate out-of-pocket expenditure for pregnant women and sick neonates.

This initiative entitles every woman delivering in a public health institution to free drugs, diagnostics and diet, besides transportation. Free entitlements have now been extended to antenatal and post natal complications and one-year-old sick infants.

Our key priority is on reducing

The recent launch of the National Urban Health Mission is a major step forward towards strengthening primary healthcare in urban areas and would help cater to the health needs of more than 10 crore urban poor. We expect it to gather pace from next year.

Under what capacities is NRHM using Information and Communication Technologies?

There are several ways in which we have started to use ICT under NRHM. Mother and Child Tracking System (MCTS) is

Our key priority is on reducing out-ofpocket health expenditure. Hence, we are emphasising on ensuring universal access to free essential medicines in all public health facilities out-of-pocket expenditure, which is very substantial in India. Medicines account for over 70 percent of health expenditure and therefore, ensuring universal access to free essential medicines in all public health facilities is being emphasised under NRHM. Last year, Rs 1,600 crore was provided to states for provisioning free drugs and this year, the figure is likely to reach about Rs 2,000 crore. We have also introduced an incentive of five percent additional allocation for states that implement free drugs initiative. Twenty eight states have already made an explicit articulation to provide free essential drugs in public health system.

Which states has NRHM been most successful so far?

It is true that states have made variable progress in terms of Reproductive and Child Health indicators. Tamil Nadu and Kerala have already achieved the national goals. Maharashtra has also joined the league. Punjab, Haryana, Gujarat, Uttarakhand and Orissa are emerging as cusp states.

a Mission Mode Project and one of the largest applications with a database of over 9 crore pregnant women and children each one of whom is tracked for services. MCTS helps us ensure and monitor delivery of services to women and children in real time. The application is used to send regular SMS alerts to beneficiaries ahead of dates when antenatal check-ups or immunisations are due, to generate weekly work plans for ANMs and to monitor how many due services were actually delivered.

NIKSHAY is a similar tracking system for every TB patient. Our ambulances are now GPS-enabled and call centre based, thus enabling us to monitor their movements better. Same is the case with Mobile Medical Units which are monitored for service delivery in remote and difficult areas. Telemedicine and teleradiology are also being promoted under NRHM.

What are the other ways by which you are leveraging IT? Hospital Management Information Systems are being put in place in

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Policy

several states, making paper work and prescriptions a thing of the past and paving way for electronic health records. HMIS captures online data on 240 key health parameters and in most of the states, individual facilities are uploading data. IT is also being extensively used to manage and monitor supply, distribution, consumption and stock of medicines across health facilities. Even for financial management, CPSMS makes effective use of information technology and tracks, in real time, funds and transactions at the level of subdistrict health facilities.

What is your view of private sector participation in healthcare sector?

The private sector has both advantages and limitations. In urban areas, the private sector has a large presence and thus offers opportunities for collaboration under the newly launched NUHM. But the focus of NRHM is on reaching the unreached in remote and far-flung areas where the private sector is hardly present and thus strengthening of public health system is an imperative. There is no doubt that private sector can play a supplemental role for critical gap filling. PPP models are highly successful in the field of diagnostics, in running ambulance services and Mobile Medical Units and providing services where public sector has limited capacity, but the demand for services is very high.

What are the areas where you think maximum impact can be made by latest advances in IT? I feel that mHealth and eHealth have vast potential and we should tap them much more than what we are doing today. For leveraging their potential to the fullest, we are trying to upgrade our own capacities at the national level. Besides strengthening IT infrastructure, our endeavour is to design holistic IT solutions. We are making efforts to increase the inter-

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Rashtriya Bal Swasthya Karyakram RBSK is one of the latest initiatives of NRHM which is an effort of going beyond survival of children and ensuring holistic development and improving their quality of life. It provides comprehensive screening of children from 0-18 years of life against Four Ds: • Defects at birth • Diseases • Deficiencies • Developmental Delays including Disabilities The initiative provides for free treatment including surgeries at tertiary level. An estimated 27 crore children are expected to be annually screened in a phased manner.

The huge surge in service delivery in public health institutions indicates the enhanced public confidence in public health system operability of applications, so that all our services become inter-connected.

We are working with the National Institute of Smart Governance and the Department of Information Technology to take forward some of these initiatives.

What challenges lie ahead for India to have an efficient healthcare system?

The most prominent challenge is the lack of highly trained human resources to cater to the needs of such a large population. This shortage is exacerbated in rural and particularly remote and difficult areas. NRHM provides special financial incentives to

attract service providers to difficult geographies. We are also encouraging graded incentives, depending on how remote the facility is. On top of the base incentive that health personnel receive for serving in difficult areas, we are now promoting performance linked incentives.The NRHM is designed in such a way that the individual states enjoy substantial flexibility in managing their healthcare needs.

The intention is to encourage different states to come up with initiatives that are designed to meet the specific healthcare challenges that people in any particular state may face. ’One size fits all’ is not an approach that NRHM pursues.

Policy

Improving the State of

Medical Education “Advancements in IT must be blended with the general curriculum in medical education for making the syllabus in tune with the needs of modern medicine,� says Dr Vishwas Mehta, Joint Secretary, Ministry of Health & Family Welfare, Government of India. In conversation with Kartik Sharma and Nayana Singh, ENN

Dr Vishwas Mehta,

Joint Secretary, Ministry of Health & Family Welfare, Government of India

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There is a huge gap between demand and supply of human resources in Indian healthcare.

How will the government overcome this challenge?

As far as Human Resources in healthcare is concerned, the trend all over the world shows that it is difficult to bridge this gap. Currently we are producing 50,000 medical graduates from 387 medical colleges in the country.

Out of these, 23,000 are specialists.

The World Health Organization (WHO) has mandated a Doctor Population Ratio of 1:1000, whereas the current ratio in India is about 1:1700. To bring this at par with WHO standards, we need to almost double this number, which is indeed a very difficult task.

It will take many years for us to create so many doctors at the current average rate of 20 new medical colleges being added every year. At this rate, even if we are adding 100 new medical colleges in the next five years, we will still not be able to produce more than 10,000 doctors; whereas we need five times more. Moreover, our current medical education is urban, which creates doctors for hospitals in towns and cities, and not for primary healthcare, needed in rural India.

What measures are you taking to ensure that rural areas have access to doctors?

The problem is that most doctors do not want to serve in rural areas for several reasons. Recently the Medical Council of India (MCI) announced compulsory rural postings for doctors, whereby every doctor has to serve in Primary Health Centres (PHCs) for at least one year before he becomes eligible for PG degree.

Many doctors have protested against this decision and different states have mixed responses to it. It is not easy to implement this decision.

How do you implement this in states like Arunachal Pradesh or Nagaland, where there are no medical colleges?

Almost 65 percent of all medical colleges are concentrated in Southern and Western India, which means more graduates to be deployed per PHC in these states.

However, one thing is clear that those choosing to work in this noble profession will have to give one year to work in rural India in the national interest.

The distribution of medical colleges is quite uneven in India. How is the government addressing this issue?

There are vast regional disparities.

Southern states have better health pa-

majority of district hospitals in India have bed capacity of less than 300, so we are going to first concentrate on those hospitals to increase their bed capacity and make them eligible for setting up a medical college.

The Central Government has also asked the MCI to relax norms and they have agreed to allow establishment of medical colleges on two separate plots, 10 kms apart. This will facilitate states to upgrade district hospitals into medical colleges with hospital on one plot and teaching facilities on another. The Planning Commission has already accepted this proposal in XI Plan and financial approvals are in final stages

Government’s intervention is vital in healthcare sector; healthcare cannot be left completely in the hands of the private sector, as their major interest shall remain commercial rameters than north. This is primarily because states like Andhra Pradesh, Karnataka and Tamil Nadu have more than 40 medical colleges each, whereas in North and Central India, 65 percent of districts (422 out of 644 districts) do not have even one medical college. So, we are going to concentrate on such under-served states and financially support them to upgrade their respective district hospitals into medical colleges. This will improve overall quality of healthcare services in under-served areas.

What is the government’s approach for those districts that have government hospitals but do not have medical colleges?

It is far more difficult to set up a new medical college than to upgrade an existing hospital into a medical college.

The MCI norms require a hospital to have minimum 300 beds to start a medical college with 50-100 MBBS seats. A

now. This will give a big boost to expansion of medical colleges in the country.

Can PPP model be beneficial for development of better healthcare infrastructure in India?

Public Private Partnership (PPP) model has not worked very successfully in the healthcare sector. However, it is possible to develop a synergy between them in certain areas like diagnostic services. Similarly, clinical resources available in government hospitals can be used for teaching purposes, provided a successful model is worked out and demonstrated. However, this has to be done at the state-level as demands and needs are different from place-to-place.

Health is one sector where government’s intervention is a must, primarily because a very large number of people cannot afford facilities and treatment offered by the private sector. Any viable PPP model has to be

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Policy

Several technologies are available to facilitate learning, but unfortunately our regulators have not incorporated them in medical education curriculum. Some are of the opinion that technology can replace teachers in classrooms, which is true to some extent as far as theory classes are concerned and support for practical suites learning before getting exposed to real-time, onsite practical training.

I am personally of the opinion that modern advancement in IT should be used to integrate with the general curriculum of medical education for enrichment of the syllabus.

What is your message to those involved in health services?

National Medical College Network The project will provide inter-connectivity, linking all government medical colleges in the country for Tele-Medicine, Tele-Consultation, m-Health and Continuing Medical Education (CME). As National Resource Centre-cum-RRC, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, will provide the leadership and also help set up five regional centres to cover the government medical colleges in the entire country. Once established, Tele-Consultation will also help doctors in remote areas to consult senior specialists, thus providing better access to health to common man

worked out very carefully after looking at all pros and cons, since it involves dealing with patients and their lives.

How is IT being integrated in medical education to upgrade the syllabus as per the latest innovations?

Telemedicine can bridge the huge gap between the demand and supply in health services. National Knowledge Network (NKN) has already started providing 100 mbps and above broadband connectivity to all major educational institutions in the country.

Models for building virtual classrooms are being developed everywhere and IITs are running suc-

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We have to maintain high standards for delivering quality health services by producing qualified professionals.

Medical education in India is known for its quality all across the world.

Lack of human resources cannot be solved by exponentially increasing the number of medical colleges. Those who are not passionate about this profession should not take it up.

At the same time, we must stop looking at doctors for all problems concerning public health. We should develop a Public Health Cadre including

It is far more difficult to set up a new medical college than to upgrade an existing hospital into a medical college cessfully based on NKN connectivity.

Virtual classrooms and surgical suites in medical colleges will allow students to witness surgeries being performed live in operation theatres. Instead of learning from books alone, we can see three dimensional computer simulation models, which can be extremely useful in subjects like anatomy, surgery, etc.

middle-level Health Service Providers or Community Health Officers (CHOs) who can be specially trained to take care of common ailments like common fever, diarrhoea, vomiting, etc. CHOs can be very effective as the first point of contact between people and doctors in rural areas. Right now, there is no one to take care of people’s health in rural areas except ASHAs and ANMs.

cover story

S

et up by the Government of India on 19th June, 2003, NIXI was founded to enable the peering of ISPs among themselves for routing the domestic traffic within the country. It is managed and operated on a neutral basis, which is in line with the global best practices for such initiatives.

Dr Govind, Senior Director, DeitY, Ministry of Communications & IT, and CEO, NIXI

What is the mandate of NIXI? Tell us about the work that the organisation is doing in India?

Currently National Internet Exchange of India (NIXI) is performing three vital functions for the country. Firstly, NIXI is the neutral meeting point of ISPs in India. Its main purpose is to facilitate exchange of domestic Internet traffic between the peering ISP members.

India’s First & Only

Neutral Internet

Exchange

“The domestic Internet scenario in India is unique with several large and small ISPs spread across a large geographical area,” says Dr Govind, Senior Director, DeitY, Ministry of Communications & IT, and CEO, NIXI This enables more efficient use of international bandwidth, saving foreign exchange. This also improves the quality of services for customers of member ISPs by avoiding multiple international hops, thus reducing latency. Secondly, NIXI has been authorised by the Government of India to serve as an .IN Registry. We have been doing this since January 2005. Now .IN domain names are available to anyone on first-comefirst-served basis. For more details, please visit www.registry.in. Thirdly, Indian Registry for Internet Names and Numbers (IRINN), a division of NIXI,

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provides allocation and registration services of IP addresses and AS numbers and contributes to the society by providing Internet-related information as a non-profit, affiliation-based organisation.

Please share an overview of the tariff policy that NIXI is following.

The domestic Internet scenario in India is unique with several large and small ISPs spread across a large geographic area. The policy followed by NIXI is basically focussed on addressing the concerns of the large as well as small ISPs, while at the same time keeping the larger national interests in mind. The idea is to promote domestic hosting of content as well as saving foreign exchange by keeping domestic traffic within India.

What is the procedure by which an ISP can join NIXI? The procedure by which an ISP can join NIXI is fairly simple. An ISP licensed by the Department of Telecommunications, Ministry of Communications and IT, Government of India, can become a NIXI peer. The member ISP must have its own AS number and use BGP4+ for peering.

Membership fee is of Rs 1,000 plus taxes per annum on all-India basis. To connect to NIXI, an ISP has to become ordinary member of NIXI by sending the following filled and duly signed forms and two copy of connection agreement with stamps on each page of the agreement: • Application Form for Ordinary Membership • NIXI Connection Agreement • NIXI Connection Form

Please provide us with some brief on .IN Registry?

The .IN Registry was set up under NIXI during January, 2005. The .IN Registry functions as an autonomous body with primary responsibility for maintaining the .IN ccTLD and ensuring its operational stability, reliability, and security.

It will implement the various elements of the new policy set out by the Government of India and its DeitY.

Ensuring Safety of .IN Registry .IN domain is one of the world’s most protected Top Level Domains (TLD). Access to .IN domains is performed via a highly redundant, global, Anycast DNS network, which protects against massive Distributed Denial of Service (DDOS) attacks.

IN registry is secured behind a Five Layer Security Ring with all critical components, fully redundant hardware, software and service provisions including a completely functional and tested disaster recovery facility.

The .IN registry is also one of the few TLDs in the world to have deployed the Domain Name System Security Extensions (DNSSEC) Technology which guarantees protection to website users.

DNSSEC ensure that they cannot be hijacked maliciously.

This is the first TLD in South Asia to deploy such a high-level of cryptographic technology for security at the domain level. .IN registry is also constantly monitored for threats and active measures are taken to mitigate abuse in coordination with CERT IN. There are additional scans and audits performed to ensure there are no known vulnerabilities.

NIXI is expecting to administer the Internationalised Domain Names (IDNs) in the near future. IDNs are the domain names in the native language.

Registration of .IN domain stands at 1.67 million as on January, 2013. Presently, 92 Registrars have been accredited to offer .IN domain name registration worldwide to customers. It has helped in proliferation of web hosting and promotion of Internet usage in the country. Two Data centres have been established in Delhi and Chennai, one acting as the primary and the other as a secondary with a maximum down time of five minutes.

What is National Internet Registry and what is its need?

The National Internet Registry (NIR) is known as Indian Registry for Internet Names and Numbers (IRINN). IRINN provides allocation and registration services of IP addresses and AS numbers, and contributes to the society by providing Internet-related information as a non-profit, affiliation-based organization, and performing research, education and enlightenment activities.

NIR is needed to facilitate the allocation of IP resources to large number of small and medium companies within the country. Also with NIR the services can be charged in local currency to avoid exchange losses. It also facilitates local training and development and is conducive for providing local language support to the entities in India.

Tell us about IRINN policy for its affiliates?

IRINN has been operational from December, 2012. Till date, more than 320 affiliates have been registered. IRINN policy is in line with Global and APNIC policies. It has the feature of Transparency and bottom up process for any policy changes. IRINN Affiliates have freedom to choose the Registry (IRINN or APNIC). As we are in line with APNIC policy, maximum delegation size for IPv4 is restricted to /22 and minimum delegation size for IPv6 address is /32 for LIRs & /48 for Corporate affiliate. The main feature of the policy is to operate in a way that is consistent with regional and global resource management policies.

october / 2013 ehealth.eletsonline.com

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company Profile I Listing

Tapping

the Right Pulse

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Health IT and medical technology are together playing a critical role in changing the face and fate of the healthcare.

Monalisa, ENN, explores the current scenario and growth potential of both the segments

T

he availability of advanced medical technology, backed by apt usage of Information Technology, has expanded both the reach as well as scope of healthcare services. The industry is witnessing a subtle, tectonic shift from symptomatic to predictive healthcare delivery model.

Rising demand for healthcare quality, better access, cost reductions, higher operational efficiencies and lower medical errors are acting as catalysts for the adoption of technology by healthcare providers. Coupled with this is the growing exposure of patients to global health standards and their increasing consciousness for preventive healthcare. Adoption of innovative and cost-effective solutions is thus increasingly becoming imperative for healthcare providers.

Rising IT Expenses No wonder, IT is gradually gaining prominence in the spending of healthcare providers and enterprises. As per a report by Gartner, healthcare providers in India will spend `57 billion on IT products and services by the end of 2013, an increase of seven percent from `53 billion in 2012. This includes spending on internal IT (including personnel), hardware, software, external IT services and telecommunications.

The report titled, “Enterprise IT Spending for the Healthcare Providers Market, Worldwide, 2010-2016�, further mentions that Telecommunications will remain the largest overall spending category, that is likely to reach `17.2 billion in 2013 from `16.6 billion in 2012 at a growth rate of 3.9 percent. “Hospital Information Systems (HIS), Picture Archiving and Communications Systems (PACS), Electronic Medical Records (EMRs) and Mobile Technologies will be high on the agenda,� says Anurag Gupta, Research Director at Gartner. “We expect to see

providers benefit by offering cost-effective business models which show quick returns on capital by improving patient coverage and improving quality of care. Health insurance growth will also catalyse technology adoption in healthcare provider segments,� he adds.

Health IT Trends Initiatives are currently focused on Digital Health Records, Telemedicine and Mobile Delivery of healthcare information. Also, the industry is moving towards a patient-centric approach that enables comparison of prices and quality of medical providers through social networking and other such platforms. Besides, the industry is gradually harnessing the potential of disruptive technologies such as cloud computing and big data.

KPMG, in a study titled “Six Converging Technology Trends 2013� identifies six disruptive technological innovations, namely – big data, cloud computing, social media, mobility, em-

bedded systems and augmented reality – that are likely to revamp the face of the healthcare sector.

Big data: New technologies in healthcare management systems consist of electronic data storage, data maintenance and exchange. However, data poses its own set of challenges in terms of volume (large quantities of data), variety (structure and unstructured), and velocity (rate of data generation). Big data analytics platforms shall prove effective in extracting intelligence from humungous patient records.

Cloud: High initial costs, need for human resources to maintain the systems and need for accessibility of data 24/7 often act as deterrents for healthcare providers in the adoption of technology. Cloud computing offers answer for all such issues. EMRs, telemedicine, patient management, and medical imaging are gradually shift-

Telecommunications will remain the largest overall spending category under

Health IT, reaching up to `17.2 billion in 2013, at a growth rate of 3.9 percent

TREND WATCH IT in Healthcare Emerging Solutions

Key Disruptive Technologies

Futuristic Trends

m-Health

Big Data

Social Media

Tele-Health

Cloud

Web-Health

Mobility

Augmented Reality

Embedded Systems Source: KPMG in India Analysis october january / 2013 ehealth.eletsonline.com

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company Profile I Listing I matrix

MARKET SEGMENT Medical Technology Sector in India Medical Equipments Medical Implants Medical Disposables and Furniture Source: NIPER Ahmedabad Medical Devices Sector Analysis 2009

The medical technology market in India was

valued at USD 2.75 billion in 2008 and is likely

to reach USD 14 billion in 2020 at a CAGR of

approximately 15 percent ing to cloud. Cloud services can now also be integrated with special medical hardware (embedded systems) for remote patient monitoring.

However, a growing concern in the adoption of cloud lies in the uncertainty whether hospitals and clinics will trust their data to be stored offsite. Ernst & Young reports that in India, some players are looking to build their own networks. It predicts that initially, private cloud is more likely to be adopted, as opposed to the public cloud, where hospitals have to share data externally.

Social media: Social media tools are gaining popularity, serving as an easy and cost-effective solution for both patients and healthcare providers, who can now monitor patients in a virtual environment. It also transforms the patient-doctor communi-

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cation from ‘one-to-one’ to ‘one-tomany’, whereby doctors reach out to a number of online users at a go using the Internet. mHealth: Right from viewing results, to ordering medicines, e-prescribing, or remote monitoring – mHealth can play a vital role in efficient patient management and quicker handling of emergency situations. Blurring lines and convergence of wireless communications, embedded systems, social networks and enabling technology of cloud computing will further propel the adoption of mobile health technologies. Mobile technology represents a high-reach, cost-efficient method for making health care more accessible, affordable and effective across the developing world.

Embedded systems: Embedded systems and Machine-to-Machine (M2M)

technology have made automated medical devices that focus on disease prevention and healthy living a reality. A number of embedded software companies and telecom operators are developing technologies to improve patient care. KPMG reports that the market is booming with a number of start-ups in Silicon Valley, application developers, carriers such as Vodafone, Deutsche Telekom, AT&T, Verizon, China Mobile, and France Telecom and giants such as IBM, General Electric and Philips.

Augmented reality: In the field of academics, augmented reality can be used by medical students to practice surgery in a controlled environment.

With 3D imagery and interactive display, complex medical conditions can be explained to patients using visualisation aids.

Consolidated Platforms The Health IT industry is expected to witness a convergence of technologies in the future, leading to an increased demand for consolidated platforms KPMG in India Analysis predicts that the convergence is likely to be more in the areas of disruptive technologies such as cloud, mobility, social media and big data as there is a clear upcoming trend of Tele-health and Webhealth. Although some players are already heading in this direction through platforms such as SOMOCLO (Social Media, Mobility and Cloud), the trend is yet to gain momentum on a large scale.

Augmented reality would also have applications, however, lesser in comparison to other disruptive technologies. AR applications would be more focused in medical education rather than actual patient treatment and care.

Medical Technology While health IT is reducing operational costs and enhancing efficiency of healthcare providers, medical tech-

FIVE PILLARS FOR

INNOVATION

Source: PwC

nology is playing a strategic role in fostering better healthcare delivery.

According to the European Medical Technology Industry Association, billions of patients worldwide depend on medical technology at home, at the doctor’s clinic and in hospitals. The medical technology market in India was valued at USD 2.75 billion in 2008 (NIPER Ahmedabad) and is likely to reach USD 14 billion in 2020 at a CAGR of approximately 15 percent (Industry Analysis, PwC estimates).

Broadly segmented into medical equipments, implants, and medical disposables & furniture, the medical technology market offers a wide range of products — from contact lenses and insulin pens to pacemakers, MRI scanners, prostheses, life-support machines and so on.

With recurrent technology breakthroughs, the pace of medical invention is accelerating, resulting in better clinical outcomes, lesser invasive procedures and shorter recovery times, hence improving overall health of people.

According to a PwC report titled, “Enhancing access to healthcare through innovation — Medical technology in India”, the future of medical technology innovation is bright and

Big data analytics shall prove effective in extracting

intelligence from humungous patient records India and China will be the stars of the 21st century. The report further states that the epicenter of innovation ecosystem is shifting towards emerging economies such as India. In the future emerging economies will have a higher spending on R&D in future providing the trigger for innovation.

Key Challenges Although the future seems promising, the Indian medical technology industry is currently plagued by multiple challenges. On one hand, the industry is fiercely fragmented with the presence of both domestic firms as well as MNCs. Also, the market is highly imports-driven which constitute and of

about 75 percent of the market. Highend medical technology products, such as imaging equipments, pacemakers, orthopaedic and prosthetic appliances, breathing and respiration apparatus, and dental equipments are largely imported by MNCs into India, giving a tough competition to indigenous players.

Moreover, the per capita spending of USD 2 on medical technology in India is significantly lower than other developing economies. Demand in India is predominantly driven from the Tier-I cities. The challenge lies in entering into smaller towns and rural areas, where penetration has remained low due to lack of affordability (for such products), accessibility (of healthcare services), awareness (about medical technology) and availability.

Way Forward Given the criticality of the situation, innovations in products alone won’t be enough. There is a serious need to rethink and redesign the entire business model. Medical technology industry needs to evolve from merely supplying devices and equipments, to providing integrated solutions for improving health outcomes.

PwC analysis has identified five pillars on which medical technology innovation shall rest, depending of on how strong these pillars are and how well they interact with each other.

These include: Powerful financial incentives; Creating capacity for quality research; Supportive regulatory system; Demand and supply of health services; and Supportive investment community.

A collaborative approach towards innovation is needed, whereby all stakeholders, including the patients, medical centres, the industry, academia, healthcare providers, health insurance companies and the government should come together to promote medical technology innovation in India.

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company Profile I Listing I matrix

HealthFore

Technologies Limited Company Details Managing Director: Maninder Singh Grewal CEO: Pankaj Vaish Management Team: Nitin Goyal, Head Operations; Suren Shukla, Senior VP; Malav Kapadia, VP-Sales Year of Inception: 2009 | Employee Strength: 350 Head Office Address: GYS Universal, Plot A-3,4,5, Sector 125, Noida, Uttar Pradesh Telephone: 0120-6171000 Email: healthfore@healthfore.com Website: www.healthfore.com Sales support: sales@healthfore.com; 0120-6171710 Pankaj Vaish

Contact Person: Amit Arora, 09654353389, arora.amit@healthfore.com

Company Profile HealthFore Technologies Limited (formerly Religare Technologies) is a global healthcare IT solutions and advisory services company. Its B2B and B2C IT solutions help hospital chains, diagnostic centres, corporates and public health enterprises realise superior clinical outcomes. HealthFore’s IT products Magnum Infinity HIS and Magnum Imaging enable providers to considerably improve patient safety and patient satisfaction, gain operational efficiency and meet regulatory obligations. HealthFore’s mHealth and Telemedicine solutions provide a platform that helps in greater healthcare access to larger segments of population. HealthFore combines domain expertise with pervasive computing, software development tools and project management techniques to make healthcare more accessible and affordable. It operates in 13 countries across South East Asia, Middle East, Africa and India.

Products and Services • Magnum Infinity HIS: Connects all stakeholders of the healthcare ecosystem securely, accurately and in real time • Magnum Imaging: Optimises clinical workflows by PACS, RIS and teleradiology • mHealth Solutions: Teleconsultation, remote diagnosis, monitoring and communication through wireless devices • Healthcare IT Enablement: Infrastructure management and technology solutions

Top Five Clients in India • • • • •

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NRHM and Government of Assam Government of Gujarat Aditya Birla Memorial Hospital Bharti Airtel Asian Heart Institute

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USP Healthcare IT integrated solutions for care management

Collaborations Business Tie-ups • Accenture • IBM • Microsoft • Oracle • Orange Business Solutions • United Health Group Technical Tie-ups • Barco • Cisco • Microsoft • Oracle • Progressive Infotech Pvt Ltd

Magnum Imaging Powers Assam Tele-Radiology HealthFore Technologies is working with the Assam Government and has set up a complete Tele-Radiology solution in the state

I

n order to meet the shortage of radiologists in Northeast India, National Rural Health Mission, Assam, and the Ministry of Health and Family Welfare, Government of India, decided to implement Healthcare IT solution.

HealthFore Technologies Ltd is working with the State Government to set up a complete Tele-Radiology solution.

Magnum Tele-Radiology Solution, HealthFore’s home grown Imaging (RIS/ PACS) product, is a complete web-based, enterprise class, Tele-Radiology system, offering a comprehensive enterprise class hospital. This includes setting up the required Tele-Radiology infrastructure including capturing of the data from the X-Ray/CT Scan/USB machine; providing software and hardware for Tele-Radiology data transmission; Central Data Centre and running of the same. HealthFore is also providing Diagnostic Reports through qualified experts on the tests.

Magnum Tele-Radiology integrates images from multiple modalities with clinical patient data, streamlining radiology department workflow and improving the radiologist’s efficiency.

SPEAK PIECE

“With Magnum at the core of our systems, our doctors are able to spend more time rendering quality care and ensuring that the most appropriate decisions about the patients’ care have been made. This has resulted in outstanding patient satisfaction.” Rekha Dubey, Senior GM – Operations, Aditya Birla Memorial Hospital

Ghulam Nabi Azad, Union Health Minister; Tarun Gogoi, Chief Minsiter of Assam; Dr Himanta Biswa Sarma, Minsiter of Health and Family Welfare, Govt of Assam; Anuradha Gupta, Additional Secretary & MD, NRHM, Govt of India; and Pankaj Vaish, CEO, HealthFore Technologies at the launch of the project on September 1st, 2013

PROJECT HIGHLIGHTS • Addresses the demand for specialised skills in interpretative radio-diagnosis across the state • Facilitates critical care delivery by assuring quicker turnaround time for emergency cases, any day any time • 1st-of-its-kind in the nation in public health sector driven by partnership model • Leverages advancements in Medical Technology and IT to deliver cost-effectiveness • Covers Tele-Radiology services for 11 District Regional Diagnostics Centres (RDCs) • Establish Data Centre in Guwahati and also supply RIS and PACS Software to manage Tele-Radiology services • Operates RDCs to service patients with necessary staffing of receptionists and radiographers • Provide remote reporting services through specialised radiologists across Guwahati, Delhi and Mumbai

“Being an integrated system, Magnum enabled caregivers to share a common unified view of patient information across departments, delivering significant value in terms of minimising turnaround time and ensuring that doctors were able to provide the right diagnosis and treatment.” Dr Lloyd Nazareth, COO, Fortis Hospitals

“All our physicians now have access to centrally-available patient information and data.

It ensures better coordination and continuity in the care we deliver. Moreover, HealthFore has been very supportive in enabling us to comply with the regional, ministry and insurance-related requirements too.” Group IT Manager, Mediclinic Middle East, Dubai

“We implemented Magnum in July 2009 to provide an integrated and patient-centric solution for the delivery of healthcare services to the NLNG community. Magnum is suitable for small, medium and big-sized hospitals. It is a complete solution for hospital operations and activities.”

Hospital Administrator & Ancillary Services Officer, Nigeria LNG Hospital

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Agfa Healthcare India Pvt Ltd Company Details Managing Director: Suresh Ranganathan Head Office Address: Technosoft Knowledge Gateway, 2nd Floor, B-14, Road No-1, Wagle Industrial Estate, Thane (West) - 400604, Maharashtra Telephone: 022-4064 2900 Email: sales.india@agfa.com Website: www.agfahealthcare.com Sales support: 022-40642900, sales.india@agfa.com Contact Person: Samith K K, 022-40642924, samith.kk@agfa.com Suresh Ranganathan

Company Profile Agfa Healthcare offers its customers an extensive portfolio of solutions, including radiology information systems (RIS), picture archiving and communications systems (PACS), cardiology information and image management systems, solutions for reporting, enterprise scheduling, decision support, and data storage as well as digital radiography, computed radiography, print solutions, film, and associated products. IT solutions developed and implemented by Agfa Healthcare work across departmental disciplines to integrate information and streamline the workflows and operations of hospitals, imaging centeres, and other healthcare facilities, enabling a more effective and efficient healthcare offering. Imaging systems developed and implemented by Agfa Healthcare capture, process, and manage diagnostic images from a multitude of sources within and beyond the healthcare enterprise, integrating these into a variety of workflows and systems. These systems are designed to bring vital information to medical practitioners regardless of their location.

Products and Services • • • • •

Computed Radiography Direct Radiography Medical Hardcopy Imagers and Films Radiology Information Systems Picture Archival & Communication System

USP Global Leader in Integrated IT & Imaging Systems

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We Stand Out • Unique Holistic Approach, enabling it to provide in-depth clinical know-how and fully integrated hospital-wide solutions

Insight.

Delivered.

Address Agfa HealthCare India Pvt. Ltd. Technosoft Knowledge Gateway.

2nd Floor, B-14, Road No-1, Wagle Industrial Estate, Thane (West)- 400 604.

Email ID for sales enquiries sales.india@agfa.com Telephone numbers for sales enquires Mumbai 022-40642900 New Delhi 011-42484387 Kolkata 033-22820745 Chennai 044-42125263

From tabletop imaging units to connecting a regional health network, our teams go beyond delivering healthcare systems. They listen. They understand.

And, they apply their knowledge and experience to deliver the right solution. Providing better care requires insight. And we deliver.

Insight. Delivered.

Learn about Agfa HealthCare at www.agfahealthcare.com

cover story

company Profile I Listing

Aosta Software

Technologies India Ltd Dr Mohan S Gounder

Company Details Chairman: Dr Nalla G Palaniswami Managing Director: Dr Mohan S Gounder CEO: Manoharan Kothandaraman Management Team: Ravishankar S, Director, Technical Operation; Veerasekharan Subbian, GM, Marketing & Sales Year of Inception: 1999 | Employee Strength: 95 Head Office Address: 287/3A Kovai Hills, Kalappatti Road, Coimbatore - 641048, Tamil Nadu Telephone: 0422-4302500 Email: info@aostasoftware.com Website: www.aostasoftware.com Sales and after-sales support: sales@aostasoftware.com, 0422-4302517 Contact Person for Clarification: Veerasekharan Subbian, 09677995577, veera@aostasoftware.com

Company Profile Aosta Software Technologies India Ltd was founded in 1997 with the goal of creating the best possible software to make the task of delivering healthcare easier. With the rise of technology throughout the healthcare field, AOSTA, began to develop cutting-edge software to better manage the information generated with firmly focus on patient safety and improving healthcare delivery. Its team comprises people who bridge both fields of Information Technology and Healthcare. The company is deeply committed to its goals of providing applications that enhance patient safety, automate revenue cycles, secure patient information, manage scheduling, and improve financial management. The company also offers software for other healthcare companies such as labs, pharmacies, as well as for long term care providers.

Products and Services BackBone is a Healthcare Management Software Suite scalable from primary care to tertiary care, multi-specialty hospitals. It is a patient-centric application integrated with management information and has over 20 modules.

Functional Solutions • BackBone Front Office • BackBone Bed Management • BackBone Ward Management • BackBone Laboratory • BackBone Radiology • BackBone Cardiology • BackBone Dietary • BackBone Pharmacy • BackBone Physician • BackBone Medical Records

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USP A simple and effective solution to manage hospitals

• BackBone Master Health Check-up • BackBone Operation Theatre Administrative Solutions • BackBone Medical Statistics and Reports • BackBone Patient Accounting and Billing • BackBone Insurance • BackBone Inventory Management • BackBone Feedback • BackBone Finance Management • BackBone Asset Management • BackBone Human Resources and Payroll • BackBone CSSD

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company Profile I Listing

Armstrong World Industries (India) Pvt Ltd Company Details CEO: Matthew J Espe (Global) Executive Directors: Omprakash Karnaney, Sanjeev Motiyani Management Team: Pankaj Sharma, Director; Flooring; Naresh Duble, Field Marketing Development & Training; Chetan Jangle, National Sales Manager Year of Inception: 1860 globally (1999 in India) Employee Strength: 10,000 worldwide Head Office Address: Boomerang, 303, A Wing, Near Chandivali Studio, Chandivali Farm Road, Andheri (E), Mumbai – 400072, Maharashtra Telephone: 022-30460800 Email: helpdesk@armstrong.com Website: www.armstrong.co.in Contact Person: Naresh Duble, helpdesk@armstrong.com 022-30460441

Company Profile Armstrong World Industries Inc is a global leader in the design and manufacture of floors and ceilings with a focus on innovation, design and environmental sustainability. The 150 years old NYSE listed company is headquartered in the US. It operates 35 plants in eight countries. In 2012, Armstrong’s consolidated net sales totaled approximately $2.62 billion. Armstrong World Industries (India) Pvt Ltd is a subsidiary of Armstrong World Industries Inc, and is a market leader in ceilings and floorings. The company has commenced its operations in 1999. Headquartered in Mumbai, Armstrong India has a pan-India presence with 11 sales offices and nine warehouses located across the country to ensure timely delivery. Armstrong pioneered the use of acoustical modular ceiling to become the market leader in the segment. Research has discovered the importance of combining aesthetic and acoustical design in the healing process.

Products and Services • Armstrong Ceilings have been developed to meet the demanding requirements of today’s healthcare facilities.

• Humiguard Plus Range offers superior performance, cost-effectiveness and easy maintenance in addition to a range of contemporary designs.

Design Approach Sound absorption: It is the part of incident sound that is not reflected by the tile. The typical expression for Sound absorption USP is NRC (ASTM) or Alpha W (AS/ Providing healthy ISO) and the measured value is environment with between 0 to1.

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world-class, highquality products

Sound attenuation: It is the control of sound transmission between adjacent spaces with a common void above them.

Sound reduction: It is the control of sound generated in the plenum or coming from the floor above.

Top 5 Clients in India • • • • •

Apollo Hospitals Fortis Hospitals Wockhardt Max Healthcare Global Hospitals

THE

“

“

RIGHT

PRODUCTS SPACES

based upon the level of risk of infection a patient is exposed to, SURGXFWV DUH GHVLJQHG VSHFLŷF WR HDFK VSDFH

Ceiling Solutions

Floor Solutions

Wall Covering Solutions

Healthcare buildings are probably the most demanding when meeting safety, indoor quality and maintenance performances.

However, we cannot forget the comfort of patients and healthcare professionals when designing a healthcare space.The Armstrong product offer can respond to any RODBHjB ODQENQL@MBD QDPTHQDLDMS HM @MX GD@KSGB@QD premise.

CEILINGS : Mineral Fibre, Metal, Wooden, Glass & Rock Wool, Suspension Systems, Accessories WALL PANELS : Wooden Glass & Rock Wool FLOORINGS : Vinyl Sheet, Tiles & Planks, Linoleum, Wooden Laminate, Engineered Wood Armstrong World Industries (India) Pvt. Ltd. Boomerang, A-304, Chandivali Farm Road (near Chandivali Studio) Andheri (E), Mumbai - 400 072 Tel: 022-3048 0800, Fax: 022-3046 0439 / 2491 3604 e-mail : helpdeskindia@armstrong.com Branches: Ahmedabad Chandigarh Gurgaon Kolkata Pune

: : : : :

+91-93272 11062 +91-172-2633 680 +91-124-2385 671 +91-33-2401 4755 +91-20-3250 2404

Representatives: Baroda : +91-93756 76005 Coimbatore : +91-87544 57957 Guwahati : +91-96780 69393 Hubli : +91-93426 60931 Jaipur : +91-87692 17000 Nashik : +91-93259 95556 Raipur : +91-93259 95527

Bengaluru Chennai Hyderabad Lucknow

: : : :

+91-80-2657 6367 +91-44-4217 5303 +91-40-3200 9868 +91-522-220 1143

Cochin Deharadun Goa Indore Ludhiana Patna Vizag

: : : : : : :

+91-96330 09209 +91-84008 84455 +91-99673 47004 +91-73899 42297 +91-95013 48167 +91-97714 15113 +91-80088 02772

3Power

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cover story

company Profile I Listing I matrix

Bird Meditech Management Team: Vijay Parmar, Managing Director; Deepak Patel, CEO Year of Inception: 2003 | Employee Strength: 15 Head Office Address: 109, 110, Nidhi Industrial Estate, Shiv Shankar Industrial Complex No. 2, NH No.8, Village Waliv, Vasai (East) - 401208, Thane, Maharashtra Telephone: 0251-3212729 | Email: birdmeditech@sify.com, birdmeditech@gmail.com Website: www.birdmeditech.net Vijay Parmar

Contact Person: Vijay Parmar, 919324001836, vijay@birdmeditech.net

Company Profile Founded in 2003 Bird Meditech has brought innovations including on-board calibration technology in radiant warmer, voice messaging technology in radiant warmers, with international quality at affordable prices.

Products and Services • • • • •

Infant Radiant Warmers Neonatal Phototherapy Equipment Electronic Weighing Machines CPAP machines Manual resuscitation bags

Turnover • 2010-11: `4 Crore • 2011-12: `6 Crore • 2012-13: `5 Crore

USP Innovative Neonatal Technologies

Top 6 Clients in India • • • • • •

PGIMER, Chandigarh Kalawati Saran Children’s Hospital, New Delhi King George’s Medical University, Lucknow King Edward Memorial Hospital, Mumbai Lokmanya Tilak Municipal General Hospital, Mumbai TB Hospital, Delhi

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Goldstar Healthcare Private Ltd Company Details Managing Director & CEO: Sadananda Reddy Management Team: R Vasundhara - Director; M Kamakshi - Administrator Year of Inception: 2006 Employee Strength: 40 Head Office Address: RT-623, Royal Towers, Shipra Suncity, Indirapuram, Ghaziabad - 201010, Uttar Pradesh Telephone: 0120-4105005 Email: sadanand@goldstarhealthcare.net Website: www.goldstarhealthcare.net Sales and after-sales support: Malleswar K, 09810139196 Sadananda Reddy

Contact Person for Clarification: Kamakshi, kamakshi@goldstarhealthcare.net

Company Profile Goldstar Healthcare Private Ltd provides turnkey solutions exclusively into healthcare sector from specialty to tertiary sectors. The comprehensive healthcare solutions for every facet of your healthcare business plan with a focus on continuous review of technology absorptions, technical upgradations, accreditation standards across globe and provide financial solutions more feasible without compromising quality. GHMIS provides a web-based Hospital Information System covering clinical, administrative and financial areas of organisations.

It helps healthcare organisations to reduce costs, streamline admin processes and improve quality of care and raise the standard of the hospitals, bringing them at par with the NABH accreditation.

Products and Services

Technical Collaborations

• • • • • • • • • • •

• • • •

Hospital Management Information System Turnkey Projects Process Development Equipment Planning and Procurement Materials Management Biomedical Engineering Services Business Process Re-engineering QA and Accreditation preparation Healthcare Recruitments Turnkey Design Services Medical Equipments , Medical & Lab Items distribution

Turnover • 2012-13: `2 Crore

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USP Team comprises experienced health administrators and doctors

Microsoft ISV All major PACS Companies Microsoft MS Dynamics (Navision) Avnet (IBM) – Cloud Computing

Top 5 Clients In India • BBC Heart Care, Jalandhar • Vagus Super Speciality Hospital, Bangalore • Panacea Hospitals, Bangalore • Jeevika Hospital, Bangalore • Ivory Hospital, Greater Noida

Keynote Speaker

A Global Conference on

PIN*****

Financial Inclusion

& Payment Systems

Dr C Rangarajan Chairman, Economic Advisory Council to the Prime Minister, Government of India

Theme: Direct Benefit Transfer (DBT)

24 - 25 October 2013, Eros Hilton, New Delhi Restoring the very essence of inclusive growth is at the radar of Financial Inclusion and Payment Systems (FIPS 2013). The Conference will have vibrant rounds of discussion on the various challenges that are being faced in having effective financial inclusion in the country.

The Global Summit comprises: Conference, Exhibition and Awards.

Confirmed Key Speakers

Prof M S Swaminathan Former MP, Rajya Sabha, MSSRF, Chairman, Conference Advisory Committee, FIPS

S S Mundra Chairman & Managing Director, Bank of Baroda

Ela Bhatt, Chairperson, SEWA & Founder Chairperson, Women’s World Banking

R K Dubey Chairman & Managing Director, Canara Bank

S Sundareshan Mission Director, Direct Benefit Transfer (DBT), Government of India

Anil Swarup Additional Secretary, Cabinet Secretariat, Government of India.

Rajeev Agarwal Secretary, Telecom Regulatory Authority of India

Ram Sewak Sharma Chief Secretary, Government of Jharkhand

Shubhalakshmi Panse Chairperson & Managing Director, Allahabad Bank

M Narendra Chairman & Managing Director, Indian Overseas Bank

M Ehsanul Haque, Managing Director & CEO, Mercantile Bank Limited

Sudhir Kumar Jain Chairman & Managing Director,Syndicate Bank

D Sarkar Chairman & Managing Director Union Bank of India

Archana Bhargava Chairperson & Managing Director, United Bank of India

many more...

FIPS Awards

PIN*****

AWARDS

FIPS Awards aim to recognise the seminal role that various organisations have been playing in the areas of Financial Inclusion, Banking Technology, Payment Systems, Mobile Banking, Health Insurance and other verticals.

Financial Inclusion Financial Inclusion

• Aadhaar Initiative • Health Insurance Inclusion in • Financial Direct Benefit Transfer Health Sector

(DBT) Initiative • Organisation of the year • Health • Access Insurance to banking and Inclusion in • Financialservices

financial building and CapacitySector • Health financial banking and • Access toliteracy • ICT based innovation

financial services

Categories Banking Technology Banking Technology • ICT based innovation

• Health IT • Health IT • Technology in Rural Health in Rural Health • Industry Technology • Infrastructure • Industry Infrastructure Initiative • Institutional

Initiative Infrastructure Initiative • Institutional Infrastructure • Internet Banking Service

Initiative • Security Initiative • Internet Banking Service • Security Initiative

Payment Systems Payment • CashlessSystems Health Payments

• Cashless Health Payments • Online Health Payments • Online Health Payments PaymentsSolution Solution • • Online Online Payments PaymentsSolution Solution • Mobile Mobile Payments of Year

of the Year • Payments • Multi-Channel Multi-ChannelPayments Solution Solution • Contactless Payments • Best Alternative Payments Project

Project partner

Conference & Award Queries:

Mobile Banking Mobile • HealthBanking Services on Mobile

• Health Services on Mobile • Online Health Services • Online Health Services MobileBanking Banking • • Overall Overall Mobile Application Application Mobile Application ApplicationDesign Design • Mobile • Multiplatform Service • MultiplatformService • Tablet Application • Tablet Application

• Insurance Feature many more...

ORGANISERS

fips@eletsonline.net Kartik Sharma, +91-8860651635, Nayana Singh, +91-8860651642 Partner Publications

Sponsorship Queries: Ragini, ragini@elets.in, +91-8860651650

fips.eletsonline.com

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company Profile I Listing

Hospaccx India Systems Company Details Managing Director and CEO: Tarun Katiyar Management Team: Nimisha Bhagadia, Practising Partner; Hemant Khavale, Senior Consultant; Prakrati Shrivastava, Head - West Zone Year of Inception: 2009 | Employee Strength: 42 Head Office Address: 505, Arcadia, Hiranandani Estates, G B Road, Thane (West) - 400607, Maharashtra Telephone: 022-41232233 Email: hospaccx.india@gmail.com Website: www.hospaccx.in Sales support: 8655170700 Tarun Katiyar

Contact Person: Prakrati Shrivastava, 09029007981, prakrati.hospaccx@gmail.com

Company Profile Hospaccx India Systems (HIS) has a strong base in India and its projects are spread across various regions.

It is one of the leading and the fastest growing hospital consultancy that is involved in all the aspects of healthcare setting. HIS caters to small, medium and large hospitals with single or multi specialty units as well as diagnostic set-ups. It has completed a number of project reports for hospitals / medical colleges / diagnostic centres / clinics, etc. Hospaccx India is staffed with people aiming to make a “Paradigm Shift” in hospital industry / sector in the coming months and years, through innovation as well as out-of-the-box thinking.

HIS provides entire range of services that any healthcare service provider, may require through the large number of specialists and associates imparting practical insights to make projects viable. The team ensures “ease, economy and efficiency” in all its projects against the backdrop of rising cost and environmental concerns through its various associations. All project executions include “pre-planning, implementation & commissioning.”

Top 5 Clients in India

Products and Services • • • • • •

Hospital management consultancy Hospital planning designing and architecture Equipment planning Operation and marketing management Human resource consultancy Hospital information systems

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Jaslok Hospital Medipulse Hospital Breach Candy Hospital Manipal Group of Hospitals Bombay Hospital

Turnover

Business Collaboration • Global Kalpatru PSIPL

• • • • •

USP We serve from small level organisations to medical colleges

• 2010-11: `5 Crore • 2011-12: `8 Crore • 2012-13: `10 Crore

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company Profile I Listing

K S Biomed Services Kaushik Shah

Company Details CEO: Kaushik Shah Managing Director: Himanshu Bhatt Management Team: Himanshu Bhatt, Sales and Marketing Division; Kejal K Shah, Finance Division; Dilip Dave, Service Division Year of Inception: 1996 | Employee Strength: 52 Head Office Address: 701, Shikhar, Opposite Neptune House, Muithakhali, Ahmedabad-380009, Gujarat Telephone: 079-26421102-04 Email: info@ksbiomed.com; marketing@ksbiomed.com Website: www.ksbiomedservices.com Sales support: 079-26421102-04; 09377742554 Contact Person: Himanshu Bhatt; 09978911705 / 09824281656, himanshu_bhatt@ksbiomed.com

Company Profile K S Biomed Services is in the business of biomedical instrumentation. It offers services, technologies and products in various areas of medicines covering about ten technologies and over 20 products. It assists its clients through total instruments management cycle, services of biomedical equipments, selection of appropriate technology platforms, product specification and engineering cost estimates, project engineering, installation, commissioning and maintenance. Its strengths lie in its people and concepts. It has a young, multi-disciplinary team that believes in building long-term relationships with its clients and works “with” rather than “for” clients. It shares its knowledge and gets enriched through participating in various seminars and workshops.

Products and Services - Distributors for

Top 5 Clients in India

• Fujifilm: for Computed Radiography Systems (CR ), Dry Laser cameras/DR and PACS systems • Samsung Medison: For ultrasound range of products • Anatomage: For Virtual Human Dissection Table • Medrad: Pressure Injectors for CT/MRI/Cath lab • Epsilon: For X-Ray/OPG • Perfint Healthcare: Robotic Biopsy Systems • Refurbished Products: > Refurbished Siemens Mammography Systems > Refurbished GE Lunar BMD (Whole Body Dexa Systems) • HIS/Hospital Software Management Solutions

• • • • •

Turnover • 2010-11: `15 Crore • 2011-12: `23 Crore • 2012-13: `31 Crore

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USP Believes in working “with” clients rather than “for” clients

SRL Diagnostics (all India) Suburban Diagnostics, Mumbai Gujarat Cancer Society C U Shah Medical College BAPS Hospital (all Gujarat)

Business Collaborations • Fujifilm India Pvt Ltd • Samsung India Electronics Pvt Ltd (HME Division) • Anatomage • Medrad • Epsilon Healthcare • Perfint Healthcare Corporation • Complete Medical SystemsUSA

CLINICAL/SURGICAL APPLICATION IMPORT REAL DICOM DATA CREATE VOLUME FROM 2D CREATE X‐RAY FROM CT/MRI DISSECT DICOM IMAGE PRE/POST OPERATION STUDIES RECONSTRUCT INTERNAL STRUCTURES ON DICOM IMAGE PERFORM VIRTUAL SURGERY ON

CT/MRI IMAGES CT/MRI IMAGES ANATOMY APPLICATION DISSECTION OF ANY REGION REPRODUCIBLE DISSECTION FOR REPEATED STUDIES FINE TUNE DISSECTION SKILLS BEFORE/AFTER CADAVER DISSECTION PORTRAYED 3D VIRTUAL IMAGE OF HUMAN BODY

Call: 09377742554/09824281656 /

www.ksbiomedservices.com

HEAD OFFICE: 701, SHIKHAR CO OMPLEX, OPP. NEPTUNE HOUSE, NAVRANGPURA‐AHMEDABAD‐380 009 Branches: Mumbai/Coimbatore/Nagpur/Jhaarkhand/AP/WB/New Delhi/Chattisgarh/MP

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company Profile I Listing

Maquet Medical India Pvt Ltd Company Details Managing Director: Ashim Purohit Year of Inception: 2004 Employee Strength: 119 Head Office Address: II Floor, Mehta Trade Centre, Sir M V Road, Andheri (E), Mumbai - 400099, Maharashtra Telephone: 022-40692100 Email: info.india@maquet.com Website: www.maquet.com Sales and after-sales support: 022-40692100, Customer support helpline number: 1800222377, 09821627838

Company Profile MAQUET, a trusted partner for hospitals and physicians for over 175 years, is the global leader in providing medical systems that meet the needs of the most medically challenging patients, while exceeding the expectations of the hospital teams that care for them. MAQUET designs, develops and distributes innovative therapy solutions and infrastructure capabilities for high-acuity areas within the hospital including the operating room (OR), hybrid OR/cath lab and intensive care unit (ICU) as well as intra and inter hospital patient transport. Headquartered in Rastatt, Germany, MAQUET is the largest subsidiary of the publicly listed Getinge Group AB of Sweden. MAQUET generated about 1.5 billion Euros in 2012, representing more than half of the Getinge Group’s annual revenue of 2.7 billion Euros. MAQUET has 6,300 employees in 45 international sales and service organizations, as well as a network of more than 300 sales representatives. Since the company was founded 175 years ago, the world has turned nearly 65,000 times and has changed substantially.

Yet today MAQUET still has the same core values that it did six generations ago. MAQUET designs, develops and distributes innovative, effective and high-quality therapeutic and infrastructure solutions.

Products and Services

Patient Transport

Operating Room

Life-sustaining ICU-quality technology solutions make inter- and intra- hospital transport safe and efficient.

A large product portfolio enables multi-disciplinary OR infrastructure solutions for more efficient clinical workflows.

Hospital Solutions & projects

Critical Care Unit User-friendly, reliable and portable CCU solutions help you achieve cost-effective and sustainable patient outcomes.

Hybrid OR MAQUET partners with hospitals to provide interdisciplinary Hybrid OR that measurably improve patient care.

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Concepts for optimized processes in OR and ICU environment.

For more information : http://www.maquet.com/int/product/index

USP Only company to provide one-stop solution for OR

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company Profile I Listing

MRK Healthcare Pvt Ltd Company Details Managing Director and CEO: R R Shah Management Team: M R Shah; Y R Shah; Sneh K Shah Year of Inception: 1965 | Employee Strength: 750 Head Office Address: B4/5, Byculla Service Industries, Sussex Road, Byculla, Mumbai - 400027, Maharashtra Telephone: 022-23748371 Email: info@mrkhealthcare.com Website: www.nulife.co.in Sales support: 022-32488484 Contact Person: Anita, 022-32488484, support@mrkhealthcare.com R R Shah

Company Profile “NULIFE” is the Trade Name under which medical products manufactured by MRK Healthcare Ltd are marketed. MRK began operations in 1961 with the production of molded rubber goods and later diversified into manufacture of surgical gloves and plastic disposable products. Other products were added gradually to the range. The company boasts of massive infrastructure facilities including highly automated manufacturing lines, packaging machinery and in-house sterilisation. Quality control is of paramount importance at MRK Healthcare Pvt Ltd. It is the underlying factor behind every phase of its operation and involves raw materials, processed goods and in process statically quality control. Constant effort is made to adopt the most advance quality control procedures.

Products and Services • Examination Gloves: Latex, Nitrile & Vinyl (Powdered & Powder Free) • Surgical Gloves: Sterile & Non Sterile Latex Surgical Gloves.

• Specialty Surgical Gloves: Microsurgery, Orthopedic, Ultra Nulife Beadless Gloves, Surgical Gloves Powder free, Elbow Length Gynecological Procedure Gloves, Double Gloves Pair.

• Urological Products: Foley Balloon Catheter, U-Drain, Urine Bag • Electro Medical Products: Needle Burner, Nebulizers, Airbed, Oxygen USP Concentrator, Weighing Scale, BP Monitors Delivers

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contemporary world-class products at economical pricing

• Disposable Products: Plastic Products for Infusion & Transfusion, I V Cannula Three Way Stop Cock, Non Woven Face Mask, Cap, Shoe Cover, Apron, Gown

Top 5 Clients in India • • • • •

Lupin Ltd Cipla Ltd Bombay Hospital Jaslok Hospital Medicity Hospital

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company Profile I Listing

Palash Healthcare Systems Pvt Ltd Dinesh V Samudra

Company Details Managing Director & CEO: Dinesh V Samudra Management Team: Prasad Kulkarni, AVP Product Development; Nilesh Ingale, AVP Technology Year of Inception: 2006 Employee Strength: 85 Head Office Address: Gopal House, 3rd Floor, Karve Road, Kothrud, Pune – 411029, Maharashtra Telephone: 020-66246161 Email: info@palashhealthcare.com Website: www.palashhealthcare.com Sales and after-sales support: 09823030025 Contact Person for Clarification: Atul Ghanekar, 020-66246161, atulg@palashhealthcare.com

Company Profile Established in 2006, PALASH Healthcare Systems Pvt Ltd is headquartered out of Pune, Maharashtra. The company was founded by Dinesh Samudra-a technocrat with over 25 years of experience in the Indian and global IT industry. The company is a specialised healthcare technology player and offers software services and solutions to healthcare providers; hospital solutions to large, medium and small hospitals, clinic solutions for automating process in various verticals such as multi-speciality, diabetes, IVF, ophthalmology and polyclinics.

PALASH Healthcare has a strong market presence across India and also provides its services and solutions to countries in Asia, Middle East, Gulf Cooperation Council, Africa, Caribbean and Europe. It has corporate office and development centre located in Pune with support office in Dubai, UAE.

Products and Services

Collaborations

• • • • • •

Business Collaborations • IMS Health • Accenture - India • Zensar Technologies Ltd

Hospital Information Management System (HIMS) Clinical Information Management System (CIMS) Fertility Clinic Information Management System (FCIMS) Lab Information System (LIS) Value Added Services such as Document Management System Management Information Dashboards

Top 5 Clients In India • • • •

Inlaks and Budhrani Hospital, Pune Dr DY Patil Hospital and Research Centre, Mumbai Inamdar Multispecialty Hospital, Pune Mewar Orthopaedic Hospital, Udaipur USP • Express Clinics (Pune, Delhi, Excellent post Mumbai, Banagalore)

implementation support

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Technical Collaborations • Microsoft • SAP Business Objects • Novarad, USA – For PACS Interfaces

Turnover • 2010-11: `1.8 Crore • 2011-12: `2 Crore • 2012-13: `4.25 Crore

PALASH Healthcare founded in 2006 has established its brand as India's leading Healthcare Information Technology provider in less than five years. 2012-13 has been a year of achievements with Business Associations in place with companies like IMS and Accenture India and PALASH spreading its Customer Base in to Caribbean Islands and Indonesia with its end-to-end Web based HIMS platform. We provide complete Healthcare IT solution to Providers Industry either in India or outside India through our well established partner network and/or our branches.

PALASHTM deals primarily in Healthcare Products and Services and has solution in place for various Medical Specialities.

PALASH Practice Manager

Multispeciality Hospitals & Clinics

Polyclinic Hospitals & Clinics

Chain Of Clinics

Diabetic Hospitals & Clinics

Ophthalmology Hospitals & Clinics

IVF Hospitals & Clinics

PALASH EMR

Hardware

Clinical Practice Healthcare Practice Manager Manager

PALASH EHR

Daycare

Oncology

Pathology & Radiology

Surgical Assisting Service

Cancer Hospitals & Clinics

Nephrocare Hospitals & Clinics

Cardiac Care Hospitals & Clinics

Urology Hospitals & Clinics

Diagnostics

Products

PALASH Analytics

Services

Hosting*

Tech Consulting

Online Profile Management Revenue Cycle Management

-

One of the very few healthcare IT companies in India to offer specialized healthcare IT products for a diverse range of applications TM PALASH developed Two Apps for integration with Microsoft HealthVault. Patient App and Data Upload App More than 150 satisfied customers Spreading its wings in APAC, MENA and EMEA regions in 2013-14

Visit us at www.palashhealthcare.com Drop E-mail to us at info@palashhealthcare.com.

Talk to us @ your Healthcare IT Needs on +91 20 66246161

Patient

PALASH Patient App PALASH Patient App - Appointment - Billing & Payments - Orders - EHR

HIS/ CIMS/ LIS/ Device

Final Data

DataUpload App (PALASH)

Clinical Data

LAB IT App Medical Services

Hospital IT App Data Upload app (PALASH)

Clinic IT App

viz PALASH or Any other HIS/ LIS/ CIMS

Medical Services

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company Profile I Listing

Spigot Software Private Limited Company Details CEO: Srinath Bettadpur Managing Director: Mangala Srinath Year of Inception: 2006 | Employee Strength: 60+ Head Office Address: #531/144, 3rd Floor, 1st Sector, HSR Layout, Outer Ring Road, Agara, Bangalore 560102 Telephone: 080-65650213-218 Email: info@spigotsoft.com Website: www.spigotsoft.com Sales support: salesenquiries@spigotsoft.com, 080-65650213/218 Srinath Bettadpur

Contact Person: Akshata Sagotia, 09036016268, akshatasagotia@spigotsoft.com

Company Profile Founded by two professionals with over more than two decades of experience in the industry, Spigot Software is a world-class, customer-focused solution provider with the aim to be the leader in the small and medium enterprise segment with global reach. It specialises in both web and non-web based solutions – Software Products, Custom Software Application Development, Staffing and Consulting services. It delivers technologyenabled software automation solutions for various business segments / industry / domains in agreed upon timeframes and high quality. It believes that technology has a key role in achieving strategic business goals and to gain an edge in this highly competitive global environment. Hence, its focus has always been to use the best of technologies and deliver high-end Business Software Solutions to its clients, which will help them accomplish their business goals.

Products and Services • Hospital Information System - Enables hospitals, clinics, and nursing homes to efficiently manage all aspects of patient care • Human Resource Management System - End-to-end information system for more efficient management of all employee administration.

• Software Services • Staffing Solutions • Business Process Outsourcing • Consulting

USP Technology-driven, owner-driven, small and agile

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Technical Collaborations • • • •

Microsoft HP IBM Cisco

Top 5 Clients in India • Vivus Group of Hospitals • Shankara Cancer Care Foundation • Janani Hospital • Bharathi Hospital • RK Hospital

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company Profile I Listing

Transasia Bio-Medicals Ltd Company Details Chairman and Managing Director: Suresh Vazirani Year of Inception: 1979 Employee Strength: 1,000 Head Office Address: Transasia House, 8 Chandivali Studio Road, Andheri (East), Mumbai - 400072, Maharashtra Telephone: 022-40309000 Email: responses@transasia.co.in Website: www.transasia.co.in Contact Person: Marketing and Corporate Communications, 022-40309000 Suresh Vazirani

Sales and after-sales support: 022-40309000

Company Profile Incepted in the year 1979, Transasia Bio-Medicals Ltd, is one of India’s largest In-vitro Diagnostics Company and offers solutions and products in Biochemistry, Hematology, Coagulation, ESR, Immunology, Urinalysis, Critical Care, Electrophoresis, Molecular Diagnostics, Diabetes Management and Microbiology. Transasia is a part of the global ERBA Diagnostics Mannheim GmbH Group. The ERBA Group has spread its footprint across USA, Europe, Turkey and Eastern Europe, Russia and France, by means of various acquisitions – ERBA Lachema s.r.o.(Czech Republic), ERBA Russia (Russia), ERBA Diagnostics, Inc. (USA) Diamedix Corporation (USA), Delta Biologicals,S.r.l (Italy), ImmunoVision, Inc.USA), Erba DDS (Turkey), ERBA Diagnostics France (France), JAS Diagnostics Inc. (USA) and Drew Scientific (USA).

Products and Services • • • • • • • • • • •

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Biochemistry - Clinical Chemistry Analyzers Hematology Analyzers Coagulation Analyzers ESR Analyzers Immunology Urinalysis Critical Care Electrophoresis Molecular Diagnostics Diabetes Management Microbiology

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USP Reliable, affordable and innovative diagnostic solutions

Business Collaborations • • • • •

Sysmex Corporation, Japan Vircell, Spain IMMCO Diagnostics, USA Medica Corporation, USA DIESSE Diagnostica Senese S.p.A., Italy • Helena Biosciences, Europe • Wako Pure Chemical Industries Ltd, Japan • Gen-Probe, USA

Organisers

KNOWLEDGE

EXCHANGE, GOA

15-17 November 2013, Resorte Marinha Dourada, Goa

Higher Education

Accelerating Growth of Higher Education in India digitalLEARNING Higher Education Knowledge Exchange - Goa is a two-day residential event being convened with the aim of bringing key decision makers and leaders in the higher education sector of the country in one platform. The stakeholders will meet and discuss on the ongoing initiatives, short-term and long-term objectives for strengthening the country’s higher education system and addressing the challenges and scope for accomplishment of these goals.

2

-Day

Residential Event

1

Networking Platform

40+ Vice Chancellors

Exclusive Roundtables & Discussions

1Goal Strengthening the Wall of Knowledge

Key Themes:

Quality, Inclusiveness, Affordability, Funds, Technology, Skill Development, and GER Who will be there?

Leaders in various government departments in education; officials from Ministry of Human Resource Development, Government of India; education regulatory bodies and funding agencies; Vice chancellors from central, state, deemed and private universities; and Directors from Institutes of National Importance For programme details - Rozelle Laha , Mobile: +91-8860651634, rozelle@elets.in For sponsorship & Exhibition details - Fahim Haq, Mobile: +91-8860651632; fahim@elets.in Amit Pundhir, Mobile: +91-8860635835; amit@elets.in

Ke.eletsonline.com

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Reaching out to the Masses Dr Arjun Kalyanpur, CEO and Chief Radiologist, Teleradiology Solutions, talks to Ekta Srivastava, ENN about the evolution of the company from a teleradiology services provider into a healthcare IT provider Tell us about the journey of Teleradiology Solutions so far.

Teleradiology Solutions was set up in 2002. Starting with a single client in the US and a single radiologist, we have grown steadily to a group of 45 radiologists and over 150 clients in 20 countries, including Singapore, Indonesia, Thailand, Denmark, the Netherlands, Tanzania, Nigeria, Djibouti and India. In 2007 we set up RXDX, a 24 x 7 multispecialty clinic and imaging centre. We moved on to set up a technology company, TeleradTech in 2010, that develops software solutions for teleradiology and telemedicine, whose flagship product Radspa was developed with input from our team of radiologists. Our Telemedicine division provides services to PHCs in Karnataka and Madhya Pradesh. We also have an active e-learning portal that conducts online training in Radiology and Pediatric Cardiology.

What are the most critical elements for an enterprise embarking on population health management?

Quality of service: This is non-negotiable in any geography or market. A remotely delivered service such as teleradiology or telemedicine must deliver the same level of quality as medicine practiced at the point of delivery.

Responsiveness to changing needs: The healthcare market is constantly evolving and the ability to modify processes and practices to meet the current standards of care is essential for an organisation in this space.

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Dr Arjun Kalyanpur

“The challenge in telemedicine in India is to have a model that is sustainable for the provider and yet affordable for the user” Flexibility to adapt to different geographies: The ability to deliver solutions cost-effectively is at the crux of providing effective telemedicine, as the need for it is greatest in economically weak regions.

What specifications do your clients demand while buying your solutions?

For teleradiology our clients are radiologists/radiology groups who are looking for technology solutions and

support in reporting emergency scans or with subspecialty scans in which they themselves do not have expertise.

Alternatively they are hospitals in remote locations where radiologists are not available. They mainly look for good report quality and rapid turnaround of reports, and a robust, seamless workflow which we offer in the form of our Teleradiology platform Radspa. For telemedicine our clients include the Tibet Government who is using our services and technology to connect their various medical centers across India, as well as NGOs in the healthcare space. In India, clients look for good technological support and immediate access in case troubleshooting of any issues is required.

How does telemedicine fit into the system’s broader care coordination strategy?

Telemedicine dovetails into teleradiology as both needs tend to coexist in similar geographies. Also the infrastructural needs and operational challenges of setting up both are very similar. Given these synergies, and given that we have over ten years of experience in running teleradiology operations, it has been a natural evolution for us to enter the telemedicine space. Our Radspa workflow is integrated with Cisco’s telemedicine solution to facilitate integrated delivery of teleradiology and telemedicine. And our RXDX clinic provides both on site as well as telemedicine consultations. Overall, our mission is to work at the cusp of medicine and IT to deliver better healthcare globally and so telemedicine is very much on our roadmap for the future.

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NARTAN Aims the

Next Generation Dr Anant R Koppar, Chairman and CEO, KTwo Technology Solutions Pvt Ltd, Bangalore, interacts with Ekta Srivastava, ENN, about the benefits of telemedicine and the NARTAN project What do you see as the benefits of telemedicine and telehealth?

Telemedicine crosses geographical barriers to provide quality healthcare facilities to rural and remote areas, thus being beneficial for the population living in isolated communities.

Non-availability of doctors at these remote places in rural India can be overcome by telemedicine through a facility to record vital signs of patients by a trained nurse or technician. Telemedicine enables the expert doctor to have access to patient information quickly in a remote location.

Tele-health is suitable for a variety of physical and mental challenges, Patients with diabetes, high blood pressure, congestive heart failure and chronic obstructive pulmonary disease (COPD) can be helped, as can those who suffer from post traumatic stress disorder, traumatic brain injury or mental illnesses such as depression and schizophrenia by regular monitoring the patient’s conditions and reducing the emergency room visits.

How have the patients and the healthcare professionals felt about this telehealth programme?

Most of our patients who have used our Kshema Telemedicine kiosks are very satisfied with the services provided. The doctors and paramedics are happy with telemedicine as per our own feedback survey conducted at

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ondary and tertiary care hospitals.

This in turn will reduce healthcare costs. Building better forward and backward linkages through a superior referral system would cause the secondary and tertiary care facilities to be more manageable and prevent them from being over burdened. This can be done by having a fully integrated EMR and analytics infrastructure to take data and turn it into knowledge. In a nutshell, accessibility and affordability are the key elements for population health management.

Dr Anant R Koppar

Primary Healthcare Centers (PHCs) in Bangalore. More than 91 percent of respondents are highly satisfied with the deployment of telemedicine at their PHCs. However, doctors in government sector tend to look upon telemedicine as an additional duty or workload.

What are the most critical foundational elements for an organisation embarking on population health management?

For a “Swastha Bharat”, efficient healthcare delivery at the primary level is very important. We need to build a strong primary care network that reduces overburdening of sec-

How do NARTAN telemedicine and clinical initiatives help meet the long-term objectives of high-quality, longitudinal care delivery?

The “NARTAN” project proposes a network of telemedicine centers as part of its overall mandate to ensure accessibility to good quality healthcare at the doorstep meeting the overall demand of good quality AYUSH treatment at PHCs and DHs. In an effort to minimise the gap in the health sector in Bihar, it seeks to promote the benefits of healing to the larger population in the natural way under the AYUSH system of medicine. The project is basically aimed to act as the next generation delivery points of AYUSH stream of medicines for overall preventive and primary healthcare solutions for long term relief for the patients in rural areas of the State.

Special Focus

Time to Redefine Cancer Care Cancer is a leading cause of death worldwide Deaths from cancer worldwide are estimated to rise up to 13.1 million in 2030 By 2020, 70 percent of world cancer cases will be in poor countries, with a fifth in India

Cancer is not a single symptom or a disease but a generic term that covers a group of over 100 diseases, each with its own distinct molecular signature. All cancers ignite with abnormal cells growth going out of control. These cells soon infiltrate and tend to destroy the normal body tissues. Each cancer behaves in a different way and has the ability to spread throughout the body.

The good news is that two thirds of cancer can be prevented. Research is proceeding so rapidly that doctors today are treating cancer more confidently and with greater precision. For some of the cancers, survival rates have improved. Major drug developments and improvements by way of radiology have given us added strength and hope of survival. Management of cancer has greatly improved, early detection has become easier and we are better aware of cancer risks and prevention. The First Indian Cancer Congress (November 21-24, 2013) addresses cancer care from prevention to palliation. We talk to the organisers to find out more about the upcoming oncology event in the country.

12th October marks the Palliative Care Day. It is all about treatment to relieve, rather than cure, the symptoms caused by cancer. It is more of an urgent humanitarian need for people suffering with cancer. It is particularly needed in places with a high proportion of patients in advanced stages like India where there is little chance of cure. Relief from physical, psychosocial and spiritual problems can be achieved in over 90 percent of advanced cancer patients through palliative care.

We talk to stalwarts in palliative care to give a first-hand account of this stream of the much overlooked cancer care.

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special focus

Indian Cancer Congress (ICC) 2013

A Game Changer in the Onco Revolution Dr Harit Chaturvedi, Chairman, Max Institute of Oncology and the Organising Secretary of ICC, a pioneering luminary in oncology, has taken the cudgel of carrying forward the mutlifaceted onco initiative. He discusses the ICC delibrations with Shahid Akhter, ENN, which is scheduled for November 21-24, 2013 in New Delhi It is heartening to know that the Indian Cancer Congress is taking place but given the magnitude of cancer prevailing in the country, don’t you think this onco revolution is happening too late?

Dr Harit Chaturvedi

Chairman, Max Institute of Oncology; Organising Secretary, drICC vishwas mehta

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Considering the daunting challenge and cancer burden of India, yes, we are late but you need to appreciate the numerous conferences, seminars, workshops in oncology that were de rigueur in the past. For instance, we had organised the thoracic oncology surgical workshop for the Ninth International Conference of Rajiv Gandhi Cancer Institute.

These were confined to certain select verticals that focused on individual aspects of oncology but the need of the hour was an umbrella event like ICC to incorporate all aspects of cancer and to reach out to all involved in the fight against cancer in different ways. This will ensure a new dawn in the Indian cancer landscape.

ICC is slated to be the biggest oncology event ever in India.

Can you please share some details on the magnitude and

highlights of the conference?

Four days of programmes and a day of pre-conference workshop is intended to act as a catalyst to augment further research, treatment and dissemination of knowledge in the field of cancer. The highlights of the congress include multidisciplinary, scientific sessions (8-10 parallel halls) that will address the national issues and problems in cancer.

The conference has been jointly organised by the four major oncology associations—Association of Radio Oncologists of India (AROI), the Indian Association of Surgical Oncology (IASO), the Indian Society of Medical and Pediatric Oncology (ISMPO) and the Indian Society of Oncology (ISO)—and the Oncology Forum. Participants will include 25 affiliate partners from across the nation from all specialities like radiology, pathology, head and neck, palliative care, etc.

ICC should be able to inspire and help in establishing interactions among the various verticals of oncology within India and also to bridge nexus outside the country.

ICC will address national issues and challenges. The plenary sessions will be addressed by national experts and international stalwarts.

There will be organ specific scientific sessions and case discussions. Challenges include mobility and awareness at various levels, cancer education, availability and improvement of infrastructure, cost of treatment and prevention, etc.

Please tell us about the foreign participation ?

Foreign collaborators include OERC, IACA, Carcinogenesis Foundation, UAE Congress and WARMTH. We are expecting the President of American Society of Clinical Oncology (ASCO), Dr Mehul Amin, Chairman of Pathology and Laboratory Medicine at Cedars-Sinai, Dr Jatin J Shah, Assistant Professor, Lymphoma/Myeloma, Divi-

sion of Cancer Medicine, The University of Texas, MD Anderson Cancer Center, Houston, Dr Mike Dickson.

We have already confirmed over 100 international faculty, 250 global thought leaders, and office bearers of leading world oncology bodies.

In European countries, it is common to see joint sessions among oncology associations.

Is this the beginning in India or we had similar deliberations earlier as well?

Joint sessions are common and routine in developed nations. With this initial, humble beginning, we hope to carry forward the baton. Now onwards this will be a periodic event.

ICC 2013 Indian Cancer Congress is the first premier meeting of oncologist, scientists, allied specialists.

Ancillary service providers, advocacy groups and policy makers in South Asia shall comprehensively address and redefine cancer care The congress will come out with well defined strategies.

They are intended to help care providers implement new ideas and research into their practice as well as further the discussion of best practices to curtail the rapid growth of cancer cases that may lead to quality care of patients.

India is a leading player in medical tourism ? Where

exactly does oncology picture in this scenario ?

ICC will strengthen and establish the fact that India is an emerging leader in health care. If you compare our health infrastructure in Metro cities, it can be compared with the best in the world. Same treatment, at times superior doctors but at a much cheaper price. A lot of patients come from the SAARC nations, Africa and other nations.

Will this oncology forum be a regular feature?

Oncology forum is a registered body and we have resolved to meet periodically. We intend to set up permanent ICC office till the next conference. The ICC is planned to be a four yearly event.

How will ICC impact cancer patients in India?

We expect to come up with national guidelines leading to better care, cheaper alternatives and cost effective options. There will be all a round efforts to create more awareness with focus on prevention and screening.

This awareness is not confined to patients but it includes general population, primary and secondary doctors and even oncologist.

There will be workshops and sessions for young onco surgeons to enhance their skills, master tips and tricks from the experienced hands in all specialities. There will emphasis on established procedures as well as emerging techniques like robotic surgery, laser, minimally invasive surgery, skull base surgery, etc. Budding radiation oncologists will get a chance to brush up with evolving and emerging technologies like Cyber Knife, Gamma Knife, High End Linacs, etc. all this will be helpful only when one has undergone the right kind of training.

Ultimately, the patients will be the main beneficiaries.

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cover story special focus

‘Our goal is to ensure a full, productive life’ Dr Shyam Aggarwal, HOD, Medical Oncology at Sir Ganga Ram Hospital since 1997 is known for his research and clinical trials. Besides pioneering works in stem cell transplants, he is also the founder chairman of National Cancer Foundation. In conversation with Shahid Akhter, ENN, he shares his onco thoughts and experience What is Multiple Myeloma and how prevalent is it in India ?

Multiple Myeloma is one of the most common haematological malignancy.

Precisely, it is the cancer of plasma cells found in the bone marrow, where it multiplies and produces the damaging protein. It also diminishes the growth of healthy blood cells.

Asians have lower incidence of multiple myeloma but they are affected a decade earlier, when compared to those suffering in the US. The incidence of multiple myeloma increases with age and in India, the median age is 50 years. There are no less than 60,000 myeloma patients in India, at any given point of time. There is an annual increase of 10-15,000 patients every year. The figure is supposed to double by 2020.

What are the symptoms of Multiple Myeloma?

Early myeloma (also called smoldering myeloma) does not show any symptom at all. Only with the progress of the disease, the symptoms start to manifest.

Symptoms for Multiple Myeloma include fever, infections, anaemia, backache and renal (kidney) failure. These problems are best summed up by the acronym CRAB, which refers to calcium levels, renal

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failure, anaemia and bone damage.

Myeloma cells dissolve the bone and this releases calcium into the bloodstream that leads to symptoms that include excessive thirst, loss of appetite and nausea. The abnormal protein damages the kidney and may reflect as anemia related fatigue.

Though any bone can be affected, but back ache is most common.

How easy is the diagnosis for Myeloma and is it readily available?

The past decade has witnessed tremendous advancements in science and this has resulted in diagnosis becoming easier, cheaper, readily available and best of all, greater accuracy.

The tests are quite readily available.

Blood and urine tests, X rays of bones and bone marrow biopsy are usually considered when multiple myeloma is suspected. The doctor may suggest a CBC (complete blood count) to get an idea of the levels of red cells, white cells and platelets in the blood.

Serum or urine electrophoresis is periodically done for monitoring purposes.

How effective are the drugs and do they interfere with insulin?

Yes, good many drugs are available.

What we require today is active cancer control programmes by the government and greater participation by way of creating awareness Bortezomib and Lenalidomide, for instance are few of the generic drugs.

For diabetic patients, there are drugs like Metformin which does not interfere with insulin. With the advent and availability of new line of molecular drugs, the role of chemotherapy has been pushed back. Some new drugs have been approved by FDA and introduced in the US and gradually they will be available here in India as well.

Now life expectancy of multiple myeloma patients have significantly increased. These drugs help to extend and improve the quality of life.

What is the life expectancy of people with multiple myeloma?

The survival rate varies on account of age, onset of myeloma, medication

and so on. In certain cases the survival rate can be as much as 10 years while for some it can be as little as 3 to 4 years. All patients below 65 must be offered bone marrow transplant which enhances life by 4-5 years.

Please give us an overall view of the cancer and the prevailing scenario in India?

Cancer is not just a single precise condition. It refers to all forms of malignant growth and there are many types of cancer arising from different types of cell. It all begins with a single abnormal cell that spins out of control and keeps multiplying. Cancer is

linked to lifestyle, tobacco and several other risk factors but good many can cers develop for no apparent reason.

Early detection is the key to cure in cancer. In India, cancer detection is usually very late and when we compare it to Europe or US, their regular screening ensures cancer being trapped at the very onset. More than two-third of the new cancers in India are presented in advance and incurable stage at the time of diagnosis.

It is estimated that in India, there are 2 to 2.5 million cancer patients at any given point of time with about 0.7 million new cases emerging every year. The figures are said to double Dr Shyam Aggarwal HOD, Medical Oncology, Sir Ganga Ram Hospital

by 2020 and India may emerge as the cancer capital ! Advances in medicine and technology will mean extended life and people living to old age when illness is most prevalent. Cancer can occur at any age but chances are higher after 45.

It seems to be an enormous burden and how do you address this as a doctor?

Cancer is a global concern spread across nations. What matters is the blue print to tackle it. Everyday, advanced cancer treatments are emerging. Cutting edge technology by way of diagnosis as well as treatment is the good news. Add to this the fact that lifestyle is in your hands and you can certainly amend it. The bad news is, we lack awareness, patients arrive too late, cancer is therefore detected late and this makes treatment difficult. Regular screening is the need of the hour and this alone can bring a radical change. Government should enhance its focus on cancer.

How good is our infrastructure in treating cancer and is it comparable with the developed nations?

I can say without an iota of doubt that India is almost at par with the best cancer treatment in the world. In the metros, select hospitals can boast of the best.

With the upcoming ICC, will there be anything new by way of breakthrough or scientific focus in the cancer treatment.

Cancer in days to come will be something to live with and it is high time to address this equation about its manageability. Multi disciplinary approach to oncology under one umbrella at ICC will prove to be very helpful.

The research aspect and approach at ICC is laudable. Almost 25 percent of ICC time will be allocated to basic research, cause and cure.

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special focus

Need to Strengthen Palliative Care in India The burden of cancer looms large and Palliative Care in India is pathetic. Dr Sankha Mitra, Consultant Clinical Oncologist, Brighton & Sussex University Hospitals and Chairman, Board of Trustees “ Eastern India Palliative Care”, shares his vision of care and concern with Shahid Akhter, ENN

Please define Palliative Care?

Palliative Care is the holistic care of the dying cancer patient and any patient with a chronic life limiting illness. It includes pain and symptom control, psychosocial and spiritual support. The word comes from the latin “ Palliare” which means to cloak or hide the symptoms of disease. The aim of Palliative Care is to reduce suffering and facilitate a dignified and humane death.

Dr Sankha Mitra

Consultant Clinical Oncologist, Brighton & Sussex University Hospitals

How is Palliative care delivered?

Palliative Care is delivered by a multidisciplinary team of trained doctors, nurses ,social workers, psychologists, physiotherapists etc working through Cancer Hospitals, Out patientclinics, hospices and home care services.

The main aspects are proper documentation of and relief of pain and other symptoms, psychosocial support by proper assessment of psycho social needs of the patient and their families, spiritual support including grief and bereavement counselling.

The staff need advanced communication skills training, training in breaking bad news, training to prescribe morphine and other painkillers according to the WHO pain ladder, support of the whole family by social workers, financial counsellors etc.

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What is the status of Palliative Care in UK? Palliative Care is a well recognized specialty in UK with higher medical training of registrars, referral of cancer patients by Oncologists to Palliative Care Consultants and nurses in hospitals when patients have life limiting cancer and other chronic diseases and referral to community palliative

care nurses and the local hospices for further management. Patients are looked after in the community and in their homes and have a dignified and humane death.

How did Palliative Care develop as a specialty in UK? TThis was not very easy and took about 30 years. This was mainly be-

cause of Dame Cicely Saunders who was working as a social worker after being invalidated out of nursing and realised that there was no one to listen to dying cancer patients and hold their hand and provide them with pain control and help alleviate their total pain which included physical pain as well as psychological pain, economic pain and spiritual pain. However, she realised that no one would listen to her so she then studied Medicine and developed St. Christopher’s Hospice in London which really started the whole Palliative care movement. This then spread across western Europe and USA.

What is the status of Palliative Care in India?

Palliative Care is a developing Specialty in India which needs to be highlighted to the general public who don’t know about the benefits of it. At the moment there are 925 Palliative Care Centres in India of which 840 are in Kerala. There is a huge need to expand Palliative Care in the whole of India. At the moment no one gets good quality of palliative care in most parts of India.

The poor die in neglect because there is no one to look after them at the time of death, the middle class die in ignorance because they are unaware of it’s benefits and they could pay for palliative care services if they were available but at the moment in a market health care system, there is no one selling palliative care as there is no one buying palliative care.The rich die in agony on a ventilator because there is no understanding of terminal care and prognosis and patients with very poor prognosis who are not appropriate for resuscitation end up on a ventilator with no benefit to them and considerable distress. We have to change this terrible situation.

What is the main problem?

The main problem is the draconian National Drugs and Psychotropic Substances Act NDPS 1985 which has pre-

vented access to Morphine , which is the cheapest drug produced in bulk in India yet not available to more than 5 percent of the cancer patients in India needing it for severe pain. The amended NDPS Act is at the moment tabled in Parliament waiting to be discussed and has been delayed everyday and has not been passed in the current session of Parliament.We have to get the amended NDPS Act through winter session of Parliament. Otherwise if it is delayed, 18 years of hard work will be lost forever and we will be back to zero. We need to highlight this important bill to the public so that they can petition their MPs so that they understand the importance of passing the amended NDPS Act during winter session of Parliament.

Please share your road map to develop Palliative Care across India?

Apart from the amended NDPS bill, we need to develop education & training centres of Palliative Care across India working with Pallium India and IAPC; we also need Out Patient Community Palliative Care Clinics across the whole of India with facility to develop Home Visits and Hospices. This will improve Palliative Care & Cancer Care across India.

Please share your precise role an initiatives taken.

I am a Consultant Clinical Oncologist based in UK. I am developing Palliative Care in Eastern India at the mo-

At the moment there are 925 Palliative Care Centres in India of which 840 are in Kerala.

There is a huge need to expand Palliative Care in the whole of India What is the problem with the NDPS Act 1985 ?

The NDPS Act 1985 is very complicated and confusing with those needing a morphine license being sent from health ministry to drugs controller to excise commissioner and back to health ministry. There are several separate licenses including a separate possession license , export and import licenses so that by the time one license is acquired , the others expire. The amended NDPS Act aims to simplify the whole process so that genuine medical institutions seeking a morphine license to treat cancer patients in severe pain can easily get it. This will be immensely beneficial to poor patients as 10 mg of morphine costs only 1 rupee.

ment and with the aid of UKDFID I have started a “ Train the Trainers” THET-Pallium India course in SGCCRI. Thakurpukur, West Bengal.

This is a 6 weeks course run every 3 months which is free for doctors, nurses and social workers. I am also running four free Community Palliative Care Clinics in West Bengal in Barrackpore, DumDum, Behala and Maheshtala. The experience of running these clinics show that Palliative Care is actually improving Cancer care across these areas.

Hence I want to roll out this model of Community Palliative Care Clinics linked to Cancer Hospitals across India as I believe this will help improve cancer care and palliative care across the whole of India.

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Special focus

Palliative Care Overlooked, Ignored and Misunderstood October 12 marks World Hospice and Palliative Care Day. Dr Rakesh Roy, Chief Clinical Tutor & Incharge, Dept. of Palliative Care, SGCCRI, Kolkata in conversation with Shahid Akhter, ENN, demystifies myths and misconceptions about Palliative Care Is palliative care for terminally ill patients only?

Not necessarily. While palliative care certainly includes terminal care, it also includes the care of the patients who may have a long time to live but suffering from life threatening or incurable disease. For example, both in AIDS and slow growing cancers, the patients may have long survival, and palliative care is certainly needed.

Does palliative care start when the disease is declared incurable?

In one word no. Ideally all principals of palliative care must be applied from the time of diagnosis. The patients’ need for emotional support may be most when the diagnosis is broken to him. Emotional support will also significantly increase the patient’s compliance to definitive treatment. So it will be best for the patient if modalities of palliative care are applied concurrent

dr vishwas mehta

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Dr Rakesh Roy Chief Clinical Tutor & Incharge, Dept of Palliative Care, SGCCRI

with definitive treatment. However the need for palliative care does become more when the disease is declared incurable.

Why is palliative care different?

Palliative care is not only for the patient; it is also for the family. Therefore it does not end even if the patient dies. It includes bereavement support for the family.

Does palliative care apply only to cancer and AIDS patients?

No, it applies to any long standing disease that causes poor quality of life though cancer contributes majority of the palliative care patients. Chronic obstructive pulmonary disease, cardiac or renal disease, chronic pain states, quadriplegia or paraplegia, all may need appropriate application.

What are the components of palliative care and is it available to affluent patients or the poor too can get this care?

Components of palliative care include facilities for outdoor care, inpatient care and domiciliary care. Palliative care is for all. Since this care involves cheap drugs therefore even the poor can afford.

Is palliative care available only in cities and what are the barriers to palliative care in India?

Palliative care is available in rural area as well. Through link centres and specialist home care delivery systems the state of Kerala has been able to provide quality palliative care to all corners.

Barriers to Palliative Care include poor drug availability, lack of education and awareness amongst physicians and community and lack of policy at the level of institution and government.

According to WHO around 24 million adults require palliative care at the end of life each year. 66 percent of these are over 60 years old. Despite this growing need, 42 percent of countries still have no identified hospice and palliative care service, while 80 percent of people globally lack adequate access to medication for treatment of moderate to severe pain.

Why is drug a barrier and is Morphine very expensive?

unfounded. Morphine features in the top tier of WHO analgesic ladder. So people should not think morphine is a banned drug.

Morphine which is WHO approved for treatment of severe cancer pain is not easily available. India manufactures morphine in few states. However it is a national shame that inspite of being a major morphine exporting country only a handful of patients have access to morphine. No. Contrary to it, Morphine is very cheap.

Will there be withdrawal symptoms if morphine is stopped abruptly?

That is not correct either. There may be withdrawal symptoms if morphine is withdrawn abruptly from som one who has been on the drug for a long time. But

The famous psycho-oncologist Buckman, once said that there was one missing chapter in Harrison’s Textbook of Internal Medicine. The missing chapter was “What do you do when all the treatment advised in all other chapters fail?� Palliative care is that missing chapter. It is about treating the illness rather than the disease Will the patient on morphine be sedated for the rest of the life?

No, certainly not. If morphine is used to morphine-responsive pain in the right dose, it does not cause sedation in the majority of the cases. In fact the patient can pursue a profession and lead a normal life while on morphine.

Will morphine cause addiction?

No, not if used properly. Medical science has clearly understood in the last few decades, that if morphine is used in doses adequate for pain relief, it does not cause addiction. The fear is totally

withdrawal symptoms do not mean addiction. We have to distinguish between addiction and physical dependence. In simple term addiction can be described as psychological dependence, manifesting as craving for the drug, steadily increasing quantity of consumption unrelated to disease progress and continued use despite harm.

If morphine is taken for pain now, will it become ineffective later when the pain gets worse?

No, this fear is unfounded too. Morphine can be continued as long as required.

Does oral morphine have side effects?

Morphine causes constipation and nausea, vomiting. However these can be effectively managed. Used with reasonable caution, it is almost impossible to cause respiratory depression with oral morphine. The right dose of morphine is what is needed to relieve the pain. If this dose is exceeded, there are toxic signs like drowsiness, delirium, and myoclonus. These serve as warning signs which prevent further consumption of the drug.

Can palliative care be delivered by any doctor or nurse or is it something to be done only by the specialists?

Palliative care is multi-disciplinary care. Family members, volunteers and professionals all have their role to play. But for anyone to do this optimally, some amount of training is necessary.

Ideally palliative care is something to be incorporated into routine medical practice. For this palliative medicine has to become part of medical and nursing curriculum. For the time being, a short period of training would enable any volunteer, doctor or nurse to practice principles of palliative care. And they have the responsibility to train the family member in caring for the patient.

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zoom in

Virtual Dissection Table With the new method of doing dissections on virtual cadavers, medical students can experience surgery and get view of more in-depth images of the human body virtually

T

he world’s first life-sized 3D interactive virtual dissection table technology, The Anatomage Table, was created by Anatomage Inc, USA, in partnership with Stanford Medicine’s Clinical Anatomy Department, California. K S Biomed Services, an established multi-specialty organisation from Ahmedbad Gujarat has taken most awaited initiative to bring this amazing technology to India.

The Virtual Dissection Table is a 7 foot life-sized touch screen anatomy visualisation table. It allows users not only to view but also interact with realistic 3D structures of the human body, offering detailed visualisations of every aspect of human anatomy. With this new method of doing dissections on virtual cadavers, students can experience surgery and get view of more in-depth

Himanshu Bhatt MD, KS Biomed Services

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images of the human body virtually.

For anatomy courses without cadavers, The Virtual Dissection Table offers the most realistic virtual cadaver. This cutting-edge technology will help raise the standards of medical education to the next level with in-depth virtual human anatomy dissection studies.

going towards more virtual anatomical exploration, but this device could also lead to having more usefulness than textbooks for various departments of medical institutions in India.

Of course, one possible constrain in India is the cost of the table, but if medical institutes consider its follow-

This cutting-edge technology will help raise the standards of medical education with in-depth virtual human anatomy dissection studies Surgeons Benefit Too The virtual dissection table has completely new way of doing ‘virtual’ exploration of the human body which allows them to explore “live” rare medical cases through uploading CT or MRI images of patients with complete dissection facility “live on virtual table” for surgical planning for the first time in medical history. It is also possible to simulate pathologies on table.

Plenty of case studies have been conducted on the way that The Virtual Dissection Table has impacted medical institutions and most of the research shows the table has immense future potential, and has thus far been implemented in various medical institutions throughout the world. Currently, over 55 institutions worldwide use the table.

Being the first of such a 3D virtual dissection device, leaves a lot of room for adding more data and modifying the device based on user feedback. The future of studying anatomy seems to be

ing features, it is worth having as part of Virtual Skill Laboratory for which even the Medical Council of India is recommending all medical institutes.

• Excellent way of repeated Anatomy education • CT-MRI image uploading of real live cases for surgical planning • Surgical planning of critical cases • Life-saving surgical procedure planning • Patient counseling for critical surgery consent • New future upgrade in same Table once installed Himanshu Bhatt, Managing Director, K S Biomed Services is very optimistic about this revolutionary Virtual Dissection Table. The buzz and popularity of this product is growing at a fast pace with each CME being participated by K S Biomed in different medical institutes all over India.

For further enquiry: info@ksbiomed.com or on +91-9824281656 / 9377742554

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Zoom in

Service at a Click Prashant Tandon, MD and Co-Founder, Healthkart.com, talks to Ekta Srivastava, ENN, about the scope of e-commerce in the healthcare industry

E

-commerce has tremendous potential in the healthcare sector. This is largely because Internet provides access to all. People can learn and avail online a whole lot of products, healthcare information, knowledge about health improvement, etc.

A one-stop-shop, Healthkart.com is an online portal for health and fitness products in India. It also deals with health, fitness and beauty on other portals like HealthKart Plus, which is credited to be India’s online pharmacy and drug database and HealthKart Fit, which is a physical store which sells about 50 different brands of dietary supplements and sports nutrition products.

“Almost one third of our sales come from Tier-III and Tier-IV places from India which are 500 towns and villages. There are lot of fake and counterfeit drugs in the market as well. Through these centralized market, we become organised retailers. We deal directly with the brands, with the company, so that the consumers get authentic products anywhere they are in India giving it a huge scope in space,” says Prashant Tandon, MD and CoFounder, Healthkart.com.

Mobile Application In India, today people have more access to mobile and so as for mobile Internet, even with smart phones access to downloading new apps have come as additional feature. Transactions through mobile phones are also growing up significantly. Healthkart Plus application, which started as purely

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Prashant Tandon, MD and Co-Founder, HealthKart.com

information app, helps consumers about how technology can make the health side more transparent.

“So we created the database of all the medicines in India, like what they do, what are the side- effects and what do they interact with, if with same salt what other cheaper substitutes are available. We created that application and we received a good response and 75,000 people downloaded the application. We have a million plus visitors in that application on a monthly basis,” informs Tandon.

Business Model HealthKart has adopted the regular wholesale model, with tie-up with brands in and around the country.

Tandon inform that: “We first make sure that the brand has basic reputation and all the clearance. We reject a lot of brands because in healthcare

there are lots of brands which are questionable. Secondly, we also make sure that we only source it from the brand or the brand authorised distributors. Authenticity is the primary value, so we make sure that we are careful about that.”

Further Plans Talking about things in pipeline, Tandon mentions that HealthKart is focusing on research. “We are coming up with the lots of new features, adding a health content site where we will be adding healthcare forums, we are also adding the feature where people can upload the prescription and get alerts if two drugs of same composition were there in their prescription. In this space the consumer’s knowledge is also so much low that we will be contenting the information over the next years,” says Tandon.

event report

Patient Safety Matters Held with the theme of ‘Improving Patient Safety and Reducing Cost of Healthcare’, Healthex International 2013 was marked by new product launches and an international pavilion

T

he fourth edition of Healthex International 2013 and first edition of Arogya Mela, was jointly organised by Bangalore International Exhibition Services and Association of Healthcare Providers of India (AHPI) on September 22, 2013. The event was inaugurated by Dr Sharanaparakash Rudrappa Patil, Minister for Medical Education, Government of Karnataka; Hans Raj Bhardwaj, Governor of Karnataka; and UT Khader, Minister for Health & Family Welfare, Government of Karnataka, respectively.

The inaugural ceremony was also graced by eminent personalities such as Dr Sriprakash KS, Vice Chancellor of Rajiv Gandhi University of Health Sciences; Dr Devi Shetty, Chairman, Healthex International 2013; Dr Prem Nair, Medical Director, Amrita Institute of Medical Sciences; and Dr Giridhar Gyani, Director General, AHPI.

Key Highlights Held with the theme, ‘Improving Patient Safety and Reducing Cost of Healthcare’ and ‘Innovation Pavilion’, the three-day seminar-cum-exhibition served as a platform for knowledge sharing and witnessed participation from national and international companies and showcased healthcare innovations by R&D organisations, healthcare start-up companies, academic institutions, public health institutions, venture capitalists and angel investors.

The exhibition witnessed participation of over 25-30 hospitals, 120 healthcare exhibitors which included healthcare equipment manufactur-

Inaugural by Hans Raj Bhardwaj, Governor of Karnataka, and Dr Devi Shetty, Chairman, Healthex International 2013

ers, 25-30 R&D companies, diagnostic centres from India, Italy, China, and Singapore. The innovation pavilion showcased innovative healthcare technology products, equipments, unique procedure methods by highend research organisations. On this occasion, Governor Bharadwaj and Minister for Health & Family Welfare, Khader, released the book on Patient Safety by AHPI.

Quote Unquote Addressing an audience of eminent doctors, physicians and medical students Bhardwaj said “Medical profession is one of the noblest ones, doctors should devote some attention and money to the poor. Everything cannot be left to the government, doctors from private practice should invest time by participating in government-sponsored medical camps to serve the poor”.

Addressing the inaugural ceremony, Dr Sharanaparakash Rudrappa Patil said “Starting new medical colleges in districts will to a large extent help in addressing the needs of people at the district level, who visit Primary Health Centers and Community

Launch of book on Patient Safety by AHPI

Health Centers for treatment. With new colleges opening up, the need for more doctors can be met. The Karnataka State Government’s plan of starting more government medical colleges will take effect from 2014-15, with six new ones opening across districts.” Dr Devi Shetty said, “Most of the clinics in India lack blood banks and at emergencies the hospital staff donate blood to the patients. These kinds of exhibitions will provide information about the facilities available in the hospitals and the common man can understand the necessity of best healthcare facility thus enabling the development of society.

The event was supported by the leading government bodies like the Department of Health & Family Welfare, the Government of Karnataka, National Small Industries Corporation; international bodies like IndianChina Chamber of Commerce & Industry, Embassy of Denmark (Trade Council); and industry associations like AHPI, Association of Medical Device Industry (AIMED), Surgical Manufacturers and Traders Association (SMTA), etc.

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launch pad

Shortest Insulin Syringe Needle To help patients adhere to insulin therapy, Becton, Dickinson and Company (BD), a global medical technology company, has launched BD Glide 6mm Needle with TBL technology, BD’s smallest ever insulin syringe needle in India. Earlier this year, The Forum for Injection Techniques India (FIT India) recommended that there is no medical reason to recommend needles longer than 6 mm for appropriate insulin delivery to patients.

This is due to the fact that longer needles (8mm) have a higher probability (15 percent) of causing an intramuscular injection compared to shorter one (6mm) reducing probability to (6 percent) which can increase the risk of hypoglycemia, a potentially life-threatening situation.

Digital BP Monitor Paramount Surgimed Ltd launches the Digital Blood Pressure Monitor, one of the best ways to now check your blood pressure with no tension of measuring the zigzag turns of the stick. The device features a large LCD display with easy to read in-progress results and measures systolic and diastolic blood pressure and pulse rates simultaneously and detects and alerts the user to irregular heartbeat. The device comes equipped with the WHO Indicator, provides an instant comparison to standards set by the WHO.

Next Generation Quadripolar Pacemaker St Jude Medical, Inc (NYSE:STJ), a global medical device company, announced the first commercial implant of the Allure Quadra Cardiac Resynchronization Therapy Pacemaker (CRT-P) in India.

The new platform of St. Jude Medical low-voltage devices includes the unique, clinically proven AT/AF detection algorithm allows physicians to identify patients at risk for stroke earlier. The ASSERT, or ASymptomatic AF and Stroke Evaluation in Pacemaker Patients and the AF Reduction Atrial Pacing Trial, was designed to determine whether the detection of arrhythmias using pacemakerbased diagnostics predicts an increased risk of stroke in elderly, hypertensive patients without any history of atrial fibrillation (AF).

Extreme Ambulance International Cars & Motors Limited (ICML), a Sonalika Group company hitting the road with its ‘Extreme Ambulance’ in India. Touted as a ‘friend in need’ for the medical fraternity, this new ambulance scores high on space, comfort, mileage and is designed to be extremely reliable on bad roads and rough weather.

Moderately priced at `6,15,000 lakh to `6,58,000 (ex-showroom price), ‘Extrerme Ambulance’ enjoys an edge over its peers as there is no AC Ambulance in price band of ` 4 Lakh to `8 Lakh. Its top speed can go up to 165 kmph making it probably the fastest and the most advanced ambulance available in the Indian market today. With a 4+1 seating capacity, this ambulance comes well-equipped with a stretcher, revolving light, hook for glucose bottle, oxygen cylinder holder, a water dispenser holder and a medical box.

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Cytometry Cell Analyzer The BD LSRFortessa X-20 Cell Analyzer delivers highperformance multicolor analysis with the most compact footprint in its class at just 30” x 29” (76.2 X 73.7 cm) and a height of 30” (76.2 cm). Offering a new level of flexibility, the analyzer can be configured with up to five lasers to detect up to 20 parameters simultaneously. While popular laser choices include blue, red, violet, yellow-green and UV, a wide range of up to 34 laser choices are available as excitation sources. Each excitation source is supported by new polygon detector arrays, and each polygon can support up to eight detectors for maximum flexibility in optical configuration. The BD LSRFortessa X-20 Cell Analyzer is designed by BD’s special order program that enables customers to configure BD flow cytometers and cell sorters to fit precise research and assay needs.

HBP-9020: An Automatic BP Monitor Omron Healthcare is making inroads into hospitals and clinics with its hi-tech automatic BP monitoring devices such as HBP 9020. Being an ultramodern device equipped with Japanese advanced technology, its support functions render it a ‘Do It Yourself’ appeal making it possible for the patients to even operate it themselves. Also, the machine is compatible with both left and right arm measurements. Other unparalleled features of the device are the presence of an ergonomic integrated cuff. It is amongst the few professional BP monitors in the market available with the moveable cuff feature. The cuff is compatible with a wide range of arm thickness (17 cm to 42 cm circumference) and also provides angle control thus making it easier for taller and overweight people to get the right measurement seating comfortably.

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listing

Agfa Healthcare India Pvt Ltd

HealthFore Technologies Limited

MRK Healthcare Pvt Ltd

Head Office Address: Technosoft Knowledge Gateway, 2nd Floor, B-14, Road No-1, Wagle Industrial Estate, Thane (West) - 400604 Telephone: 022-4064 2900 Email: sales.india@agfa.com Website: www.agfahealthcare.com

Head Office Address: GYS Universal, Plot A-3,4,5, Sector 125, Noida Telephone: 0120-6171000 Email: healthfore@healthfore.com Website: www.healthfore.com

Head Office Address: B4/5, Byculla Service Industries, Sussex Road, Byculla, Mumbai - 400027 Telephone: 022-23748371 Email: info@mrkhealthcare.com Website: www.nulife.co.in

Hospaccx India Systems Aosta Software Technologies India Ltd Head Office Address: 287/3A Kovai Hills, Kalappatti Road, Coimbatore -641048, Tamil Nadu Telephone: 0422-4302500 Email: info@aostasoftware.com Website: www.aostasoftware.com

Armstrong World Industries (India) Pvt Ltd Head Office Address Boomerang, 303, A Wing, Near Chandivali Studio, Chandivali Farm Road, Andheri (E), Mumbai – 400072 Telephone: 022-30460800 Email helpdesk@armstrong.com Website www.armstrong.co.in

Bird Meditech Head Office Address: 109, 110, Nidhi Industrial Estate, Shiv Shankar Industrial Complex No. 2, NH No.8, Village Waliv, Vasai (East) - 401208, Thane Telephone: 0251-3212729 Email: birdmeditech@sify.com , birdmeditech@gmail.com Website: www.birdmeditech.net

Head Office Address: 505, Arcadia, Hiranandani Estates, G B Road, Thane (West) - 400607, Maharashtra Telephone: 022- 41232233 Email: hospaccx.india@gmail.com Website: www.hospaccx.in

ITDOSE Infosystems Pvt. Ltd Head Office Address: D-159, 1st Floor, Sector-7, Noida 201301 Telepone: 1204115455 Email: info@itdoseinfo.com Website: www.itdoseinfo.com

K S Biomed Services

Head Office Address: 701, Shikhar, Opposite Neptune House, Muithakhali, Ahmedabad-380 009, Gujarat Telephone: 079-26421102-04 Email: info@ksbiomed.com; marketing@ksbiomed.com Website: www.ksbiomedservices.com

Maquet Medical Profile

Goldstar Healthcare Pvt Ltd Head Office Address: RT-623, Royal Towers, Shipra Suncity, I n d i r a p u r a m , Ghaziabad - 201010, Uttar Pradesh, Telephone: 0120-4105005 Email: sadanand@goldstarhealthcare.net Website: www.goldstarhealthcare.net

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Palash Healthcare Systems Pvt Ltd Head Office Address: Gopal House, 3rd Floor, Karve Road, Kothrud, Pune – 411029 Telephone: 020- 6624616 Email: info@palashhealthcare.com Website: www.palashhealthcare.com

Software Associates Information Technologies Pvt Ltd Head Office Address: B-1205,Shriram Symphonye, Off Kanakapura Road, Bangalore, Karnataka - 560062 Telephone: 924-361-7836 Email: info@softwareassociates.co.in Website: www.sa-his.com

Spigot Software Private Limited Head Office Address: #531/144, 3rd Floor, 1st Sector, HSR Layout, Outer Ring Road, Agara, Bangalore 560102 Telephone: 080-22584082 Email: info@spigotsoft.com Website: www.spigotsoft.com

Transasia Bio-Medicals Ltd Head Office Address: II Floor, Mehta Trade Centre, Sir M V Road, Andheri (E), Mumbai - 400099 Telephone: 022-40692100 Email: info.india@maquet.com Website: www.maquet.com

Head Office Address: Transasia House, 8 Chandivali Studio Road, Andheri (East), Mumbai - 400072 Telephone: 022-40309000 Email: responses@transasia.co.in Website: www.transasia.co.in

RNI No. UPENG/2011/38140

UP/GBD - 140/2011 - 2013

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