Ehealth sep16 web edition

Smart

12th August 2016, New Delhi

Asia’s first Monthly Magazine on the enterprise of healthcare Volume 11

Issue 09

September 2016

EDITOR-IN-CHIEF: Dr Ravi Gupta EDITORIAL TEAM - DELHI/NCR Senior Assistant Editor: Nirmal Anshu Ranjan Assistant Editor: Souvik Goswami, Gautam Debroy, Kusum Kumari Senior Correspondent: Manish Arora BANGALORE BUREAU T Radha Krishna - Associate Editor MUMBAI BUREAU Kartik Sharma - Senior Assistant Editor Poulami Chakraborty - Correspondent JAIPUR BUREAU Kartik Sharma - Senior Assistant Editor CHANDIGARH BUREAU Priya Yadav - Assistant Editor HYDERABAD BUREAU Sudheer Goutham B - Senior Correspondent LUCKNOW BUREAU Arpit Gupta - Senior Correspondent AHMEDABAD BUREAU Hemangini S Rajput - Assistant Editor SALES & MARKETING TEAM: eHealth Product Head: Fahim Haq, Mobile: +91-8860651632 Senior Executive: Priyanka Singh, Mobile: +91-8860651631 SUBSCRIPTION & CIRCULATION TEAM Manager Subscriptions: +91-8860635832, subscription@elets.in DESIGN TEAM Creative Head: Pramod Gupta, Anjan Dey Deputy Art Director: Om Prakash Thakur, Gopal Thakur, Shyam Kishore EveNt Team Manager: Gagandeep Kapani ADMINISTRATION Head Administration: Archana Jaiswal EDITORIAL & MARKETING CORRESPONDENCE

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Contents

september 2016 | VOLUME - 11 | ISSUE - 09

CURE

10 Cover Story

Prevention is Better than Cure

Prevention

Protection of health not accomplishable in a single conversation, rather demands ongoing deliberation & policy changes

36 Conference Outcome

Smart Healthcare Conclave – Celebration of Innovation & Confluence of Ideas on One Platform

59 Special Feature

Sink or Swim

Learn about new psychological challenges spreading in urban spaces

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Understanding Preventive Care

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Alere Inc: Accelerating Accurate Decision-Making to Offer Better Health Namal Nawana CEO & President, Alere Inc

18 National Heart Institute: Taking Preventive, Promotive & Primary Secondary Healthcare to Masses Dr OP Yadava CEO & Chief Cardiac Surgeon, National Heart Institute

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Preventive Care Cervical Cancer: Make it Preventable via Inclusion in Immunisation Programme

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Cyber Threat

34 Seclore: Enabling Efortless & Secure Collaboration Amit Malhotra VP, Sales India, Middle East & Africa, Seclore

Understanding Emotional Health

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ePsyclinic.com: Offering Prevention via Identification of Stressors & Emotional Supportive Counselling

Chest Research Foundation: Severity of Respiratory Diseases More than a Headache Dr Sundeep Salvi, Director Chest Research Foundation

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24 Healthcare vs. Health Cure - Understanding Sick Care Business Sridharan Mani Director & CEO American Megatrends India

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Eye-Q: Disrupting Traditional Eye Care Settings via Technology & Vision Dr Ajay Sharma Founder Eye-Q Vision Pvt Ltd

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Shipra Dawar Founder, ePsyclinic.com

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wayForward: Managing Stress through Preventive Care Ritvik Singh CEO, and Dr Navya Singh Founder, wayForward

Genomics

64 Positive Bioscience: Leveraging Genetic Information to Provide Personalised Health Solution Samarth Jain Founder & CEO Positive Bioscience

editorial

Keep Healthcare in Good Hands, Not in Invisible Hands Healthcare is undoubtedly a public good that cannot be left to the unregulated control of the market, rather the overall goal should be to alleviate sufferings of the common masses from the rising burden of treatment costs by regulating those with the mission to extract money and detract the ongoing progressive healthcare initiatives.

In order to achieve an ideal healthcare system, relevant factors, such as universal access, cost-effective treatment or fair distribution of financial cost to lessen the ever-rising burden of healthcare, etc., need to be built in the healthcare system, with unwarranted special attention to vulnerable groups, such as women, children, differently abled and the aged . It’s only when we succeed in achieving these goals that we will be able to make ‘Preventive Care’ the defining benchmark for the healthcare sector. eHEALTH Magazine as the voice of the healthcare sector through the September issue primarily focusing on ‘preventive care’ wants to spread word on the need to decrease the burden of insecurity due to the rising concept of sick care business steered by ‘cure’ rather than ‘care’. The key to creating a healthy & productive population is to understand the dire need of strengthening screening measures across medical facilities and in the national policies by generating adequate political will. Moreover, the healthcare stakeholders and thought leaders need to deliberate to successfully revise the healthcare landscape by including newer diseases that have steadily crept in due to numerous man-made factors, such as respiratory diseases, cervical cancer among women, etc., to increase emphasis upon compulsory screening for detecting them at an early stage.

Whether we like it or not, stress has become another point of concern in the society, especially due to new socioeconomic dynamics of the society. Therefore, eHEALTH Magazine has tried to capture the overall picture by comprehending the factors that dismantle our overall well-being. Often unnoticed and untreated, mental diseases or stress can mostly play havoc on the overall mental constitution of the patients. With the aim to spread awareness, we have tried to capture the key reasons and solutions available at fingertips to understand this problem which is more than what it appears to be.

Join us in the ride of spreading awareness!

Dr Ravi Gupta ravi.gupta@elets.in

September / 2016 ehealth.eletsonline.com

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Cover Story

Preventive Care

Preventive Cure:

Prevention is Better than Cure

CURE

Protection of health not accomplishable in a single conversation, rather demands ongoing deliberation & policy changes, shares Kusum Kumari of Elets News Network (ENN)

Prevention

W

ith increased focus on ‘Preventive Care’, we have now reached the stage in healthcare sector where we need to stop for a moment and look around to comprehend the entire healthcare system and its internal dynamics.

Interestingly, healthcare stakeholders are now breaking the old patterns and questioning what they have been always instructed to follow to get acquainted with different views and approaches.

The healthcare sector is now thankfully witnessing an increased focus on spreading awareness about ‘preventive care’ rather than confirming to the system that was nothing but sick care business. With this objective in mind, thought leaders through different platforms are now willingly coming together to deliberate on the existing gaps, such as lack of appropriate screening for early diagnosis of diseases, insufficient infrastructure & manpower, and lack of political will to make screening the national agenda, which are the key reasons behind increased treatment costs and disease burden. The need of the hour is to change our thinking to transform healthcare policies and systems. Addiction to till-now-unquestioned traditional thought processes will only lead to status quo rather than innovation and healthier & productive population.

We need to also understand the deep connect between health and profit or economic growth. Undoubtedly, preventive care will play the crucial role in accelerating India’ economic growth, as only healthier population can prove to be productive in the long run. And, only appropriate screening measures and strengthening of health policies on preventive care will enable to achieve a healthier population.

With the primary ambition to explore gaps in the current healthcare system that are proving to be roadblocks in achieving ‘Preventive Care’ in totality across India, we asked some of key healthcare stakeholders to share their inputs on the following questions: • Screening is the primary medium to strengthen preventive care. In the light of the above, what do you think are the major challenges in the screening programme running across India? What are the major changes you suggest in the national guideline?

• How are healthcare providers planning to address the health-related challenges due to non-communicable diseases (NCDs)?

Here are the excerpts:

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Cover Story

Preventive Care

Dr Deepak Patkar

Director, Professional Services, Nanavati Super Speciality Hospital • Establishment of efficient referral systems, sustained monitoring of patients with adherence to global clinical protocols, maintaining health records of past and present patients, treatment services through provision of subsidised options like state health insurance, essential support services and last but not the least enhanced synergies between policymakers and private sector players remain the key challenge areas in the smooth implementation for screening programmes across India. In order to make screening programmes for various diseases a successful endeavour, the Government needs to allocate enhanced funds for public healthcare. For a country the size of India with diverse demographic profiles and disease histories, increased funds for the healthcare sector can go a long way in ensuring a healthy and disease-free existence for its people. Providing training to health workers to provide first-stage treatment procedures and create a base-pool of primary health professionals at the village, town and city level should be given priority in the national health guidelines.

Private sectors may indeed play a very important role in this regard and we suggest that the national policies should incorporate guidelines for them, as well with regard to the screening programme. With Government’s support, screening can be carried out in these sectors at a subsidised rate, making them available to even a greater population. We also need to standardise the screening techniques and protocols.

• Realising the need to tackle the ever-growing menace of non-communicable diseases (NCDs), the Government of India announced the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 2008. The broader contours of the scheme were to be implemented in one district of seven states in India.

Providing critical support to other national health programmes like the National Rural Health Mission (NRHM) and the National Programme for the Health Care of the Elderly (NPHCE), schemes like NPCDCS have made a positive attempt to plug the gaps in different stages of identifying and providing effective treatment methods for NCDs. The Government has formulated an NCD service package to be implemented at different levels by the public health system. Starting from the community healthcare centre at rural levels, the package would also be implemented at district hospitals and hospitals providing tertiary care facilities. NPCDCS has also identified screening camps as a core execution area of its agenda.

Dr Mukesh Batra

Founder and Chairman, Dr Batra’s Group of Companies • In India, the lack of awareness for screening of diseases has been evident in the way we view healthcare, most of it stems from educational and behavioural factors to cultural and economic considerations. Low awareness on screening procedures, lack of easy availability and cost of screening, and lack of skilled healthcare professionals and appropriate infrastructure are some of the major reasons India lacks in screening and early detection of diseases. At the Government level, one needs to put in place screening programmes and communicate the benefits of early detection. The screening procedure must be cheap, easy, and acceptable and available to all individual. The Government should identify standardised protocols, ranging from screening to diagnosis of individuals to ensure the spread of diseases is controlled. The Government should bring in a seamless integration between screening to consultation and then prevention, and this is possible only when we have skilled caregivers and healthcare professionals in place.

• Increase in non-communicable diseases (NCDs) causes a huge economic burden, especially for a country like us as we have the largest youth population in size currently. The rapid spread of NCDs points at two key challenges India faces, i.e. double burden of infectious and chronic diseases due to malnutrition and on the other hand obesity due to change in lifestyle . These two factors weaken the health systems that are already compromised.

To address NCDs, one must ensure that service delivery, human resources, medicines and technology, information systems, financing and governance work synergistically. In the absence of any of these pillars, India would further suffer. The most important task currently is to fix the limited and poorly distributed health force in India and ensure skilled healthcare professionals are available and accessible to all. Standard protocols for screening and diagnosis are followed and awareness about early detection is provided. Awareness on public health and healthy lifestyle has to be brought in at an early age, so as to achieve healthier India.

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Preventive Care

Alere Inc.

Alere Inc: Accelerating Accurate Decision-Making to Offer Better Health Alere has been establishing benchmarks in diagnostic & monitoring services by delivering high-quality products and services to both patients and healthcare providers. These services & devices have been strengthening decision-making capabilities of healthcare stakeholders by providing accurate and actionable information. As a firm believer in innovation and changes, Alere has been successfully steering changes, shares Namal Nawana, CEO & President, Alere Inc exclusively with Elets News Network (ENN) Since our September issue focuses on ‘Preventive Healthcare’, could you please walk us through your point-ofcare diagnostic products that are enabling prevention through screening?

Point-of-care diagnostics is a growing and dynamic industry. Alere delivers reliable, actionable information through a full suite of rapid diagnostic tests.

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Our products accelerate decisionmaking for the most costly chronic conditions, in infectious diseases, cardiometabolic diseases and toxicology, helping to deliver better clinical and economic healthcare outcomes globally.

• Our infectious disease diagnostic tests and monitoring devices provide results for over 75 types of infectious diseases, including those caused by bacteria, viruses, fungi or parasites.

Tests are available across a variety of platforms, including rapid point-ofcare diagnostic tests and advanced instruments that provide results in as little as 5 minutes. Our products and services include tests to assist in the diagnosis and management of many infectious diseases, including human immunodeficiency virus (HIV), malaria, dengue, tuberculosis and many more.

• Our cardiometabolic portfolio includes tests to assist in the diagnosis and management of many cardiometabolic factors and conditions, including cardiac markers, glucose and HbA1C, cholesterol levels, blood gases, and home monitoring for ventricular

assist device (VAD) and oral anticoagulation.

• Our drug and alcohol testing products and services allow you to make fast and informed decisions.

Alere’s toxicology solutions are used in a multitude of settings, such as hospitals, clinics, physician offices, criminal justice systems, workplace, rehabilitation centres, occupational health clinics, home testing centres and more.

Undoubtedly, early screening of diseases and economic growth are closely related to each other. In the light of the above, please enumerate the ways by which Alere is assisting in achieving the above.

We make critical test results available immediately, which eliminates needless delays that affect outcomes, increase costs and burden healthcare systems.

Faster results enable better decisions that get patients back to what matters most — a safe, healthy, enjoyable and productive life.

For example, India has the third highest number of estimated people living with HIV in the world. According to the HIV Estimations 2012, the number of people living with HIV/ AIDS in India was 20.89 lakh. With

Alere Inc.

technology advancements and scientific breakthroughs, HIV has become more manageable. Alere is at the forefront of these advancements, working to provide tools to help monitor those with HIV and provide results that put them on the path to better health. The Alere Pima™ CD4 Analyser is an important tool in helping to improve access to results and ultimately better manage this disease.

Alere’s Pima CD4 Analyser provides the healthcare professionals (HCP) with easier access to dependable absolute CD4 count in less than 20 minutes at the point-of-care, without a lab. Not only does it increase efficiencies, it also enhances patient management, allowing you to make important treatment decisions and provide antiretroviral therapy (ART), if needed. Working closely with the Clinton Health Access Initiative, Inc. (CHAI), we have provided Pima CD4 devices to help their initiative to make HIV testing and care more accessible. We are also supplying National AIDS Control Organization (NACO) to further strengthen their efforts to enable affordable testing to patients in remote areas. The machines are presently deployed in several ART centres.

What are the key challenges related to cardiometabolic diseases, new psychoactive substances, antimicrobial resistance, etc. in an emerging country like India. How is Alere overcoming these roadblocks?

• Cardiovascular disease (CVD) is one of the main causes of mortality and morbidity worldwide. As an emerging population, South Asians bear a disproportionately high burden of CVD due to genetic predisposition and other lifestyle factors.The key challenges being faced in cardiac care in India are lower availability, accessibility, and affordability of effective and efficient treatment, coupled with the absence of a focused policy towards noncommunicable diseases, including

Preventive Care

Key Products • Alere Pima™ CD4 Analyser: An important tool in helping to improve access to results & ultimately better manage HIV. • CLIA-waived molecular test: Helps in detecting and differentiating influenza A and B virus in less than 15 minutes.

• epoc® Blood Analysis system: The first and only pointof-care solution for testing blood gases, electrolytes and metabolites.

• Alere q HIV-1/2 Detect: Provides the next-generation virological HIV-1 and HIV-2 results for both infants and adults at the point of care within 50 minutes.

CVDs. The strategic priorities must include purposeful education, continuous screening and monitoring, and a focus on improving the health of populations. Alere has a strong portfolio of cardiometabolic screening solutions to assist in the diagnosis and management of many cardiometabolic factors and conditions, including cardiac markers, glucose and HbA1C, cholesterol levels, blood gases, and home monitoring for VAD and oral anticoagulation. Antimicrobial resistance is one of the major public health problems, especially in developing countries where relatively easy availability and higher consumption of medicines have led to disproportionately a higher incidence of inappropriate use of antibiotics and greater levels of resistance compared to developed countries. In India, the infectious disease burden is among the highest in the world. If left unchecked, antimicrobial resistance will result in difficulty in controlling the diseases in the community and lead to ineffective delivery of the healthcare services. Rapid diagnostic tests are high on the patient safety agenda, but require widespread uptake and investment.

They can improve diagnostic precision in GP consultation, and increase patient education,

as well as are cost effective, and importantly, reduce antibiotic prescribing. We believe that there should be an integrated approach between providers and consumers to effectively prevent antimicrobial resistance. Alere is committed to engaging with all key stakeholders of the antimicrobial resistance (AMR) programme to explore the effective use of appropriate diagnostic methods pertaining to antimicrobial resistance, monitoring and hence prevent the rampant misuse of antibiotics.

• Alere has a unique and wide range of rapid toxicology testing solutions for drug and alcohol testing.

We are collaborating with state governments in supporting their resolve to have a drug-free state.

With the recent announcement of the launch of an integrated manufacturing facility in India, please enumerate the key diseases identified by Alere in India that demand extensive early screening and better disease detection tools?

As you are aware, we have invested in a state-of-the-art manufacturing facility for rapid tests. Alere believes in Prime Minister Narendra Modi’s vision of “Make in India,” and is committed to improving access to affordable rapid diagnostics in India and throughout the

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Preventive Care

Alere Inc.

Asia Pacific region through this new world-class manufacturing facility. The Manesar facility will initially produce more than 150 million rapid diagnostic tests per year and will have the capacity to expand to 300 million tests over time.

Globally, Alere manufactures more than 1.5 billion tests annually and is deeply committed to working with governments, non-governmental organisations and other partners to make the company’s rapid tests affordable and accessible for those who need them.

In particular, the malaria tests manufactured in Manesar will help support the Government goal of eradicating this deadly disease in India by 2030.

How are Alere products different from other products in the Indian market? Please provide details.

• Alere is committed to delivering high-quality products and services that patients and providers can rely on for consistently accurate and actionable information. We deploy unique innovative technologies that not only transform diagnostic products, but also expand into new platforms and solutions with proven health and economic outcomes. Alere’s products give providers, physicians and patients access to the right information at the right time.

• In India, Alere Medical is the market leader in point-of-care tests and is also one of the fastest growing diagnostic companies having a national footprint. We are the market leader in rapid diagnostic tests for dengue and malaria. We have a comprehensive portfolio spanning the HIV continuum of care. Our cardiometabolic products and services provide timely cardiovascular and metabolic information used in a wide variety of settings, including hospital urgent care, laboratory, doctor’s office, or at home. Alere has a unique &

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Alere Inc - Key Takeaways • Offers products that accelerate decision-making for the most infectious disease, cardiometabolic disease and toxicology.

• Has diagnostic tests & monitoring devices that provide results for over 75 types of infectious diseases.

• Makes critical test results available immediately.

• Supplying Pima CD4 devices to NACO to enable affordable testing in remote areas.

• Committed to engaging with all key stakeholders of the AMR programme to explore the effective use of appropriate diagnostic methods.

• Collaborating with state governments in supporting their resolve to have a drug-free state.

• Manesar facility to initially produce more than 150 million rapid diagnostic tests per year & will have the capacity to expand to 300 million test over time. wide range of toxicology testing solutions for drug and alcohol testing. We are collaborating with state governments in supporting their resolve to have a drug-free state. Alere works very closely with various state governments, government organisations and institutions like NACO and National Aids Research Institute (NARI). We also work with non-government organisations, such as the Clinton Foundation, and support them in their initiatives.

What kind of expertise and research & development (R&D) is involved in the entire science behind the point-of-care diagnostic products developed at Alere’s manufacturing units?

We believe that fundamental changes to the way healthcare is practiced are inevitable, and we aim to successfully drive those changes well into the future.

Our R&D efforts have helped deploy unique technologies that innovate transformative diagnostic products with proven clinical and economic outcomes.

Some examples of the scope of our innovation include: The Alere i is an isothermal molecular

technology platform that combines the performance of traditional PCR-based molecular testing with the speed and convenience of rapid diagnostic testing.

In 2015, Alere launched the first and only CLIA-waived molecular test to detect and differentiate influenza A and B virus in less than 15 minutes.

CLIA-waiver allows for broad use by healthcare providers, ranging from hospitals and physician offices to clinics and other healthcare settings.

The epoc® Blood Analysis system is the first and only point-of-care solution for testing blood gases, electrolytes and metabolites.

Alere offers high-quality and reliable HIV screening and monitoring tests, such as Alere q HIV-1/2 Detect, which provides the next-generation virological HIV-1 and HIV-2 results for both infants and adults at the point of care within 50 minutes.

A range of connectivity solutions that enable rapid point-of-care and inhome diagnostics to transmit data in real-time to a single integrated Alere platform – all managed centrally by our CloudCare environment. The integration of these and existing technologies will drive greater quality, accessibility and effectiveness in healthcare.

Preventive Care

National Heart Institute

National Heart Institute: Taking Preventive, Promotive & Primary Secondary Healthcare to Masses National Heart Institute has been strengthening preventive care through various mediums ranging from health awareness sessions to regular checks at all levels of the society. It believes in reaching out to the rural masses to ensure increased public awareness on health, shares Dr OP Yadava, CEO & Chief Cardiac Surgeon, National Heart Institute in an exclusive interview with Elets News Network (ENN) On the recent 35th foundation ceremony, the National Heart Institute released some of the major eye-opening data related to heart diseases. What major shifts have you witnessed in the released data?

We have noticed that there is 9.74 per cent increase of female patients in the last 4 years in the National Heart Institute. Further, 28 per cent of patients are less than 40 years of age. This thereby clearly shows that lifestyle disorders are definitely on the rise and that women, though less prone to develop coronary artery diseases till menopause, are by no means totally immune and lifestyle disorders do afflict women in significant numbers at a young age too.

Over the last 35 years, what have been the major achievements and areas of improvement of the National Heart Institute?

The National Heart Institute has grown with the ethos of sustainable and community-centric development.

It subscribes to the model of earning from a small section of paying patients and using those profits for the benefit of the underprivileged and underserved.

Certain major achievements of the National Heart Institute have been: • School Health Programme • Rheumatic Fever Prevention

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Programme of 3 weekly injectable penicillin prophylaxis for the prevention of rheumatic heart disease, which has now been adopted internationally • The National Heart Institute is the collaborative centre for preventive cardiology of the World Health Organization (WHO) for Southeast Asia and is also involved in the training of nurses and paramedical staff for the Southeast Asian countries on the behalf of WHO • Free pacemaker bank • ‘Gift of Life’ programme in collaboration with Rotary International where children are offered free open heart surgeries • The National Heart Institute has a

widespread outreach programme, where heart camps are held in remote areas of the country • Setting of a telemedicine Programme between the remote areas of Uttarakhand and National Heart Institute is another feather in our cap • A number of other socially relevant programmes like Vyadhi Nidhi Programme of Uttarakhand Government, Winning Heart Programme and collaboration with Sameer Malik Heart Care Foundation Fund a key project of the Heart Care Foundation of India for treating girls and young women suffering from rheumatic heart diseases.

Specific areas that we want to focus on are taking the tertiary care services to the doorstep of the masses. The corporate hospitals are targeting tier-I and tier-II cities for profit margins, but the National Heart Institute is trying to reach out to the rural belt and take the services to the very doorstep of the masses with the aim of serving the masses. Additionally, the focus would

Key Takeaways • 9.74% increase of female patients in the last 4 years • 28% patients are less than 40 years of age

National Heart Institute

be on health promotion, education and sensitisation of the masses towards health and to bring about a change in the outlook and the mindset of the general public towards health.

How is the National Heart Institute planning to spread awareness about the increased number of cardiac cases?

Please provide details.

Health awareness and education of the patients and masses is the forte of All India Heart Foundation (AIHF). It has released a number of booklets and documentary films for the education of the masses. As the clinical research and medical care delivery wing of the AIHF, the National Heart Institute holds regular camps, where preventive screening of blood pressure, blood sugar and other common ailments is done. Besides these, regular lectures are conducted, exhibitions are put up and health films are shown.

Our volunteers also go out to the villages and speak to the small group of people in the language they understand to make the discussion meaningful. Lectures are also held in captive groups like schools and intercolleges. In fact, in Delhi, the National Heart Institute has started a school health programme, which would be covering 100 schools in Delhi in a year.

As a part of this initiative, students of class IX to XII would be educated by the experts on the prevention of heart disease from the very onset.

What are the future plans of the National Heart Institute in terms of affordable quality care in the cardiology segment?

The National Heart Institute is setting up a cardiac care unit in collaboration of the Government of Uttarakhand in Base Hospital, Almora with the aim of reaching out to masses. On the personal level, I have set up Uttarayana Hospital in a remote village of Almora district with the aim of taking preventive, promotive, and primary and secondary

Preventive Care

National Heart Institute – Preventive Care Measures • Holds regular camps to conduct preventive screening of blood pressure, blood sugar, etc.

• Conducts regular lectures (rural areas, schools & inter-colleges), exhibitions, health education camps & health check camps • Regularly Screens health films • Aims to start satellite centres in remote areas & link them with telemedicine programme • Has collaborated with the Government of Uttarakhand in Base Hospital, Almora • Striving to make healthcare affordable using indigenous products healthcare to people.

The National Heart Institute aims to start satellite centres in remote areas and link them with its telemedicine programme where the focus would be on developing the right attitude to health by holding regular sensitistion and health education camps, and where besides health checks, health education would be the main focus.

To make treatment more affordable, use of indigenous products, new techniques in recycling and off-pump techniques are being developed and introduced.

What kind of policy-level changes are required in the Indian healthcare ecosystem to achieve the entire vision of ‘Universal Healthcare’?

To achieve universal healthcare, all the stakeholders need to participate equally. However, participation of the public and, more importantly, medical professionals in this effort has been inadequate. The medical fraternity has to take responsibility and each one of us need to spend time in our clinics for health education. Both patient and their accompanying relatives should be sensitised regarding the health.

Also, we need to incorporate our traditional systems of medicine and look at a holistic healthcare model, which is most likely to succeed as these systems have greater acceptability in the public, certainly much more than

allopathy and some of those modalities of treatment, which may not be as well scientifically validated, but originated from wisdom of generations, are highly effective and seem to work for a particular set of population in that geographical ecosystem. So these local micro-health systems should be encouraged and given due importance and if need be, scientific studies should be carried out with due rigour to validate them.

Just as the environment has microclimate, even health has microecosystems, which may vary every 50 kilometres. This fact has been corroborated by the relatively new field of pharmacogenomics. So instead of developing national and international programmes, we need to now visit the small ecosystems and customise the needs of people and match them to the locally available treatment modalities.

The physical model of healthcare delivery as postulated by Descartes has failed miserably all over the world and it needs to be complimented with other models, including but not limited to Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH). Universal healthcare is a total myth, and the only way we can ever contemplate getting close to it is by preventing illness and promoting health. Additionally, insurance models should be modified so that health promoting activities can become reimbursable.

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Preventive Care

Chest Research Foundation

Chest Research Foundation: Severity of Respiratory Diseases More than a Headache

In an exclusive interview with Kusum Kumari of Elets News Network (ENN), Dr Sundeep Salvi, Director, Chest Research Foundation shares eye-opening data & statistics related to the growing menace of respiratory diseases amongst the Indian populations. He underlines the need to reform medical education and medical practices to include lung or respiratory related health challenges growing with rapid construction and infrastructural challenges in an emerging country like India What are the main objectives of the Chest Research Foundation? Please provide details.

The Chest Research Foundation was started in 2002, with the sole intention of achieving two objectives.

Firstly, we need to generate knowledge in lung diseases, which is one area lagging behind in comparison to other healthcare segments in India.

Although India is witnessing a huge problem of

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respiratory diseases, there is no research taking place. Due to our massive dependence on imported knowledge, which may not be necessarily applicable in our country, lung diseases are witnessing lack of appropriate treatment.

The Chest Research Foundation believes that we need to generate contextbased knowledge for India, which is different from other countries in terms of risk factors, nutrition, lifestyle, etc. There is a need to understand respiratory diseases locally.

Secondly, there is no need of generating knowledge if it fails to reach the masses.

In brief, the Chest Research Foundation believes in imparting knowledge to healthcare providers and common people. The two founding pillars of our foundation are ‘generation of knowledge’ and ‘dissemination of knowledge’. The overall objective of setting up the Chest Research Foundation was to relieve the suffering of people through research and education.

Over the years, we have conducted many researches. Last year, we got ‘Best Respiratory Team in South Asia’ award from the British Medical Journal (BMJ).

Currently, we plan to start a certificate course on asthma for training the trainers. The quality of care that a doctor offers in practice for both asthma and chronic obstructive pulmonary disease (COPD) is qualitatively poor.

The medical practitioners are not offering the best treatment that is currently available due to various reasons. More than smoking alcohol, lifestyle diseases, etc., respiratory diseases are one of the biggest causes of suffering and death in India, more than smoking. We

Chest Research Foundation

Preventive Care

conduct regular workshops for both the trained and untrained medical practitioners.

Have you been able to make any impact at the national policymaking level as India now has around 13 most polluted cities in the world?

A committee with Dr K Srinath Reddy as the chairperson was established by the Ministry of Health & Family Welfare, Government of India to look into the issues of air pollution and the effects on health in India. I was part of the advisory board formed.

In 2015, we came up with a document, including suggestions for policy change, which is just being submitted to the Government of India.

As such, there is another meeting that is going to take place. Following this meeting, all changes will start getting implemented in policies. However, such policy-level changes are from the air pollution perspective. From the respiratory disease perspective, POSEIDON Study is one study we hope will bring policy-level changes.

Overall, POSEIDON Study is perhaps one of the biggest studies ever done. It included a simple questionnaire that aimed at understanding real life situations.

Despite the fact that 70 per cent of the healthcare is private practice and only 20 to 30 per cent is public practice driven, most of the healthrelated information is largely available from the government sector and no information is available from the private sector. Therefore, we wanted to know the larger picture.

The primary reason behind conducting POSEIDON Study was to determine the key reasons behind patient visits across India. Once we have the answers, we will be able to determine the common diseases afflicting the Indian population, and then we will be able to bring infrastructural changes to handle such problems. Additionally, our

Chest Research Foundation – POSEIDON Study • National average - 50% of total number of patients visit doctors for respiratory problems • Delhi average - 54% of patients visit doctors for respiratory problems • Total registered doctors - 1.5 million • Daily consultations - 25 to 30 patients a day – 35 million patients visit doctors every day (excluding patients who don’t visit doctors despite being ill) • 30% patients presented with cough • Indians have the lowest lung function values • COPD is the second most common reason for deaths in India medical education, both for MBBS and non-MBBS, is largely driven by an age-old curriculum. A significant part of the curriculum is not relevant and contemporary. The curriculum should be at par with the world-level education. There is a need to invest more on research and development (R&D). Once we know the most common ailments afflicting the Indian population the most, we will be able to prioritise the investment money.

What methodology did you adopt to derive conclusions?

In order to determine the right findings, we have looked at all the

factors of the disease spectrum that a doctor sees. Overall, we started with 13,250 doctors from 880 cities and towns of the country. We have tried including doctors from all the states and union territories. We got data for around 205,000 patients. Looking at the large number of doctors and patients involved, the POSEIDON Study has undoubtedly created a huge database.

We defined an urban city with a population of more than 1 million, which is the standard definition.

During the study, we found that there were distinctive differences between those cities with 1 million population

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Chest Research Foundation

and those with less than 1 million population. For example, in Delhi, hypertension is the most common disease and the second most common disease is obstructive airway diseases, including both asthma and COPD. Personally, if you ask me what are the three most common diagnoses that the doctors make across India during the clinical practice, my answer would be hypertension, asthma and COPD. In order to derive the right data, every doctor part of the study kept a record of every patient (private clinics, government clinics, private hospitals, government hospitals and healthcare providers) on a daily basis. Around 70 to 80 per cent of doctors who participated in the study were from private medical facilities and the rest 20 to 30 per cent were from the government facilities. We randomly selected 13,250 doctors who after examining every patient spent the next 20 to 25 seconds in determining the relevant answers in the questionnaire, which was prepared on the International Classification of Diseases (ICD) standard recognised by the World Health Organization (WHO).

What were the key observations during the entire study?

Firstly, almost half of the patients visit doctors for respiratory problems. In comparison to the national average of 50 per cent, 54 per cent of patients in Delhi visit doctors for respiratory problems, starting from the pediatric age group. The pediatric age group is 65 per cent and the adult is one of the highest across the country.

The POSEIDON Study gave us a tremendous insight into the burden of respiratory diseases in India.

There are 1.5 million registered doctors in India and on an average, a doctor sees about 25 to 30 patients a day. If we add up all these numbers, 35 million patients visit the doctors every day, which does not include

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Asthma has emerged as the biggest health risk among children due to increase in air pollution

patients who fall sick but does not visit doctors. Most of the patients presented with cough (about 30 per cent), which could be because of infection or also because of chronic lung diseases due to air pollution and other environmental factors.

Unfortunately, we Indian have the lowest lung function values on the planet, according to the study published 2 years ago in Lancet Respiratory Medicine, where ling function values were compared between people from the United States (US), Southeast Asia, Europe and Atlantic. In comparison to the western populations of the same age, height and gender, we have lung function is 35 per cent. Our healthy people are worse than the Africans and Southeast Asians. This is something we need to start thinking seriously, probably because of the quality of care.

Q. What kind of impact do you expect out of the POSEIDON Study on the national policies?

The Government of India needs to accept the fact that India has got huge respiratory problems.

Respiratory diseases have been till now largely neglected. The solutions

will not come easily, as it is huge burden; therefore, we need to start undertaking aggressive measures, else the things might spiral out of control. For example, COPD is the second most common reason for deaths in India. For all these years, we believed that COPD was caused due to smoking; however, the fact to be underlined is that about 80 per cent of COPD cases occur in people who have never smoked, which is due to air pollution that they are exposed to. We need to have a national programme on respiratory diseases.

Asthma, which is a big problem in growing children, has been spreading exponentially. Unfortunately, the total number of asthma cases doubles annually.

Spirometry, which is the most important tool for checking respiratory diseases, is not available in most medical facilities.

We need to make doctors look for respiratory diseases. For increasing the use of spirometry, which requires a lot of effort, doctors need to be trained on this and increase awareness about it.

The Chest Research Foundation wants to be involved in suggesting solutions and recommendations at the individual, local and national levels.

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Preventive Care

American Megatrends India

Healthcare vs. Health Cure - Understanding Sick Care Business

Sridharan Mani, Director & CEO, American Megatrends India deliberates over the entire healthcare system that has steadily transformed into a sick care business despite increase in life expectancy & power of spending. In this extremely focused article, he highlights the fundamental flaws in the healthcare structure & how due to lack of preventive cure people are losing productive years, which is in turn impacting the entire well-being of the individual and economy of the country

“Men at some time are masters of their fates: The fault, dear Brutus, is not in our stars, But in ourselves, that we are underlings.”

—Cassius in Julius Caesar Truly inspiring lines from William Shakespeare Is healthcare playing the same hardline realities with us now? Are we becoming underlings of the healthcare system? Is our freedom for leading a healthy and happy life has taken a beating?

Let me start with a clear distinction between “Care” and “Cure” and review how we are progressing with Care aspects of health.

“Care” is serious attention or consideration applied to doing something correctly in order to avoid damage or risk.

“Cure” is to help sick person become healthy again by relieving the symptoms of a disease or condition that made the person ill.

“Healthcare” by definition should imply that necessary steps are taken to avoid damages to health and life. Is that happening?

Ask yourselves, in this real world, are we more mirrored by “Care” or “Cure” when it comes to health and life?

Be aware of the realities. Welcome to the world of health care/cure – The Sickness Business.

You, me and them believe that the current healthcare system is for care and it is so not true. Here is why?

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American Megatrends India

T

oday’s healthcare system is indirectly promoting people to be sick than be healthy. Though “Care” is now much fashionably used among the healthcare stakeholders, “Cure” continues to be underlying aspect of the system. Therefore, there is a need to reflect upon the reasons behind the entire much debated and controversial “Sick Care Business” to empower patients to become the real decision-makers in the entire process.

In order to enhance the common understanding on the differences between “Care” and “Cure”, we need to know the difference between the two concepts. On the one hand, cure is always an aftermath attempt to recover to the normal state after an event caused by ignorance and carelessness. On the other hand, “Care” is all about undertaking adequate steps to prevent the occurrence of diseases by being cautious and aware.

A critical comparison of disabilityadjusted life year (DALY), which measures the overall disease burden and productive years of life lost due to the diseases burden, data of 2000 and 2012 highlights some of the eyeopening facts.

• World population has increased by 16.4% • Health spending has increased by 145%

Year

Population (In Billion)

2000 6.08 2012 7.08 (16.4% )

Life Expectancy at Birth (In Years)

Total Global Expenditure for Health (In Trillion USD)

Years of Life GDP Per Lost due to Capita (in Disability USD) (DALYs) (In Million)

66.4 70.5 (6.17% )

2.96 7.25 (145% )

1,382.80 2,747.92 (106.8% )

Preventive Care

Estimated Loss due to DALYs based on Value of Statistical Life (Study by Harvard)

$5,448.7 $10,498.50 USD 22.8 trillion in 2010 USD 43.4 trillion by 2030

Comparison of DALY data of 2000 and 2012 reveal eye-opening facts

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• Life expectancy has gone up by 6.17% • Years of precious life lost due to disability have also doubled – 107% • Productivity/income loss due to disability is significant and estimated to be 43.4 trillion by 2030.

Disability Adjusted LifeShall Yearwe conclude the following based on the above facts?

• Quality of life is suffering: Life

expectancy has gone up by 4.1 years but years lost in disability have doubled.

• If the spending has increased by 145%, why DALYs is not coming down and life expectancy has meagerly improved by 6.17%?

• Where the spending is happening and why it is not effective in reducing DALYs? • Is today’s healthcare system fundamentally flawed?

Disability Adjusted Life Year (DALY)

Understanding the concept of DALY

Copyright © 2015 American Megatrends Inc.

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www.ami.com

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Public Document (PUB)

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American Megatrends India

Yes, today’s healthcare system is fundamentally flawed. Here are the reasons: • Primary focus is on Cure. “Get Sick” to get attention else you are your own to stay healthy.

• It is no longer about “Care”.

Encourages getting sick to get cured.

• Healthcare revenue model is based on the level of sickness, i.e. higher the sickness, higher the revenue potential. Treatment is based on affordability.

• Level of sickness is due to leading an unhealthy lifestyle.

• Importantly, unhealthy life puts additional burden on dependent’s life.

• Biomedical waste, toxins and plastic dumping is an ongoing challenge and it does affect our environment.

• Doctors, hospitals, clinics and specialists are blamed or sued when misdiagnosis happens, as

American Megatrends India – Strengthening Preventive Care than Sick Care Business • Offering products to increase preventive care • Has designed affordable & portable lifestyle products, such as AMI VitalsFit™ & AMI B.O.L.T™, to empower patients • Enabled with technology to share health records instantaneously with quality healthcare providers • Upscaling the products through stringent research and development (R&D) • The ONLY Indian company to be win the milestone achievement award along with four others at Qualcomm Tricorder XPRIZE they have to deal with life and death situation every moment thus increasing the liability of care.

• In 2012, 93% of healthcare spending happened for “Cure” as per Frost & Sullivan Report. Very little emphasis is on “Prevention” and left to individuals to take care.

Transform from ‘Health Cure’ to ‘Healthcare’

AMI VitalsFit™ diagnose a set of 15 diseases & is portable

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Kindly remember, Care is about prevention and promoting well-being.

Prevention is always better than Cure, and it is inexpensive.

The transformation needed to take us back from Cure to Care is simple.

• IF YOU CAN PREVENT, WHY GO FOR CURE!!!

• Promote wellness, promote good health • Encourage leading life without diseases • Spend on activities, good food, products and solutions that help you to keep healthy and facilitate to keep a tab on your health • Regularly monitor

Healthcare Spending by Activity Prevention 7% Monitoring 12%

Diagnosis 17%

Treatment 64%

Healthcare spending on preventive care is comparatively lesser than other healthcare segments

vitals to keep a tab on your health.

It helps you to:  Identify the indications of silent killers like hypertension, diabetes, etc., well before time  Keep your chronic conditions in check.  Identify the right diet and lifestyle based on your health conditions  Lead a healthy and happy life.

By transforming from “Cure” to “Care” and by regularly monitoring health to ensure all health parameters in range, we can stay fit and reduce global disease.

As Peter Drucker said, “If you can’t measure it, you can’t improve it.”

Preventive Care

Cervical Cancer

Cervical Cancer: Make it Preventable via Inclusion in Immunisation Programme On the eve of 10 year of anniversary of cervical cancer prevention in India, Kusum Kumari of Elets News Network (ENN) spoke exclusively with the experts to comprehend the gravity of problem when it comes to cervical cancer. We as the voice of healthcare sector underline the importance of integrating cervical cancer screening in the national programme as implemented across many developed countries to make women health one of the priorities in the healthcare agenda, as recommended by the international bodies, such as the World Health Organization (WHO), United Nations (UN), etc.

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Cervical Cancer

D

espite cervical cancer being totally preventable, India contributes to onefourth of the occurrences of cervical cancer and one-third to the total cervical cancer death globally.

The cervical cancer vaccine has been taken up by many countries and also around 100 countries have included this vaccine in their national immunisation programme.

In the light of the above successful integration of cervical cancer screening in the national programme, India with such a high disease burden needs to also implement it in its strategy on a priority basis to take care of women health. In order to enhance awareness about cervical cancer, the goal should be to vaccinate adolescent girls, as at this age they are in school and can be easily targeted. At this particular time, girls have a high antibody system. The higher the antibody response, the better the immunity system will be.

Moreover, health is the fundamental right of women, which is realisable through collaboration with the government.

Understanding Cervical Cancer Screening The need of the hour is to generate absolute political will to include cervical cancer in the

Dr Sharda Jain, Director, Global Institute of Gynaecology

Preventive Care

Cervical Cancer – Key Recommended Measures • Vaccinate adolescent girls to enhance awareness on cervical cancer • Make healthcare the fundamental right of women • Need to create political will on including cervical cancer in the national programme • Increase focus on screening programmes countries.

Cervical cancer uniformly spread out in India.

is

Reasons - Cervical Cancer • Lack of hygiene • Multiple partners

Vaccination

Dr Gerry Wain, Director of Gynaecological Oncology, Westmead Hospital, Sydney

immunisation programme, only private sectors alone cannot solve this issue. Vaccination in itself is not enough, as around 80 per cent of younger people have human papillomavirus (HPV) infection. HPV infection has to get into the tissues before it starts making precancerous infection that eventually turns into cancer.

In comparison to breast cancer where we have found that at treatment levels things have improved dramatically, in cervical cancer because things are picked up late there is a need to focus on screening tests. In cervical cancer, survival is not under control. Out of the 200 HPVs, only 50 cause cervical cancer.

The screening programme starts at the age of 21 and finishes at the age of 65. Both the target age group and cervical cancer need to be taken into the national immunisation programme. The country needs to become serious about screening programme as done in the developed

There are two vaccines available in India that include Gardasil and Cervarix. Gardasil helps in protection against 4 types of HPV, of which HPV types 16 and 18, two high-risk HPVs that cause about 75 per cent of cervical cancers. In India, 85 per cent of cervical cancer cases are due to HPV 16 and 18. At any given time, 5 per cent women are infected by HPV type 16 and 18. Besides these 2, there are another 13 viruses. A new vaccine is coming to the Indian market in 2017 which include 9 of the 15 oncological HPVs. This has already been launched in the rest of the world.

The doctors need to spread awareness about these vaccines, especially gynecologists.

As the screening is not cheap as it costs from Rs 250 to Rs 1,100 and Rs 1,200 for high-risk groups, it needs the Government’s intervention, as every stage involves money. The women in India have the right to say no to cervical cancer.

Screening Criterion The person is examined by a gynecologist, especially vagina, by conducting the Pap smear method to detect precancerous lesions in order to allow early treatment and thus prevent these from evolving into cancerous lesions.

In Western countries, screening

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Preventive Care

Cervical Cancer

Cervical Cancer Don’t Wait & Watch, Get Screening Done Today Itself!

has been around 50 to 60 years for cervical cancer. Overall, screening has been done in a lot many ways, of which some have been more successful than others. The West screening programmes have impacted positively the high rate of cervical cancer.

Recommended Measures As such, India comes under the category of developing countries where there is no tradition of screening for cervical cancer and also has a high rate of cervical cancer in the population. It’s a complicated challenge to conduct screening in India. It’s not simple as we need support from a lot of organisations and structures. We need healthcare

Key Takeaways • Compared to breast cancer, symptoms for cervical cancer get detected quite late • Survival is not under control in cervical cancer

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Dr Anupam Sachdeva, Senior Consultant and Head, Pediatric Hematology Oncology & BMT, Sir Ganga Ram Hospital

systems and infrastructures and sufficient human resources.

After identifying the problem, we need to ensure that treatment reaches the doorsteps of people as people do not access infrastructures. The percentage of people covered is very low. During strategy planning, we need to put investment in infrastructure, treatment and motivate people to access treatment by accelerating behavioural change and social consciousness towards cervical cancer. As of now, it is so much

easier and convenient to organise screening and vaccination and cover a large number of women. The WHO recommendation is that vaccination should be given to young adolescent girls and screening for women.

Immunisation is a world-recognised activity and integrating this programme into the system is the only solution.

Now with the majority of girls in age 9 to 13 years going to school, it is much easier to target them. Such awareness programmes can also spread sexual education among young women or sensitise them about such issues.

We need to make young girls brand ambassadors of spreading awareness about cervical cancer.

If you vaccinate a young girl before sexual activity, there is essentially 100 per cent chance that there will be no cervical cancer. The chances get reduced but probability exists; therefore, we advise continuous screening. However, the need for screening programme for a vaccinated person will come down dramatically than for that of an unvaccinated person.

Eye-Q Vision Pvt Ltd

Preventive Care

Eye-Q: Disrupting Traditional Eye Care Settings via Technology & Vision Dr Ajay Sharma, Founder, Eye-Q Vision Pvt Ltd, has been establishing milestones in the field of ophthalmology by adopting the latest technologies way ahead of others, such as stitchless cataract surgery or phacoemulsification, fundus photography, etc. He has been redefining the concept of ‘eye care’ by introducing an interesting & first-of-its-kind confluence of advanced technologies & cost-effective care across tier-III & tier-IV areas to enable people to access care at doorsteps. Dr Ajay Sharma shares his experience, vision and recommendations in an exclusive interview with Kusum Kumari of Elets News Network (ENN) Please walk us through the reasons and other details behind establishing Eye-Q Hospital?

As such, I have been practicing ophthalmology since 1995, which I started from a small set-up. In 1999, I built a multi-speciality hospital, where the majority of the work was ophthalmology along with other specialities. In around 2004, we realised that we need to change, as Gurgaon (now Gurugram) started flourishing with the coming up of big chains and hospitals, such as Paras Hospitals. With the coming up of such big corporate hospitals that where empanelled with us, we knew we shall not be able to compete with them.

Therefore, we decided to do something that we know and that is ophthalmology. In 2006, along with a couple of centres we started another centre. In 2007, I met my business partner Rajat Goel, who is from one of the Indian Institute of Management (IIM). In 2007, we started Eye-Q Hospital. Way back in 1990s, Gurgaon (now Gurugram) was

just like tier-III and tier-IV cities. We thought of making social impact by providing services in far-flung places where in actuality the real need of eye care exists.

When we started, there were not many good eye practices, practitioners, technologies and devices/equipment.

People were operating 20 to 30 years old equipment. Additionally, there was no appropriate infrastructure. As such, government programmes have been running ever since 1960s with the focus on prevention of blindness, Vision 2020 programme, etc. In order to make such programmes successful, some trust needs to be built. The entire methodology of conducting camps is a conventional technique, but when the era came of implantation of lenses the concept of camp surgery cannot be done. With the development of

Eye-Q – Key Objectives • Deliver quality care • Believes in adopting medical devices offering benefits in the long run • Aims at offering comprehensive eye care services

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Eye-Q Vision Pvt Ltd

equipment, such as microscope, etc., and increased chances of infection, the concept of camp was decreasing.

With the location of the best eye care facilities in tier-I and tier-II cities, people need to travel along with family members or friends. Therefore, we thought of delivering the same quality care in small towns, where the response was really good.

We established our first centre in Rewari. Within a month, our outpatient department (OPD) reached 100 as we charged the same or less, with the only difference being the comprehensive ophthalmology services offered.

Patients not only received retina, glasses, medicines, cataract detection facilities, laser, etc., but were also offered all facilities during their waiting time, such as air-conditioned environment, water, etc. For them, such facilities were truly disruptions. Our efforts were appreciated by everyone.

What major technological interventions have been adopted at the Eye-Q Hospitals?

Please provide details.

Eye-Q – Key Takeaways • Adopter of the latest technologies • Ensuring eye care & treatment in villages & tehsils via small vision centres • Has real-time consultation facility at vision centres via cloud • Total 30% equipment from indigenous manufacturers & rest from multinational companies • Has started home visits in far-flung areas; optometrist carries a box worth Rs 18 lakh during such visits Any technology which comes to India is adopted at the Eye-Q facilities. Ever since 1996, I have been personally involved in adopting the latest technologies. In 1995, I learned one of the technologies which even the best of eye surgeons and professors of medical institutes/colleges were merely thinking of practicing, which was stitchless cataract surgery or phacoemulsification. In 1996, I started practicing phacoemulsification despite expensive equipment, particularly when most of the doctors were still in the initial stages of learning across India. For me, this particular event changed everything. When we started

Eye-Q, even then phacoemulsification was not done by 80 per cent of the doctors. We made phacoemulsification the baseline for every cataract surgery across all our centres. In this way, we set the benchmark. In retina laser, which again had very few experts and very few equipment, we started with fundus photography, fundus fluorescein angiography, green lasers, optical coherence tomography angiography (OCTA), etc. In 2003, we got laserassisted in situ keratomileusis (LASIK) quite early, when again LASIK came to India in 2000, but there were very few machines in north India when we started.

We also brought femtosecond LASIK, which is a blade-free LASIK, to make surgeries painless. We tried to adopt technologies that were costeffective and have the capability to deliver quality care to patients. For lenses, we have good lenses now.

What are the key reasons behind the lack of enough indigenous manufacturers in the field of ophthalmology?

Fundus photography

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In terms of indigenous manufacturers, other than one or two companies that are manufacturing eye care medical devices, we don’t have many manufacturers in the Indian market.

Appasamy Associates is the only company manufacturing eye care equipment. The second company is Aurolab for laser equipment.

As we always aimed to deliver quality care, we did not buy many machines as we never wanted to buy a machine that

Eye-Q Vision Pvt Ltd

cannot deliver services. Across all our centres, we have slit lamps, few lasers and indirect ophthalmoscopes, which have been manufactured by the Indian manufacturers. Around 30 per cent of our equipment is from the Indian manufacturers and the rest is from the corporates.

As such, medical devices are capital intensive and need heavy investment in research and development (R&D); therefore, we do not have many indigenous manufacturers in the fray. We need medical devices that have been created after an intensive R&D, clinical trials, etc. These companies need R&D support from the Government of India (GOI), along with private companies. The GOI needs to start from medical colleges to create an intensive campaign around medical device manufacturing.

Personally, I have tried a low-price Chakshu, which is a phacoemulsification machine developed by three IIT students. Although it was developed very properly, it could have benefitted to many ophthalmologists. However, the innovators were not able to take it to the next level due to the lack of appropriate funding for research and inappropriate production facility.

Therefore, the Government needs to focus on the innovation sector.

In intraocular lenses, Indian companies are giving strong

Preventive Care

Dr Ajay Sharma was one of the early adopters of phacoemulsification

competition to multinational companies. We lack a Food and Drug Administration (FDA) like stringent approval procedure in India. As such, ophthalmology is a huge sector, we need indigenous high-quality medical devices, else good ophthalmologists will go down and remain stagnant to top 10 per cent ophthalmologists. Since the markets have become competitive, indigenous manufacturing companies are increasing prices and multinational companies are decreasing prices.

In India, we lose around $37 billion annually because of lack of awareness regarding eye correction. What are the major socioeconomic impacts

All Eye-Q centres are equipped with advanced medical devices, such as indirect ophthalmoscopes

of eye care?

The number of ophthalmologists present in tier-III or tier-IV cities is less. Additionally, there are also fewer facilities. As a result, we have witnessed many farmers in the rural belt, who due to the lack of easy options for eye correction witness severe impacts on productivity. In order to address such challenges, We have started small vision centres in villages or tehsils, where the patient gets his eye checked by a certified optometrist and through cloud talks to the doctor there and then. If there is any problem, which cannot be solved at these centres, then the patient will be directed to go to the hospital. Minor cases, such as glasses, detection of cataract, etc., are detected using small cameras by the Indian firms like Forus and other companies. These fundus cameras enable to take the picture of patients without dilating their eyes. Once these images have been clicked, they are immediately uploaded on our software and shared with the doctors. This enables immediate scheduling of an appointment, which ensures screening at the doorstep. Other activities that we are piloting are home health visits, which cover refraction, slit lamp examination, fundus photography, etc.

We have created a box worth Rs 18 lakh that is carried by the optometrist during home visits.

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Cyber Threat

Seclore

Seclore: Enabling Effortless & Secure Collaboration Seclore has been playing a forefront role in information security. It strategically adopts a holistic view to comprehend customers’ pain points in data security to define the best approach to close the gaps. Amit Malhotra, VP, Sales India, Middle East & Africa, Seclore, shares information related to services being offered by Seclore in an exclusive interview with Elets News Network (ENN) Please walk us through your products and services. What measures have been initiated

by Seclore to address the challenges posed by increased cyber threat?

Seclore is a fully automated, secure and advanced Enterprise Digital Rights Management (EDRM) solution.

It enables organisations to control the usage of information wherever it travels or is stored. The ability to enforce and audit who can view, edit, copy, screen capture, and redistribute files, from which device, and for how long, empowers organisations to embrace external collaboration with confidence.

Two years ago, we observed a major security gap in leading organisations when they collaborated with external vendors, contractors & suppliers.

Another significant area of concern was unprotected file downloads taking place from the existing Enterprise Resource Planning (ERP) and Enterprise Content Management (ECM) systems and a lack of control over sensitive information when disseminated over emails and through Enterprise File Synchronisation and Share (EFSS) solutions.

To make it easy to automatically ‘attach’ persistent file-centric security to documents and email text, Seclore developed pre-built connectors for the existing Information Technology (IT) systems, including email, ECM,

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EFSS, Data Loss Prevention (DLP) and ERP solutions. Additionally, Seclore has developed an innovative policy federation capability so that organisations can seamlessly leverage and augment the existing access control policies already existing in other systems. The connectors and policy federation mean that Seclore enables companies to protect files faster than anyone in the market. Today, we enable effortless and secure collaboration for over 1,000 healthcare, pharma, legal, manufacturing, and Banking, Financial services and Insurance (BFSI) companies worldwide.

With the increased usage of unapproved wireless devices in the workplace network, the phenomenon of ‘Shadow IT’ has increased rapidly. In the light of the above, how is Seclore securing the data?

Bring Your Own Device (BYOD) in workplaces is a modern day reality and organisations need to have an effective policy in place to ensure confident adoption of new productivity enablers.

The same thing is now happening with the EFSS solutions; employees are using a variety of methods to share and access information that is outside the traditional ‘control’ of IT. Seclore EDRM protects files, irrespective of how they are shared (email, USB and file

sharing services) and on whatever device they are accessed from. The granular usage controls and advanced capabilities ensure that files are secure not only while they are in transit, but also while the files are being worked on, and wherever they are stored. You can even control which devices a file can be accessed from, meaning you can lock down access to files from defined IP addresses. That means you can control and ensure that sensitive information on mobile devices, personal laptops, USB drives and home computers is totally secure.

Seclore

We are living in the time when corporate espionage has emerged as a booming business and numerous cases of leak of classified information have emerged. As a key player in the information security, do you think Indian healthcare service providers comprehend the magnitude of this risk, especially when health data can play such a crucial role in the national agenda?

The Pharmaceutical Industry today spends more on Research and Development (R&D) than any other sector. Five of the top ten R&D budgets globally are spent by pharmaceutical companies.

A big aspect of their business involves external collaboration and outsourcing of operations. However, pharma companies are in a varying degree of maturity in developing a policy for data-centric security.

Hence, corporate espionage and security breaches have become commonplace occurrences, costing the pharmaceutical companies millions in lost revenue and market advantage.

We have provided consultancy to various healthcare and pharma providers, both in India & globally, to ensure the safety and security of their intellectual property (for example, product dossiers, R&D data, classified information on drug formulation, etc.), as they collaborate with external parties, such as Contract Research Organisations (CROs), Active Pharmaceutical Ingredients (API) manufacturers, laboratories, university

Seclore - Key Takeaways • Empowers organisations to forge external collaborations securely • Enables organisations to adopt data-centric security • Has developed an innovative policy federation capability to leverage existing access control policies • Has developed prebuilt connectors for the existing IT systems scientists and clinical trial companies.

This has helped organisations achieve truly comprehensive, persistent datacentric file security and governance.

We have also initiated discussions with several government agencies and healthcare bodies to start a dialogue towards a comprehensive national healthcare data-centric policy in order to ensure that the breaches are minimised. This is increasingly becoming critical in view of the huge digital push initiated by the Government across sectors.

What business and pricing models are being followed by Seclore while providing services to customers?

Seclore adopts a holistic view when it comes to pricing & services. We first spend time understanding our customers’ business, drill deep to discover critical risk factors and use cases, and work to leverage the

New Workplace-Based IT Challenges • Effective policies needed to ensure confident adoption of new productivity enablers • IT security issues arising due to the concept bring your own device (BYOD) • Increased IT risk due to a variety of methods to share and access information

Cyber Threat

existing IT systems. In order to plug every potential leakage point, we partner closely with the customer to comprehend the degree of collaboration with external vendors and suppliers before recommending the ‘best approach’ towards datacentric file security.

Depending upon the actual use case, we recommend the number of individual protector licenses, and connecter licenses with the existing IT systems to the customer.

What measures are being undertaken by Seclore to scale up its technologies and solutions? Please provide details.

By leveraging pre-built connectors and our unique policy federation, we can automatically protect more files faster than anyone, enabling organisations to rapidly close security gaps. We are consistently developing additional capabilities that also advance the security and ease of use in EDRM. Some recent examples, such as Bring Your Own Key (BYOK) capabilities, two-factor authentication to further lock down server-to-server communication, email protector auto discovery, and enhanced agentless access to protected documents.

In general, our focus on datacentric security ensures that any type of document will remain protected, wherever it travels or is stored.

Partnering closely with customers, we combine deep industry expertise and uniquely open and scalable persistent data-centric technology to seamlessly extend their security infrastructure beyond the organisation.

As a result, every day, over 6 million users across 1,000 companies in 29 countries “Seclore” their documents. They have come to rely on Seclore’s fully automated, secure, and advanced EDRM solutions to accelerate the adoption of datacentric security and close their collaboration security gaps.

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Smart

Conference Outcome 12th August 2016, New Delhi

Smart Healthcare Conclave – Celebration of Innovation & Confluence of Ideas on One Platform “Learning never exhausts the mind” ― Leonardo da Vinci

Smart Healthcare Conclave concluded successfully on 12th August 2016 with some thoughtprovoking key takeaways that will undoubtedly guide all our healthcare stakeholders in strengthening the healthcare ecosystem. The learning of the conclave will enable all of us to renew and refocus our approach towards the entire healthcare sector. Through this report, compiled with a vision, we earnestly wish to both broaden thought processes and kindle innovative ideas on healthcare.

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Smart

Conference Outcome 12th August 2016, New Delhi

Adoption of Good Policies & Technology – Talisman of Healthcare Problems

K

eeping in mind the fact that technology plays a vital role in widening the healthcare services, we are adopting world-class technologies to ensure efficient medical and healthcare service delivery across the country. Our Prime Minister Narendra Modi has expressed concern about providing healthcare services to rural and difficult areas. It was a big challenge to deliver better healthcare services to villagers at their doorstep. But we have tried to ensure this by adopting good policies and technology within the department and the situation has improved a lot at ground. Our metropolitan cities do have both private and public facilities in healthcare. There is a need to spread awareness among people and if we worry about this more than other factors then half of the healthcare problems can be solved. The really important factor is that we need to involve more number of people in healthcare. We are trying to strengthen the role of National Health Mission (NHM) in different states with adequate support of all people. It requires collective efforts from all communities, as well as the government and private industry. The suggestions and feedback coming out of vibrant sessions happening at this summit should be submitted to the Ministry of Health & Family Welfare to strengthen healthcare ecosystem.

Chief Guest: Shri Faggan Singh Kulaste, Hon’ble Minister of State, Ministry of Health & Family Welfare, Government of India

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Conference Outcome 12th August 2016, New Delhi

Technology, Preventive Care & State Support – Key to Successful Implementation of Health Measures “We need to create appropriate infrastructure, communication, and law and order to retain doctors in public sector medical facilities” Dr Jagdish Prasad Director General of Health Services (DGHS), Ministry of Health & Family Welfare, Government of India

W

e face so many problems related to communicable and non-communicable diseases (NCDs), so the Government of India has undertaken many initiatives in the e-health systems. We have done a pilot project in four districts of the country where we are mapping out the entire country as far as infrastructure and human resources is concerned to enable adequate information related to healthcare (such as competence of doctors, qualification of doctors, etc.).

This is one of the project that is going on.

In the Ministry of Health & Family Welfare, e-filing has been initiated. Even in small files we do e-signings.

Since now we are fighting with NCDs, which are totally preventable diseases, at least 70 per cent can be prevented or delayed, we are working along with the AYUSH system in six districts in the country at the moment that include Gaya (Bihar), Lakhimpur Kheri (Uttar Pradesh), Bhilwara (Rajasthan), Krishna Nagar (Andhra Pradesh), etc. In these districts, we are focusing on lifestyle diseases. We have posted about 30 Yoga teachers and 30 to 40 AYUSH teachers.

The cost of treatment of NCDs is very

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costly to patients and they are also not curative.

Now we are also asking all health secretaries of states to come up with a proposal because we want to have in every district at least one naturopathy hospital.

This will ensure adequate treatment through normal physical activities or Yoga.

The states have to now come forward as they will be providing land and we will be giving funds to open naturopathy hospitals. We are also asking corporates to come forward and work on the above project.

We are now not just focusing on infrastructure, but also on prevention.

Investment in prevention is necessary to reduce cost of treatment.

Today, I will also talk little about organ transplant as 13th August is the Organ Transplant Day. The Government of India has formed the National Organ & Tissue Transplant Organisation (NOTTO) in Safdarjung Hospital, which has five branches across India. These branches will be region-wise controlling information on organ transplant. We are now promoting both prevention and organ donation of life-saving organs.

We need to create appropriate infrastructure, communication, and law and order to retain doctors in public sector medical facilities. Doctors need appropriate environment and academic facilities to work; therefore, we need to introduce such facilities in the public healthcare facilities.

As 70 per cent of our population depends on private healthcare facilities, the Prime Minister has taken a policy decision of the National Insurance Policy, where the daily wage workers, rickshaw pullers, etc. in metros will be covered. We are covering nearly 40 crore population under this policy and every family will be given up to Rs 1, 60, 000 for treatment each year. We are trying to enlist hospitals and this policy is likely to be implemented in 2017. We are funding states to purchase essential medicines. Another initiative undertaken by the Government of India is introduction of drug pharmacies where drugs are purchased directly from manufacturers which will decrease price of cancer drugs to a large extent. We also plan to upgrade district hospitals. We have chosen 60 districts with more than 300 beds to be converted into medical colleges.

Under the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), we have already given the fund of around Rs 120 crore to each medical college to develop super-specialities.

These are few steps undertaken by the Government of India and we are initiating progressive healthcare measures to take India to another level.

Smart

Conference Outcome 12th August 2016, New Delhi

Establish Trust Models of Collaborations to Strengthen Healthcare “The strength of both public and private sectors when combined together can offer quality care to 1.2 billion people” Dr Ashok Seth Chairman of Fortis Escorts Heart Institute, New Delhi and Head, Cardiology Council of Fortis Group of Hospitals

W

hile we can talk of availability, affordability and quality, for me the major challenge is how to integrate the strength of the two verticals - both private and public healthcare sectors. We have to accept the single fact that the two are major portals of delivery of healthcare in the country. The public sector has the reach and accessibility, but, unfortunately, gets overburdened.

As a result, the public sector is not able to maintain the quality, infrastructure, high levels of technology and techniques, and the increasing cost of advanced care. On the other hand, private sector offers efficiency, expertise, high-quality infrastructure, etc. at a cost factor which becomes not very affordable to many common people.

Actually, it’s the strength of the two which when combined together that can offer quality care to 1.2 billion people.

And, yet we keep looking at each other’s deficiencies. Therefore, the public and private sectors need to sit together on the same side of the table. The Government should comprehend that we need to create an alliance between the two sectors. The

Government should see private healthcare providers as the best allies to deliver healthcare efficiently downstream & the private sector should see a great ally in the Government for enabling reach with some profitability. It’s the lack of appropriate efficiency in care that led to the rise of private healthcare models.

The saddest part is when a private healthcare provider opens a 100-bed hospital next to the public hospital. The patients have to pay a huge amount of money for accessing care at the private hospital, only because the Government is not able to deliver the same quality care.

Both the sectors could have been married together with the same infrastructure.

This is the biggest challenge in the Indian healthcare system.

Secondly, as we go down the healthcare model, quality has to be maintained even when healthcare services have to be delivered at a highly subsidised rate and in some states for free. Moreover, the entire system has to be transparent. The patients in rural areas need to have the same rights, such as quality care, outcome measures and the best healthcare services.

The policymakers have the major task in their hands for 1.2 billion people, but the measures that will transform healthcare and country cannot be populist. The populist measures may seem good, but may not have any relevance. Therefore, we need to transform such populist measures into benefits. The measures that may not look beneficial visually now will prove beneficial in future.

The opportunities in healthcare are paramount because healthcare delivery to 1.2 billion people always ensures innovations. I compliment you for holding such a great meeting today, where brains which have been thinking of the best and the most frugal ways of offering healthcare to the masses through e-technologies and various partnerships between different organisations came together. All these models are a great opportunity in achieving universal healthcare.

Healthcare delivery cannot be a philanthropy mission. It cannot be a no-win situation for some and win-win situation for others. Therefore, we need to define the advantages. The advantages will come out of partnerships between the public and private sectors, amongst the innovators, amongst the young individuals creating small hospitals for healthcare service delivery, amongst entrepreneurs, etc. The Government can also leverage benefits from such collaborations that can emerge as trust models.

In order to strengthen healthcare, all stakeholders need to be involved equally as in the round table. Such a platform is a winwin situation for the industry, Government, corporate healthcare deliverers, doctors and finally to the patients. Patients also need to be presented as a stakeholder in every decision-making process. Let’s not look at each other with suspicion. We need to have a sustainable vision for healthcare, which cannot be achieved without publicprivate partnership models.

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Smart

Conference Outcome

Voice of Leaders

12th August 2016, New Delhi

Alok Kumar Mission Director, National Health Mission Government of Uttar Pradesh Vision • With the help of IT-enabled system, supply chain management and inventory management can be taken care of Key Takeaways • IT is an important tool for private and government sector. It has made deliverance of services transparent and time bound • IT acts as an effective monitoring tool for administrators and authorities • We are implementing many projects under the PPP model to strengthen healthcare system in the state

Gyanesh Pandey Chairman & Managing Director, HSCC (India) Ltd Vision • Help hospitals to achieve healthcare anytime, anywhere • Change people’s minset towards the implementation of innovations & changes. Only when people will be implementing the changes, they will be using them Key Takeaways • Trying to undertake cost reduction initiatives by minimising the cost of important activities in hospitals

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4 ASIA’S FIRST MONTHLY MAGAZINE ON e-GOVERNANCE

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Smart

Conference Outcome

Voice of Leaders

12th August 2016, New Delhi

George Kuruvilla Chairman and Managing Director, BECIL Vision • Integration of technologies in government medical facilities to enable benefits to the last person • Study various technologies to implement the project through partnership or empanelment Key Takeaways • A centralised cloud system in the government sector is needed to have data in one place in a secure way • Big data can be fruitfully utilised for the benefit of the poorest of the people

Rajesh Gupta Head – Healthcare Solutions, Medanta The Medicity, Gurgaon Vision • Providing mobile platforms to both patients & doctors • Developing collaborative care • 3 Cs – Communication (giving right information to patients), Collaboration (between care team and patients) & Convenience Key Takeaways • Strong infrastructure & robust hospital information system (HIS) with all the required modules • All billing, supply chain, etc. are online • Trying to bring all the data centres on one platform to enable sharing of information • Running numerous business intelligence projects & analytical work, at about 90% implementation both business and clinical analytics • Conducting a pilot with DocBox to integrate its application with equipment to fetch data directly into the application - Allows maintenance of accuracy & printing of only relevant information

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Smart

Conference Outcome

Voice of Leaders

12th August 2016, New Delhi

Alok Khare VP-IT, Jaypee Hospital, Greater Noida Vision • Focus on information technology (IT) • Adoption of such a technology that can enable migration to a newer technology Key Takeaways • Hospital information system (HIS) is the main enterprise resource planning (ERP) for the hospital • Soon planning to become from 500-bed to 900bed hospital • Cloud is an inescapable medium for storage of data

Ch. Somashekar Assistant General Manager (IT), Aarogyaahri Healthcare Trust, Telangana State Government Vision • Bridge information gap • Simplify our insurance & treatment procedures • Planning pharma centres & ICUs with the help of the state government on highways Key Takeaways • Basic reason behind creating app by Telanganabased Aarogyasri Healthcare Trust was to prevent deaths of accident victims & people in emergency in remote areas • Collected geographical coordinates of 269 hospitals in the state to provide shortest distance on the map.

• Also incorporated phone numbers, speciality details, etc.

• Implemented the facility of downloading Health Card • Incorporating nearby ambulance service details

september april / 2016 ehealth.eletsonline.com

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Smart

Conference Outcome

Voice of Leaders

12th August 2016, New Delhi

Dr Ravi Gaur COO, Oncquest Laboratories Ltd, New Delhi Vision • Need to have devices more focused on prevention & monitoring • Affordable, accessible devices that can be used at the peripheral level are required Key Takeaways • We are into high-end technology testing where technologies are very expensive; therefore, inhouse systems need to be developed to validate these technologies to bring down cost • Need to have a big R&D lab to test medical devices to cut down investment & ultimately cost

Dr Shuchin Bajaj Founder Director, Cygnus Hospitals, Gurgaon Vision • ICT can enable access to super-specialists living in metropolitan cities to most underserved population • Need to focus on primary care than tertiary care to enhance preventive care & address policy gap • Future lies in real-time monitoring • Need to increase big data role in evidencebased care, particularly in public healthcare sector Key Takeaways • Started in 2011 and we have now 11 hospitals • Entire HMS runs on cloud

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Smart

Conference Outcome 12th August 2016, New Delhi

Brainstorming Sessions

L to R: Vinod Menon, CEO, Smart Genex Technologies; Jaikant Singh, Head- Partnership & State Alliance, National Skill Development Corporation; Anjan Bose, Secretary General, Healthcare Federation of India; Moderator: Dr Supten Sarbadhikari, Project Director, Centre for Health Informatics of the National Health Portal, Ministry of Health and Family Welfare, Government of India; Chief Guest: Shri Faggan Singh Kulaste, Hon’ble Minister of State, Ministry of Health & Family Welfare, Government of India; Dr Deepak Agarwal, Chairman- Computerisation & IT, AIIMS, New Delhi; Neeraj Lal, Group COO, Sunshine Global Hospitals, Gujarat; Sumit Puri, CIO, Max Healthcare, Gurgaon; N K Ramakrishnan, CIO, Sir Ganga Ram Hospital, New Delhi; Dr Rajesh Gupta, Head – Healthcare Solutions, Medanta The Medicity, Gurgaon.

Smart Hospitals for Smarter Healthcare Services

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Key Takeaways:

Achievements of Participating Hospitals:

 As far as making health smart in India is concerned, the Government of India has also undertaken many measures, such as the National eHealth Authority (NeHA) is in the process of being set up.  The National Centre for Informatics is getting registered as an autonomous society under the Ministry of Health & Family Welfare that will be acting as the Secretariat.  Being ‘smarter’ means being ‘better’, both in terms of cost, as well as outcomes.  Use of mobile phones, which is very prevalent in the country today, can be tapped as an opportunity in healthcare.  Compared to other countries, we are forced to see 10 times more patients - one & only way to really cater to our population is by becoming smarter.  Smart healthcare changes can be categorised into IT process related changes and IT infrastructure.

 Max Healthcare, Gurgaon: For efficiency, we are doing a lot of work to improve our own internal processes, the best way to reduce waiting time, cost control for materials, etc.  Max Healthcare, Gurgaon: We want to go ahead and diversify into wellness and prevention, so we have launched a big digital initiative in home care.  Medanta: We are developing mobile apps for patients for not only appointments, but also to access health reports, discharge summaries, etc., as well as share with other doctors.  Sunshine Global Hospitals, Gujarat: Named our intensive care unit (ICU) as a happy unit & creating a room called counselling room.  Sir Ganga Ram Hospital, New Delhi: One of dream projects of Sir Ganga Ram Hospital is Smart OPD - in 12 months’ time we will be one of the very few hospitals in the country where the entire OPD is completely digital & all hospital records are captured in a very structured manner and put across for evidence-based clinical practice.  AIIMS, New Delhi: Recently tied up with Hitachi through a Japanese funding agency NEDO to reduce expenditure of power consumption by 50% using a lot of smarter technologies.

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Smart

Conference Outcome

Brainstorming Sessions

12th August 2016, New Delhi

L to R: Sridharan Mani, Director & CEO, American Megatrends India (P) Ltd; Dr Shuchin Bajaj, Founder Director, Cygnus Hospitals, Gurgaon; Gunjan Kumar, CIO & Head New Initiatives, Regency Healthcare, Kanpur; Moderator: Dr D S Rana, Managing Director/Chairman, Sir Ganga Ram Hospital, New Delhi; Alok Khare, Vice President – IT, Jaypee Hospital, Noida; Nikesh Singh, Group CEO, Meenakshi Mission Hospital and Research Centre, Madurai.

ICT-Enabled Healthcare System Key Takeaways:  One solution does not fit everything! It’s always business first, then the technology comes the next. We need to understand the core competency of business, then we can always get external vendors to add on top of this.  ICT is the only way to promise healthcare to the population.  We can use very good and high-end technology as and when we require it, but the problem is that the healthcare stakeholders must be willing to adopt these technologies and have enough human resources to implement those technologies.  We need to know the switching cost & hidden cost before collaborating with an IT vendor.  There should be a decent level of redundancy built in to ensure that whatever are being committed to the clinicians & internal service providers are predictable, reliable and consistent.  We know that technology can bring a lot of improvement in economy, setting process and healthcare/cure; however, it can become an expensive affair, especially to have enterprise solution for bigger hospitals, and when there are no standard processes.  The IT is a good differentiator between good and normal organisations.

Achievements of Participating Hospitals:  Cygnus Hospitals, Gurgaon: Started in 2011 and we have now 11 hospitals. Entire HMS runs on cloud.  Regency Healthcare: By 2018 end, we will have seven hospitals up and running.  Regency Healthcare: We started working on a truly medical-grade infrastructure, which was initially considered a passive investment.  Jaypee Hospital, Noida: For selecting IT vendors, we identified four to five parameters, such as whether they are using the latest technologies, open sources or proprietary services, whether they have really healthcare domain knowledge or not and last important point was whether this will address mobile technology or not.

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Smart

Conference Outcome 12th August 2016, New Delhi

Brainstorming Sessions

L to R: Dr Rajiv Kumar Jain, Additional Chief Medical Director, MoHFW, Indian Railways; Dr Ravi Gaur, COO, Oncquest Laboratories Ltd, New Delhi; Moderator: Dr Jitendar Sharma, Director-WHO Collaborating Center for Priority Medical devices & Health Technology Policy, NHSRC, MoHFW, Government of India; Rajiv Nath, Forum Coordinator, Association of Indian Medical Device Industry

Medical Devices Sector: The Road Ahead

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Components & Landmark Achievements:

Other Key Takeaways:

 Quality – For the first time in the history of medical devices, the industry came forward and told that we will make voluntary standards for good manufacturing practices, which resulted in Indian Certification for Medical Devices (ICMED) (including internationally benchmarked standards, such as ISO 13485, ISO 9001 and over and above good selection criteria for machines). Such a forward-looking step was taken even before the government or any other agencies took such a measure.  Selection process of the requirement – The Government in consultation with the industry has frozen the technical specifications and an advisory has gone to all the state governments to ensure no particular standard of a particular nation is used as exclusionary criteria during procurement to give a level-playing field to all players.  Cost – Medical device manufacturing is costly because it requires certain high investment in scientific facilities that are capital intensive in nature. A great step was undertaken by the Andhra Pradesh Government by establishing Andhra Pradesh MedTech Zone (APMTZ) where the Government is setting up all capital-intensive scientific facilities, laboratories, etc. that will be leased out to the manufacturers in Vishakhapatnam. APMTZ will enable to decrease the cost of good quality products.

 Affordable quality healthcare is only possible with the access to home-grown affordable quality medical devices.  Affordability and accessibility are definitely the key, but along with that we also need to see viability.  Isolation will not deliver benefits, interdependency required in healthcare sector.  When we started the journey, India had 70% import dependency, which was not accurately estimated.  As of now medical device industry has more positives than negatives  Healthcare providers need to tap into the effectiveness of this growing strength of the medical device segment without diluting it with mechanisms that are not completely industrial in nature, but are based out of the conflict of interest mechanisms between different healthcare stakeholders  Our perception that IT has not penetrated in northeastern states needs to be changed.

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Smart

Conference Outcome

PSU Presence

12th August 2016, New Delhi

Need of the Hour – Better Utilisation & Maintenance of Healthcare Infrastructure We have been taking lot many initiatives to improve healthcare structures and are proud to have built around 150 hospitals in the country, as well as abroad. In India, states like Uttar Pradesh (UP), Himachal Pradesh, Kerala, etc., we have built and maintained hospital structures which exhibit the improvements and changes adapted by this industry. As far as efficiency in services is concerned, it has also reached to growth levels.

Whatever infrastructure is already there in our country it needs to be utilised and maintained in a better way. ICT must be utilised as an integral part for execution of any projects.

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Smart

Conference Outcome 12th August 2016, New Delhi

Linking Remotest Areas via Information Technology The total concept behind IT-enabled healthcare services is about gathering requirement, designing according to the requirement, solution delivery and maintenance of the services being provided. IT support can very easily create linkage with the remotest areas through video conferencing and telemedicine through their integration and customisation.

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PSU Presence

Smart

Conference Outcome

Industry Presence

12th August 2016, New Delhi

Introduction of Technology to Herald Smarter Healthcare Service Providers We have introduced SmartGenX, a vital monitoring system which continuously monitors the vital stats for non-critical care patients, providing a 24x7 monitoring system. This device uses Bluetooth and Wi-Fi-enabled integrated devices on smart wearable which collect data and health vitals. These vitals are later monitored by specialists and physicians. Additionally, there are wearable jackets and devices by which all vital parameters can be monitored by the central nurse station and doctors. This will enable to create a big data for better analysis & sending alerts to both patients and doctors.

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Smart

Conference Outcome 12th August 2016, New Delhi

Healthcare vs. Health Cure – Understanding Sick Care Business Current healthcare system is nothing but cure business, and it’s truly the business of dealing sickness When we have more than 100% of money being spent on healthcare, we expect disabilities to come down& more people to live healthy lives. However, we have seen the reverse as more number of people are now living with disabilities.

Despite increase in spending, the quality of care has not enhanced. Today’s healthcare system is fundamentally flawed as there is cure and no provision for cure. The healthcare revenue model is based on the level of sickness. Only 90% of spending goes on cure and only 7% on prevention.

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Industry Presence

Smart

Conference Outcome

Industry Presence

12th August 2016, New Delhi

True Primary Care Key to Holistic Care As per the tech trends in healthcare, patients must have the maximum exposure and interaction with doctors at the primary level which continues to the secondary level and then tertiary level. We provide polyclinic solutions and hospital solutions ranging from hospital information system (HIS) to clinical systems. Moreover, to create ease in healthcare services, we would soon be launching ambulatory products which are being made available for free to single clinic doctors. Amazing part is that, IT healthcare has reached to rural regions of the country. With that it can be proved that IT-enabled devices will provide the foundation for true primary care platform from where one can actually have continuity of care going up to secondary and tertiary healthcare.

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Smart

Conference Outcome 12th August 2016, New Delhi

Smarter Solutions for All With the intent to provide the industry with healthcare solutions, we sought to do it in a smarter way by fulfilling needs of not only the end users but also the caregivers, as well as the administrators. Â As required by the industry, solution providers need to innovate solutions to help healthcare industry to offer its services in an efficient way while creating ease for patients.

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Industry Presence

Smart

Conference Outcome

Industry Presence

12th August 2016, New Delhi

Medical Products Service: Providing Quality Solutions for Better Performance

De Bono Flexcom (i) Ltd: Excellent Solutions for All

september april / 2016 ehealth.eletsonline.com

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Smart

Conference Outcome 12th August 2016, New Delhi

Industry Presence

Robosoft Technologies: Ensuring Better Management of Healthcare Industry

Hindustan Syringes & Medical Devices Ltd: Offering Solutions in Remotest Corners via Established Business Network 56

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Smart

Conference Outcome

Healthcare Awards

12th August 2016, New Delhi

Awards: Applause for Innovation & Groundbreaking Healthcare Measures

Uttar Pradesh Health System Strengthening Project for Best IT Solution for Public Health

Madhya Pradesh Public Health Services Corporation Limited for Best IT Solution for Public Health

Aarogyasri Healthcare Trust, Government of Telangana for Best Emerging Healthcare App

dWise Healthcare IT Solutions Pvt. Ltd. for Best Healthcare IT Application Company

District Panchayat Sabarkantha for Best Innovation for Social Cause in Healthcare

Star Imaging & Path Lab Pvt Ltd for Best Diagnostics and Imaging Centre

Bhamashah Swasthya Bima Yojna for Fastest Growing Government Health Insurance Scheme in Rajasthan

CONGRATULATION WINNERS! Sunshine Global Hospitals, Gujarat for Best Multi-Speciality Hospital of the Year

Trivector Biomed LLP for Efforts in Providing Smart Solutions for Infertility Management, Infection Control and Critical Care

september april / 2016 ehealth.eletsonline.com

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Understanding Emotional Health

Special Feature

Sink or Swim Learn About New Psychological Challenges Spreading in Urban Spaces “Life is indeed colourful.

We can feel in the pink one day, with our bank balances comfortably in the black, and the grass seemingly no greener on the other side of the fence. Then out of the blue, something tiresome happens that makes us see red, turn ashen white, even purple with rage. Maybe controlling our varying emotions is just ‘colour management’ by another name.”

-Alex Morritt Impromptu Scribe

I

f you ask us, we will without hesitation confirm the fact that emotional health has comparatively more stressful impacts on our well-being than other diseases. And, undoubtedly when our emotional health is in bad state, even our self-esteem turns out be in equally poor condition.

Unfortunately, unlike physical illnesses, which are tangible enough to be diagnosed for appropriate care, emotional or psychological illnesses are difficult to be identified as most of the times symptoms are seen as nothing but merely as behavioural disruptions or personality disorder beyond cure.

With the coming up of newer workplace challenges & a stressful socioeconomic environment, innovators are now coming up with online solutions comprising interesting context-based modules with tips and exercises to allow users to identify whether their condition

pinpoints to an ongoing stressful phase or not. Moreover, these tools are not only becoming popular among the common masses, particularly in the urban spaces, but are also emerging as a necessary part of the clinical practice or consultation.

These tools are also proving to be a remarkable medium to remove the stigma attached with emotional illnesses or mental diseases by spreading awareness on the need to have such platforms to discuss ‘stress’ rising among people. eHEALTH Magazine as the voice of the healthcare sector strongly aims to highlight rising emotional health crisis among people who come across as happier and healthier but are silently wrestling with the negative impacts of stress. With this goal in mind, we present exclusive interviews of healthcare stakeholders providing innovative solution in this domain.

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Understanding Emotional Health

ePsyclinic.com

ePsyclinic.com: Offering Prevention via Identification of Stressors & Emotional Supportive Counselling Shipra Dawar, Founder, ePsyclinic.com shares the key workplace stressors affecting emotional health of both the genders, particularly in the light of key socioeconomic changes that have redefined the priorities and roles of both women and men in India. She emphasizes on the need to identify stressors during the preventable stage through appropriate counselling and care to ensure well-being

W

hen women were newly wedded during the 70s, 80s or maybe early 90s, the only role expected of them was to look after the family and rear up the children. The men during this period could spend their lives doing a 9 to 5 job, which earned them the pay packet needed to feed the family, as well as provide for good education.

Stress was minimal and unidirectional. The same, however, cannot be said for the world of 2016. Women today are competent careerists yet expected to be an ideal wife at home, as well as the omniscient mother. Men today are not only the bread earners, but are also expected to be the complementary partner in running the family, as well as looking after the children. Stress today is multidirectional, and much, much more in intensity.

Though stress levels might differ with the role played, one common point of stress faced by both the genders is the workplace stress. Gone are the laidback days of relaxed jobs, today’s cutthroat corporate world does not allow anyone a minute to laze off.

We have few opportunities and there are a minimum of 1000’s of us slogging to make the cut. But it is not only the competition that creates stress at the workplace. While excessive workload with unrealistic deadline makes

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organisations. The same is illustrated in the following diagram Today stress is stemming from the following key areas within the workplace:

Workload • Unmanageable and insufficient workload • Unrealistic expectations and deadlines, from both the employer and concerned employees • Technology overload

Control people feel rushed and overwhelmed, poor content and load of work further make people feel that their skills are being undermined.

Stress has been defined in different ways over the years. Originally, it was conceived of as pressure from the environment, then as strain within the person. The generally accepted definition today is one of interaction between the situation and the individual.

It is the psychological and physical state that results when the resources of the individual are not sufficient to cope with the demands and pressures of the situation. Thus, stress is more likely in some situations than others and in some individuals than others.

Stress can undermine the achievement of goals, both for individuals and for

• Lack of time and control over aspects of the job • Lack of involvement in decisionmaking • Employees’ suggestions and feedback being taken into account • Lack of influence of performance targets Work Relationships – Many jobs demand regular contact with other people at work. Poor or unsupportive relationships with colleagues and/or supervisors can be a potential source of pressure. In addition, pressure can occur if individuals feel isolated or unfairly treated. This can be a result of: • Aggressive management styles – manager always keen on finding faults • Lack of understanding and

ePsyclinic.com

leadership • Lack of support and isolation at work • Insufficient peer support • Poor relationship with peers – bullying and harassment • Other taking credit for personal achievements

Job Security • Job insecurity, i.e. lack of job permanence, fixed-term contracts, etc.

• Future job chance • Fear of skill redundancy • Financial remuneration associated with the job. While this might not be a sole factor, but it can influence the stress when coupled with other dissatisfactory aspects.

And, stress is also arising at the point of intersection between the personal and the professional: Work-Life Balance – The demands of work have the potential to spill over and affect personal and home life and so put a strain on relationships outside work, for example: • Long & unsocial hours – additional work from home hours can be detrimental to personal and family relationships • Work interfering with home and personal life • Excessive travel times

Preventive measures for stress primarily include understanding the signs and symptoms and nipping it in the bud. Training helps to prevent stress through: • Becoming aware of the stressor and signs of stress.

• Stress usually builds up gradually.

Thus, using the awareness of the signs in interrupting the behaviour patterns helps to break the formation.

• Analysing the situation and keeping an active plan handy to minimise the stressor, as well as the stress reaction.

• Learning skills of active coping and relaxation techniques create a lifestyle that works as a buffer against stress.

• Practising the above in low-stress situations to maximise success and boost self-confidence and motivation to follow through.

Stress management, therefore, needs 3 stages: • Primary intervention or Prevention looks at the issue at source in order to prevent it from occurring.

• Secondary intervention or Management includes training for the job in aspects of health and safety, support in providing adequate management of the social and technical aspect employees’ working life. A successful

Workplace has emerged as the primary reason behind the rising stress level

Understanding Emotional Health

Key Features – Stress • After-effects of interaction between the situation & individual • Multidirectional • High Intensity • Different stress for different roles management includes both prevention and management of stress for the employees.

• Tertiary invention or Minimisation deals with the provision of counselling and employee assistance programmes and outsourced social services to assist employees who feel that need for extra support.

We at ePsyclinic face both the challenges. As India’s trusted online emotional and mental health clinic, we come across people who happen to be stressed beyond their personal coping abilities. On the other hand, 30 per cent of cases that we see are mild and preventive, emotional supportive counselling is what we offer. Through the process of identifying the stressor and a step-by-step systematic approach, we successfully offer them prevention, as well as intervention.

Times have changed, so have roles.

As much as work stress affects both the sexes, stress as a whole might be a tad more for the women, who still have to take up their roles as homemakers and caregivers after the working hours.

But gradually we are reaching up to a point of equilibrium where men are also stepping up to help their partners in the matters of the household. New age couples do not restrict themselves to gender-defined job descriptions.

Today, we have fathers who are more pro in child care than the mother, and husbands who are better chefs than the wives. We, as a generation, look out for solutions rather than focusing on the problems. This is a hopeful picture, which eventually would surely give rise to a better and newer dawn.

september / 2016 ehealth.eletsonline.com

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Understanding Emotional Health wayForward

wayForward: Managing Stress through Preventive Care

wayForward through its goal-focused approach has successfully come up with a range of modules divided into sessions of 5 to 10 minutes and including tips, interactive tools & relaxation exercises to address newer emotional health challenges being witnessed on a regular basis due to socio-economic changes in the society. wayForward aims at a long stint in the healthcare industry by offering clinically wellresearched qualitative modules to the end users, share Ritvik Singh, CEO, and Dr Navya Singh, Founder, wayForward exclusively with Elets News Network (ENN)

Ritvik Singh, CEO, wayForward What drove you to establish an online platform addressing emotional health issues being witnessed by people on a regular basis? Please provide details.

I have a finance and engineering background, and I worked in some of the most stressful work environments on Wall Street and saw people being impacted by stress. Lot of people feel burnt out because of high stress and their performance level drops, and they find it hard to live regular life. I got more interested in the application of technology in emotional health field when I got an app made for a professor of psychology at University of Michigan that deals with mindfulness and burn out.

My co-founder, Dr Navya Singh, has worked in mental healthcare for over a decade, in three different continents and she was the driving force behind the company. She has worked with trauma survivors, such as Rwandan genocide survivors and female trauma survivors.

By working with such diverse patients, such as college students to psychiatric inpatients, she realised that emotional wellness is critical to peoples’ overall well-being. Together with our third co-founder, Stan Miroshnikov, who is a technology expert, we started on a journey to make mental and emotional

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Ritvik Singh, CEO, and Dr Navya Singh, Founder, during the official launch of wayForward along with the Fortis Hospital representatives

healthcare available to everyone.

As a tool how is wayForward assisting people of different age groups in aging in an emotionally healthy manner. Please walk us through the different modules and how they assist in identifying depressive symptoms and addressing them through mental strategies?

At wayForward, our philosophy is that we should solve and prevent problems before they get out of hand and cause serious illnesses, or worse outcomes for individuals, families and society.

The modules are focused on solving problems, such as relationship-related

issues, or work-related problems, such as work-life balance, conflict at work, or performance anxiety like public speaking anxiety or exam anxiety.

The modules are divided into small sessions of 5 to 10 minutes, which contain video-based tips and knowledge, interactive tools and relaxation exercises. In addition to our self-use programme, we can connect users with an expert trained as a counsellor or therapist as their personal coach.

What technical measures have been undertaken by wayForward to ensure data and patient privacy during the entire assessment?

wayForward

The wayForward programme encrypts user data. Additionally, we do not require users to share their actual name. They can use a pseudonym.

We keep personal information related to payment separate from app-based personal information.

Additionally, our text chat makes it easier to connect with our expert coaches without anyone knowing. So it maintains user privacy.

In order to increase focus on ‘emotional health’ in India, could you please throw light on the business strategies and collaborations that are in the pipeline?

We have officially partnered with Fortis Healthcare across India, and are in discussions with a number of other organisations. Raising awareness about mental and emotional health is one of our main areas of focus, as we are a mission-driven company. We are reaching out to a number of notfor-profit and for-profit organisations to raise awareness regarding such problems.

Dr Navya Singh, Founder How will you define ‘Emotional Health’ in a universal context?

For you, what are the minimum requirements to consider a person emotionally healthy?

Emotional health is the health of your mind, just as physical health is the health of your body. For a person to be emotionally healthy, they have to be able to functional optimally, maintain healthy relationships in their personal and professional lives, and be able to perform well at work or studies. For example, you might have a job and a family, yet if you wake up each morning not wanting to face the day, there’s obviously something not at all right with your emotional health.

On the flip side, you could have an extremely time-consuming work life and plenty of other personal responsibilities,

What are the key challenges in the field of emotional health in a country like India?

Like I mentioned in the last question, awareness is a big barrier. Stigma is another major barrier, as society accepts seeking help and care for physical health conditions like diabetes, but somehow mental health is seen as a taboo.

wayForward modules maintain patient privacy along with strategic mental exercises

wayForward – Key Takeaways • Using technology as a platform to address emotional health • Aims at solving & preventing problems before they transform into serious illnesses • Has modules focused on solving problems ranging from relationship-related issues to exam anxiety • Maintains data & patient privacy • Reaching out to not-for-profit & for-profit organisations to raise awareness • Plans to launch a women-focused programme soon

Understanding Emotional Health

but if you are still able to look at the positive side of life and find pleasure in everyday living, your emotional health is likely to be better than most.

Overall, an emotionally healthy person has a good quality of life and is able to overcome problems of everyday life. Stress is a part of life, but being able to manage stress properly is essential for emotional health. We believe in preventive care, and would like to tackle issues before they get worse.

What kind of modules are available for population that remains neglected when it comes to ‘emotional health’, such as pregnant women, adolescents, elderly people, etc.

We currently have modules for relationship problems, such as problems with husband/wife, children, friends, parents, colleagues, etc. Then we have a section for work-related pressures, such as work-life balance, conflict at work or work performance.

Research data suggests that anxiety starts during adolescence for most people and if left unaddressed, can lead to other problems, such as depression and substance use. We plan to launch a women-focused programme soon.

How different are the modules for workplace challenges and modules for emotional health issues witnessed in other socioeconomic spaces?

Workplace challenges differ significantly from other social spaces.

And, our modules are designed to address these differences. Hence, they are goal-focused, so people can select the problem they are struggling with and what outcomes they want to address, such as, performing better at interviews, which would be more workplace related, to dealing better with relationship with one’s spouse, which would be more personal. Also, we have a section for exam anxiety, which is available to students.

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Genomics

Positive Bioscience

Positive Bioscience: Leveraging Genetic Information to Provide Personalised Health Solution By giving preference to quality over quantity, Positive Bioscience has been playing a pioneering role in guiding treatment plans in an effective manner by applying both deep data expertise and research to genomic testing anlyses to offer personalised health solutions. With especially hand-picked experts and stringent quality control measures, Positive Bioscience aims to empower patients on preventive care and expand in the cancer genomics space to sequence 2 in every 10 cancer patients in the next 3 years in India, shares Samarth Jain, Founder & CEO, Positive Bioscience in an exclusive interview with Elets News Network (ENN) How is Positive Bioscience ensuring ‘personalised health management’ amongst the patients? Please provide details Positive Bioscience offers interpretational analysis of deoxyribonucleic acid (DNA) based diagnostic tests for cancer patients and healthy individuals. We offer two tests that include Personal Genomics, which is a test for healthy individuals, and Personal Genomics tests like Positive Protect can detect the risk of diseases before it manifests. Most diseases have a genetic component. Positive Protect tests help to decode these genetic components to predict disease risks even before the diseases manifest themselves. The other test is Cancer Genomics, which helps to find out which treatment option is best to treat your cancer, personalise the treatment plan to improve treatment outcome and reduce treatment costs. Our genetic tests provide insights into the genetic basis

for health, informing the individuals about their risk for diseases, responses to drugs and their lifestyle habits. By combining this genetic information with health history and appropriate genetic counselling, we then provide actionable steps for a healthier life.

In what ways is Positive Bioscience empowering doctors in addressing the challenges of their patients and in the medical field?

The common man seldom understands the role his/her family health history can play in his/her own life. Many people are also unaware of how genes form the basis of most of the diseases that we suffer from. Through our personal genomic tests, we wish to empower the masses about the matters of their own health. We want to educate them about the power of prevention and how a simple genetic test can inform them about their disease risk even before the

Genetic Tests – Key Takeaways • Provide insights into the genetic basis for health (e.g. risk for diseases, responses to drugs and lifestyle habits) • Enables to undertake actionable steps by combining genetic information, health history & genetic counselling • Guide a treatment plan in an effective manner

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diseases have a chance to develop. This will not only keep them updated with their health, but also cut down costs that often come with a surprise diagnosis, as well as the fear about their health.

For Cancer Genomics, we provide physicians with important information through our proprietary systems

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Genomics

Positive Bioscience

that analyse genetic reports to guide the healthcare management of their patients. Cancer is a complex disease driven by several specific genetic changes. These genetic variations have the capacity to guide a treatment plan in an effective manner if known to the physician. Hence, physicians, hospitals and medical practitioners as part of their practice of precision medicine, request genetic tests and analyses.

Applying our deep data expertise and research to genomic testing analysis, we provide medical experts with the information they need to make decisions on the treatments.

What kind of research and development (R&D) facilities and experts are available at Positive Bioscience to enable continuous upgrade and enhancement?

Positive Bioscience provides a personalised health solution based on one’s genetic information. At Positive Bioscience, we give utmost importance to the quality of our tests and this sets us apart from our competition. Genomic testing has huge implications on a person’s life and well-being, and it is very important that these tests adhere to the most stringent quality control measures.

All our tests are carried out in NABL/ CAP/CLIA accredited laboratories in the United States (US), Korea and China, while few tests are also done in India. The genetic information captured through our tests is also helping us build a proprietary database to understand and follow the patterns of diseases in the Indian population.

Genomics is a niche space with a handful of experts. We have hand-picked the best talent from that available in the market who help share our vision and understand the business. Most of our employees have worked with Fortune 500 multinational companies and come with extensive experience. We have more than 40 experts from various areas of expertise, including highly qualified data scientists, bioinformaticians, computational biologists, scientific

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Positive Bioscience – Key Offerings • Personal Genomics – A test for healthy individuals to detect the risk of disease before it manifests as most diseases have genetic component • Cancer Genomics – A test for finding out the best treatment option to treat cancer officers, and marketing and sales professionals.

What are the key challenges in operating in the Indian healthcare ecosystem? Please provide details.

The healthcare scenario in India is quite complex, with management, care and services being at various stages, and for us, developing the infrastructure for serving the needs of practitioners across the country was a priority.

Currently, the healthcare model in our country is primarily focused on treatment rather than prevention.

This approach has several drawbacks like increased treatment costs, higher mortality rates, lack of effective care, etc. The awareness about genomic testing is still very poor amongst the people, as it is amongst healthcare providers, doctors and pharmaceutical companies.

The clinical genomics revolution is already popular in the western countries where about 1 in every 10 cancer patients are undergoing genetic testing to guide their treatment. In India, this number is relatively poor with only 1 in 10,000 patients taking genomic testing. We want to expand in the cancer genomics space and wish to sequence 2 in every 10 cancer patients in the next 3 years in the country.

What were the principle objectives and reasons behind establishing Positive - Academy for Training in Genomics and Clinical applications (ATGC)?

What are your future goals in terms of such training academies?

Positive ATGC is an initiative to help oncologists gain competency at using genomics in their practice. Positive ATGC workshops have been designed to enhance the education of clinical oncology professionals on the topics of cancer genomics, cancer risk assessment and application of precision medicine in clinical practice.

The initiative will be rolled out across the country in association with the Indian Cooperative Oncology Network (ICON) and Molecular Oncology Society (MOS). With the vast increase in knowledge stemming from genetics research and the development of new technologies in genomics, genetics education and training of oncologists is critical for building capacities to understand, interpret and appropriately apply such information. With the acceleration in the advancement of genetic technologies, the education and training efforts must also increase. This initiative is our contribution to enable the integration of genomics into clinical practice, so that patients in India can benefit. Positive ATGC will also conduct 6-month training programmes on genomics for doctors. The training will be certified by a leading medical university. Positive ATGC aims to reach out to over 200+ doctors by 2017.

The academy will publish periodic newsletters for updating oncologists with the latest developments in genomics technology. Positive ATGC will conduct regular workshops in Delhi, Hyderabad, Bengaluru and Mumbai. Participants of the workshop will be awarded a certificate, which will be accepted as a continuing medical education (CME). The workshops will also be available online.

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