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Unfolding Future Growth Potential
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Making India Global Wellness Hub
Transforming India’s Healthcare Landscape
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June 2017 | Volume 12 | Issue 06
18
Special feature
12
COVER STORY
Cardiology & ECG Equipment: Unfolding Future Growth Potential
14
Policymaker’s perspective
New Technology Changing Rural Landscape R Prasanna Commissioner, Health Services Government of Chhattisgarh
industry perspective 16 India Virtual Hospital: Empowering Medical Travellers Swadeep Srivastava Managing Partner India Virtual Hospital 17 Hospital Companion: A Service for Patient Convenience Dr Tarun Sahni Advisor, India Virtual Hospital and Senior Consultant, Internal and Hyperbaric Medicine, Indraprastha Apollo Hospitals-New Delhi 22 mCURA: Offering Effective Solution to Indian Health System Dr Paparao Nadakuduru Senior Consultant Physician, KIMS Hospital, Kondapur 26 Fujifilm: Offering Quality Diagnostic Solutions for Healthy India Chander Shekhar Sibal Executive Vice President Fujifilm India 28 Siemens Healthineers: Leveraging Technology to Take on Heart Diseases Sanjay David Head of CT in India on Cardiovascular CT/Coronary CT Angiography Siemens Healthineers India 34 Making End-To-End Primary Healthcare Service A Reality in India Manasije Mishra Managing Director Indian Health Organisation & Aetna India
Medical Tourism: Making India Global Wellness Hub
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product lAunch
Schiller DS20 Making Routine Check-ups Modern, Simple & Faster
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HEALTHCARE INNOVATIONS
Philips Intelli Safari: Taking Affordable Health Tech Closer to the Masses
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Special story
Three Years of Modi Government Transforming India’s Healthcare Landscape
42
industry feature
Envisioning Cardiovascular Therapeutics in Next Decade Tapan Ghose Director and Head Department of Cardiology Fortis Flt. Lt. Rajan Dhall Hospital
46
Conference Report
Care with confidence
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Editorial Realising Growth Potential of Cardiology and ECG Equipment Critical medical care for patients suffering from non-communicable diseases, like cardio-vascular diseases, is a growing concern for India. According to a reputed medical journal Lancet, over 60 per cent of the world’s heart patients will soon be found in India. However, another way to look at this huge challenge is to find ways to increase heartcare in the country. It is in this context that a huge opportunity lies ahead for cardiology and ECG manufacturers in the country. Our cover story, Cardiology and ECG Equipment -- The Unfolding Future Growth Potential, in the June issue of eHealth magazine, attempts to find out potential areas of growth for the industry, even as it revisits the challenges ahead. In the last two decades, the medical tourism and wellness sector have evolved as the leading sectors of the Indian economy with a considerable contribution to the national income, trade, investment and employment. Our special feature, Medical Tourism -- Making India Global Wellness Hub, discusses the multi-faceted contribution by the sector in detail and why the country needs to utilise one of its biggest inherent strengths to raise its share in global healthcare market. High on innovation, a rising demand and rejuvenated confidence to translate opportunities into success, the Indian pharmaceutical industry, which is among the top three in terms of volume globally, is growing in leaps and bounds. However, much of this growth will depend on Indian pharma companies’ capacity to adopt Information Technology to drive their productivity and improve efficiency. Keeping in view increased digital adoption by the pharma industry, we recently organised Pharma CIO Symposium in Mumbai in April with an aim to bring synergy to this growth process. Emerging as an ideal platform for CIOs and other industry stakeholders across organisations, the symposium helped to bring more clarity on opportunities and challenges. This latest issue of eHealth magazine carries a detailed conference report to help our readers gain useful insights from the leaders of the industry. As part of our endeavour to create a knowledge-sharing platform for the Indian healthcare industry to meet, discuss, deliberate and decide on the future roadmap for the industry, we are organising the 7th Healthcare Leaders Forum in Delhi on June 30. We look forward to seeing you there and be a part of the ongoing revolution in health space that is geared to make delivery of health services more affordable, accessible and inclusive.
Dr Ravi Gupta Editior - in - Chief Elets Technomedia Pvt. Ltd ravi.gupta@elets.in
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COVER STORY
Cardiology & ECG Unfolding Future Equipment Growth Potential Increasing incidences of non-communicable diseases like heart failure in India points towards the potential for cardiology and ECG equipment to rise in the country. Therapeutic devices like coronary stents, peripheral stents, vascular stent grafts, and artificial heart valves will be utilised in more numbers, writes Vivek Ratnakar of Elets News Network (ENN). JUNE 2017 | ehealth.eletsonline.com
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Increasing incidence of noncommunicable diseases like heart failure is a matter of great concern for India owing to the costs associated with it. This adversely impacts financial spending and puts undue strain on the economies of countries like ours. Lower economic groups which have to spend significant amount of their income on heart care will be worst affected. This points towards the potential for cardiology and ECG equipment to grow in the country. “The devices industry in expected to see a technological revolution in the coming decade in India. Equipment utilised for cardiovascular diagnostics include ECG, echocardiography machine, Holter monitor, loop recorders, ambulatory BP instrument, TMT machines, etc. An ECG is the backbone of cardiovascular diagnostics and used in cardiovascular therapeutics at a mass level in our country,” said Tapan Ghose, Director and Head, Department of Cardiology, Fortis Flt. Lt. Rajan Dhall Hospital. “In keeping with the growth of cardiac diseases, the number of cardiac catheterisation labs is expected to double in coming years,” he adds.
He also says that utilisation of implantable defibrillator implantation (ICD), cardiac resynchronisation therapy (CRT-D and P) utilisation will grow many fold in coming years in India. Therapeutic devices like coronary stents, peripheral stents, vascular stent grafts, artificial heart valves both (mechanical and bioprosthetic) valves will be utilised in more numbers. Advent of non-surgical technique of TAVR (non surgical aortic valve replacement) is a boon for the heart patients. There is an urgent need to have centres of excellence for this in our country. Structural device therapy is a growing area, according to Ghose. Sensing the growing demand for affordable cardiology equipment, the government recently put a cap on their prices. Stents are wire-like meshes that are used to remove blocks, largely in the heart. Innovation and smart technologies are essential to providing solutions that address the rising risks of cardiovascular diseases. “Sustainable development begins with promoting a safe and healthy country. We are entering a significant phase where efforts to prioritise investments in innovation and research are being initiated that can deliver better health and value for money to our patients,” says Swaminathan Jayaraman, Chairman and Managing Director, Vascular Concepts Ltd.
invasive therapy. It offers its products for the treatment of arterial diseases, which include coronary artery and peripheral vascular diseases. But not many Indian cardiology equipment manufacturers are well knows as Vascular Concepts is in the global market. Although separate data are not available for cardiology equipment, it too suffers a huge import dependency. It presents a huge challenge for the industry. The Indian medical device market is fed by MNC importers, Original Equipment Manufacturers (OEM), Indian MSMEs and a few midsized corporations who have faced brutal and unfair competition from their foreign counterparts but still managed to bravely stay afloat. India-made devices lose out to imported devices due to flawed certification and tendering norms, a skewed market place and an image perception challenge. At the current rate of 7-8 per cent rate of GDP growth and the government’s promise to allocate more funds by increasing GDP spending from 1 to 2.5 per cent in health care sector; increasing number of both government and corporate hospitals, cardiovascular equipment market is poised to see a revolutionary change in coming years.
Vascular Concepts is a Rs 150-crore Indian company which serves as a global leader in cardiovascular technology. Founded in 1998, it has its corporate headquarters and R&D facility in Bengaluru. Vascular Concepts designs, develops, manufactures and markets endovascular devices that aid less
ehealth.eletsonline.com | JUNE 2017
COVER STORY
P
ointing out heart failure as an important global health problem, the reputed medical journal Lancet in a recent study said that India will soon have nearly 60 per cent of the world’s heart patients. The study was aimed at measuring mortality in one year in patients with heart failure in India along with Africa, China, the Middle East, Southeast Asia and South America. The researchers also explored demographic, clinical, and socioeconomic variables associated with mortality.
14
POLICYMAKER’S perspective
New Technology Rural Landscape
As the country is embracing digitisation with a tremendous speed in various sectors, Chhattisgarh state’s health department is also not far behind as it is using various digital initiatives to reach the last mile connectivity in health services, says R Prasanna, Commissioner, Health Services, Government of Chhattisgarh, in conversation with Arpit Gupta of Elets News Network (ENN).
R Prasanna Commissioner, Health Services, Government of Chhattisgarh
Q
What are the various initiatives undertaken by Directorate of Health Services using Information and Communication Technologies (ICT) for improving efficiency of the public healthcare system? We have started various e-health and m-health initiatives in the State. Some of them are: Human Resource Management Information System (HRMIS): HRMIS is a tool to manage the Human Resource (HR) related tasks which are being performed in the health department. This project captures collective information of health department’s employees. Kayakalp: Kayakalp helps to promote cleanliness, hygiene and infection
JUNE 2017 | ehealth.eletsonline.com
control practices in public health care facilities. One online portal has been created for assessment and peer review of performance related to hygiene, cleanliness and sanitation. After the assessment, the awards are distributed based on the performance of the facility on the following parameters: • Hospital upkeeping • Sanitation and hygiene • Waste Management • Infection Control • Support Services • Hygiene Promotion
Rashtriya Bal Swasthya Karyakram (RBSK) The main aim of this scheme is to detect and manage the 4Ds prevalent in children of Anganwadi Centre (6 weeks to 6 years) and government aided schools (Six years to 18 years) based screening. These 4Ds are defects at birth, diseases in children, deficiency conditions and developmental delays including disabilities. Nursing Home Act : This is an online web portal for any private hospital/ maternity home/ nursing home, clinic and physiotherapy unit, medical laboratory or diagnostic services. Any new or established medical facility can register for license under nursing home act. E- Hospital System : (Implemented in three districts hospitals) E-hospital
15
system made easy access to data to generate varied records including classification based on demographic, gender, age, and so on hence, enhancing continuity of care. It helps as a support system for the hospital authorities to develop comprehensive healthcare policies. E-mahtari : This is online tracking system to track due and overdue services to be provided to the pregnant women during pregnancy, during delivery and after delivery and also to the newborn child up to five years. The aim of e-mahatari is to ensure that every woman gets complete and quality pre- and postnatal care and every child receive a full range of immunisation services.
Q
Demonetisation has opened a new scope for cashless transactions across India, how Directorate of Health Services is working to make cashless payment system across the nation? We are using the following systems for cashless transactions: Direct Benefit Transfer (DBT): With the aim of reforming government delivery system by re-engineering the existing process in welfare schemes, for simpler and faster flow of information/ funds and to ensure accurate targeting of the beneficiaries, de-duplication and reduction of fraud Direct Benefit Transfer (DBT) was started on 1st January, 2013 by the Government of India. In Chhattisgarh, DBT was piloted in two districts namely Koriya and Dhamtari in 2013. After successful piloting, it was rolled out across the State in 2014-15.
Cash incentives under various health schemes are directly transferred to the beneficiaries’ bank account. Main schemes are Janani Suraksha Yojna, Family Welfare Programme and Mitainin incentives. Salary of contractual staff working under National Health Mission is transferred through DBT directly to the employees’ salary account. In 2016-17, the department has transferred Rs. 16 crores to beneficiaries’ bank accounts through DBT. Public Financial Management System (PFMS): Public Financial Management System (PFMS) was initially started as a scheme named CPSMS of the Planning Commission in 2008-09. To overcome the weaknesses of conventional government financial management system and to introduce improved systems, the last decade has witnessed large scale reforms in the public financial management systems in India.
Q
What all ICT initiatives the Ministry is working on or planning to introduce in the near future? We are soon going to launch the following android applications: Health Emergency- Mobile App): This app provides information about various programmes and schemes of Department of Health and Family Welfare, information about Chhattisgarh’s pregnant women and child vaccination scheduler, Body Mass Index and diabetes risk calculator and other information for general public.
The overall objective of the public financial management system is to help the Directorate of Institutional Finance of the Government of Chhattisgarh to identify gaps and weaknesses in expenditure tracking for health sector
Q
mHealth is a very important component of eHealth. Tell us about medical and public health practices supported by mobile devices like mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices? Some of the mHealth apps we are using are: CGMSC-Drug Info (M-Application): This android app provides drug information to its stakeholders, doctors, pharmacists and general public. Some of the key parameters of the drugs like expiry can easily be known. It also gives information about count of the issued medicine to any particular facility/district of Chhattisgarh, drug which is mostly consumed in particular district.
ehealth.eletsonline.com | JUNE 2017
POLICYMAKER’S perspective
Changing
16
industry perspective
India Virtual Hospital: Empowering Medical Travellers
A professional organisation with doctors, healthcare professionals, patient guides on board, India Virtual Hospital team is trained to support and help patients to manage their medical and surgical care away from home, says Swadeep Srivastava, Managing Partner, India Virtual Hospital, in conversation with Elets News Network (ENN).
Swadeep Srivastava Managing Partner, India Virtual Hospital
Q
How do you see the growth of medical tourism in India?
As healthcare turns costlier in developed countries, India’s medical tourism market is expected to more than double in size from $3 billion at present to around $8 billion by 2020. The industry grew at a CAGR of 15 per cent during 2010-15. It says that cost is a major driver for nearly 80 per cent of medical tourists across the globe. The cost-consciousness factor and availability of accredited facilities have led to emergence of several global medical tourism corridors - Singapore, Thailand, India, Malaysia, Taiwan, Mexico
JUNE 2017 | ehealth.eletsonline.com
and Costa Rica. But among these corridors of health, India has the second largest number of accredited facilities (after Thailand). Bangladesh and Afghanistan dominate the Indian medical tourism market with approximately 34 per cent share. Similarly, the domestic medical travelers market – patients travelling from smaller cities to metro cities like Delhi for tertiary care treatment – is growing at a healthy pace. Our research shows that about 25% of beds are occupied in most hospitals of Delhi by domestic medical travellers. This segment offers huge potential. As the sector gets more organised with serious players like India Virtual Hospital leveraging technology and filling the numerous gaps and challenges to improve patient treatment journey, the sky is the limit for India’s medical tourism market. We are fortunate that the government is too supporting this sector with much needed reforms. Along with it the push to popularise AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) are another major attractions for international medical travellers.
Q
How is India Virtual Hospital (IVH) pegged to tap the medical tourism market of India?
The objective of IVH is to create an organised, professional and tech-oriented process of ‘decisionmaking’ by empowering patients with right and relevant information and facilitating them at every step for smooth and seamless patient care experience. IVH is a tech-enabled specialised Medical Concierge Service addressing the needs of Medical Travelers (domestic & international) looking for quality medical treatments in Indian Hospitals and Health Care Centres. A professional organisation with doctors, healthcare professionals, patient guides on board, IVH team is trained to support and help patients to manage their medical and surgical care away from home. The robust technology support plays an integral role with features like electronic medical records, IVH App etc to make the module more efficient and scalable. We have for the first time introduced a concept of ‘Patient Happiness Index’, which is calculated by adding up feedback of the patient at all the 5 levels of our support and intervention, which becomes a parameter to judge the success of our ‘care module’ along with partner hospitals and doctors and their treatment experience given to the patients. Sandeep Srivastava can be contacted at: mp@indiavirtualhospital.com
17
A Service for Patient Convenience
A professional service like Hospital Companion, which handholds the patient and his family members throughout the treatment journey in an alien city and country is the need of the hour, says Dr Tarun Sahni, Advisor, India Virtual Hospital and Senior Consultant, Internal and Hyperbaric Medicine, Indraprastha Apollo Hospitals-New Delhi, in an interview with Elets News Network (ENN).
DR Tarun Sahni
Advisor, India Virtual Hospital and Senior Consultant, Internal and Hyperbaric Medicine, Indraprastha Apollo Hospitals-New Delhi
Q
With tertiary care treatment limited to metro cities such as Delhi, what are the challenges faced by domestic and international patients? One aspect lacking in Indian healthcare system is the challenges faced due to multiple issues faced by patients and their family members during the treatment journey. Unfortunately, almost no one has acted upon to comprehensively mitigate these challenges as they are not directly related to medical services, but is a huge challenge for patients and their attendants.
Right from the time when a patient is advised for operation or procedure in a metro city, there are numerous questions that he faces, who is the right doctor, hospital, treatment, cost, early appointment coupled with queries of stay, commuting and insurance. Add to this, the whole process of admission to the hospital, attending the patient, discharge and recovery process takes a huge toll on the patient’s family members financially and mentally. You may have come across untoward incidents between hospitals and family members. Most of these are due to lack of communication and misunderstanding, which spoils the whole patient journey despite medical services being of the top quality.
Q
What are the ways to mitigate the challenges faced by patients?
According to me, a specialised service to address these hurdles is the need of the hour. An experienced professional agency / service is required who handholds the patient and his family members throughout the treatment journey in an alien city or country. They should be well versed with hospital procedures and can become an
efficient communicator between the hospital and the patients. They should act like a patient guide and help the patient in selecting the right doctor, hospital, treatment and cost. I am pleased to share that India Virtual Hospital has come up with such a model named Hospital Companion. The Hospital Companion will provide end-to-end services to patients and their family members in three stages: diagnosis stage, hospitalisation stage and recovery stage. While the patients can contact the hospital and doctors for their medical needs, they can contact the IVH Hospital Companion for all other need and support.
Q
What are the other benefits of “Hospital Companion” especially from hospital’s perspective?
A trained Hospital Companion can smoothen external hurdles for the patients with personalised attention thereby complementing the services of doctors and hospitals. This is useful in effective communication; during admission and discharge processes and other support services like insurance claim, and coordinating with multiple stakeholders on behalf of the patients. Dr Tarun Sahni can be contacted at: advisor@indiavirtualhospital.com, www.indiavirtualhospital.com
ehealth.eletsonline.com | JUNE 2017
industry perspective
Hospital Companion
18
SPECIAL FEATURE
Medical Tourism Making India Global Wellness Hub India’s low cost, skilled medical personnel and world-class hospital network serve as a driving force for medical tourism. The other advantage for India in this space includes the high degree of medical specialisation in the country, observes Elets News Network (ENN).
M
edical tourism, which is pegged at roughly 25 per cent year-on-year growth, has immense scope in India owing to availability of world-class doctors, excellent medical facilities and a bouquet of medical services that covers the whole gamut of modern medicine as well as traditional forms of medicine and yoga. “As healthcare turns costlier in developed countries, India’s medical tourism market is expected to more than double in size from $3 billion at present to around $8 billion by 2020. The industry grew at a CAGR of 15 per cent during 2010-15. Cost is a major driver for nearly 80 per cent of medical tourists across the globe,” said Swadeep Srivastava, Managing Partner, India Virtual Hospital. India’s low cost, skilled medical personnel
JUNE 2017 | ehealth.eletsonline.com
and world-class hospital network serve as a driving force for medical tourism. The other advantage for India in this space includes the high degree of medical specialisation in the country. Another trend that’s fast evolving in India, which can be called as a ‘byproduct’ of medical tourism is that many hospitals are starting their operations in African countries. While low-cost offered by the Indian healthcare sector could be one major factor making medical travellers from developed countries choose India as their destination to avail quality services, non-availability of quality healthcare in many African, South Asian and Middle Eastern countries is opening up a new opportunity for Indian healthcare providers to set up their bases in those countries.
For private healthcare providers there are opportunities for building hospitals, labs, for training medical workers in partnership with the country they want to operate in. The domestic medical travellers market – patients travelling from smaller cities to metro cities like Delhi for tertiary care treatment – is growing at a healthy pace. “Our research shows that about 25% of beds are occupied in most hospitals of Delhi by domestic medical travellers,” Srivastava said. However, there are still many issues that need to be resolved to help accelerate the growth of medical tourism. Lack of ethics and transparency is one major issue that should be resolved by the Indian authorities. Foreigners getting
19
SPECIAL FEATURE
mislead by touts should be looked into seriuously. Besides, creation of a positive healthcare experience; infrastructure issues such as transportation and law and regulatory hurdles be removed; Integrated infrastructure for facilitation and ensuring seamless movement of patients from their arrivals to hospitals to their departure also need to be addressed by the industry by taking the government on board. If we need to meet both domestic and international demand in the healthcare sector, the government and the medical fraternity need to pool together resources to build excellent hospitals and medical schools across the country. It is also necessary to build technological
prowess and a software interface for health services. Building health cities in India is also a good opportunity to attract foreign medical travellers to the country. The five pillars of clinical excellence in the healthcare sector should include service excellence, preventive healthcare, accessibility to finance and quality assurance.By implementing these five pillars, India has the potential to become a global hub for medical tourism. India maintains not only a robust accreditation system but also a large number of accredited facilities. With government policies geared towards ensuring the quality and affordability go hand-in-hand, the golden age for medical tourism in India could just be beginning.
ehealth.eletsonline.com | JUNE 2017
Industry Perspective
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industry perspective
mCURA: Offering Effective Solution to Indian Health System mCURA, a complete, scalable, and effective solution for the entire healthcare community, is a very unique way of developing health records. The solution has an excellent format, which covers all the basic aspects of a patient, says Dr Paparao Nadakuduru, Senior Consultant Physician, KIMS Hospital, Kondapur, in conversation with Elets News Network (ENN).
Dr Paparao Nadakuduru Senior Consultant Physician, KIMS Hospital, Kondapur
Q
How mCURA has helped the OPD at the hospital streamline its processes?
Improving the performance of any healthcare system needs to be relooked. Age-old conventional systems are going on in the patient care area. When you aim to improve the performance of the healthcare system, you need to institutionalise the networking. It means creating electronic health records, which includes creating the software, hardware, technical support and ensuring accessibility of the technical data.
JUNE 2017 | ehealth.eletsonline.com
When we get a database and analyse it, it helps in prioritising areas of prevention, areas of health promotions. Data helps in gearing up the system, thus improving the overall quality of work. mCURA has a very unique way of developing health records. They have an excellent format, which covers all the basic aspects of a patient. It includes all the details with a provision of attaching all the investigation reports. The pharmacy requirements are also linked to the data base of the pharmacy. It’s a very convenient single paper. mCURA solution facilitates handing of all the records to the patient through a printout.
Q
Can you shed light on how mCURA is complete, scalable, and effective solution for entire healthcare community? mCURA also provides a complete health record to the patient, laboratory, radiology and pharmacy. It has offered information on how many prescriptions are honoured at the pharmacy. We can access the information and the system can alert the patient if there are any abnormal results of their investigations.
Q
Can you share with us some figures reflecting the positive impact mCURA had on the patient care? mCURA follows a patient-centric approach. Availability of information right from the personal data, physician record, lab investigations, pharmacy and follow-up, helps the physician to check the compliance by the patient. In five-six instances, we found that the patients did not regularly take the prescribed medicine. mCURA allows us to check whether the patient is taking the drug after the prescription. Data also facilitates access to information that how many prescriptions were honoured by the pharmacy. Initially, I found that only 29 per cent of my prescriptions were honoured and as we improved the pharmacy facility, we could improve it to 85 per cent.
Q
How viable is the mCURA solution in terms of cost?
mCURA is an economically viable solution for most of the healthcare organisations in the country. At a very littile cost, the system provides very useful data.
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• Distributed PACS for multiple centers • Multi modality, Multi patient and Multi view Enterprise PACS Viewer • Integrated VNA and cloud storage Architecture • Patient centric and Time line based Work lists • Archival and publishing on CD, DVD and Blu-ray Discs • Dockable Toolbar and Filter Panels for Maximized Image View • Seamless integration with HIS, RIS and PACS • Multi view layout support extended up to 10×10 matrix • Patient Reporting utility for one stop solution
• Enterprise level CVIS and PACS • Migration of Legacy Patient Image Archives • Vendor Neutral Archive (VNA)
• Third Party integration for HL7 as well as non-HL7 systems • Device interfaces and workflow automation
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industry perspective
FUJIFILM Offering Quality Diagnostic Solutions for Healthy India
Chander Shekhar Sibal
Executive Vice President, Fujifilm India
5 2 1.
n o i l bil
With 1.25 billion people to screen and diagnose, the requirement of proper tele-radiology setup, digitisation tool and the right infrastructure is humungous in India. Fujifilm, a leader in digital imaging solutions, endeavours to provide best services in the remotest areas across the country through digitalisation of X-rays, enabling better image quality at the lowest X-ray dose, says Chander Shekhar Sibal, Executive Vice President, Fujifilm India, in an interview with Elets News Network (ENN).
JUNE 2017 | ehealth.eletsonline.com
Q
Fujifilm is known as a leader in digital imaging solutions for healthcare industry. What differentiates your solutions from your competitors? Fujifilm is a leader in digital imaging solutions with over 120,000 Computed Radiography (CR) systems installed worldwide. In India, too, we have over 12,000 CR system installed. We have approximately 50 per cent market share of the CR market. We have over 400 Digital Radiography (DR) systems installed. Being the
27
Q
Access to quality diagnostic products and solutions is a big challenge in tier-2, tier-3 cities and towns across India, what are your plans to address this critical issue? We are focusing on increasing our market share and customer satisfaction. We are planning to install systems in smaller places in tier-2 and tier-3 cities with increased focus on corporate sector, local product and radiology segment. Fujifilm India Private Limited has recently signed a contract with Pune-based KRSNAA diagnostics Pvt Ltd, a leading diagnostic player in the PPP (Private Public Partnership) sector, to install 1,000 Computer Radiography across India. Our endeavour is to provide best services in the remotest areas across the country through digitalisation of X-rays, enabling better image quality at the lowest X-ray dose. This would help improve efficiency and quality of X-ray reporting, resulting in faster and more accurate diagnosis. Our designs are compact, easy-to-operate and provide high quality outputs with minimum efforts.
Q
How do you see digital imaging solutions space evolving in India?
In this era of digitisation, the quality of workflow is getting better and the efficiency of professionals is increasing in hospitals. With the help of technological advancement, doctors are able to manage workflow
systems in a better way and are able to treat more patients. Healthcare is reaching to tier-3 cities and serving villages where various screening programmes are initiated by the government for healthy India. We have observed an emerging market trend with more doctors going for Flat Panel Digital Radiography systems and PACS. This clearly shows awareness among doctors about low-dose technologies and better image quality, coupled with efficiency or faster output to patient with clear diagnosis.
healthcare. We need to focus on hospitals to make them well equipped with better technologies. The digitisation trend will continue to be strong in future. Better quality equipment would improve image quality and reduce x-ray dose.
We are focused on digitising small clinics in small cities and villages with our Computed Radiography and Digital Radiography and connecting them with tele-radiology for faster diagnosis.
Quality Picture Archiving and Communication System (PACS) and Radiological Information System (RIS) system would improve the workflow, efficiency and quality of reporting, thus providing better and early diagnosis. India is also fighting with increasing non-communicable diseases like cancer, diabetes and cardiovascular problems. Early diagnosis is most important to treat these diseases. We have developed Full Field Digital Mammography (FFDM) with 50 micron resolution to detect breast cancer at the onset.
Q
Q
What are the key opportunities you see for Fujifilm in the Indian healthcare space?
Imaging technology is very important in India. We have 1.25 billion people to screen and diagnose, for which we require very efficient systems. As we have an acute shortage of radiologists who can report images like CT scan, MRI and X-ray, the requirement of proper tele-radiology setup, digitisation tool and the right infrastructure is humungous. I believe that we require robust systems as well as electronic medical records for better quality treatment, and going forward digitisation would help to bring a complete change in the medical technology. Through digitisation, we can now store, retrieve images and compare the graphs of patients to make the process of diagnoses better and effective. Recently, the government has also come up with a new policy with greater emphasis on preventive
Apprise us about new innovations and solutions by Fujifilm that you think have the potential to bring India closer to achieving its universal healthcare goals? Living up to our motto, which is ‘Value from Innovation’, we are committed to provide products and services that not only enhance image quality and work flow but also keep the patients’ well-being in mind by delivering least X-ray dose to patients undergoing a procedure. Fujifilm is into digitisation of X-rays. We sell Computed Radiology and Digital Radiology products which facilitate digitisation of x-ray, coupled with PACS and RIS to provide faster access to images to consultants sitting in metro cities or big hospitals. This way efficient and quality diagnostic service can be provided to patient in tier-2, tier-3 cities and villages. We have point of care dry chemistry analysers FDC – NX 500 I, which can provide instant results at doctor’s clinic within a minute.
ehealth.eletsonline.com | JUNE 2017
industry perspective
first company to bring out the FCR 101 CR system in 1983, Fujifilm is the pioneer in CR systems space. Our systems use ‘Image Intelligence’ to assure consistently high quality output. Our systems are user friendly with rugged design and fast service response, giving us an edge over the competition.
28
industry perspective
Siemens Healthineers
Leveraging Technology to Take on Heart Diseases Siemens Healthineers India, the pioneer in cardiac CT imaging in the country, offers leading non-invasive imaging technologies to diagnose coronary diseases among high risk patients. In an interview with Elets News Network (ENN), Sanjay David, Head of CT in India on Cardiovascular CT/Coronary CT Angiography, Siemens Healthineers India, talks about the accuracy of the equipment and convenience they offer to the patient.
Sanjay David
Head of CT in India on Cardiovascular CT/Coronary CT Angiography, Siemens Healthineers India
Q
Tell us about Siemens Healthineers legacy in cardiovascular CT. What are their key advantages? Siemens Healthineers India brought cardiac CT to India in the year 2000. Since then we have launched a number of products in the Somatom series of CT scanner models. We are the pioneers in cardiac CT imaging. The advantage of cardiac CT imaging
JUNE 2017 | ehealth.eletsonline.com
is that you can see the coronary arteries in a non-invasive manner. The patient is not required to be admitted in the hospital for cardiac study. Compared to the traditional methods for evaluating coronary artery disease, this system gives you a very high negative predictive value and a very high sensitivity. If the system confirms a coronary disease, you can be 99 per cent sure of it.
Q
Does it require special skills or technical knowledge to get the coronary CT angiography done on the patient? I think, you need to have the right CT scanner with the required speed and the right temporal resolution because the heart is a beating organ. The scan has to be fast enough to capture good images of the heart as it is beating. The heart vessels we
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industry perspective
see through the imaging equipment is the size of a few mm. If you see a vessel, which is fraction of a cm and it is beating at a speed of 5-7 times a second, you also need to have a good spatial resolution to see the object of this optic size. Once the object is imaged a lot of things are automated through the CT scanner. A lot of manual interventions that were required 15 years ago are not required any more. There is a lot of artificial intelligence embedded in our CT scanners, which allows the doctors to have the results of the same quality every time scanning is done, irrespective of who is operating the machine.
Q
Does Siemens Healthineers also provide some kind of training to the doctors?
Once the images are delivered, the final decision whether the patient has a coronory disease or not is arrived at after the doctor evaluates the images. This is a very special expertise which cannot be tought to the application specialist team. The specialist team trains the doctors on how to use the machine to get the images. We have tie-ups with several organisations like the Society of Cardiac CT USA and Escorts Hospitals India over the last four years to train the doctors over this technology.
Q
What are the cost implications for the patient as well as the hospital adopting this technology? Once the images are delivered, the final decision whether the patient has a coronory disease or not is arrived at after the doctor evaluates the images. This is a very special expertise which cannot be tought to the application specialist team. The specialist team trains the doctors on how to use the machine to get the images. We have tie-ups with several organisations like
JUNE 2017 | ehealth.eletsonline.com
the Society of Cardiac CT USA and Escorts Hospitals India over the last four years to train the doctors over this technology.
Q
Are you also looking to expand the adoption of your coronory CT technology to Tier 2 and Tier 3 cities? We have a range of cardiac CT scanners so that it can be affordable for hospitals in Tier 2 cities as well. Some of the big chain hospitals and major cardiac hospitals would like to have the highest level of technology and systems, whereas smaller hospitals with less number of patients would go for a lesser sophisticated technology and systems.
Q
How are Siemens Healthineers CT scanners be made available to diagnose patients in small villages? A good example of this is a hospital in Pune, which has tied-up with several nearby villages so that the patient can book an appointment and get himself tested. The benefit is that the patient can go back to his routine work and also get a thoroughly checkup done. This model also helps in bringing down the cardiac diagnosis cost.
Q
How can early diagnosis of coronary disease be linked with India’s universal healthcare goals? Studies have shown that 50 per cent of deaths due to heart disease happen due to the first attack. That means the patient does not know that he has a heart problem. We believe that this technology will play a big role by identifying the disease early in high risk patients and the patient can be advised to make changes in the lifestyle.
We are the pioneers in cardiac CT imaging. The advantage of cardiac CT imaging is that you can see the coronary arteries in a non-invasive manner.
DS20
DIAGNOSTIC STATION DS20 DS20
SIMPLIFY YOUR DAILY WORK î Most vital signs and physical assessment tools in one device î Perfect tool for Atrial Fibrillation Screening: One resting
rhythm channel can be acquired just by connecting only 3 electrodes, without multiple ECG cable connections
î Large interactive touch screen and self-explanatory user
interface for maximum user-friendliness
î 12-lead ECG interpretation, spirometry and Pulse Wave
Analysis (PWA)
î Connectivity to EMR, PACS, HIS for easy data access
DS20 is a Practical and yet Sophisticated Diagnostic Station
For enquiries contact : sales@schillerindia.com | Website : www.schillerindia.com | Toll-Free No. : 1-800-2098998 Swiss H.Q.: Schiller AG, Altgasse 68, P. O. Box 1052, CH - 6341 Baar, Switzerland, Indian Corporate Office: Schiller Healthcare India Pvt Ltd., Advance House, Makwana Rd, Off. Andheri Kurla Road, Marol Naka Metro Station, Andheri (East), Mumbai - 400 059. Tel.: + 91- 9323799863, +91-22 61523333/ 29209141 | Fax: +91-22-29209142 E-mail: sales@schillerindia.com, support@schillerindia.com Factory : No. 17, Balaji Nagar, Puducherry 605010 CIN : U33110MH1997PTC111307
All registered trademarks acknowledged
32
PRODUCT LAUNCH
Schiller DS20
Making Routine Check-ups Modern, Simple & Faster
Designed for spot measurements and routine check-ups of non-critical patients, DS20 is its most comprehensive diagnostic station with unique features like resting ECG, PWA, and spirometry that enables physicians to perform tasks in five minutes with one device, which may otherwise take 20 minutes with multiple devices.
Schiller has recently announced the launch of DS20, its most comprehensive diagnostic station with unique features like resting ECG, PWA, and spirometry. It is designed for spot measurements and routine check-ups of noncritical patients. In addition to physician offices, retirement homes, hospitals and clinics, DS20 is a useful tool for routine checkups in occupational medicine.
JUNE 2017 | ehealth.eletsonline.com
DS20 enables physicians to perform tasks in five minutes with one device, which may otherwise take 20 minutes with multiple devices. It is an ideal tool for patient induction process in a hospital, as the patient’s vital parameters are quickly checked on a single platform and the data can be automatically transferred and stored to the Hospital Information System (HIS) through
HL7 protocols. One of its important features, the advanced Pulse Wave Analysis (PWA), helps in easier understanding of hemodynamic and the process of arterial aging within minutes with graphical indication, which is useful in screening patients for early evidence of vascular disease and monitoring the response to the therapy given.
DS20 simplifies daily wORK
33
PRODUCT LAUNCH
• Main vital signs and physical assessment tools united in one device • Ideal for arrhythmia and atrial fibrillation screening: one resting rhythm channel for display, storage and printing with three electrodes • Large, interactive touch screen • Intuitive guidance and ease of use
Fast and easy to use DS20 immediately detects connected sensors and automatically displays the corresponding value. This fast operation allows for easy addition or removal of parameters. Thanks to its intuitive user guidance, Schiller’s DS20 is selfexplanatory and very little training is needed. The large interactive touch screen supports the highest user-friendliness.
One touch Simply touch the large, high-resolution colour display and you are in business recording, and selecting the highest quality ECGs.
• Perform • Review • Store or export wherever you want
Connected The DIAGNOSTIC STATION DS20 is a networked device. Seamless connectivity to EMR, PACS, HIS or Schiller’s SEMA3 Cardiology Information System is possible and bidirectional communication allows for easy data access, while Wi-Fi with strong security enables direct and fast transmission.
Expandable Easily add new functions and other devices or future technological developments. The DS20 is ready for the most common functions and will satisfy new requirements.
• DS20 on trolley - easy transport between rooms • DS20 on wall mount - saves space • One-time patient data entry - saves time and reduces data errors • Large display (18.5 inch) - all information at a glance, no sub-menus • Touchscreen and intuitive icons - one touch to measurement • Interface to scales - automatic weight, height and BMI measurements ehealth.eletsonline.com | JUNE 2017
34
industry perspective
Making
Primary Healthcare
Globally, technology is making healthcare affordable and accessible. In the next few decades the idea of driving to a doctor’s clinic, waiting and physically meeting the doctor will be obsolete, says Manasije Mishra, Managing Director, Indian Health Organisation & Aetna India, in an interview with Elets News Network (ENN).
Manasije Mishra Managing Director, Indian Health Organisation & Aetna India
JUNE 2017 | ehealth.eletsonline.com
35
industry perspective
Service a Reality in india Q
Why preventive healthcare is important for a country like India?
The modern sedentary lifestyle, ignorance of minor health problems and self-medication are among the reasons for increasing disease burden in India. The small amount of money spent on preventive healthcare indicates that we are more reactive rather than proactive in adopting preventive approach towards health. Lack of access to a good primary healthcare system, increasing healthcare costs and poor doctor to patient ratio are some of the other reasons for low adoption of preventive healthcare in India. To tackle these challenges, Indian Health Organisation has recently introduced vHealth by Aetna, an end-to-end primary healthcare service. At its heart is our own team of doctors, who operate from a stateof-the-art telemedicine centre. They are supported by 16,500 clinicians
in our medical partner network, which includes dentists, diagnostic centres, specialist doctors, medical centers, hospitals and pharmacies. With this ecosystem in place, we organise blood tests and medicine delivery at patients’ home, refer them to appropriate specialists for consultation in their vicinity at a discounted fee.
Q
What are your key solutions and offerings in the preventive healthcare segment?
With vHealth by Aetna, which is an integrated primary care ecosystem, we offer a wide range of solutions that cater to varied healthcare needs of an Indian family. There are various packages we offer. vHealth by Aetna: An integrated primary care ecosystem that provides unlimited teleconsultation for a family of four members and access to our discount medical partner network for a modest price of Rs 2,400 per year. By using vHealth as their first point of contact for any health concern/query, our members will
be able to get appropriate treatment, guidance and motivation to navigate through the complex healthcare system. The service is availed through voice calling by dialing our toll-free number and video consultation through our mobile app vHealth by Aetna. Freedom Membership: Our preventive package available at Rs 3,650 a year entitles a family of four members for unlimited vHealth teleconsultations, two free annual health check-ups, dental packages and discounts on day-to-day medical expenses including medicines, diagnostic tests and consultations from IHO health partner’s network. Classic Membership: While the average health expenses of an urban Indian family range between Rs 20,000 and Rs 35,000, our classic consultation membership helps people save up to 50 per cent on their health expenses. This membership, which costs Rs 5,880 per year, entitles a family of four members for unlimited teleconsultations with Swiss telemedicine trained physicians,
ehealth.eletsonline.com | JUNE 2017
36
industry perspective
10 free consultations with any doctor in top hospitals, two free annual health check-ups and discount card for savings on diagnostic tests, medicine purchases, dental and other minor treatment.
Q
How Indian Health Organisation is contributing in improving healthcare delivery in the country? Who are your important partners? Our team of doctors has completed over 5,000 consults in three months and we are delighted with the patient feedback. It makes me proud to say that our doctors at vHealth were able to provide appropriate diagnosis and treatment for 70 per cent of the cases which led to avoidance of any further medical support. Several patients commented that we have identified the root cause of their long-standing medical problems. Patients were also delighted that they were able to get the undivided attention of the doctor for over 30 minutes with the help of our handholding and follow ups. Apart from managing acute and chronic patients, we have helped diagnose cases like hemochromatosis (iron overload), gastric cancer, triple vessel disease, nephrology, parkinsonplus and more. With our focus to make quality healthcare accessible in India, we have tied up with Medgate AG, a Swiss market leader in telemedicine. They have developed the science of remote diagnosis for over 15 years. We use detailed medical and training protocols customised for India. We also use their patient management system. We recruit well-qualified and experienced doctors from reputed institutes. These doctors undergo four weeks of telemedicine training and get certified to Swiss telemedicine standards by Medgate after an
JUNE 2017 | ehealth.eletsonline.com
To tackle these challenges, Indian Health Organisation has recently introduced vHealth by Aetna, an endto-end primary healthcare service. At its heart is our own team of doctors, who operate from a state-of-the-art telemedicine centre.
extensive written and practical assessment. Our doctors have the ability to diagnose patients through scientific evidence-based protocols. If a patient suffers chronic headaches it could be due to migraine, tension, eye problems, medication, neurological problems, sleep deficiency, cervical spondylosis, brain tumour, etc. Our clinical protocols help doctors to probe in a systematic way and unravel relevant points. This information along with medical history, photographs and test reports enable us to diagnose or make referrals. Consistent follow-up with the patient throughout the journey of the disease also helps our doctors assess the response to the treatment and take corrective action if required. Recording of consultations are reviewed by our Medical Director, scored against a detailed checklist and regular feedback provided.
We also ask patients to rate the consultation as well as the overall service.
Q
How can healthcare be made more affordable for masses?
Globally, technology is making healthcare affordable and accessible. In the next few decades the idea of driving to a doctor’s clinic, waiting and physically meeting the doctor will be obsolete. Technology, including smart phones, remote sensors, connected devices, will provide access to primary care services. During the soft launch of vHealth, over 70 per cent of the consults to our telemedicine centre did not require a physical follow-up. Smart prepaid subscription plans can be effectively used to manage costs while ensuring quality care. Our classic consultation membership helps our members save about 50 per cent of their outpatient medical expenses.
Q
What is the current reach of IHO in the country? Apprise us about your focus areas and future plans.
We have our pathology and pharmacy network in 300 plus cities and specialist medical partner network in 38 cities. India needs a robust primary healthcare system, which families can use as their first point of contact for any health requirement. The system should be able to help people get the right guidance, diagnosis, and treatment. vHealth by Aetna can fulfill this need. We intend to add one million members to our current membership base of half a million. We are confident that with clinical excellence and the widespread partner network, we will be able to achieve this goal.
NatioNal SUMMit
38
Healthcare Innovations
Philips
Intelli Taking Affordable Health Tech Closer to the Masses
april 2017 | ehealth.eletsonline.com
39
Safari Equipped with advanced cutting-edge products and designed to treat patientsranging from adults to neonates in ICU, CCU, as well as general wards and nursingcare units, Philips IntelliSafari will travel to Tier 2 and Tier 3 cities of India showcasing the latest in affordable life saving technologies.
H
ealthcare technology major Philips India on Tuesday showcased its low-cost health technology solutions on wheels in Ahmedabad as part of its campaign to reach out to hospitals, nursing homes and clinics in Tier 2 and 3 Indian cities with an aim to familiarise them with the latest affordable innovations in healthcare. “Through the IntelliSafari drive, we want to assure people that advanced technological solutions need not always come at a cost. Healthcare products which are affordable, and having hightechnology features and qualitative solutions are key to increasing access to healthcare in India and thereby saving lives,” Seshadri said during the flagging off ceremnony. “As healthcare solution providers, we are committed to making that happen by relentlessly working on new technology solutions,” he added.
Equipped with advanced cutting-edge products, designed to treat patients ranging from adults to neonates in ICU, CCU, as well as general wards and nursing care units, the mobile van will travel to Rajasthan and other parts of India after covering Gujarat. The equipment on display include Intensive Care Unit, portable patient monitoring solutions, networking solutions, cardiographs (ECG machines), fetal and maternal monitors, defibrillators and AED devices, and portable ventilator and BIPAP devices made by Philips India. India has emerged as one of the crucial countries for the expansion of the Netherlands-based company, which last month launched new diagnostic equipment developed and designed in its R&D centres in India and manufactured at its facility at Chakan near Pune in Maharashtra.
Dr Naman Shastri, Cardiac Anesthetist, SAL Hospital, Ahmedabad, said, “A healthcare provider’s responsibility is to provide early and accurate diagnosis along with the best possible treatment. But the availability of latest technology at a price that can make it viable for hospitals to use them has always been a big challenge. With Philips taking such an initiative, hospitals can now focus all their energies on providing patients with the best possible healthcare services. Being committed to offer healthcare solutions to masses, it is our responsibility to provide early and accurate diagnosis along with the best possible treatment.” IntelliSafari is a programme that gives healthcare providers in non-metros the opportunity to experience Philip’s advanced expertise and technological solutions, which brings quality healthcare closer to the masses. The expert demonstrators from Philips help doctors and clinicians to validate the usability of these technologies in a ‘real’ day-to-day hospital environment. IntelliSafari was launched by Philips India in July 2012 and reached several Tier 2 and Tier 3 cities in North India in the initial phase. The goal of the programme is to bring new life saving technologies closer to the people at an affordable price.
ehealth.eletsonline.com | JUNE 2017
Healthcare Innovations
Shankar Seshadri,
Senior Director and Business Head – Patient Care and Monitoring Solutions and Ultrasound, Philips India, flagged off the specially designed mobile van IntelliSafari from the Gujarat capital on a 30-day trip, covering key cities in the state.
40
SPECIAL STORY
YEARS OF MODI GOVERNMENT
Transforming India’s Healthcare Landscape
T
he last three years have seen concrete steps that have transformed people’s lives, Prime Minister Narendra Modi tweeted on the eve of the third anniversary of his government at the Centre, summing up his government’s achievements. For the healthcare sector, the past three years saw a slew of measures being undertaken to help make healthcare more affordable with a sharp focus on empowering citizens to access quality healthcare services
JUNE 2017 | ehealth.eletsonline.com
using better mobile and internet connectivity; policy interventions to reduce cost of medicines and medical equipment; and bringing more people under the health insurance net, benefiting millions of patients across the country during the process. When a little over a year in office, the Modi government successfully lobbied to get the United Nations declare June 21 as the International Yoga Day. The mass yoga performance, led by the Prime Minister himself, attracted
the world’s attention when it set the record of most number of people participating in such an event. The event achieved two things — it reinforced India’s image as the world’s leading soft power and furthered the government’s aim to promote healthy lifestyle in a country that is grappling with the serious challenges posed by lifestyle diseases. A slew of schemes including affordable health insurance coverage and the Jan Aushadhi Yojana for retail sales of generic drugs were
41
introduced in the last two years to make healthcare more affordable. To help digitise healthcare system in order to bring more transparency, awareness and easy accessibility of quality healthcare to the masses, the government has initiated National Health Portal and digitisation of government hospital services under the ‘Digital India Mission’. Keeping up with the technological transformation impacting the delivery of services in the country, various mobile apps like ‘NHP Indradhanush’, ‘NHP Swasthya Bharat’ and ‘Mera Aspatal’ were launched by the Ministry of Health and Family Welfare. The immunisation programme, Mission Indradhanush, has been successful in reaching to crores of children, ensuring they are fully immunised. The ministry in a tweet on the day of completing three years
in office, said that there has been a 6.7 per cent increase in the coverage under the programme as compared to 1 per cent in 2014. The government has also opened 83 outlets under the Affordable Medicines and Reliable Implants for Treatment (AMRIT) programme, serving close to 18 lakhs of patients in three years. According to the health ministry, the AMRIT programme has saved Rs 103.55 crores to the patients, as “medicines and implants worth Rs 175. 23 crores were sold for less than Rs 71.67 crores”. Perhaps the biggest achievements for the government in the healthcare sector came in the form of National Health Policy and Medical Devices Rule in 2017. Both these policy intervention are set to transform the Indian healthcare sector, making the delivery of services more affordable and inclusive.
SPECIAL STORY
The last three years of the government, led by Prime Minister Narendra Modi, have helped Indian healthcare system move closer to the set goals of providing affordable and inclusive healthcare to the citizens. The government’s interventions at the policy front and targeted programmes have been playing an instrumental role in this endeavour, writes Vivek Ratnakar of Elets News Network (ENN).
The National Health Policy looks at problems and solutions holistically with private sector as strategic partners. It seeks to promote quality of care. The focus is on emerging diseases and investment in promotive and preventive healthcare. The policy is patient centric and quality driven. It addresses health security and ‘Make in India’ for drugs and devices.In order to provide access and financial protection at secondary and tertiary care levels, the policy proposes free drugs, free diagnostics and free emergency care services in all public hospitals. In order to leverage the pluralistic health care legacy, the policy recommends mainstreaming the different health systems. Towards mainstreaming the potential of AYUSH, the policy envisages better access to AYUSH remedies through co-location in public facilities. Yoga would also be introduced much more widely in school and work places as part of promotion of good health. As the government has been opening new AIIMS, the latest being approved by the Cabinet in Assam, to address the need for quality health institutions across the country, it would be too early to conclude that India will soon be able to overcome all the challenges. However, it is clear that the Modi government at the centre is committed to the cause of creating a healthy India and the steps it has taken so far will go a long way in ensuring that.
ehealth.eletsonline.com | JUNE 2017
42
industry FEATURE perspective
To meet the growing challenge of non-communicable disease burden in India, cardiovascular diagnostics medical equipment including ECG, echocardiography machine, Holter monitor, loop recorders, ambulatory BP instrument, etc, are expected to see manifold increase in demand, writes Tapan Ghose, Director and Head, Department of Cardiology, Fortis Flt. Lt. Rajan Dhall Hospital, for Elets News Network (ENN). Tapan Ghose Director and Head Department of Cardiology, Fortis Flt. Lt. Rajan Dhall Hospital
r a l e u ad c s ec a v D o t i ip x d h r rs e e a tn e N r r e C a h p t t ow n c i i g l ee np b n u m ma s i p c e- d to ed s. n i t t o va ire rain nce i i r u p qu r t ie s i e d e y re fo r sc s v p ea entl eed ula n a r c c E er In urg ng n vas is owi dio h T gr car in JUNE 2017 | ehealth.eletsonline.com
43
industry perspective
ted projec be on r e h t O uld ses wo ses ($0.98 n e p x e isea tory d cer ($0.25 a r i p s e r .15 ), can trillion diabetes ($0 alth e ), trillion and mental h ) . trillion .03 trillion) 0 ($
A
ccording to the World Economic Forum and Harvard School of Public Health, cardiovascular diseases top the list of NCDs adding to the projected economic burden between 2012 and 2030. Of the total, NCD burden of $4.58 trillion, $2.17 trillion will be spent on cardiovascular diseases alone. To meet the growing challenge of disease burden, India is expected to see doubling of ICU beds and equipment utilisation in both private and government sectors by 2030. Digital technology, innovative ideas, new business startups, easy loan to professionals, lowering of interest rates will open a new chapter in the coming decade in the Indian healthcare sector. Three
D’s in healthcare service boom will include doctors and paramedics, drug industry and device industry. Despite having the largest number of medical colleges in the world, producing 30,000 medical graduates and 18,000 specialists annually, India is far from the World Health Organisation (WHO) norms of one doctor per population of 1,000 (India has one doctor per 1,319 patients). Nurses/ANMs are equally less than the required norms. Short fall of specialists in community health centre is 81.2 per cent at present. Cardiac diseases require highly trained and skilled manpower for providing the desired services. There is a huge requirement of trained cardiovascular man power in the country. Increased
private-public partnership is urgently required to meet the growing need for trained manpower in cardiovascular sciences. National Board of Examination is required to develop a mechanism to identify the centres of excellence in particular area of cardiovascular therapeutics and include these in the programme, rather than acting passively as an accreditation body only. Trans-radial coronary intervention and structural heart disease therapy should be included in medical curriculum in cardiology. Medical collages should focus on applied research as a part of PG curriculum relevant to our country. Indian pharmaceutical industry’s contribution is immense not only in the India but across the world. India
ehealth.eletsonline.com | JUNE 2017
44
industry perspective
devices will be increasingly utilised in our country.
is dubbed as the pharmacy of the world. Multiple cardiovascular drugs made in India are available at an affordable cost. Anti-platelet agents, anti-hypertensive agents, statins, beta-blockers and anti-diabetic medications are available in most of the community health centres in our country.
Heart failure is emerging as a new tsunami in cardiovascular therapeutics. Precise estimate of the disease burden in our country is not known. Based on my experience of over 25 years in four tertiary care hospitals (government hospital, trust hospital, corporate hospital), I presume that implantable defibrillator implantation (ICD), cardiac resynchronisation therapy (CRT-D and P) utilisation will grow many fold in coming years in our country.
The devices industry in expected to see a technological revolution in the coming decade in India. Equipment utilised for cardiovascular diagnostics include ECG, echocardiography machine, Holter monitor, loop recorders, ambulatory BP instrument, TMT machines, etc. An ECG is the backbone of cardiovascular diagnostics. The full potential of ECG are yet to be utilised and used in cardiovascular therapeutics at a mass level in our country. One innovative utilisation of mobile phones is ECG and oxygen (SPO2) saturation monitoring integration. While most of the available mobile phones with ECG monitoring give only one lead (Lead I) and can be used for rhythm diagnostics, modification of software and utilisation of earphone cable could potentially be used to take all 12 leads recording of an individual. This can be recorded and preserved in the device and can be transmitted for interpretation, utilising the digital platform. I have personal experience of a handheld ECG recording instrument from our country. The device requires refinement. Because of increasing burden of atrial fibrillation in the country, Holter utilisation will be higher. The Holter monitoring, similarly, can be integrated with the mobile technology and can be used more freely at an affordable cost.Rhythm diagnostics using mobile technology and internet are already in use in our country. In
JUNE 2017 | ehealth.eletsonline.com
keeping with the growth of cardiac disease, the number of cardiac catheterisation labs is expected to double in coming years. Diagnostics cardiac catheters, vascular sheaths, wires used in the country are mostly imported at present. There is an urgent need for innovation, human trial and patent application in the area of trans-radial and trans-femoral diagnostic catheters and other disposable devices used in cardiac sciences.Therapeutic devices like coronary stents, peripheral stents, vascular stent grafts, artificial heart valves both (mechanical and bioprosthetic) valves will be utilised in more numbers. Advent of nonsurgical technique of TAVR (non surgical aortic valve replacement) is a boon for the heart patients. There is an urgent need to have centres of excellence for this in our country. Structural device therapy is a growing area. Devices for cardiac shunts (ASD, PDA devices, vascular colis and plugs), left atrial appendage closure
This is largely because of residual burden of damaged hearts (EF < 35%) from premature coronary heart disese in the population. Heart failure will be a major cause of hospitalisation. More number of left ventricular assist devices (LVAD) will be implanted. In keeping with growing burden of heart failure population, number of cardiac transplantation will increase. Cardiac, renal transplantation, hepatic transplantation are available in many centres of Fortis Network Hospital & other hospitals in our country. Fortis Flt. Lt. Rajan Dhall Hospital recently completed 1,000th kidney transplantation successfully. Expert immunologists and immune suppression agents are available in our country. Sufficient donor heart and recipients are also available in our country. Itâ&#x20AC;&#x2122;s a matter of time that we see a huge surge in the number of cardiac transplantations in the country. At the current rate of 7-8 per cent rate of GDP growth and the governmentâ&#x20AC;&#x2122;s promise to allocate more funds (increasing GDP percentage from 1 to 2.5) in health care sector; increasing number of both government and corporate hospitals, cardiovascular healthcare is poised to see a revolutionary change in coming years.
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CONFERENCE REPORT
Innovations Reshaping Indian Pharmaceutical Landscape
Delegates at the inaugural ceremony of the elets Pharma CIO Symposium in Mumbai.
India is on the cusp of a momentous paradigm shift in healthcare. Where on the one hand there is a growing need to improve the existing health delivery system, while on the other hand a vibrant ecosystem is required to promote innovation and research and development to discover new molecules and reinforce India’s reputation as a leader in natural medicines -- an area that is of late witnessing a number of policy interventions. Elets Pharma CIO Symposium held in Mumbai on April 21 offered a grand opportunity for Pharmaceutical CIOs, policy makers, regulators, industry experts and industry stakeholders to come together to deliberate, network and bring in unique synergies to the system and push forward digital adoption to drive innovations. The first of its kind Pharma CIO Symposium examined the growth of Indian pharmaceutical industry from the perspective of how Information Technology is adding a
june 2017 | ehealth.eletsonline.com
new dimension to the growth of the industry globally, even as experts stressed that to innovate continously “is not a matter of choice anymore and has rather become a necessity”. Also came up for discussion India’s proven capabilities in cutting edge disciplines like chemistry and biotechnology, which should be leveraged to make forays into innovations in drugs. By an estimate, the industry is all set to expand at a Compound Annual Growth Rate (CAGR) of 16 per cent to $55 billion by 2020. Much of this growth will depend on Indian pharma companies’ capacity to adopt IT to drive their productivity, improve efficiency and maintain cost effectiveness. With an eye on the changing scenario in the Indian pharma sector, Elets Pharma CIO Symposium has come as a major breakthrough, helping India develop a vibrant ecosystem to achieve its healthcare goals.
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A Peek into Innovations in Pharma Industry VR Shah
Deputy Commissioner Food and Drug Control Administration, Gujarat “ Sharing the latest developments in Food and Drug Control Administration (FDCA) of Gujarat, VR Shah, Deputy Commissioner, FDCA-Gujarat said that FDCA along with some other state government departments have been identified under the Right of Citizen to Public Services (RCPS) Act. “The moment I receive an application, its acknowledgement has to be sent to the applicant within three days. If there are any documents to be furnished or there are some lacunas then we have to inform the applicants about them. An officer is designated to look into the grievances and is assigned a time limit to dispose off the case. If the officer fails to do so, the applicant has the right to sue him.”
J Jayaseelan
Chairman Indian Drug Manufacturers Association “In 1970s, the government took two major decisions. The first was removal of product patents to enable Indian pharma industry grow. This helped us to do reverse engineering.The second major decision was government imposing restrictions on imports of drugs. Although these policies helped in the growth of Indian pharma sector, the negative impact was the migration of companies focused on R&D out of India due to removal of patent protection. In 2005, when we again became part of the global patent system no Indian pharma company could launch a single molecule on its own. One formulation can fetch, say, $100 million which is good. But one new drug can help India earn as much as Rs 50,000 to Rs 70,000 crores from just one product.”
Mayur Parmar
Food and Drug Control Administration (FDCA), Gujarat “Pharma industry is the second most regulated industry in the world. When it comes to IT adoption, the industry is more reactive than proactive because regulations in always top of its mind. Consider a situation where one fine morning you find all the data on your computer is lost. That would still be fine as we can tackle it. But imagine that same thing happening with the health data of a person. Suppose a patient has been receiving cancer treatment through nano-robots and someone hacks these nano-robots. So, we need to take care of these challenges when we adopt IT.”
Yugal Sikri
Chairman Pharmaceutical Management, School of Business Management & Director, Pharmaceutical Technology Management, SPP School of Pharmacy and Technology Management, NMIMS University. “Innovations are happening in india at a dramatic pace. In the last 10 years a lot of things have disappeared that we thought were part of our lives. We need to look at digitalisation and innovations from the perspective of fast changes happening around us. I don’t think it’s a choice. It’s rather a necessity. It is mandatory for us to be digitally aware about what’s happening around. Business is changing dynamics and it’s important for us to keep pace with the change and understand the new lingo.”
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CONFERENCE REPORT
Inaugural Session
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Key Takeaways • In the area of ease of doing business, Gujarat government authorities have identified certain areas where officials need to deliver on the commitments. • Earlier, when Gujarat FDCA officials used to go for an inspection the report could be submitted after about a week or 10 days. But now the report has to be submitted within 24 hours and the person inspected is able to see that report within the next 48 hours. • All the agencies concerned will now be collectively setting out the dates for routine inspections and they will be conducting their respective inspections on a single day. • The Central Drugs Standard Control Organisation (CDSCO) has opted for e-platform, through which each and every retailer and wholesaler will be connected to make available all the data about the stock of the medicines. • The track and trace system of the inventory is enabling a drastic shift in the Indian regulatory functioning. It will be fully focused on technological innovation, capacity building of the officers as also of the small and medium sized manufacturers. • It’s high time that organisations have a department called digital education where every single employee of old age or middle age can learn the new lingo. • Even the largest of pharma organisations do not have digital education department to make every single employee digitally enabled. • Today, a mobile phone connects us to the people, organisations, and a large information highway (internet) which runs across the globe. • Wearable devices are coming out in a big way. Innovative products like fibrotronic, which acts as a sensor to capture health data our body generates, have been launched recently. It means that everything is getting connected to the information highway (internet) -- thanks to the Internet of Things. • Wearable devices are increasingly giving information about blood pressure, glucose level and all other relevant metabolic parameters constantly round the clock. • In 2016, a contact lense was launched which
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measures the glucose level from the lacrimal fluid (tears). These devices are generating huge data -structured as well as unstructutred -- which is being used by AI to generate useful information. To store and archive the huge amount of data, cloud technology has come up, as also the discipline of analytics. In 2005, when India became part of the global patent system no Indian pharmaceutical company could launch a single molecule on its own, although the country did well in technological innovations like special pharma formulations. One formulation can fetch, say, around $100 million for the country. But one new drug can help India earn as much as Rs 50,000 to Rs 70,000 crores from just one product. After India became a part of the global patent system, all the multi-national companies have started coming back to the country for R&D because of good availability of talent in basic sciences and information technology. Today, no R&D can take place without IT. For the next 30-40 years, India needs to focus on innovations and strengthen its roots in biosimilars and biotechnology. India is very good at pharma chemistry. In the first quarter of 2017, of the 171 ANDAs approved 55 were from India. Indian companies are continuously having 30-35 per cent of the ANDAs filed in the US. Every third ANDA is from India. The areas for future growth include R&D and biosimilar. The future growth potential of Ayurveda, Siddha and other traditional medicine systems is huge for India. Despite India being one of the leading the source country for natural medicines, China enjoys more than 90 per cent of the market share. India needs to find out the active principles in each herb. Concerted efforts are required to bring new molecules and products in traditional medicine systems. Pharma industry attracts the highest foreign direct investment. If it is taken up as a flagship industry it will help Indian economy to grow further.
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• Before 2005 Indian pharmaceutical companies could meet the domestic needs, but after the patent system came into play only multinational companies could launch any new drug -- although they are partnering with Indian companies for marketing purposes. • Indian companies might do well in exports but with Generic Prescription Code to come into force, the Indian pharma industry needs to find a way to meet the impending challenges. • In the active pharmaceutical ingredient (API) space, India has proven capabilities. But over dependence on China for 70-75 per cent of APIs will not augur well for India. Unfortunately, Indian manufacturers depend on China only for the cheap raw material and not for any technological reason. • India has a price control mechanism in place. Since there is a control on the end product price, Indian manufacturers are unable to match the price offered by China. • There are deliberations happening on imposing import ban on Chinese products, but unfortunately if you are going to put a lot of import burden on China
APIs then most of the products may not be available for domestic consumption. Until we are able to make APIs at a comparable cost to China, we will not be able to provide the products at the price NPPA fixes. • Unlike formulation business, API business is a 24/7 business. It is a high power intensity business. Power is a very important component where China has an edge over India as the cost of power in China is negligible. Any part of India cannot give that kind of power support to API industry. • The current government had announced 2015 as the year of API. A lot of talks took place on this subject but the API industry is still on its own. Nothing happened fruitfully and a lot of decisions are still in the pipeline. • There is requirement for a separate ministry for pharma industry, as regulatory part is looked after by the Health Ministry, export by the Commerce Ministry and pollution control by the Forest Ministry. The Pharma Department is part of the Chemical and Fertilisers Ministry. Since the Pharma Department is newly-formed, no responsibility has been assigned to it, so it does only price control.
Panelists during the inaugural session of elets Pharma CIO Symposium at Vivanta by Taj-President, Mumbai.
ehealth.eletsonline.com | june 2017
CONFERENCE REPORT
Key Challenges for Indian Pharma Sector
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Industry Presentation Technology Changing Dynamics of Business
Ajit Sodhi
Managing Partner & CTO mySingnatureBook “ Businesses are changing very fast owing to the accelerating rate of technological innovations and adoption, said Ajit Sodhi, Managing Partner & CTO, mySingnatureBook, as he cited the example of telecom industry to put his point across to the audience. “I give an example how the telecom industry was started. Way back in 1800s it took almost 80 plus years before we could see the dial up phone but the technological change from the dial up phone to Nokia popular model happened in much shorter time. But the smart phones came up very fast. Businesses are changing. Today Pfizer’s competition is not from Eli Lilly but from Qualcomm,” he said. “GM Motors was at one point of time the world’s biggest car maker. Ford and GM Motors were running the entire automobile sector.
They were the global leaders making lot of money. But today Tesla is the most valued company in the US,” he added. Tesla changed the whole business model of how a car is produced, sold and how the people are experiencing the whole utilisation of the car, according to Sodhi. “Tesla is making only 70,000 cars a year, while GM is making five million cars a year. Nobody could have thought in their wildest dreams that GM will be caught behind. There are a lot more companies like these that are changing the whole economies. If you are not changing; and you are not digital your survival is on stake,” he said. Our vision ties off with the same thing. We are helping all those organisations which are trying to achieve their changed goals in a more secure and transparent manner, Sodhi added. He also explained the best practices for digital adoption and how mySignatureBook can help in getting organisations digitised.
Key Takeaways • Digitisation of pharma sector may reduce development cycle time and cost, evolve patient care model and comply with industry and country regulators. • Change should happen quickly, but it cannot be
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haphazard. It has to be very accurate. • All the companies which are 100 per cent digital are able to grow their revenues much easily as they are able to control their cost, and cost impacts their profits -- pushing them further up.
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Disruptive Innovations and New Technologies in Pharma Industry and Engaging Physician/Patient to New Digital Era Jasmine Gorimar Head-Technology Boehringer Ingelheim
“It’s very cliche to say that necessity is the mother of innovation, but what kind of innovation we are talking about? Is it only in the area of new drug development? No. Is it innovations in the area of consumerism? The consumer is changing, their behaviour is changing, their habits are changing… the whole environment is changing. Not only the internal Indian pharmaceutical environment is changing, but the global market is changing. Not only the pharmaceutical market but the behaviours across the industries are changing. We are talking about not only the changes in the area of consumerism but also in the area of supply chain management.”
Atul Aslekar
Gyan Pandey
“Talking about disruptive technologies, he said that drug discovery and development is seeing a huge amount of data getting generated. “There are a number of opportunities to use big data and connect it way back to the design and development aspects of medicines. Particularly in the Indian context, as the digitisation ramps up, we are quite sure that we will have multiple data points which will give lots of insights to the pharma companies to provide India-specific solutions.”
“Speaking about disruptive technologies happening in the pharma manufacturing, he said that disruptions are happening everywhere along with digitisation. “The two words that resonate on any forum are: disruptions and digitisation, which are intricately linked together. It is not that digitisation is a new concept but the whole automation or digitisation’s impact is now connected across the processes end to end. This makes the world more connected. IT is involved in every aspect from ideation to drug discovery, manufacturing, and from supply chain to supplying drugs to the end customer. It is again involved in analysing all those data points to make it more efficient.”
Director Nova Lead Pharma Inc
Chief Information Officer Aurobindo Pharma Limited
Amit Singh
Pharma Sales Director South and South East Asia, Elsevier
“Sharing Elsevier’s experience of going digital, Amit Singh said that “Content is the king and we own a lot of content, but the challenge for us was to find out how we are going to position ourselves going forward in the future. So, the first part was how to go from print to E (electronic). That part is already done now. The next part would be how to use the data in terms of big data analytics or machine learning. A lot of these things are being taken up in the pharma industry as well. The whole idea is how we use the data once we have it in the digital format or machine learning format. We use the data to draw certain inferences. We believe in helping our customers in the pharma segment as well as doctors.”
ehealth.eletsonline.com | june 2017
CONFERENCE REPORT
Panel Discussion 1
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Anil Gidwani
Ajit Sodhi
“Disruptive innovation is something which is connecting. The people at the bottom of the pyramid are using IT. This is disruptive. We are also getting transparent by using IT. The other important disruption is taking place in the monitoring space. We are monitoring trials, representatives and processes. Then you have feedback mechanism, which is getting fast.” On how to use IT disruption in the pharma industry, he said that in the marketing and sales division a sales representative can use an app and can give you an exact picture of his doctor visits. This eliminates the job of the area manager. If he has a question, he can send it across to the product manager and get the reply immediately. “Similarly, on the manufacturing side we can do even more. For example, we can measure the weight of the tablet, the variation between one tablet to another.” “Disruption in IT is introducing transparency. It brings us more closer to each other. Today, if FDA has a website where pharma companies can upload details of each and every batch produced with detailed specification of each and everything, FDA inspection becomes an online process.”
“In the next 5-10 years, we are going to see personalised care start happening in India. With computing power going up so fast and so cheap, it has become very fast and cheap to compute your human genome. We are already witnessing a lot of research and products coming up in personalised healthcare. With the computing power processing ability is so easily available in cloud that you can reach out to many patients and subjects. Research is also getting very fast and innovative.”
Director Dana Group
Managing Partner & CTO mySingnatureBook
Panelists deliberating during the panel discussion on ‘Disruptive Innovations and New Technologies in Pharma Industry’.
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Key Takeaways • Google Health is putting in a good amount of investment to track individuals when they are not sick. The company is going to track people when they are very young and see how they are fairing in their health. Based upon that, they are going to collect a huge amount of data and the analytics will come into play. • Very soon the accountability will be very high for physicians to see whether the services provided by them were really required or not. The tracking and traceability is going to happen very soon. • Big IT companies like Google, IBM and Microsoft, etc are already making a huge amount of investments into healthcare applications to allow trace and traceability of the transactions that are occurring through Blockchain. • Auto industry has been very fast in adopting changes on the digital platform. But in the pharma industry, this adoption has been a bit slow. The reasons could be seen from the business point of view or regulations. • As pharma is the second most regulated industry in the world, it has to maintain proof of records over a period of time. In India, financial records are maintained till 8 years, but all the batch records of a particular drug till the time it is in the market. Most of the times, these records are on the paper.
• Focusing on data integrity and maintaining the record in the paper format will be very costly and also it may not be conclusive to prove to the auditors that there are no manipulations. • The areas in pharma sector suitable for digitisation are the factory and the supply chain. If you talk about inventory management, the inventory carrying cost in the pharma is too high. If you have the right supply chain system where you have the visibility, better planning, better utilisation and self life, you can deliver in time and avoid millions of dollars of losses. It will eventually be beneficial for the society because drug companies will be able to provide drugs at lower costs. • Today, in India we have about one million deaths because of medical negligence. The number in the US is also similar. So, if we can actually use the data, put a context to the data and help physicians a lot of quality in terms of measurable outcomes will come to medicine and that can help drive the next wave of growth for pharma. • Currently, we are seeing the growth in pharma slowing down. The thing that can help Indian pharma get out of the current slowdown is the digital innovation. • There is the need to use data to help physicians come out with more measurable outcomes.
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Panel Discussion 2 Policies for the Pharma Industry -- Challenges and Opportunities VR Shah
Deputy Commissioner Food and Drug Control Administration, Gujarat “The scenario between 1970s and 1980s was an example of opportunity when India decided to follow the policy of “Patent to Process” and by reverse engineering the industry grew in leaps and bounds. But the period from 1994, after India became a signatory of TRIPS (Trade-Related Aspects of Intellectual Property Rights) with 10 years window, can be called as challenge because now pharma firms cannot replicate the products which are already in the market. This forced the pharma industry to either go for exports or domestic list of off-patent generic drugs. It also forced the pharma companies to start concentrating on R&D.”
Panelists with their trophies at the elets Pharma CIO Symposium in Mumbai.
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J Jayaseelan
“New regulations and government policies should not be looked as roadblocks for the pharma industry. When we are developing molecules for the domestic market, we tend to be a little relaxed in presenting the data. But the new government policy requires manufacturers to present the data in a specific manner. So, whatever data we are gathering from clinical trials in India, that data is getting recognised elsewhere as well. It underlines the success of the regulatory authority.”
“We are already the top exporting country in the pharma sector. The direct challenges for Indian pharma companies in this area include fast evolving international regulations, data integrity and other new concepts. The challenge of doing business in a regulated market is very high for Indian pharma companies. Suppose an Indian pharma company has invested Rs 500 crores in its facility for export. Now, an EU auditor coming for inspection and seeing some differences in the company’s data will immediately issue an import alert on the company. To get an USFDA approval, a company needs to invest heavily and wait for three-four years before starting doing business. But because of one import alert, the entire export business of the company can come to a standstill.”
Head-Clinical Development Reliance Lifesciences
Chairman Indian Drug Manufacturer’s Association
Saisudha Patro
Managing Director Mundial Pharmaceuticals Private Limited “When we talk about the policies, we need to see whether these are beneficial to entrepreneur, investor or the new comer to the marketplace. As an Indian player, I may have the technology, knowledge and good labour, but still I am not so competitive because we keep on paying different types of taxes. Most of the efforts of the Indian pharma companies are diverted towards cost saving and increasing sales, rather than focusing on innovations and R&D.”
Madhusudhan N Saraf
Principal and Professor of Pharmacology Bombay College of Pharmacy “Pharmaceutical industry is a knowledge-based industry and the most important component of it is human resource. Today, we are facing the challenge of availability of quality human resource. Inspite of the fact that we have a number of educational education imparting pharma education, there is a big dearth of quality people who can cater to the industry. Industry-academic linkage is the need of the hour.”
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CONFERENCE REPORT
Dr Pravin Ghadge
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Key Takeaways • The key initiatives of the Gujarat FDCA in e-governance space include two portals: DMLA and XLN. • The XLN portal is especially designed for the chemist shops. Some 33,000 chemists in Gujarat are on this portal along with the drug inspectors and all FDCA officials. • Any person can check the credentials of the nearest chemist shop and pharmacist on this portal. Nearly 14 states have replicated the XLN module. • The XLN website is connected with the FDCA laboratory in Baroda, Pharmacy Council of Gujarat and Pharmacy Council of India. The moment a sample is considered not of the standard quality, all 33,000 stake holders get an SMS alert so that they can prevent using that particular batch of the product. • Similarly, there is the DMLA website for pharma manufacturing firms. It facilitates firms to apply for a product and get permissions online. The database of 250,000 product permissions granted to the firms is also available there. • Very few companies in India are going for eBMR (Evidence-Based Medicine Reviews). If Indian companies have to build their reputation in pharma sector, they need to adopt such global best practices. • When the US and EU regulators see a small difference in the data, they are not bothered about the end-product quality. They tell the company that since you have not signed on a particular date as required, your data is not believable. So, the end
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product quality cannot be checked. This is a new learning for the industry. In the last three years, top 25 Indian companies have invested more than Rs 22,500 crores in the US. They have started their formulation facilities in the US. The reason for the step is that even if they get an adverse observation there, no import ban is imposed on them. The problem can be addressed much faster in the US than in India. But no company has an API facility there because it is a ‘Red Category’ industry associated with pollution. Egovernance and Digital documentation is going to help Indian pharma companies to meet the challenges of regulated markets. There are more than 10,000 pharma companies in India, out of which top 25 companies contribute 82 per cent of sales. Any policy the government introduces should think of small and medium pharma companies as well. The latest challenge for small and medium companies comes from the generic medicine code or the Uniform Code for Pharmaceutical Marketing Practices (UCPMP). Once the UCPMP comes in, all the small and medium marketing companies will slowly vanish. The small and medium companies should understand that they have to find out unique products like in naturopathy, or have products in bio-similar segment. Today, the consumers are becoming more aware and, therefore, over the counter medicines offer a good opportunity for the pharma industry to grow.
Key speakers discussing their ideas at the panel discussion on ‘Leveraging IoT and New Age Technology for the Growth of Pharma Sector’.
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Leveraging IoT and New Age Technology for the Growth of Pharma Sector Mayur Danait
Chief Information Officer Lupin “Lifesciences industry is considered to be laggard when it comes to adoption of technology. It’s not so proactive, as some of the other industries have been. In all fairness, there is a very strong reason for that. It is the second most tightly regulated industry. In the last couple of years, we have also seen a lot of industry headwinds. We have seen the R&D productivity falling across the world, competition increasing coupled with thinning margins and falling prices. We have also seen the cost of compliance going up, putting a lot of pressure on manufacturers. I think there are four areas where IoT will be relevant: one is drug discovery and development, while others include manufacturing and supply chain, sales and marketing, and pharmacovigilance.”
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CONFERENCE REPORT
Panel Discussion 3
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Ravi Sharma
Chief Information Officer Marksans Pharma Limited “Speaking on the impact of Internet of Things on R&D, Ravi Sharma, Chief Information Officer, Marksans Pharma Limited, said, “IoT has a big role to play in organ on the chip in future because lot of studies have been done on the subject and there will be restrictions and people will not volunteer for it. If some kind of silicon chip is emedded in a human body, it will not have side effects but we will be able conduct most of studies on the molecule.”
Devendra Dhawale
Sanjay Moralwar
Director, CIO Advisory & Digital Consulting KPMG “In 2012, a student whose name was Jack Andraka won the Smithsonian American Ingenuity Award for an early stage pancreatic cancer test. When he developed that test he did not have any facilities. What the organ on a chip is going to do for a researcher is going to promote a ‘do it yourself’ trend. If you are adept enough in R&D, there is a lot of innovation expected from this.”
Group CIO Zydus Cadila
“Wherever you are required to collect data and there is a hinderence in collecting it, IoT will be utilised there. We don’t have much R&D happening on animal healthcare in India. Countries in the Western world are already using IoT to collect animal health data through RFIDs and chips. Similarly, wearable patches is not a big market in India, but it is a big market in the US.”
Key Takeaways • IoT has great potential in manufacturing as it can play a big role in capturing data at source. It can help in adoption of proactive approach in ensuring that a failure does not happen. • Pharma companies are under lot of pressure to serialise the products. A lot of investment
june 2017 | ehealth.eletsonline.com
is being made in track and trace. The entire industry is looking at it from the compliance point of view. But there are lots of IoT devices available in the market today which can also capture information on the go about all the shipments.
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MEETS BIO-MEDICAL WASTE NORMS 2016 EQUIPMENTS PVT. LTD.
Waste Segregation Trolleys ● Stainless Steel / Mild Steel trolley on castors ● One, Two, three and four compartment waste segregation system. ● Stainless steel trolley on castors. ● Foot operating system for opening of lid. ● Bins can be interchanged as and when required. ● The bins comply UN and NFX standards of safety. ● Autoclave-able and environment friendly, reusable plastic bins as per BMW colour coding. ● Available Bin Sizes 30 Ltrs, 60 Ltrs
Manual Needle Cum Syringe Hub Destroyer ● Available in 0.8 Ltr. & 3 Ltr. capacity
Options of Red, Blue, Black, Yellow, Green & White
Sharp Containers - Eco Series ● Available in 1.2 Ltr. &
5 Ltr. capacity
Sharp Containers - H Series
Wringer Trolley
● Available in 0.8 Ltr., 3 Ltr.
● The entire frame of the trolley is made up
& 6 Ltr. capacity
of stainless steel. ● Bucket Capacity is 25 Ltrs. each ● Comes with a utility bin and mop holder. ● Wringer trolley with one, two and four bin options available. ● High quality down press wringer for easy squeezing. ● Lockable wheels. ● Long handle for easy handling.
WB-120 ● Waste Bins with Foot
Paddle & Wheels
● Available in 120 Ltr.
capacity
Red, Blue, Black, Yellow, Green
Red & Blue Bin
ARVS Equipments Private Limited A-98, Sector-1, DSIIDC, Bawana Industrial Area, New Delhi 110 039. INDIA Call us at: +91-11-27751793 / 94 / 95 / 96 +91-9818355977, +91-9873255359
Write to us at: vishvesh@arvsequipments.com dilip@arvsequipments.com sales@arvsequipments.com
WB (F) 25 ● Waste bin with foot pedal ● Available in 25 Ltr.
capacity
Red, Blue, Black, Yellow
For more information about our products, please visit: www.sharpsandwastecontainers.com APRIL / 2017 ehealth.eletsonline.com
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RNI NO. UPENG/2011/38140 | UP/GBD - 140/2017-19
Posting Date: 20 & 25
www.akhilsystems.com
Blood Bank Management A deeply integrated information system that tracks the complete blood transfusion cycle from donation to transfusion.
HIS
Equipment Maintenance A complete maintenance manager that is facilitated with preventive maintenance- AMC scheduling, Fixed Asset Register, complaint management and much more.
Dietary Management
Move your Hospital towards complete digitization with Miracle HIS Ancillary Modules.
Miracle Dietary Management ensures the best nutritional care for the patients with the precaution master, diet form, kitchen order entry, extra diet order and all the other things necessary for the nutritional care.
Linen & Laundry Automate all the laundry management operations and ensure the best management of all the linen.
CSSD
Ensure the best patient care by tracking and monitoring the use of sterilized equipment. Akhil Systems Pvt. Ltd. your healthcare IT Partner
205-206, Vardhman Times Plaza, Plot No. 13, Road No. 44, Pitampura, Commercial Complex, New Delhi-110034. Phone: +9111-42644111, +91 9968464439