JANUARY 2022, VOLUME 6 ISSUE 01 `200 INDIA MED TODAY
Radiology and Business
JANUARY 2022
APPROACH
FEATURE
INNOVATE
IMPACT
What Holds Back Radiologists’ Productivity
Advances in Radiodiagnosis and Imaging
Photon CT changing the CT Scan Space
The Revolutionary Journey of Radiology – From an Accident to a Futuristic Science
Edit Note
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January 2022 EDITORIAL Editor Neelam Kachhap Sub-Editor Abishek Raj editorial@ indiamedtoday.com
Propelling the growth of radiology in India
BOARD OF ADVISORS Dr Alexander Thomas Dr Girdhar Gyani
The global radiology as a service market size is expected to reach $4.7
Dr Prem Kumar Nair
billion by 2028, registering a CAGR of 20.3 percent over the forecast
Dr Bhabatosh Biswas
period, according to the report and India is witnessing a tremendous
Dr Alok Roy
growth in this space. The
increasing number of medical images and low availability of radiologists around the globe are the factors propelling the market growth over forecast years.
Ramesh Kannan
CONSULTING EDITOR Dr Libert Anil Gomes Dr Salil Choudhary Venkatesh Ganesh
The January 2022 issue of India Med Today gives an in-depth
ART & PRODUCTION
coverage of the radiology sector in India, featuring entrepreneurship
ScreeTract | Shylesh
journeys, the challenges faced and their advice to the younger
ADVERTISING Gunjan Chauhan
generation of radiologists.
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The issue also covers how GEHealthcare is investing significantly to reach out to small radiology
The Media Ant
centres and entrepreneurs, advances in radio diagnosis and imaging andmuch more. In the The
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issue also covers Nitin Stephen Abel, Business Leader, Image-Guided Therapy, Philips Indian
DIGITAL MARKETING
Subcontinent, talking about how Philips with its latest innovations, Image-Guided Therapy
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January 2022
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CONTENTS
17
28
19
FEATURE
IMPACT
APPROACH
Advances in Radiodiagnosis and Imaging
The Revolutionary Journey of Radiology – From an Accident to a Futuristic Science
What Holds Back Radiologists’ Productivity
UPFRONT
21 COVER STORY
Radiology and Business 4
January 2022
03 Editorial 06 Letters 07 News Roundup 32 Interview 34 Innovate 35 Feature 37 Opinion 39 Event Report www.indiamedtoday.com
CHECKIT OUT ONLINE
Guest Editor
Dr D Umashankar, Director & Senior Consultant Radiologist, Prima Diagnostics, Yelahanka
I am grateful to IndiaMed Today, one of
long enough to make all the mistakes
Minister’s vision of the “Make in India”
the premier Healthcare publication in
and learn from them”.
programme, we hope that in the future,
the country, to consider me as a Guest Editor for this issue. It is a privilege to
As an entrepreneur, I would ask my
the production of imaging equipment
fellow brethren who are entrepreneurs
with high-end specification becomes an
or aspiring to be one to keep the
affordable reality. This should be able
following in mind in their journey.
to bridge the rural- urban disparity in
Radiology is one of the earliest medical
access to quality diagnostic imaging.
The topic of radiology entrepreneurship
speciality to be completely digitised
Availability of radiologists, the other
is dear to me, as it has opened up a
giving us the sobriquet 'frontrunners of
bug- bear, can be overcome by tele-
world of opportunities and a new
technology' and hence makes it also the
radiology services.
perspective to my life as a radiologist.
most 'vulnerable' to change. Change is
work for the intellectual content of the issue, reviewing the articles and come up with new ideas.
Today’s
radiology
practice
involves
not only good radiological skills but also financial and people management qualities. These qualities have to be developed and nurtured over time. Our medical colleges teach us the “science of radiology” but nothing about the “business of radiology”. A management degree, after 9-10 years of blood, sweat and tears to obtain an MD in radiology, is aspirational but not practical. Hence the only other viable option available is learning on the job, by working with
inevitable. You either keep pace with the
Ultrasound
Imaging
has
undergone
change or be left out. We are presently
several advances in technology and
in a position, to integrate the application
is considered the cornerstone in the
of artificial intelligence into healthcare
practice of most medical specialities.
to exploit the higher efficiency provided
However, its benefits in the Indian
by AI and to perform more value-added
scenario are largely muted due to
tasks. Radiologists should become more
regulatory curbs restricting its use by
visible to patients and remain relevant
the PC & PNDT act. We have to think
due to our ability to communicate the
out of the box to liberate this truly
diagnosis
amazing
values quality
by
and
considering preferences,
assurance,
patients’ providing
interventional
procedures and policy making.
and
affordable
technology
from the clutches of PC & PNDT Act and ensure that our patients receive its numerous benefits including point of care applications.
select titans in the field of radiology
In the coming years, my brethren in
or setting up your radiology startup. I
tier- II and tier-III towns will become
would like to acknowledge Dr Ashwath
the major contributors to the projected
Narayan CN, who bestowed enormous
growth
faith on my abilities nurtured my
Radiologist-Entrepreneurs
management skills and let me build
regions should be at the forefront of
like the flu and consider it as part of our
and successfully run the radiology
adopting technology and flaunt the
lifestyle. Investments in masks, gloves,
department at Padmashree Diagnostics,
latest in imaging technology. A focus
PPE kits, development of diagnostic kits
Bangalore. We should bear in mind that
on ROI in this setting would drive up
and vaccines etc, may be diverted for
“It is better to learn from the mistakes
the demand for affordable imaging
creating better healthcare infrastructure
of others, because you can never live
equipment. With the honourable Prime
for all of mankind.
of
the
radiology
industry. in
these
Moving forward, I hope the governments around the world realise that the COVID pandemic is just another viral infection
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5
Letters
T
he performance of hospitals is expected to remain strong going forward, driven by a healthy ramp-up in elective procedure volumes and strong ARPOB levels. Pent-up demand and market share gains for organised players in the high-end/complex surgery space is supporting healthy occupancy levels while the uptick in footfalls at metro centres of hospitals in addition to the higher amount of surgical work is driving improvement in ARPOB. Overall, ICRA expects occupancy to improve to 62-64 per cent in FY2022 from 52 per cent in FY2021 for its sample set of seven listed hospital companies while ARPOB is expected to expand by 8-10 per cent. Benefits from improving scale, cost-optimization efforts, and ancillary revenues from COVID-19 are expected to support margin improvement for the sample set to 19-20 per cent in FY2022. Further, given healthy accruals and relatively lower debt levels, debt metrics for the sample set are expected to witness considerable improvement in FY2022.
Mythri Macherla, Assistant VP & Sector Head, Corporate Sector Ratings, ICRA
We are developing additional technologies to support our customers and society in the near- and long term. We have been aware that, like most viruses, SARS-CoV-2 would continue to mutate and that effective testing strategies would be a key to curbing the pandemic. In addition, testing plays a crucial role in making informed decisions and reducing transmissions. With this backdrop, our TaqPath Assays are developed to ensure that clinicians, researchers, and public health officials have access to effective tools to accurately detect COVID-19, even as the virus continues to mutate and evolve. Amit Chopra, MD, India and South Asia, Thermo Fisher Scientific "In 2021 we saw a significant partnership between the government and the healthcare sector to fight the pandemic as well as in the massive inoculation drive that was undertaken by the nation. The results augur well for this collaboration to continue in the future too. While everyone can be proud of the progress made so far, it is imperative to realise that a lot of work still lies ahead and we
should strive to reach our vaccination goals as soon as possible in the new year. Unvaccinated pools of population anywhere in the world is a matter of concern as it could give rise to worrisome mutants and therefore a global effort is required to tackle that challenge. The success of our vaccination drive and India's stature as a leading manufacturer of vaccines could mean that our country would be in the forefront of such a mission." Dilip Jose, MD & CEO, Manipal Hospitals Our lessons as we enter 2022 is that corona is going to be with us for a while and only corona appropriate behaviour of masking, distancing, hand washing avoiding crowds, mass aggressive complete vaccination, robust public health measures of surveillance, vigilance, testing including genomic sequencing, tracking, isolation and building up a robust healthcare system are the only measures that can save us from this deadly scourge. Dr Sudarshan Ballal, Chairman, Manipal Hospitals
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January 2022
News Roundup
Translumina's foundation stone laying ceremony at AMTZ Vizag
Translumina to set up Asia’s largest heart valve manufacturing facility at AMTZ Vizag Translumina performed the foundation stone laying ceremony of Asia’s largest heart
valve
manufacturing
facility
at
Andhra Pradesh Medtech Zone (AMTZ) in Vizag. “We plan to complete the facility by December 2022 with more than 100,000 square feet of manufacturing space with the
state-of-the-art
equipment
and
infrastructure,” said Punita Sharma Arora, Co-Founder, Translumina.
Dr Mohan’s Diabetes Specialties Centre opens centre in Siliguri Dr Mohan’s Diabetes Specialities Centre has now launched its comprehensive care
Piramal Pharma to invest minority stake in Hydbased Yapan Bio Piramal Pharma announced an investment of Rs 101.77 crore in Hyderabad-based Yapan Bio augmenting the capabilities of its Contract Development and Manufacturing Organization (CDMO) business, Piramal Pharma Solutions (PPS). PPL holds a 27.78 per cent equity stake in the company as a result of this investment. Yapan Bio provides process development, scale-up, and cGMP compliant manufacturing of vaccines and biologics/bio-therapeutics, including high containment product classes (up to BSL-2+), recombinant vaccines, RNA/ DNA vaccines, gene therapies, monoclonal antibodies, therapeutic proteins, and other complex biologics. Yapan’s FY21 turnover was Rs 12.4 crore. The company has already earned revenues of Rs 11.8 crore for H1FY22 and is poised for fast growth in response to strong market demand.
centre for the people of North Bengal in Siliguri. The Chief Guest of the occasion was Dr GB Das, gynaecologist and Head of New Ramkrishna Seva Sadan and the Guest of Honour was Dr Rajesh Saini, CEO, Siliguri Greater Lions Eye Hospital in the presence of Dr Manodip Acharyya along with his team.
Medica with Rotary club launches Rotary Medica Wellness Card Medica Superspecialty Hospital in collaboration with Rotary District 3291 has launched the Rotary Medica Wellness
Card for Rotarian, Rotaract and RCC members of Rotary Club Kolkata. The wellness cards will have a special discount on treatment for members of Rotary club at Medica Superspecialty Hospital, Kolkata. There was also a health screening camp organised by the Rotary Club Kolkata and Medica Hospital at Rotary Sadan. Various tests including Random Blood Sugar, Blood Pressure, Height, Weight, Body Mass Index (BMI), Blood Grouping and Bone Mineral Density (BMD) were conducted. The occasion was graced by Prabir Chatterjee, District Governor of Rotary Club, Sinchana Bhattyacharya, District President of Rotary Club, Dr Saumitra Bharadwaj, President Medica Group of Hospitals, and Dr Vikas Kapoor, Vice Chairman, Group Director & Ortho Surgeon of Medica. This special initiative is supported by Rotary Club of Calcutta Endeavour.
Cipla acquires stake in Clean Max Auriga Power Cipla has acquired up to 33 per cent of partnership interest in Clean Max Auriga Power. This agreement is in line with the company’s commitment to enhance the share of renewable power sources in its operation and to comply with the regulatory requirement for being a captive user under electricity laws. Clean Max
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7
News Roundup Auriga Power is a special purpose vehicle engaged in the business of production, supply and distribution of solar and wind or other renewable energy generation plant. The company was incorporated on February 18, 2019 and was formed to set up captive wind and solar, renewable power generation plant (Project) in Karnataka.
Aster Medcity, Kochi launches Aster Heart Rhythm Centre Aster Medcity has launched the Aster Heart Rhythm Centre to cater to treatments for all disorders related to heart rhythms. Dr Praveen Sreekumar, Consultant Electrophysiologist, Aster Medcity, Kochi will take the lead as Director of the Aster Heart Rhythm Centre. Dr Azad Moopen, Founder CMD, Aster DM Healthcare inaugurated the heart rhythm centre in the presence of Dr P P Mohanan, President Cardiological Society, Farhan Yasin, Regional Director, Kerala & Oman, Aster DM Healthcare, Dr Anil Kumar, LeadSenior Consultant, Aster Cardiac Sciences, Aster Medcity, Dr Praveen Sreekumar, Director, Aster Heart Rhythm Centre and Dr Anup Warrier, Chief of Medical Services, Aster Medcity. The centre will ensure timely diagnosis and precise treatment for various disorders related to heart rhythms. Heart arrhythmia treatment includes medications, catheter procedures, implanted devices or surgery to control or eliminate fast, slow or irregular heartbeats. Heart arrhythmias may feel like a fluttering or racing heart and may be harmless. However, some heart arrhythmias may cause bothersome — sometimes even lifethreatening — signs and symptoms.
VaccineOnWheels plans to add 50+ doctor-based mobile vaccination clinics
COVID-19 at high risk of developing
VaccineOnWheels (VOW), part of Jivika
Dohme (MSD) to manufacture and supply
Healthcare Group, having India’s first
Molnupiravir in India and to over 100 low
doctor-based mobile vaccination clinic is
and middle-income countries (LMICs). The
expanding its reach to the newly opened
regulatory approval comes on the back of
age category of 15 years to 18 years in all
a five-month collaborative trial conducted
cities of its operation. Starting January 3,
by a consortium of companies.
2022, VOW is ready to begin inoculating the
new
population
group
alongside
providing booster doses to senior citizens and frontline workers. Operational in Maharashtra, Telangana and Karnataka,
severe disease. Earlier in the year, Cipla entered into a non-exclusive voluntary licensing agreement with Merck Sharpe
Cardiothoracic specialist Dr Kumud Dhital joins SPARSH Hospital
VaccineonWheels with their 100+ Mobile
Cardiothoracic specialist and heart and lung
Clinics has administered more than half
transplant surgeon Dr Kumud Dhital have
a million COVID-19 vaccinations since
joined Sparsh Group of Hospitals to lead
April 2021. The company is underway in
the Heart and Lung Transplant Unit at the
expanding its reach into Jharkhand and
soon-to-be-launched Sparsh Multi-organ
Tamil Nadu where it will be adding 50+
Transplant Centre in RR Nagar, Bengaluru.
units by January 2022. This will bring
With over 24 years of experience as a
the total operational units to 150+ with a
cardiothoracic surgeon, Dr Kumud Dhital
capability to administer more than 25000
has been associated with top hospitals
doses a day.
across the UK, Europe, and Australia before
Cipla receives EUA to launch oral anti-viral drug Cipmolnu in India Cipla has been granted Emergency Use Authorisation (EUA) permission by the Drug Controller General of India (DCGI) for the launch of Molnupiravir in the country. Cipla plans to launch Molnupiravir under the brand name Cipmolnu. Molnupiravir is the first oral antiviral approved by the UK Medicines and Healthcare products Regulatory Agency (MHRA) for the treatment of mild-to-moderate
Dr Kumud Dhital joining Sparsh. Known for his expertise in complex heart and lung surgeries, Dr Dhital specialises in the management of the endstage heart and lung failure including heart and lung transplantation as well as in the implantation of mechanical circulatory support devices. He is globally renowned for being the surgical pioneer of DCD (donation after circulatory death) Heart Transplantation, the first series of which he performed as the principal surgeon leading a dedicated team in 2014 at St Launch of Aster Heart Rhythm Centre
8
January 2022
Vincent’s Hospital in Sydney, Australia.
Plix raises $5 million in Series A funding from Guild Capital, RPSG Capital Ventures Plix, a fast-growing clean plant-based nutrition brand for daily wellness and strength, announced that it has raised $5 million in Series A funding from Guild Capital and RPSG Capital Ventures. The funds will be used for launching several first-of-its-kind products in the nutraceuticals segment tackling key health concerns. Over 85 SKUs are planned for launch in the next 12 months. The company is also looking to hire new senior leadership talent, reinforce their R&D team and enter new markets. The wellness market is estimated at $1.5 trillion globally and $10 billion in India. Awareness about health and wellness is a megatrend that has emerged in the wake of the pandemic. Nutraceuticals as a sub-segment is a big driver of this growth, expected to reach $18 billion by 2025.
HealthPlix releases Prescription Summary Dashboard for doctors HealthPlix Technologies announced the release
of
the
Prescription
Summary
Dashboard for doctors. The new feature release from the ROBIN suite, is an analytical software that sits on HealthPlix flagship product – EMR. With this second feature release – Prescription Summary Dashboard, doctors are now able to analyse their historical prescriptions within a few clicks enabling them to identify different cohorts of patients and the treatment given to them. Doctors may also use realtime analytics to stay ahead of the curve and make sure that their patients receive the best possible treatment (personalised care). Prescriptive analytics makes use of patient health information to assist doctors in advanced treatment planning, assessing high-risk patients and dealing with a large amount of patient information
Immersive healthcare training, education platform
GHA, 8chili launch first immersive healthcare training, education platform in Metaverse Global Healthcare Academy (GHA) has entered into a strategic partnership with leading California-based tech startup 8chili to bring healthcare training and medical education to the Metaverse. The collaboration has already published 200+ hours of virtual reality (VR) content across multiple subspecialties including dentistry, oral and maxillofacial surgery, orthopaedics, skull base, spine, neurology, ENT, paramedics, nursing and oncology. GHA will deliver these immersive VR training courses to more than 20,000 healthcare professionals across the globe in 2022 and beyond, making it one of the world’s largest VR-based training deployments.
will provide private as well as government jobs for Persons with Disabilities (PwD’s). The portal enables people with visual impairments access the website using assistive technologies, such as screen readers. Sarthak Educational Trust has been working since 2008 and in the last 13 years has successfully reached out to 4 per cent (0.8 million) of disabled populace in India and Trained – 34,300 and Placed – 23,450 PwDs to let them excel in their fields and inspire many. Several national and global experts took part in the two-day event and brought together knowledge and practical wisdom towards the disability inclusivity movement in the country.
Protean eGov Technologies joins hands with Indian Academy of Pediatrics
Union Minister Nitin Gadkari launches Sarthak’s Rozgar Sarathi job portal for persons with disability
Protean (formerly NSDL e-Gov), India’s
The 8th National Conference on Disability
to all other OPD clinics, enabling early
hosted
diagnosis,
by
Sarthak
Educational
Trust
leading e-governance institution, launched its healthcare solution ‘Protean Clinic’, along
with
the
dIAP
programme
of
the Indian Academy of Pediatrics. The system will be offered to IAP’s 35,000 member paediatricians and subsequently specialised
treatment,
and
and National Abilympics Association of
superior patient engagement capabilities
India, ended on an empowering note
to prevent, diagnose, treat and manage
in a much efficient way. It further helps
with Nitin Gadkari, Union Minister for
diseases better, both in-clinic and at-
in predicting patients who are at greater
Road Transport & Highways launching
home. OPD clinics using the system will be
risk and connect with them proactively to
Sarthak’s Rozgar Sarathi online job portal
certified and promoted in their locations
minimise it.
(https://www.rozgarsarathi.org/)
as
which
Protean-certified
SMART
clinics,
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9
News Roundup offering specialised services with the highest privacy and security standards. Protean intends to connect the network to the National Digital Health Mission of the Government of India, solving the country’s lack of accurate and real-time epidemiology data, thus empowering healthcare policy and standards nationwide.
Roche receives CE mark for cobas SARS-CoV-2 qualitative test Roche announced that its cobas SARSCoV-2 Qualitative test has received a CE mark for the use of saliva samples in the detection of SARS-CoV-2 on the widely available, high-throughput cobas 6800/8800 Systems. This non-invasive test is for any individual, including those suspected of COVID-19 and those without symptoms. Saliva sample collection represents a convenient testing approach for patients, who can easily self-collect their own samples. Due to the noninvasive nature of the test, it is a more tolerable experience for people who require frequent testing, such as those working in high-risk environments. The test also provides patients with the option to self-collect their saliva sample on-site, following the instructions of a healthcare professional. By reducing physical contact, this method of sample collection can help decrease the risk of exposure to the virus for healthcare professionals.
Twin Health appoints Prabh Singh as its CEO Twin Health, makers of the Whole Body Digital Twin technology, announced the appointment of Prabh Singh as the CEO
Prabh Singh
10
January 2022
for its India operations. Founded in 2018, Twin Health invented the Whole Body Digital Twin to reverse and prevent chronic metabolic diseases like Type 2 Diabetes, while improving energy and physical health. The health tech firm had recently raised $155 million Series C funding to scale its presence in India and the US. Singh will head the India operations for strategy, marketing, regulatory, public policy, go-tomarket, product, and technology divisions. He will be responsible for scaling Twin Health in India as the country has the second-highest number of lifestyle-related diseases in the world after China. Prabh is currently serving as EVP and Head of Subscriptions at the Disney-owned video streaming service Hotstar and will take over his new position at Twin Health in January 2022.
Syngene International extends collaboration with Amgen till 2026 Syngene International announced the extension of its long-standing multidiscipline research collaboration with Amgen, a leading biotechnology company. The contract is currently extended until the end of 2026 and its scope includes integrated drug discovery and development solutions in discovery chemistry and biology, peptide chemistry, antibody and protein reagents, pharmacokinetics and drug metabolism, and pharmaceutical development. In addition to operating the existing Syngene Amgen R&D Center (SARC), under the new contract, Syngene will also build and operate a dedicated laboratory that will enable R&D project acceleration.
North India’s first Centre of Entrepreneurship in Medi Electronics and Health Informatics starts operations in Lucknow North India’s maiden Centre of Entrepreneurship – “MedTech” has opened at the SG – PGI, Lucknow. The centre of entrepreneurship shall provide state of the art facilities to startups in the field of medi electronics and health informatics providing impetus to the startup culture in the state. The Centre of Excellence shall provide plug and play facilities, co-
working/incubation space, high-speed Internet (500MBPS), Medi electronics & Health informatics & IoT Labs, Support on Intellectual Property Rights, Assistance for Marketing and Network Outreach amongst other facilities. The newly built facility, in partnership with Software Technology Park of India, Ministry of Electronics and IT and Government of Uttar Pradesh is strategically housed at the PGI Medical facility, providing a suitable environment for the Medi electronics Startups to thrive.
AYUSH Ministry to upgrade infrastructure and increase access to services in Uttarakhand The Ministry of AYUSH announced a series of initiatives to strengthen the AYUSH infrastructure in the state of Uttarakhand. The initiatives announced under the National AYUSH Mission(NAM) scheme will help in promoting Ayurveda, Unani, Naturopathy, Herbal Medicines and the development of the AYUSH Industry in the state. Uttarakhand has been blessed with natural resources and vibrant traditions of AYUSH practices which has the capabilities to contribute to the healthcare needs of people in this region. As the Chief Guest of the programme, AYUSH SAMVAAD, Union Minster of AYUSH, Ports, Shipping & Waterways, Sarbananda Sonowal announced a series of initiatives for expanding and upgrading AYUSH Infrastructure in the state. Chief Minister of Uttarakhand Pushkar Singh Dhami was also present on this occasion.
UpHealth opens digitallyenables acute care hospital in Nagaland UpHealth has opened the first digitallyenabled hospital in the Indian state of Nagaland. The hospital, called HelloLyf HX, is the first facility of its kind and a revolutionary re-thinking of traditional hospitals with a state-of-the-art climateresilient design vetted and approved by the acclaimed Indian Institute of Technology, Roorkee. The Nagaland hospital represents the first such hospital that UpHealth constructed. Many such hospitals are planned across India, with many more scoped for Africa with aggressive timelines. UpHealth is also exploring the
dominant market leadership in the dialysis space. NephroPlus had raised a prior round of funding in 2019 from InvestCorp, one of the leading global private equity investors. In the last two years, it further cemented its market leadership position by adding 80+ centres in India, entered the Philippines market with the acquisition of Royal Care Dialysis and bagged a significant USD100mn dialysis contract in Uzbekistan, which includes building world’s largest dialysis centre in Tashkent. So far, NephroPlus has signed up 200+ reputed hospitals as partners for operating dialysis centres including Fortis Hospitals, CARE Hospitals, Medanta and Max Healthcare. It has also set up PPP centres in partnership with state governments and operates the country’s largest dialysis centre at Tirupati.
Acute care hospital possibility of similar hospitals in rural and underserved areas of the US. The HelloLyf HX hospital is outfitted to provide COVID-19 care and resources to Nagaland during the ongoing pandemic and use as an acute care hospital post-pandemic.
Lupin’s Goa manufacturing plant receives EIR from US FDA Lupin has received the Establishment Inspection Report (EIR) from the United States Food and Drug Administration (US FDA) for its Goa manufacturing facility, after the inspection of the facility in September 2021.The US FDA has determined that the inspection classification of the facility is Voluntary Action Indicated (VAI). “We are happy to have received the EIR from US FDA with Voluntary Action Indicated classification for our Goa plant. This is a significant milestone as we build back our reputation of being best-in-class in Quality and Compliance. We are committed to manufacture and supply products of the highest quality from all our manufacturing sites.” said Vinita Gupta, CEO, Lupin.
Life
Sciences
has
signed
NephroPlus raises $24 M from IIFL AMC and existing investors NephroPlus has closed $24 M Series E round of funding to pursue growth opportunities across
India
and
select
international
markets. The current round led by IIFL
Aragen acquires Intox Aragen
and development platform for the pharmaceuticals, biotechnology, animal health and agrochemicals industries. It will enable Aragen to conduct safety assessment studies from a Good Laboratory Practice (GLP)-certified facility for submission to regulatory agencies such as the United States Food and Drug Administration (USFDA), the United States Environment Protection Agency (USEPA), the European Medicines Agency (EMA), and others globally. Intox is a reputed GLP certified pre-clinical contract research organization (CRO) with its test facilities in Pune, India. It has conducted more than 15,000 GLP studies for global clients which include large and midsized customers across pharmaceuticals, biopharmaceuticals, plant protection, nutraceuticals, and medical devices.
Asset a
Management
(IIFL
AMC)
along
with investment from existing investors InvestCorp and Bessemer Venture Partners
definitive agreement to acquire Pune-
(BVP) comes on the heels of notable
based Intox. The acquisition will expand
scale-up that the company has delivered
Aragen’s end-to-end integrated discovery
in recent years towards maintaining its
CDRI scientist probes mitochondrion of malaria parasite, hints into alternative drug targets Dr Niti Kumar, Scientist at the CSIRCentral Drug Research Institute, Lucknow, a Swarnajayanti fellowship awardee of 2020-21, along with her research group, is trying to identify proteins that influence the shape-function of the single mitochondrion that the malaria parasite harbours as well as how it undergoes repair. Understanding these processes will help decipher how the parasite adapts to environmental perturbations, mitigate drug-induced toxicity (phenotypic drug resistance), drive recurrence of infection after completion of treatment, and relapse from dormant stages.
Veeva appoints Varadarajan Raj Srinivasan as GM of Vault Quality Veeva has appointed Varadarajan Raj Srinivasan as GM of Vault Quality. Srinivasan is a strategic business leader and partner in the life sciences industry. Raj joins Veeva Systems from Navitas Life Sciences, where he served several large globals and India-based pharmaceutical companies. He played a strategic role in helping organisations move from paperbased processes to digital systems for greater efficiency and compliance. Going
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News Roundup in Latin America and Southeast Asia. Prestige BioPharma’s trastuzumab (HD201) is a proposed biosimilar to Roche’s Herceptin and can be prescribed for the treatment of HER2 positive breast and metastatic gastric cancer. Trastuzumab targets human epidermal growth factor 2 (HER2). In some types of cancer cells, HER2 is overexpressed and stimulates the growth of the cancer cells. Trastuzumab works by selectively binding to HER2, thereby stopping the growth of these cancer cells.
Varadarajan Raj Srinivasan
Vineet Gupta joins Eli Lilly as GM of India affiliate
forward Srinivasan will be responsible for building a large cross-functional team focussed on driving customer success with Veeva’s Vault Quality solutions in India. He will be adding to Veeva’s existing local team of over 100+ employees currently serving both India-based and global pharma customers.
Eli Lilly and Company (India) has appointed Vineet Gupta as the General Manager of its India subsidiary with effect from January 1, 2022. Gupta will take over from Luca Visini who served as Managing Director of the company in India from February 2018 to December 2021. Gupta joined Eli Lilly
regional reference lab in Bengaluru. The new lab is well equipped to process more than 500 tests in-house with 1000 health packages every day and other test results are processed from the central facility of the company in Noida. The lab provides all diagnostic test reports within 8 to 12 hours post receiving the sample. Commenting on the launch, Dheeraj Jain, Founder, Redcliffe Labs said, “Redcliffe Labs is building a National modern chain in the fastest time frame to make health tests accessible to all. We have the support of the world’s big Healthcare giants on the Dx technology piece and our field strength on the fulfilment. This is in line with the company’s belief that healthcare is everyone’s right. The recent launch of the Bangalore lab is due to the high demand for home collection diagnostics in the city especially due to the pandemic that has resulted in 24/7 home collection services. The extensive test portfolio and quick test results that the lab offers provide convenience to consumers.”
Healthians ties up with QRX
Aster Aadhar Cancer Centre opens in Kolhapur
QRX and Healthians, India’s largest health testing network with a presence in 130 cities, have joined hands in procuring and maintaining the applicable license for Rapid PCR tests based on RT Lamp technology (called SARAL TEST) provided through the labs and testing facilities of Healthians. The test provides instant credible results in 30 minutes and is ICMR approved.The partnership between QRX and Healthians for providing Rapid PCR Tests for COVID will help in taking the testing to the doorstep of the common man and commercial business hubs through collection centres as well mobile van testing facilities. QRX and Healthians will jointly partner in terms of setting up the infrastructure for the testing mobile vans and operating them.
Aster Aadhar Hospital, Kolhapur has launched “Aster Aadhar Cancer Center”. The specialised centre will enable patients to access several cancer care treatment options under one roof. The cancer centre is also equipped with the Halcyon – A Linac Accelerator, used in radiation oncology, which is a lot more precise, faster and accurate than previous generations. A highly streamlined process, enables the treatment session to be completed in as less as 10 minutes. This minimises the risk of patient movement and increases both patient safety and treatment quality. It is also the third installation at any hospital in Maharashtra and the first in a SemiUrban area. Installation of the world-class machine was carried out with the support of S 2 Infotech International.
Prestige BioPharma partners with Dr Reddy’s Prestige
BioPharma
and
Dr
Reddy’s
Laboratories announced that the two companies have entered into a binding agreement for an exclusive partnership for the supply and commercialisation of
Prestige
BioPharma’s
proposed
trastuzumab biosimilar in select countries
12
January 2022
Vineet Gupta in 2010 as Marketing Director for India, followed by a role as Corporate Affairs & PRA (Pricing Reimbursement and Access) Director in 2012, and has since served in various strategic leadership roles across multiple countries including General Manager roles in Thailand, Philippines and Indonesia. He is currently based out of the Lilly Corporate Headquarters in Indianapolis (US).
Redcliffe Labs launches regional reference lab in Bengaluru Redcliffe Labs recently launched a large
Schindler India sets up oxygen generation plant at Terna Speciality Hospital & Research Centre Schindler India and Terna Public Charitable Trust have jointly launched a PSA oxygen generation
plant
at
Terna
Speciality
(former Managing Director of The Carlyle Group). Suki will use the fund to make strategic investments that will lead to an expansion of its user base through new and existing partnerships with leading health
systems
and
medical
groups
while bolstering employee growth and development. In addition, Suki will advance the AI capabilities of Suki Assistant, its voice-enabled digital assistant, and Suki Speech Platform, its proprietary voice platform, as well as add new features that streamline
documentation,
coding
and
other administrative tasks for physicians.
Encube Ethicals enters Indian consumer market with Soframycin Oxygen plant at Terna Speciality Hospital & Research Centre Hospital & Research Centre. Schindler India & Terna Public Charitable Trust had facilitated the setup of an oxygen generation plant at Terna Speciality Hospital and this oxygen plant works on the principles of Pressure Swing Adsorption (PSA) and enable efficient distribution of oxygen for the needy patients in Navi Mumbai, Raigad and Thane.
SPARC licences development, commercialisation rights of PDP-716, SDN-037 to Visiox Pharma Sun Pharma Advanced Research Company (SPARC) has entered into an agreement
Healthium Medtech opens facility at Rohisa Industrial Estate, Ahmedabad Healthium Medtech announced the launch of its latest manufacturing facility in Ahmedabad. The facility owned by Uteshiya Medicare is located at the Rohisa Industrial Estate and has been licenced by Healthium Medtech to exclusively manufacture its wide range of arthroscopy products marketed under the brand Sironix. The CDSCO-certified facility is spread across 70,000 sq ft. The Ahmedabad facility was inaugurated by Arjunsinh Chauhan, Minister for Rural Housing & Development, Government of Gujarat.
with Visiox Pharma (Visiox) to grant exclusive worldwide rights (except for India and Greater China) for the development and commercialisation of PDP-716 and SDN-037. Under the terms of the license agreement, SPARC will be eligible to receive an upfront payment, milestone payments and royalty on sales, in addition to 10 per cent equity in Visiox. “We are excited to enter into this collaboration. The collaboration with Visiox allows us to make PDP-716 and SDN-037 available to patients seeking to overcome the challenges associated with the currently marketed formulations of these drugs,” said Anil Raghavan, CEO, SPARC.
Suki raises $55M in Series C funding Suki, a leader in voice artificial intelligence (AI) technology for health care, has closed a Series C funding round of $55 million, led by March Capital, with additional support from Philips Ventures, and all previous investors including Venrock, Flare Capital, Breyer Capital, and inHealth Ventures. The round is also comprised of super-angels who are leading figures in technology, healthcare, and finance, including Gaingels Group, Pankaj Patel (ex-Chief Development Officer of Cisco), Andrew Deutsch (CEO of RIMA Radiology), and Russell Farscht
Encube Ethicals has entered the Indian consumer market with its recent acquisition of Soframycin from Sanofi. Encube is entering into the Indian B2C market for the first time and will be setting up a PAN India network, leveraging and building on Sanofi’s existing network. With this acquisition, Encube is taking its first step towards addressing the Indian market with its labelled products. Currently, the brand is sold through a network of more than 3000 distributors and 550,000+ retailers across the country, and it is already well entrenched in the Indian household and minds.
IAS launches Indian Ligament Registry Indian
Arthroscopy
launched
Indian
Society
(IAS)
Ligament
has
Registry
(ILR). ILR is an initiative of the Indian Arthroscopy Society which is the official national
organisation
for
arthroscopy
surgeons. The society has an ever-growing list of active & associate members, now numbering over 3,000. The Society is best known for its extraordinary work of nurturing and training young arthroscopic surgeons across India. The registry is a
pan-India,
surgeon-initiated
clinical
database, created with the purpose of monitoring and improving the quality of ligament surgeries in India. Through the Registry, IAS aims to support improved clinical
outcomes,
patient
safety
and
academic research.
www.indiamedtoday.com
13
News Roundup Medpho forays into Agra Noida-headquartered digital healthcare startup Medpho has launched its healthcare services in Agra, Uttar Pradesh. Shashank Saini, Founder & CEO, Medpho during the inauguration briefed about the company and its services and the organisation’s work model to bridge the gaps of the present healthcare system. He also talked about the recent innovations and developments in the healthcare sector and their implications on rural India.
NMPB in tie-up with CSIR-CIMAP Lucknow to promote medicinal plants The National Medicinal Plants Board (NMPB) and the Council of Scientific and Industrial Research-Central Institute of Medicinal and Aromatic Plants, (CSIRCIMAP), Lucknow signed an MoU for extending joint collaborative efforts to promote the production of quality planting material (QPM) of medicinal plants.The MoU will facilitate the development of QPM of medicinal plants and herbs identified by NMPB and help in the establishment of the nurseries for QPM development, promotion, conservation and cultivation of the appropriate medicinal plants in different agro-climatic zones. CSIR-CIMAP Lucknow can also research mass multiplication, agro-technology development, quality planting material generation of selected medicinal plants and herbs.
AYUSH Minister Sarbananda Sonowal inaugurates 50-bed hospital in Moreh, Manipur Union Minister of Ayush and Ports, Shipping & Waterways Sarbananda Sonowal inaugurated a 50-bed integrated Ayush hospital in Moreh, Manipur through virtual medium and announced major initiatives for the development and promotion of the AYUSH industry in Manipur. Addressing a press briefing the Union Minister stated that the ministry has decided to develop 15 AYUSH dispensaries, seven 10-bed hospitals, 100 school herbal gardens, 16 nurseries in each district and 50 Health and Wellness Centres (HWCs) in the state. The Union Minister was attending a program on ‘Phytopharmaceutical Mission to promote the documentation, scientific validation and evaluation of traditional healthcare practices of North-East India’ in Imphal as Special Guest of Honour. Manipur Chief Minister NBiren Singh, Union MoS Dr RK Ranjan Singh, Advisor to CM (Health), Manipur, Dr S Ranjan Singh also attended the function.
Employment and Chairman, ESIC, Bhupender Yadav launched a dedicated pilot programme for a preventive annual health check-up for insured persons aged 40 years and above at four ESIC Medical Colleges/Hospitals located at Ahmedabad, Faridabad, Hyderabad and Kolkata, in New Delhi. It will benefit insured persons in the early detection of diseases. The minister informed at the meeting that he will himself monitor the progress of the Pilot Annual Preventive Health Check-up Programme in four ESIC Hospitals so that the same can be replicated throughout the country.
Dr Harish Pillai appointed as CEO of Philippinesbased Metro Pacific Hospital Holdings Dr Harish Pillai has been appointed as the Chief Executive Officer of Metro Pacific Hospital Holdings (MPHHI), which manages the largest private hospital network in the Philippines with 19 hospitals and 3750 beds, two allied healthcare colleges, a growing primary care network, oncology centres and a central laboratory. Dr Pillai will work closely with the Board of
Govt launches dedicated prog for preventive annual health check-up for ESIC insured persons
Directors to direct and guide the MPHHI
Union
engagement and clinical quality.
Minister
for
Labour
and
management team as it delivers on its clinical, service and business strategy while ensuring alignment and continual improvement in its patient experience, service development, physician and staff
Neuberg Diagnostics launches 10 new labs in North India Neuberg
Diagnostics
announced
the
launch of 10 diagnostics labs and 100+ touchpoints
across
Delhi,
Chandigarh,
Haryana, and Uttar Pradesh. The latest expansion is well-aligned with Neuberg’s commitment to improving access to the best-in-class testing facilities and giving a fillip to employment opportunities in the region. The 10 diagnostic labs are wholly owned by Neuberg while the 100+ touch points are set up in their own or franchisee business model. The 10 wholly-owned labs are equipped to conduct and process-wide variety of tests. Additionally, Neuberg is NMPB and the CSIRCIMAP Lucknow during the MoU
14
January 2022
equipped to conduct futuristic tests such
as genomics, proteomics, metabolomics, molecular biology, and digital pathology with advanced systems like NovaSeq6000. Two of these are also state-of-the-art reference laboratories. Collectively, these 10 laboratories are capable to process about 10,000 samples in a day and deliver results within the given turnaround time which differs from test to test while maintaining the best-in-class quality.
Motherhood Hospitals launches second comprehensive women and children’s hospital in Pune Motherhood Hospitals inaugurated its second hospital in Lullanagar, Pune today. The Bengaluru-based healthcare chain is part of Asia Healthcare Holdings, the only single-speciality healthcare platform company in India. Through a dedicated team of well-experienced gynaecologists, neonatologists and paediatricians, the hospital provides a comprehensive range of services for women & children. The occasion was graced in the presence of Assistant Police Maharashtra Prema Patil and Damini squad. The comprehensive women and children hospital in Pune is equipped with 24 operational beds with nine beds of Level 3 Neonatal Intensive Care Unit. The key specialities include gynaecology, pregnancy care, neonatology, paediatrics, advanced laparoscopy surgery, foetal medicine, and radiology. The hospital has two state-of-the-art operative theatres and medical intensive care units. The hospital will provide 24/7 service by a team of full-time doctors that includes paediatricians, gynaecologists, a trained and experienced team of nurses and nutritionists and physiotherapists, lactation consultants as part of the larger team.
Launch of robotic-assisted neuro-rehabilitation centre in Bengaluru centre was inaugurated in the presence of Dr CN Ashwath Narayan, Minister of Science & Technology Government of Karnataka, Akiko Sugita, Consul General of Japan in Bengaluru and actor Raghavendra Rajkumar. World’s best robotic rehabilitation units – Walkbot Premium, Armeo Spring and Senso – are being imported to offer the most efficient solutions for human movement therapy using modern technology.
in CIMS Hospital, Ahmedabad, and QRG Super Speciality Hospital, Delhi NCR. The platform now has a 3000+ employee base including 600+ doctors.
Dr V Mohan recognised as Tamil Nadu’s topmost scientist-cum-researcher Dr V Mohan, President, Madras Diabetes Research
Foundation
(MDRF)
and
QRG Super Speciality Hospital joins Marengo Asia Healthcare
Chairman, Dr Mohan’s Diabetes Specialities
QRG
by Stanford University, Elsevier BV and
Super
speciality
Hospital,
based
Centre, has been ranked and recognised as Tamil Nadu’s topmost scientist-cumresearcher in a list compiled and published
in Faridabad in Delhi-NCR, has joined
SciTech Strategies. A team from Stanford
Marengo Asia Healthcare platform as
University along with Elsevier BV released
part of its quest to be a pan-India player.
an updated list of the Top 2 per cent
Sakra World Hospital opens robot-assisted neuro-rehabilitation centre
Samara Capital, QRG Family Investment
of scientists worldwide, including the
Office
Investment
citations of the scientists in 2020. Over
Office have invested together to form
100 scientists from Tamil Nadu were
Marengo Asia Healthcare, a platform with
included in the list of Top 2 per cent of
a vision to emerge as one of the leading
scientists. Heading the list of all these
Indian
chains,
scientists, across all categories of science,
Sakra World Hospital (JV of Secom and
which shall stand for the patient first
is Dr Mohan from the Madras Diabetes
Toyota Tsusho, Japan) launched a world-
approach and clinical excellence. Within
Research Foundation. Dr Mohan has over
class robotic-assisted neuro-rehabilitation
one month of its launch in 2016, Marengo
1,430 publications to his credit, and which
centre in Bengaluru, the first-ever in
Asia Healthcare has rapidly grown to a bed
have received 159,000 citations; he also
Karnataka.
strength of 1000+ with its investments
enjoys an h-index of 139.
The
new
state-of-the-art
and
Godrej
Family
multispecialty
hospital
www.indiamedtoday.com
15
News Roundup
Oxygen generation plant
IIL donates oxygen generation plant to TIMS Gachibowli Indian Immunologicals Limited (IIL) has donated a PSA oxygen generation plant to the Telangana Institute of Medical Sciences (TIMS), Gachibowli for service to patients in need of Oxygen support. IIL had facilitated the setup of an oxygen generation plant at Telangana Institute of Medical Sciences (TIMS), Gachibowli. The oxygen plant works on the principle of Pressure Swing Adsorption and enables efficient distribution of oxygen for needy patients. The plant is capable of supplying oxygen to 70 patients at a time. IIL had taken up this initiative as part of their Corporate Social Responsibility (CSR) and executed it through Sambhav Foundation, an initiative of LabourNet, a Bengalurubased Social Enterprise. The cost of the plant is Rs one crore.
16
January 2022
Feature
Advances in Radiodiagnosis and Imaging A substantial percentage of diagnostic imaging examinations are not well justified, and an unnecessary radiation burden is placed on the population, where radiation protection of patients can be more efficient
In a world where medicine is becoming more and more advanced and evidencebased, radiodiagnosis has become an important branch of medical science. The branch uses radio waves to arrive at a diagnosis, guide minimally invasive procedures and research that can help patients with their ailments. It is a vital service for both early diagnosis as well as to guide therapeutic procedures. Dr Sudhakar Banakar, Consultant Radiologist, BGS Gleneagles Global Hospital
Over the past decade, all these imaging modalities have witnessed many advances, which include;
Ultrasound • Shear wave Elastography for various organs like thyroid, breast, liver. • Harmonics and compounding: Helps in filtering out the fundamental echo signals that are transducer generated resulting in crisper images. • Contrast ultrasound uses a unique type of intravenous contrast agent to improve the better imaging of blood vessels and organs. • Fusion technology synchronises ultrasound imaging with computed tomography (CT) or magnetic resonance (MR) image, which helps in detecting the hard-to-find lesions easier. • Handheld, pocket-sized ultrasound equipment has been developed.
Radiography • Digital single-photon X-ray imaging to reduce radiation dose and to improve resolution.
• Dual-energy mammography
CT and MRI MRI and CT scans are widely used imaging modalities that use different technologies to create images of the body. MRI is a medical imaging technique that uses computer-generated radio waves and magnetic fields to create detailed and accurate imaging of the organs and tissues in the body. CT uses X-rays that hit an object directly so it can be picked up on film or captured by detectors inside a machine called a tomograph. Both techniques have their benefits depending upon what you are trying to see. Over the years, much advancement has taken place in this area CT and MR imaging which includes, diffusion and perfusion MRI imaging, MR spectroscopy in conditions like stroke and tumours. With 3D printing, a 3D printed model of a structure can be availed that resembles the ideal visualisation of the anatomical structure. Dual-energy CT gives a much superior lesion detection and tissue characterisation. New detector technology has been introduced that uses microelectronic circuits. Newer advances in MRI are aimed at reducing scan time, reducing noise during the scan.
Development of AI in radiology Algorithms are being prepared to read X-rays, CT, MRI, etc. However,
www.indiamedtoday.com
17
Feature
AI technologies fall within a narrow scope, with the U.S. Food and Drug Administration (FDA)which improves the applications used only for detection, but not for diagnosis. All medically approved AI tools have their unique functions, such as detecting occlusion or haemorrhage. It is completely up to the radiologist how to utilise these tools in the background of the clinical picture and lab findings.
from medical exposure is becoming more of an issue, which has made the tracking of individual radiation history a valuable tool for radiation protection of patients.
Deep learning: Greatest advance in AI, however, will be improved image quality. Processing all the collected raw data with the advanced AI tools can improve the contrast and spatial resolution, allowing for immediate scan results, which provides higher quality images, and potential dose reductions.
Tracking radiation exposure of patients to determine cumulative effective dose (exceeding 100 mSv and in some cases, 1 Sv are now being reported).
Current concerns regarding radiation dose and safety regarding radiodiagnostics The rapid growth in the use of CTscanning is a major factor in the increasing collective dose to the global population from medical exposure. According to current reports, a substantial percentage of diagnostic imaging examinations are not well justified, and an unnecessary radiation burden is placed on the population, where radiation protection of patients can be more efficient. Additionally, to an increasing collective dose, the cumulative dose to individuals
The following suggested:
measures
are
being
Justification of medical exposuresusing ALARA (As Low As Reasonably Achievable) principle.
Effective communication between clinicians in radiological practice and health professionals who are knowledgeable about ineffective dose reduction strategies. Use of newer methods to track patient exposure to systematically raise awareness of patient dose, and to incorporate the inclusion of this data for patient management. Measures to be taken by patients themselves • Awareness that Ultrasound and MRI imaging has no radiation. • Get X-ray examination done only in x-ray facilities licensed with AERB. • Do not crowd the room where the X-ray is taken. Wait for your turn. • Cooperate with the radiographer, to avoid repeat X-ray examination. • If you need to be assisted by your relative during X-ray examination, ask for a lead apron for your relative. • Covering the body parts other than one to be radiographed with a lead apron. • In no case, a pregnant woman should assist the patient during exposure. • Female patients, if pregnant, must inform the radiographer so that necessary precautions can be taken during X-ray examination. Carry old X-ray/CT records.
18
January 2022
Impact
The Revolutionary Journey of Radiology – From an Accident to a Futuristic Science The branch of radiology has always been the fastest adapting area of healthcare and a pioneer in the integration of different technologies.
Dr Avni K P Skandhan, Radiologist, Aster Medical Imaging, Aster MIMS Kottakkal
With the advent of the new year, it's time to reflect on the advancements that radiology has undergone.
timeline, it grew in leaps and bounds
“I have seen my death!” was the comment from William Röntgen’s wife, when she saw the first X-ray which was of her hand with the wedding ring. Since this, happy accident radiology has skyrocketed to shine as an indispensable part of medicine today. From the year 1895, through the radiology
resolution images; from 2D to 3D and
with every decade. The transitions are many, from pixelised images to high4D acquisitions; from the black and white shades to colour-coded images; and from large structural abnormalities to the molecular level and chemical abnormalities. It's not just the quality of the images, but also the variety of modalities that have been added on and
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19
Impact
the improvisation in each of them. The branch of radiology has always been the fastest adapting area of healthcare and a pioneer in the integration of different technologies. These rapidly developing technologies have allowed medical professionals across the globe to take better care of patients. Radiography transitioned from traditional X-rays to Computed Radiography (CR) and Digital Radiography (DR) which provide filmless, high-resolution images and faster acquisition. The sick patients could be catered to, by portable units. These have become the foundation for today’s medical practice. Artificial Intelligence (AI), is an upcoming feature in the radiographic evaluation, predominantly during the pandemic period. The further newer techniques are Dual-energy DR imaging, DR tomosynthesis and dynamic digital radiography (DDR). Mammograms came into vogue in the mid-20th century and transitioned from 2D mammography to highresolution digital mammograms and 3D mammograms/computed tomosynthesis. This heralded an era of early detection of breast cancer and improved survival. Fluoroscopy transitioned from the funnel-shaped cardboard machines, requiring long acquisition times in darkened rooms to currently DSA (Digital subtraction angiography) and even hybrid imaging of DSA with CT (Computed Tomography). The images acquired are detailed and helpful in the evaluation of the vascular and nonvascular contrast administered studies. Ultrasonography is the earliest nonionizing radiation modality and hence got wide acceptance in obstetric imaging and as the first line of investigation in various other scenarios. Smaller machines lead to a rise of Point Of Care Ultrasound Scan (POCUS) and fastening treatment delivery. Further advances led to new probe designs which helped in detailed high-resolution superficial
20
January 2022
imaging,
endoluminal
imaging,
3D
and 4D volumetric imaging, contrastenhanced imaging etc. Doppler imaging helps in detailed structural and dynamic evaluation of the vessels. CT has developed fast from single slice to multi-slice CT’s providing excellent, high-resolution cross-sectional images of the body with a faster acquisition. The various algorithms provide highly representative images.
The
3D newer
reconstructed techniques
of
integration of the AI algorithms into the CT systems and dual-energy CT aid in certain specific conditions. The advent of Magnetic Resonance Imaging (MRI), improvised neurological, musculoskeletal with
very
body
imaging
high-resolution
and
images.
Contrast administration, Diffusion and Perfusion imaging, highly weighted T2 images, such as MR Urogram, MRCP, myelogram
etc.
SWI
(Susceptibility
weighted imaging) and time of flight (TOF) imaging have become the norm. Further innovations such as volumetric analysis, MR spectroscopy providing the chemical composition, MR tractography depicting
the
white
matter
tracts,
dynamic MRI for pelvic floor integrity,
cardiac MRI showing the structural and dynamic function of the heart, foetal MRI with detailed evaluation of the foetus and functional MRI detecting the brain activity lead to improvised methods of evaluation. Nuclear medicine, which involves radiation produced within the human body via various radiotracers has also undergone significant development, especially with wide usage of the PET scan and bone scans. PET MRI is another upcoming development in a similar league. Opening the floodgates of the digital era, led to a shift from a film-based system to that of a filmless system and heralded a new generation of radiologists who reported on filmless, DICOM (Digital Imaging and Communications in Medicine) compatible monitors linked to PACS (Picture Archiving and Communication Systems) with cloud storage of images. The rapidly evolving and constant innovations in medical imaging technology meant a landscape, which may not look the same, in the forthcoming decade and hence a regular update is recommended.
Cover Story
Radiology and Business
In the era of startups, entrepreneurial decisions are the norm- not the exception. In 2020, the health-tech sector recorded 77 deals raising $455 million in funding when compared to $512 million funding in 62 deals in 2019. However, there are certain business areas where startups have not yet dared to go. One such area is ‘Radiology’ www.indiamedtoday.com
21
Cover Story
I
ndiaMedToday chronicles the journey of four such entrepreneurs who are blazing the trail in the field of radiology and share their unique experiences which have helped them as entrepreneurs.
How and why did you move towards entrepreneurship? There was a scan centre where I was working that was coming for sale; reluctantly took over hoping that I could manage it well. What were the challenges you faced when you started? Old
equipment,
high
CMC
costs,
replacement costs etc. were some of the challenges. What are the core values that you have instituted in your organisation? HighDr A Anbarasu Managing Director Aran Diagnostic Imaging, Coimbatore
quality reporting, empathy to patients,
How did you first become interested in radiology?
How do you work with people who
It was fascinating to diagnose conditions and help the patient even before surgery and treatment. I am talking about the period -1990/91. 22
January 2022
back up each other to ensure errors are avoided.
have a different perspective towards the work that you do? Find the best quality in them and make them realise that will help them to move up in ladder; everyone has some.
Who are the people who have been your guiding light and strength throughout your entrepreneurial journey? Family, friends, seniors, a few special employees, doctors and patients. What advice would you give to the younger generation of radiologists who are looking to start their centre? Knowledge, quality, good equipment
in this regard. Hence, I wanted to start a diagnostics centre at the periphery for an affordable price yet maintaining the quality. When we started our first centre at Chikkaballapur in 2016, it was a new place, new people and we had a tough time for people to know us, accept us and trust us. We took utmost responsibility to open our centre at a well-known place which is near to the bus stand and public related offices. Though we faced this situation in the beginning later on we were very happy with the response we got. Our main motto and thumb rule at our work is to have a healthy atmosphere amongst staff and respond to the patient or their side with utmost concern and respect. To guide them with proper information and deliver our services. Yes, people had their views on us initially that going to rural areas after having a good job at city. A very few people had a feel of what we are doing is good and right for the public. The only way to answer them was by showing results and that dealt with the issues.
Dr. Praveen Reddy, MBBS, MD (Radiology), Chairman, PVR Diagnostic Since I was in my final year I was very much interested in imaging and its working physics. I understood that it was a challenging branch and yet very vast. Though we may not get recognised directly from patients our role was very much needed. When I was pursuing my MD at KIMS Bengaluru a majority of the patients were from rural backgrounds. Seeing them
travelling
for
investigations
and timely treatment put me in deep thinking that something has to be done
It was my family who was with me through all times. My sons had to sacrifice a lot of time for me. My friends who trusted in my decision had always backed me whenever I had a doubt. Of course, my teachers and my senior doctors guided me with even minute things. With my minimal knowledge and experience of this journey I would like to tell my younger radiologists to have a healthy competition, never let down our fellow doctors, always have a good rapport and take anything sportively. The profession is as important as personal life so balance it. The COVID-19 pandemic has brought the status of the public health infrastructure in the country into sharp focus. The overall government spending on health has increased in 2020-21 because of the pandemic. However, it remains to be seen if this increase is going to be
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23
Cover Story
pioneers of radiology - Dr Ganesh K and Dr Prasad Hegde. Dr Ganesh taught me radiology and Dr Hegde enlightened me on the path of entrepreneurship in the radiology field. I used to work for a corporate hospital in Bengaluru but somewhere my roots were calling me back and moved to my place, where the quality of machines, affordability and approachability of high-cost scans was a mirage.
Dr Veeresh Hanchinal Managing Director, K V Hanchinal Healthcare Services sustainable. Healthcare, one of the fastest-growing sectors in the country, is poised to reach Rs 71.26 thousand crores by 2021, driven by increasing expenditures on health by both the private and public sectors. Rising income levels, increasing awareness on health and insurance penetration are seen as the key drivers of the Indian healthcare industry. Entrepreneurship has always been an uphill task but never an impossible one if done with the right attitude and ethics. All the medical colleges teach the students the science of medicine but none of them shows to how to handle a business model of our own. The market can be categorised into four main segments as private hospitals, medical colleges, government hospitals and diagnostic centres. Each of these entities owns its model of diagnostic setups. However, running the centres of their own has many challenges, such as investments, qualified technologists, radiologists and infrastructure. To fill these gaps I decided to enter the risky market and try my luck with an honest effort. I got into the field of radiology accidentally but later developed a keen interest and started learning in my college, where I came across two 24
January 2022
This inspired me to start investing in small places where I can provide services at affordable costs. In the beginning, I started a small ultrasound scan centre. Later, I came across Public-PrivatePartnership (PPP) models, government tenders and started my centres both in the private and government sectors. My biggest fear at the beginning was, will my investment in high-end equipment pay me back better returns. Will installing 1.5 T MRI and 32 slice CT in small taluk and backward districts work out. I started the PPP model in Gadag, where implementing the government projects at their campus was the biggest challenge. To realise it, I had to work
with government officers at the state
Initially, it was my teacher Dr Hegde
level.
who inspired me to start this “Doctor
The second challenge was getting a
Entrepreneurship”.
But
my
entire
loan of more than Rs 5 to 6 crores,
family, wife, parents and brothers all
for which I worked with Canara bank
stood by me in tough times. It’s their
and got a loan through 'MSME' thanks
constant support, belief and blessings
to the Government of India's scheme.
that encouraged me to walk through
Later, the biggest jolt for my career
this rough voyage.
was Quenching of MRI machines twice at government sites due to an accident that was not covered in the warranty. Teamwork, discipline, quality of the reports and keeping low cost at private centres and following government rules according to an agreement. Recruiting radiologists at small places and paying them a fair amount of share and regularly discussing the problems faced
The younger doctor generation should take up the challenges and make a difference. the government and banks are coming up with different investment plans along with start-up investment firms, which are looking for ideas. We can make wonders if we take the initial tough road and sail through the hurdles. Believe me, we are capable of doing
by my colleagues and coworkers and
wonders if we believe in ourselves.
partners.
Nothing is impossible, no need to worry
My staff is my pillar and my partners
we are doctors, we have professional
are my strength, without whom I
security
wouldn’t have been where I am today.
strength, we can take the risk.
and
knowledge.
With
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this
25
Cover Story
to recover this without resorting to market gimmicks. Now we have grown by leaps and bounds with all the cutting edge imaging technology under one roof including but not limited to MRI, CT, 4D ultrasound, Digital Mammography, Digital Radiography, PACS etc. What are the core values that you have instituted in your organisation?
Dr D Umashankar, Director & Senior Consultant Radiologist, Prima Diagnostics, Yelahanka How did you first become interested in radiology? I was always fascinated by technology and right through my undergraduate course I slowly began to realise how certain cutting edge technology can radically transform healthcare, including making a diagnosis and then treatment of patients. When I finished MBBS way back in 1993, healthcare technology was booming. Ultrasound, CT scan & MRI scan were beginning to change the way clinicians looked at patients from an entirely different perspective, impacting how an accurate diagnosis could be made with absolute confidence. A short posting in Radiology during my internship made me resolve that Radiology was my true calling. How and why did you move towards entrepreneurship? The entrepreneurship journey has been very memorable so far. I happened to meet the right people at the right times who had faith in my abilities and supported my setting up and running a diagnostic centre. The idea was to be at the forefront of technology and deliver the best for our patients in terms of quality healthcare at a very affordable cost. A straightforward way to address this incongruity about quality and affordability was to do “volumes”. Newer machines meant high capital expenditure and we had
26
January 2022
Quality always comes first. One of the first important decisions we took was to tread the quality path. We are probably the only diagnostic centre anywhere to boast of being triple-accredited by NABH for Medical Imaging Services, NABL for our Laboratory Services and ISO 9001 for quality management services. A good orientation towards these quality programmes meant that the core functioning of the centre was well taken care of by the various process leaders with a strong sense of ownership. We also believed that our customers come first and the working of the centre is designed to be highly customer-centric placing a very high value on their time spent at our centre. My team also believes in strong ethical practice, which builds the trust of our customers. What were the challenges you faced when you started? Challenges always bring out the best in me. Getting regulatory approvals was the first challenge I had to face. It was eased by help through good friends and well-wishers. Handling unscrupulous local competitors are always a work in progress. Strong faith in the quality and effective communication with patients and referral doctors pays a rich dividend. Unruly local elements are another nuisance we face. We have to devise effective methods to handle these situations by out of the box thinking. How do you work with people who have a different perspective towards the work that you do? The most important role of a radiology administrator is to make people with diverse backgrounds work together
in harmony. An effective and relevant training programme brings all the stakeholders to learn from each other, which builds a strong team. Trust and mutual respect should form the core values of a team and a leader should foster these qualities amongst the team members. As much as we focus on our strengths, we must also address our weaknesses to make ourselves stronger. A strong foundation based on quality, ethics and trust builds a reliable team, which stands you in good stead. Who are the people who have been your guiding light and strength throughout your entrepreneurial journey? My family including my parents, wife and children strongly believed in my dreams and gave me unstinted support. Dr Ashwath Narayan, a close friend and now a minister in the Government of Karnataka very graciously let me learn from my mistakes and lovingly guided me when I strayed. My foundation as an able radiology administrator is to a large extent due to his benevolence. Dr Gururaja Rao, my present CEO believed in my abilities and helped set up the present diagnostic centre in Yelahanka. Many other friends and well-wishers have provided timely help and support in the effective running of the centre. What advice would you give to the younger generation of radiologists who
are looking to start their centre? I would like to strongly recommend radiology as a career to anybody who would care to listen to me. I would be delighted to have somebody come by and experience in real-time how much satisfaction there is in being a radiologist. They will be able to experience first-hand, how over the last 20 years, how the “art of diagnosis” in healthcare has shifted from history and physical exam to imaging, and that imaging is now becoming the new physical examination. I know for sure we radiologists make a significant difference for our clinical colleagues who are trying to help their patients. Even when things are hard, you feel good about what you’re doing, because it is worthwhile caring for the sick and needy. A successful radiology department requires a functional and effective leader who is fluid and flexible in their approach. An effective leader is necessary to consistently move your team in the right direction. An effective leader understands the power of, and the necessity for, contextual leadership. Only those leaders who can quickly recognize and adapt their methods to the situation at hand will be successful over the long haul. Remember that the most important leadership skill you can ever learn is how to lead yourself.
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27
Approach
What Holds Back Radiologists’ Productivity Radiologists’ productivity barriers and tools that can help to overcome them Source: Sectra Imaging IT Solutions
Managing the imaging backlog from the
pandemic
and
the
growing
volumes from the rapid development in cancer care will affect all radiology professionals. Luckily, technology and IT tools are also advancing and here to help radiologists tackle these higher volumes and increased complexity, and to become more productive while also reducing the risk of burnout. To adopt the right technologies that truly unlock
28
January 2022
the full potential of a diagnostic system, one needs to identify what are the current barriers today? In a nationwide survey by Californiabased Canopy Partners, radiology executives representing 67 organisations in 24 states were asked about the barriers hindering radiologists from being productive. They found that the biggest challenges were related to workflow, including image sharing,
remote reading, interface upgrades, the radiologists’ communication, and access to prior exams. They especially highlighted the need for efficient workflows and the importance of having one standardised user interface in order to reach a state of flow. To provide more hands-on advice on how to achieve efficient workflows and feel productive in daily work by overcoming barriers like these through the use of new technology and diagnostic IT tools, Spectra decided to conduct our survey. Let’s dig deeper into the areas in which radiologists experience the most challenges that negatively impact their performance. 1. Workflow management distribution
and
case
2. Oncology image review/reading 3. General image review/reading 4. Multidisciplinary tumour boards, remote work, and collaboration 5. Access to advanced diagnostic tools 6. Reporting and result distribution
Workflow management and case distribution
as easily being able to go back/forward and resume image presentations.
How to tackle this challenge The struggle of picking the right case to report on due to insufficient information about when the report must be completed and the lack of automatic, speciality-based case allocation can be solved with well-integrated workflow orchestration software. Rules-based workload allocation will enable the right exam to be distributed to the right radiologist more easily, based on a set of criteria and tailored for each department’s needs. More over, an analytics dashboard can provide an overview of the exam distribution, the status of SLAs, and the current performance.
Oncology image review/reading When it comes to reviewing oncology cases, the biggest challenge reported is getting a good patient overview and disease progression due to the lack of support for efficiently handling multiple priors and follow-ups. Secondly, radiologists feel that it is too timeconsuming to adhere to and follow tumour evaluation guidelines and assessment rules, such as RECIST, PI-
RADS, iRECIST, and PERCIST . The third biggest barrier is the lack of relevant clinical measurement tools for lesions.
How to tackle this challenge When reviewing oncology cases, streamlined and smart reporting forms and structured reporting templates— together with consolidated information in one application—can efficiently manage multiple priors as needed for patient overview when doing followups. Built-in structured reporting that can be customised to the disease or subarea facilitates adherence to reporting guidelines, which was reported as another productivity barrier. When it comes to structured reporting, integrated tools such as those for assisting in tracking lesion progression over time play an important role. Some lesion tracking tools allow for a semi-automatic population of image measurements into the reports and a structured comparison of lesions over time, which can significantly speed up oncology case reviews and help to tackle the third biggest barrier—the lack of relevant clinical measurement tools for lesions.
Without a doubt, the biggest challenge in this area is that radiologists often get interrupted and need to spend a lot of time finding the case and rearranging the images again in order to continue reporting. This was followed by the fact that it is hard to pick the right case to report due to insufficient information about when the report must be completed, and the lack of automatic case allocation based on speciality. Being interrupted and the hassle of finding the case again, rearranging images, and getting back to an efficient state of reading are considered significant barriers to feeling productive, according to the survey. Diagnostic application should support seamless and dedicated workflow capabilities for handling interrupted workflows, such
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29
Approach
General image review/reading Looking instead at factors related to general image review, the survey responses were much more evenly spread. The top factors selected were that the radiologists experience too many context switches to other systems due to not having access to relevant EMR data in the diagnostic application, that the system generally is too slow and almost a tie between poor display protocols and that the system is not easy to use.
How to tackle this challenge To overcome the main barrier of having too many context switches to other systems due to not having direct access to relevant EMR data, the diagnostic application should offer an optimised diagnostic context. It needs to provide the right information at the right time. This is enabled by an efficient exchange of data between the diagnostic system and the EMR. An essential first step is to ensure context synchronisation and single sign-on, which will result in significant time savings.
Multidisciplinary tumour boards, remote work, and collaboration The radiology experts and opinion leaders have articulated the increasing prevalence of MDTs and collaboration across disciplines as a growing challenge. These meetings are not only time consuming to conduct, but also to prepare and to follow up on. Within this area, the two highestranking factors hindering radiologists from feeling productive was the lack of access to reports and images from other specialist areas such as pathology and cardiology, closely followed by the lack of built-in support for preparing MDTs in conjunction with the daily case review. Thirdly, radiologists lack integrated functionality for following up on cases after the meeting.
How to tackle this challenge To truly improve collaboration across disciplines and in conjunction with 30
January 2022
MDTs, support for integrated diagnostics needs to be adopted. Utilising an enterprise imaging system that includes both pathology and cardiology in the same platform as radiology makes it easy to access each other’s images and reports—before, during, and after the MDT. It is important that the diagnostic imaging system offers built-in support to facilitate the steadily growing MDT preparation, follow-up, and presentation work. Enablers for remote reading are important for remote participation in MDTs as well as for ensuring efficient collaboration regardless of physical workplace. In both these scenarios, the system needs to guarantee high performance and secure connections and ways of sharing patient data. One common facilitator is to use a single diagnostic application that offers embedded tools for efficient communication with colleagues and at the same time a high-security connection to the diagnostic imaging system, such as a VPN or client-based certificates. To simplify the implementation of a comprehensive enterprise imaging system, a subscription-based pricing model normally facilitates an expansion to other departments as well as managing the growth in the number of exams.
Access to advanced diagnostic tools The main barriers reported by the radiologists when it comes to access to advanced diagnostic tools were the complete lack of advanced functionality for specific tasks, followed by too many context switches between applications due to a lack of integrations, and the fact that the integration with these advanced tools is not seamless.
How to tackle this challenge Using a single diagnostic application for diagnostics, workflow, reporting, and advanced tools is an important enabler to overcome the two main
barriers reported in this area: the complete lack of advanced functionality for specific tasks and too many context switches between applications. This also facilitates remote work, since you don’t have to switch applications or workstations. Instead, you get access to all clinical tools through one user interface, where all patient data is synchronised, without the need to log in to several systems. The third biggest barrier was poor integration with third-party applications. To improve workflow and reading efficiency, the diagnostic application should be able to offer a comprehensive portfolio of a combination of native tools and tightly integrated third-party tools, hence minimising the need to switch to separate applications. This is particularly important for radiologists handling high volumes such as breast radiologists, who need quick access to, for example, ABUS/ABVS and breast mpMRI.
Reporting and result distribution When it comes to reporting and results distribution, the top three barriers selected by the radiologists were the lack of structured reporting tools, the lack of functionality to compare findings in the current exam with priors, and poor speech recognition software and language detection.
How to tackle this challenge The lack of structured reporting tools was the top challenge reported by the radiologists. reporting
Support
templates
for
structured
together
with
supporting tools such as assistance for tracking lesions over time will be very helpful to increase productivity and enhance the workflow. To tackle the issue of poor speech recognition software, having a single diagnostic application for diagnostics, workflow,
reporting,
and
advanced
tools will help. So-called PACS-based reporting is often perceived as a way of streamlining the reporting workflows and
is
something
we
see
being
increasingly adopted, in particular in Europe. Streamlined and smart reporting that offers one application for image review and report¬ing will address the challenge of too many context switches. It is now time to create a game plan to make sure you will be able to manage the growing volumes in the post-COVID era and the increasing demands from cancer care. By studying these barriers, we hope to help you in the process of identifying your own bottlenecks and the areas where new technologies are likely to have the biggest impact.
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31
Market Interview
Our Focus is to Address The Requirements of Our Customers First Innovations in the Image-Guided Therapy segment is one of its key focus areas in India. Nitin Stephen Abel, Business Leader, Image-Guided Therapy, Philips Indian Subcontinent, talks about the company's innovations in this space, and how it has aligned with the Indian government's 'Make in India' drive
Can you tell us what the Philips Image Guided Therapy business is all about? Philips develops solutions to help its customers decide, guide, treat and then confirm the right care, for every patient, in real-time.
Nitin Stephen Abel, Business Leader, Image-Guided Therapy, Philips Indian Subcontinent
Our focus is to address the requirements of our customers first, keeping the patients at the centre of everything we do, in line with our objective to achieve, what we call the ‘Quadruple-Aim’ i.e. to have better clinical outcomes, improved patient experience, improved staff experience and lowering the cost of care. We combine meaningful innovation with evidence-based technologies to simplify workflows while enhancing patient care and reducing the overall cost. Patients with coronary artery disease, peripheral artery disease or lead extraction indications benefit from our integrated solutions that enhance the art of minimally invasive procedures. Our product portfolio consists of interventional imaging systems (cathlabs and mobile c-arms), smart devices, software and services. We have a full range of products that the customers can opt for depending on their clinical needs.
32
January 2022
We constantly innovate and strive to expand therapeutic indications in cardio, neuro, spine, ortho, onco etc. with the focus to drive care with better clinical outcomes and high productivity. Can you outline Philips’ innovations in the Image-Guided Therapy space? In the Image-Guided Therapy arena, we constantly push ourselves to innovate minimally invasive procedures in a growing number of therapeutic segments, with significantly better clinical outcomes and high productivity. We further plan to expand our portfolio through the acquisition of many more similar companies that suit our strategic fit, like the recent one being Vesper Medical for the treatment of deep venous disease. With such synergies, we provide clinicians with a complete procedural solution for the treatment of myriad complex diseases. Furthermore, we are expanding in newer therapy areas such as neuro, spine, ortho and oncology and continuously innovating to bring in solutions such as the first spectral detector angio-CT solution that combines breakthrough spectral detector CT-imaging and real-time fluoroscopy in a flexible environment where all modalities are
operated through Philips Image-Guided Therapy System - Azurion with FlexArm. This will bring valuable additional information in minimally invasive procedures for areas such as oncology, stroke, and trauma care. Given the evolving global healthcare scenario, Philips is also focusing on delivering engaging solutions using existing products through bundled or integrated approaches. We are also building on futuristic technologies like augmented reality in healthcare, fibreoptics technology for 3D-coloured imaging, no X-ray procedures, telemonitoring, precision diagnosis etc. to further enhance newer frontiers apart from cardiology, like neurology (for stroke patients), oncology, orthopaedics, spine etc. which can be dealt with more intensely in a Cath-lab setting easily. If you could give us a sense of the significance of 1000+ active Cath lab installations. How have the Cath labs have benefited patients and healthcare institutions in India? India suffers from a huge cardiovascular disease (CVDs) burden with one in four deaths because of CVDs including ischemic heart diseases. Unfortunately, today in India we are limited with just about 2000 active Cath-labs in ~150 cities. We acknowledge this huge unmet clinical need and hence have aggressive plans to customise local requirements and double the number of active Cath labs in the next few years - with the focus on improving accessibility and affordability particularly in the quality of cardiac and neurovascular care, in tier II and tier III markets. We believe this is just the beginning of a long journey and we will continue to break newer grounds through meaningful innovations and solutions for our Indian customers to help them improve millions of patient lives in the remotest locations of our country. Are the products a part of 'Make in India'?
have
C-Arms - we are now working towards
being
localisation of interventional suites to
a leader in the health technology
increase affordability and accessibility
space, and especially in the field of
particularly in tier II and tier III markets.
Over
the
past
transformed
decade,
ourselves
we into
interventional cardiology.
We also have Philips GBS in Chennai
Our Pune Healthcare Innovation Center (HIC) plays a pivotal role in enabling Healthcare innovation for Philips across the globe. It has the unique advantage of housing all functions of the Healthtech imaging business including innovation, engineering, manufacturing, marketing,
which
is
an
in-house
competence
centre for our company’s business services and processes, striving for e2e process optimisation resulting in faster workflows, collaboration across functions and leaner operations.
customer services, procurement, quality
How have customers and technicians
and regulatory providing vital solutions
adapted
worldwide.
Therapy products and services?
We
currently
including
the
have mobile
six
products,
C-arm
that
have been designed, developed, and manufactured here and 1000+ systems have been exported globally to 100 countries including the US and Europe.
to
Philips
Image
Guided
We are glad that over the last several decades our customers have resonated very passionately with our products and services and they have also graciously accorded their views with us and others.
Traditionally, Philips has been present in
Our customers’ trust in the Philips brand
the premium and performance segments
encourages us to continuously innovate
but with the Pune innovation centre,
and strive hard each day to earn their
the focus is also to address the growing
respect, by delivering the best solutions
need of the ‘fit-for-purpose’ segment
to help them improve millions of patient
as well. In the IGT-cluster, apart from
lives.
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33
Innovate
Photon CT changing the CT Scan Space Team IMT
with higher spatial resolution at lower radiation dose.
Key Difference between CT and Photon Counting Techniques The CT scan systems in the healthcare infrastructure
include
solid-state
scintillation detectors. The regular CT scan takes two steps to deliver the results, the first step includes conversion of absorbed X-rays into visible light, and then the light is converted into an electrical signal. The results consider the accumulation of thousands of X-ray photons collected gradually and measured as a whole. Distinctively, technology Naeotom Alpha is the world’s first photon-counting CT scanner. (Courtesy: Siemens Healthineers) CT
signals, making it more efficient than
scan systems has been in limited
the current CT scan technology. The
phases. Different versions of CT scans
exposure of radiation reduces by 45
were developed but none to change
per cent in Ultra High Resolution scans
the functionality of it. The photon-
using a photon counting technology,
counting CT paves a way for a new
unlike in regular CT Scan using a UHM
detector to be utilised for clinical
comb filter.
Technological
upgradation
in
routine. These detectors defeat the
the directly
photon-counting transforms
the
X-ray photons into electrical signals, delivering more usable data than the usual CT scans. The photon-counting detector measures charges and energy of
the
individual
X-ray
photons
emanating inherent spectral sensitivity.
Benefits of Photon Counting Technology High-resolution
images
owing
to
Naeotom Alpha debuted in September
smaller pixels help the medical staff to
2021, when the U.S. Food and Drug
make clinical decisions and give clarity
Administration
it
on the health condition of the patient. It
had granted clearance to the scanner.
removes the electronic noise and lowers
The FDA said in a press release that
radiation exposures, both significant in
this
imaging
regular CT scans. The alleviation in the
launched
device advancement" in CT in nearly a
radiation exposure allows screening for
Naeotom Alpha, a photon counting
decade. Interestingly, Photon-counting
a larger pool of population suffering
CT Scanner, which the medical device
CT measures and processes data in a
from lung cancer. Additionally, the
major claims, is the first in the world.
different method than conventional
intrinsic results capture the tiniest
Photon counting CT scanner directly
CT
tissue of the lungs, without the pain of
converts the X-Ray photons into electric
mean radiologists could get images
limitations of the currently used CT detectors, by providing usable data at a high resolution with innate spectral information, less radiation dose, and without electronic noise. Siemens
34
Healthineers
January 2022
was
the
(FDA)
"first
instrumentation.
announced
major
So
this
could
holding your breath.
Feature
At the Cusp of Healthcare Transformation Accessibility for All GE Healthcare is investing significantly to reach out to small radiology centres and entrepreneurs
Future-ready healthcare ecosystems will stand on the roots of accessibility. We are not just preparing to fight a pandemic but also the disease burdens that already exist. For instance, as the point of care shifted to COVID-19 patients, we saw the outbreak exacerbating the Dr Shravan Subramanyam, Managing Director, Wipro GE Healthcare and President & CEO, GE Healthcare South Asia
threat
diseases.
of
non-communicable
With
non-communicable
diseases (NCDs) accounting for nearly 63 per cent of all deaths in India, it’s a healthcare crisis we cannot ignore. From delayed diagnosis to inaccessible screenings, lack of advanced radiology to Covid-induced restrictions, limiting the treatment options for NCD patients,
Strengthening healthcare frontiers The story of Indian healthcare must go
beyond
metros,
including
and
empowering Tier II and Tier III cities. We are now witnessing small radiology entrepreneurs and start-ups fighting the cancer burden in their cities, making significant
progress
in
diagnostic
accessibility. Now, how do we make the latest technologies available to them? Can we look at lucrative investment opportunities in the smaller towns where many radiology start-ups and entrepreneurs are active? All they need is the impetus to help them grow.
the challenges are many. However, in
The
the last two years, we have also seen
transformative in that context and
an acceleration in what the healthcare
we at GE Healthcare are seeing an
system can offer and its potential.
uptake of the latest technology and
The growth trajectory got the muchneeded
fillip
in
PM’s
Ayushman
Bharat Mission with its outlay of Rs 64,180
crore.
Resilient
healthcare,
with provisions for accessibility, calls for deeper structural reforms that cut across geographies. Take, for instance, even as Ayushman Bharat ensured hospitalisation to over 2.2 crore people, India’s healthcare spending remains abysmally low. The question is, how do we strengthen this sector which is expected to reach $372 billion in 2022?
last
two
years
have
been
equipment among small entrepreneurs. Saboo Hospital, Washim, a 60-bed multi-speciality facility, is one such example. Dr Vivek Saboo, the owner of Saboo Hospital, Washim, believes that healthcare issues are not restricted to geographies. The lack of proper diagnostics modalities forces patients to rush to bigger hospitals even for simple diagnoses. Diagnostic modalities at the grassroots are not just critical, rather fundamental to meet the patient needs, closer home.
The gaps are glaring, and they must be
We
addressed now.
reach out to small radiology centres
are
investing
significantly
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to
35
Feature
and entrepreneurs. We are creating products ‘in India, for India’; building digital tools for remote clinical decision support and incubating and harnessing the brainpower of start-ups through our Edison Accelerator program, to reach customers faster and with quality and affordable healthcare.
to open access and create value for the health care professionals across India, who work in silos with little help. Foundation for the Future
Today, we have access to smarter technologies, with AI and frugal innovations improving patient outcomes. The big question is, how do we create an ecosystem that improves access to these innovations, addressing the domestic demand, ensuring it reaches these start-ups and small radiology entrepreneurs who are rising. The answer lies in a digital-first approach.
The healthcare of the future will rest on the pillars of 3Ps— Preventive, Predictive and Prescriptive. This calls for an ecosystem play with all stakeholders to deliberate on a sound radiological education as well as underscore the technology plays that will transform the healthcare outcomes. For instance, platforms like the Indian Radiological and Imaging Association (IRIA) bring forth the latest in the practice of diagnostic radiological and imaging modalities, radiation medicine, molecular imaging and other related subspecialties/super-specialities and is a place to watch out for.
Let’s understand this with an example. The digital-first world we live in has helped us democratise access and unlock better value in healthcare systems. To reach tier II and III markets, digital platforms can enable reach and quality. With that vision, we designed The GE Shop, the B2B eCommerce Platform, to address the currently underserved tier II & III markets. The platform aims
Data-driven technology is now enabling actionable insights. How we use them to our advantage and help improve healthcare outcomes, is a careful choice that calls for government and private intervention. Investing in frugal innovation, prioritising innovations in the field of radiology and care quality are the building blocks that will transform India’s healthcare story.
Riding the Digital Wave
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January 2022
Opinion
Can Omicron Spread Derail India’s Economy? The speed of spread and the mistaking of the illness for other minor respiratory illnesses both have the potential to quickly affect workforces in offices. This, in turn, can have a debilitating effect on the economy, which is one of the best-performing ones in the world. Explains more
Dr Vikram Vora, Medical Director, International SOS (India)
With Omicron cases surging in India (nearly 1,500 cases), the healthcare infrastructure in India is gearing to meet this threat posed by this new COVID-19 variant, which has brought life to a standstill in some parts of the developed world. One of the things to be noted about Omicron is the speed of its spread. From November 23, 2021, when a new COVID-19 variant was first reported from South Africa to December 23, 2021, when this variant was detected in over 106 countries, the march of Omicron has been relentless. As it continues to drive record-breaking case
numbers in countries like the US, the UK, France and Germany, global daily case numbers have doubled during this period. What is causing this rapid spread are mutations, of which over 50 have been discovered in the Omicron variant as compared to the older variants (including Delta). These have conferred the properties of increased transmissibility and a shorter incubation period which is now seen to be as low as three days. Closer home, cases in the major metro cities of Mumbai and New Delhi have suddenly increased by as much as 100 per cent in four to five days.
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37
Opinion
Symptoms & Confusion The symptoms that Omicron causes in those infected ranges from those similar to other variants to a few distinct ones. Symptoms like fever, body ache, sore throat and fatigue have been encountered before but the Omicron variant differs in presenting with cough and a runny nose – symptoms that can be easily mistaken for routine “change-of-weather” illnesses. Also, the characteristic loss of smell and taste is not commonly seen with Omicron. This causes confusion and delays seeking of medical help and diagnosis – in turn promoting the spread of the infection to those in the home or outside. Business Continuity Risks The speed of spread and the mistaking of the illness for other minor respiratory illnesses both have the potential to quickly affect workforces in offices. This, in turn, can have a debilitating effect on the economy, which is one of the bestperforming ones in the world. “With quarantine requirements still being in place, increased absenteeism is a likely result. And with workers being away, supply chain disruptions could create added problems for business continuity. After two long years, some business activities were slowly returning to normal – business travel had just begun to pick up but with countries and states enforcing changing regulations and testing/quarantine requirements, travel delays and disruptions are almost certain. Also, business meetings and events can rapidly turn into superspreader events that could lead to additional challenges. Vaccination Relevant? This raises the most pertinent question, which everyone is asking- is vaccination relevant? Vaccination continues to prevent serious disease and death. The Omicron variant causes a milder illness but that is true particularly for fully vaccinated individuals. Experience with unvaccinated individuals especially in South Africa and the
38
January 2022
UK shows that these make up a large
at all times. Today there are antigen-
number of hospitalisations resulting
based rapid tests that can be done at
in complications. Studies have shown
home and many are using these but fail
that full vaccination in individuals who
to report the results on the government
have previously had COVID-19 or have
portal. This leads to a lower number
had a booster dose leads to a better
of cases being reported and can instil
immune response. Hence, getting the
a false sense of security leading to
second dose of the vaccine is extremely
complacency.
important and those eligible must go in
Here are some suggestions on how to
for a booster or “precaution” dose as soon as available.
deal with Omicron; • The
gold
standard
for
testing
Dealing with Omicron
continues to be an RT-PCR test and
With the year-end being a day away, the
any individual whether vaccinated
natural holiday spirit has come to the
or not should get a test done if
fore. However, year-end celebrations like New Year’s Eve parties, vacations
symptomatic. • Full
vaccination,
masking
and
at popular holiday destinations etc all
social distancing continue to be the
can turn catastrophic pretty quickly
mainstay of our defence against
with Omicron being an uninvited guest
COVID-19 regardless of the variant.
to the party.
• Organisations
should
seek
and
Any individual with even a common
consult medical and security experts
cold, should isolate for four to five days
for any return to the office to
and even after that, must wear a mask
mitigate any risks for the workforce.
Event Report
ICC Puts Spotlight on CDSS Panelists highlighted the need for interventions like CDSS, that is poised to be a game changer in the way we deliver healthcare in India
Highlighting the need for implementation of Clinical Decision Support System in India’s healthcare ecosystem, Indian Chamber of Commerce (ICC), recently organised
a
virtual
session
#ICCHealthcareInitiatives.
under
Focussed
on the importance of evidence-based medicine, the session was organised with an aim to initiate a dialogue around
the
successful
utilisation
of CDSS. Chaired by Dr Ramakant Deshpande, Executive Chairman Asian Cancer Institute; Member, ICC National Healthcare Committee; the event, was attended by renowned clinicians and experts from the healthcare Industry. In his welcome address, Dr Deshpande, reiterated
the
need
for
elevating
healthcare delivery in India through digital support tools, to ensure better patient
outcomes.
posed
unprecedented
COVID-19 challenges
has in
our healthcare system, some of which have led to transformative changes. It has demonstrated the benefits of digital transformation and the value of support tools to make faster yet effective medical decisions. Moderating the session, Dr Sanjeev Singh, Medical Director, Amrita Institute of Medical Sciences,
highlighted
the
need
for
interventions like CDSS, that is poised to be a game changer in the way we deliver healthcare in India. Sharing his views on the subject matter, A senior healthcare consultant of NITI Aayog, Dr K Madan Gopal, believes, while creating digital health IDs is a muchneeded initiative from the government, efforts need to be made with regards to medical errors. He pointed out, “CDSS has come into the picture at a very fitted time. It is observed that even with the launch of Ayushman Bharat Digital Mission (ABDM), there has been certain challenges associated with technology, that the healthcare ecosystem has put technological integration in silos. The architecture for the use of technology can be well understood from the fact that it is mandated to have Electronic Health Records since the enforcement of Clinical Establishment Act (2011) still hospitals have not fully incorporated EHRs as yet. Secondly, we are grappling with issues like medical errors, for which lot of clinical decision support system has been piloted but we do not have any policy that works or clinical effectiveness.” According to Prof Dr Suptendra Nath Sarbadhikari, Fellow International
www.indiamedtoday.com
39
Event Report
Academy of Health Sciences Informatics Expert, Roster for Digital Health -WHO, there is a lack in awareness and adoption of technology to ensure proper health in smaller cities and remote areas of the country. He said, “There are two ways of adopting anything, one is the topdown approach where one starts from the legal mandate and the other is on the basis of the demand of users. Today, people want doctors to use the data of electronic wearables as the primary data to build on the treatment, but there is a lack of health data literacy. Hence, to begin with EMR is the first thing that shall be incorporated in healthcare. And if National Medical Commission makes it mandatory it will be a paradigm shift, which will eventually lead CDSS to become more of a routine educational curriculum.” Harish Ramachandran, Country Manager, Clinical Effectiveness, Wolters Kluwer, India, highlighted the role of technology in ensuring access to healthcare for all. “In my view, COVID 19 pandemic has emphasised the need for evidence-based medicine, and analysis of clinical information to drive better health outcomes. CDSS ensures both value for the care team and improved patient outcomes. As technology continues to evolve, it plays a crucial role in providing easy accessibility of healthcare to even the remotest areas. The idea is to enable clinicians to make a quicker and effective diagnosis point of care. UpToDate, by Wolters Kluwer, is an information dashboard that is authored and verified by specialists and clinicians. Besides enabling doctors to make medical decisions, it also allows them to remain updated about their patients.” “CDSS come at an advance stage, the basic stage requires to have a robust EHR system in place. The challenge is that there is an illiteracy among doctors. They use computerised systems and digitalisation in the rest part of their lives, but shy away from documenting medical cases in forms of EHR in the hospital system. Reason 40
January 2022
being they have not learnt anything in
further helps in enhancing patient safety
their practice hence it is very important
and
that right from the undergraduate level
complications, ensuring efficiency and
we need to imbibe EHR literacy and also
affordability”
create an understanding that CDSS into
avoiding
potentially
dangerous
the EHR is basically meant to augment
The overall discussion stressed on the
their decision making and not replacing
lack of practical knowledge with respect
their
Geetika
to medical errors, which continues to
Madan Patel, Governing Body Member
be a massive concern in the healthcare
& Medical Director, Parul University;
delivery. Owing to this, implementation
Member,
of CDSS is the anticipated way forward
decision,”
ICC
added
Dr
National
Healthcare
Committee.
to
Commenting on affordability of CDSS, Dr Joy Chakraborty, COO, P.D. Hinduja
improve
patient
outcomes
and
streamline clinical issues to ensure superlative healthcare delivery across
Hospital & MRC, said “There is a need
the country. It could also be considered
for plummeting the cost of CDSS, to
as a resource to help address the
drive
driving
shortage of medical professionals in the
system
country. CDSS is a partnership towards
reduces healthcare costs by eliminating
a common goal of safer, more efficient,
duplicate and redundant testing. This
and affordable clinical outcome.
clinical
widespread
adoption,
effectiveness.
CDSS
The Evolving Cybersecurity Landscape Remote working has increased cyberthreats. But even after the global pandemic is over, it’s going to be important to take actionable steps to combat the sizable security risks.
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https://www.mcafee.com/enterprise/en-us/assets/reports/restricted/rp-carr-wfh.pdf https://www.mcafee.com/enterprise/en-us/assets/reports/restricted/rp-carr-wfh.pd Source: https://www.darkreading.com/cloud/as-cloud-adoption-grows-dlp-remains-key-challenge/d/d-id/1335000 https://newsroom.ibm.com/2020-07-29-IBM-Report-Compromised-Employee-Accounts-Led-to-Most-Expensive-Data-Breaches-Over-Past-Year https://www.gartner.com/smarterwithgartner/is-the-cloud-secure/ https://media.nominet.uk/wp-content/uploads/2019/02/12130924/Nominet-Cyber_CISO-report_FINAL-130219.pdf
8 https://www.mcafee.com/enterprise/en-us/assets/reports/rp-cloud-adoption-and-risk-report-work-from-home-edition.pdf McAfee and the McAfee logo are trademarks or registered trademarks of McAfee, LLC or its subsidiaries in the US and other countries. Other marks and brands may be claimed as the property of others. Copyright © 2020 McAfee, LLC. 4619_0920 SEPTEMBER 2020
